How Do We Judge Quality?

Fox News posted an article recently that said many more people are using online ratings in order to choose a doctor.  Apparently 59% now say these ratings are either somewhat important or important when choosing a new doctor.  Similarly, The Guardian recently had an article about how we should be evaluating the quality of education at the University level.

The core problem with rating systems and key information statistics and the like is that often, the rating systems are biased both due to the people who choose to participate in the rating systems, and that as we gather more and more data, we’re not always sure of the markers of quality, assuming we can define quality well.

Let’s take the physician example.  Patients who leave reviews online are either thrilled with their doctor or disgruntled, or they have been specifically asked to leave a review.  So you should expect, on average, to see wildly great recommendations or really awful ones, but not a lot of middle ground, which probably is more indicative of patient experience.   On top of that, we know that no matter how great a doctor is technically and no matter how well educated, other things like office wait time and “front of house” staff also help bias a patient’s view of the experience in the office.  If you come to see a doctor and you are nervous and worried, and that’s compounded by seemingly indifferent office staff, loud daytime TV and antiquated magazines, it’s natural to think the doctor is not spending enough time managing the customer service portion of the business, so how well is he managing the patient care aspect?  However, in many offices, especially in hospital based practices, the doctor may have very little to do with the hiring or management of the front office, so these markers are entirely irrelevant to the quality of care delivered.

Likewise, there are many doctors I know who are wonderful and terrific people, but I hear stories from other physicians and nurses about their level of attention to detail or general practice styles that would make you very wary of sending a friend or neighbor to see them.  In other words, medicine’s core skill set- observation, diagnosis, and treatment decisions- are less likely to be observed or adequately evaluated from the patient’s perspective, although you will get a good sense of bed side manner perhaps or office efficiency.

Now let’s look at school.  Just because we all have been to school, and are armed with both positive and negative experiences from our years in education, gives us very little experience with understanding different pedagogies, ways to teach, or curriculum design.  Very few parents even understand basic child development and psychology, let alone the best way to teach a subject to a specific child.  While I think students should have a voice in teacher evaluations, since they are in the best position to see what it’s like to sit in a teacher’s class every day, this information has to be filtered as well, as students will be as likely as the rest of us to judge a teacher’s effectiveness based on their treatment of us as individuals.  For example, a few years ago, my son had a run in with a teacher that was unusual in its scope and difficulty.  But that teacher has been teaching for years, and for most students, there isn’t much of a problem.  Should her career be determined by whatever her conflict with my son was about, or should it be looked at as a whole, and all the kids she has helped?

The bottom line here is that we can only expect so much out of online rating systems, and even recommendations by friends.  The best we can hope for is an opinion from someone who knows the profession well enough (peer to peer) to give a more educated and nuanced evaluation of quality, and data to consider regarding trends of interactions and experiences.  This is not to say that there aren’t external markers of quality that can be created and benchmarked- things like c-section rate, or common assessment test scores- but these are just one among a group of factors that make up what we can call quality or competency at a job, particularly one that is so dependent on personal service and interaction.

As much as I love the internet, feedback, reviews and rating systems, I also know some of them are biased and colored by extremely good and extremely bad experiences, some of which may not even reflect on the business itself.  (Let’s not even talk about people gaming Yelp reviews.)  And I become more and more concerned when people are evaluating services that have long term, life altering consequences like education and medical care.  If I have a bad experience with a plumber, I can try a new one.  If I have a bad experience with a cardiologist, I could die.

Take those reviews, especially when everything important to you is on the line, with a grain of salt.

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Framing The Question

I’ve read a couple of interesting blog posts over the past few days that have really got me thinking.  The first was from my friend CC Chapman, on the YSN blog, asking whether apps will kill work ethic.  The other was about iPads in education by Matt Levinson on the Edutopia Blog.  Both have a common theme about learning, and both have an underlying message as well- what is happening with the switch to mobile technology and instant answers in the world of education?

I read CC’s post and thought about the past week, where we were without power for almost five days in temperatures below freezing.   The lack of electricity meant entering a world of scarcity- conserving power on each device we had until we could get to someplace to recharge; spotty connections on phone lines and to data, because all the cellular networks were overloaded; and even with the power of Google, we had to solve our own problems about keeping our house warm, making sure pets were ok, and pipes didn’t freeze.  Facebook helped us connect with friends, and we received lots of help, support, and offers of help that were invaluable on every front.  While Facebook took over and was more efficient for connecting people to resources than the phone might have been in the old days, many of the issues required good, old fashioned driving around and gathering supplies- with the phone simply saving time and trips.

In an emergency, you can’t always rely on your social networks, apps or the internet to solve problems for you.  We had an incident where unexpectedly hot coals were put into a receptacle that, if not caught, could have caused a fire.  No one thought about googling that issue before it became one, or during the emergency, and it was by experience and past knowledge that it was solved and taught to the next generation. A lot of lessons were learned, but not one of them involved a search online, even if we had power.

I say this because often we’re so focused on efficiency and solutions we don’t always focus enough on the problem itself and formulating good questions.  For example, when Matt Levinson talks about teachers’ frustration with iPads, it’s because the person is expecting the iPad to solve all problems or be something it is not.  It’s not the iPad’s fault.  It’s like trying to use a screwdriver as a hammer.  You can kind of get it to work, but it might not be the best tool for the job.  However, the iPad has a lot of great things going for it, including the ability to capture photos and videos to integrate into projects on the fly- great for making sure your observations in a science experiment, for example, are accurate.

This is why in our school district, we’re trying to take the “device” out of the equation when we’re talking about technology in school.  What a teacher wants to accomplish, what the learning goals are, needs to come first.  A variety of tools, ranging from mobile devices to computers to cameras, tablets, overhead projectors, etc. can then be selected to get the job done as efficiently as possible, while enhancing, not detracting, from the educational goals.    In other situations, we have to look at whether ownership of technology- ie personal versus borrowed, makes a difference in both how the tech is treated, but also how the students learn to use and master it.

It’s not unlike the difference between your personal car and a rental.    Your car is likely tailored to your personal preferences and needs, ranging from the radio station selection to the contents of the glove box (where often no gloves actually reside!)  The personalization helps define your ownership and the idiosyncratic way you use the car, while simultaneously treating it well because it has to last a long time.  Compare that to most rentals, which are often driven in more extreme ways than personal cars, and even if you take care of the interior and exterior to avoid extra costs, your involvement and investment are minimal and temporary.

So back to making decisions like Bring Your Own Technology for schools.  School can’t be expected to be The Apple Store, Microsoft Store and Radio Shack for every device under the Sun, but as more students and faculty have their own devices, the less need there may be for this command and control approach.  The more opportunity kids have to customize and kick the tires on their own personal devices, the more adept they will become with them, and the easier it will be for them to use.  There’s investment in this set of tech tools this way, versus borrowed technology.  And in the end, there will be more investment in making the device, whether its a tablet or laptop or projector, to reach farther out to the edges of the devices capabilities.  That’s a good thing.  We should know what device to choose for the job at hand and be able to use a wide range of them, in any environment, rather than just one- it’s just like learning multiple languages, or knowing what tool to select from the aisles and thousands of choices at Home Depot.

CC’s starting question is whether instant gratification and making everything easy had long term effects on how we think and react to challenges.  I know with the power outage, I began to think that full time access to electricity has in some ways made me soft and less resourceful.  Yet I also know that often when I face a problem, I mentally go through my friends and family members I can ask for help if I need it; I don’t always Google a solution first, even though I know I could.  Why?  Sometimes my social network seems faster, the advice better or more personal, or perhaps asking also helps build social bonds and friendships that are more important in the long run than googling an answer.  Sometimes people are much better at helping you find the right question and answer, when you aren’t really sure about the boundaries of the challenge at hand.

That said, we should help everyone – kids, friends, everyone- learn to ask the next question, help solve their problems, and learn to develop a stack of resources, real and virtual, to rely on when you don’t know the answer.  Google and the internet are getting more crowded every day.  Search algorithms that prioritize information based on your past searches and your social networks sometimes gets you closer to the answer, but often may cut you off from new and novel information you need.

I love the internet and search, and that so many people share solutions to their own problems, in order to help you when you run against the same challenge.  But there’s still no substitute for having enough knowledge on hand, in your head, to make sure you are properly diagnosing and identifying the problem itself, and can ask the right question.  If you ask a fuzzy question, such as “what is this spot on my arm?” you could get an answer ranging from bug bite to melonoma, and treatment for both are radically different with lots of pros and cons, not to mention costs attached.

In the end, I think we need to get better at question formation, and struggling with asking better questions, all the time.  We also have to teach our kids these skills, so they, too, become better critical thinkers and analysers of problems, before they just try to pitch solutions at problems, hoping one sticks, rather than using the right tool for the job.  Often that just makes the problem more complex and more difficult than it was at the start.

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Seeing Unions Through The Eyes of Teachers

This past weekend at Educon 2.6, Kevin Jarrett and I hosted a session entitled “How Unions Can help Foster Education Reform”.  This was prompted by a question I have had for a long time, which is whether the public view of unions aligns teachers more with hourly wage employees and less with professional, knowledge workers, to their benefit or detriment.  I come to this conversation not as a teacher, like Kevin, but as a parent, with concerns about education quality, progress, reform, and innovation.

I learned more than I can probably express here from teachers and union representatives that were in attendance.  One of the positive things we came away with is that Unions could do a lot more to serve as a hub of information, professional development, and innovation than many do today.  Trade unions often have halls where their members can come and learn new practices in their trade, trade ideas, try out new skills and the like, but less of this seems to happen in Teacher’s Unions than say, for carpenters or plumbers.  Unions could do a lot for their public image if they began to host, sponsor and encourage meaningful professional development among teachers and foster a sense of excellence and continuous improvement.

It’s clear that the public hears a lot of negative things about unions and teacher’s unions in particular.  There’s a sense that tenure is granted too soon (usually within three years) making it hard to get rid of teachers who may not yet have proven their dedication or even proficiency in their profession in that time period.  There’s a sense that some teachers continually go above and beyond what is required, but others work “bell to bell”, never doing anything other than they are required to under contract.  In a day and age when so many people are working well beyond their paid hours, the perception of teachers working a shorter day, having summers off and the like, fuels a sense of disrespect that’s often not supported by reality.

Reality included teachers taking part time jobs after school and in the summer to make ends meet financially.  Reality included paying daycare costs for young children that approaches what they are earning teaching.  Reality includes working in an increasingly hostile environment, where teachers are routinely looked down upon as babysitters rather than as skilled knowledge workers we entrust our children, and their futures, to every day.  All of this is much different from the picture painted in the media.  Reality includes teachers in Philadelphia public schools having to buy all their copy paper themselves, making it literally personally expensive whenever a child needs to print out an assignment or needs a copy of a handout.  All of this leads back to a discussion about Unions.

Unions exist to both collectively bargain for contracts for its members, and to ensure safe working conditions for teachers- and therefore, students as well.  Every time a teacher lodges a complaint because a building is in disrepair, or there are rodents in the hallways, this is not only reasonable, but it is something parents should be grateful for as well, as the teachers are looking out not only for their own welfare but that of their students. Every time a teacher looks to the union to help provide advocacy on their behalf to ensure a professional and enriching work environment, they are actually taking affirmative steps to ensure the environments in which our children learn are better as well.

We look at an education system that is underfunded, in part because the government deferred making contribution to pension plans in the past, that are now catching up with us during a time of economic contraction.  And while it seems logical to paint this escalating cost structure on pension plans and unions, it is our government officials who never adequately funded the plan in the past who are to blame.  It is the fact that people live longer than when the pension plans were developed that is in part to blame.  However, the teachers themselves have spent years giving of themselves to help raise and nurture our kids.  Like firefighters or police officers, they went into the profession thinking they were getting one thing, but ended up with something quite different.  Every time we ask them to take less, we are also asking our children and ourselves to get less and expect less in the process.

My favorite quote is an old African proverb, told to me by Rick LaVoie: “When the elephants fight, it’s the grass that gets trampled.”  When the adults in the system are at war, whether it’s districts, unions, teachers, parents, governments- the loser is our children.  The negativity breeds anything but the nurturing learning atmosphere we want for our kids.  They receive both the benefit and the burden of every argument and dispute, in the form of low morale and energy even from the best teachers, where generating that energy to invent, create and put more into your job seems pointless if its not recognized and appreciated.

Teaching is more like what my husband deals with as an OB GYN.  He has two patients to care for- the mom and the baby, and sometimes its necessary to balance the needs of one with the needs of the other, but they are inextricably tied together.  Likewise, as we look at our education system, we can’t ignore that the fate of our teachers and the fate of our children are inextricably ties together, and that if we hurt one, we in turn harm the other.  I don’t think I appreciated that as fully as I needed to before this weekend.

That said, I think teachers do have to ask their Unions to be more than lawyers and negotiators, but to be the center of what’s good for education and kids.  It should be helping teachers become better professionals every day, and help coach beginning and more experienced teachers alike to learn new techniques.  They should be a place where teachers can seek help and moral support when they have a particular challenge, but also be held accountable for improving and doing better when they struggle.  Unions can be so much more than what they are portrayed, but they have to see themselves in that role of professional coach and trainer, not just as a contractual negotiator and standard bearer.  The Union could be so much more, and could help to bring us together not only for the sake of the teachers, but for the sake of the children as well.  If that happens, I think you’ll find more parents and communities standing behind both teachers and unions, and less seeking to find ways to undermine them at every turn, in any way possible.

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8 Tips for Driving In The Snow

As a native Upstate New York resident, I learned how to drive in the snow almost as soon as I learned how to drive.  It wasn’t an optional experience.  I learned how to drive in the snow and ice, whether I was driving standard or automatic transmissions, and before they had ABS on every car.    This week, with the snowstorm here on the East Coast, I not only got to drag out all my snow driving skills, but had the opportunity to teach them also to my kids.  Since this seems to be a challenge area for many people, here’s my best advice.

1.  If you have been putting off buying new tires, consider doing it sooner than later.  Driving on snow and ice involves having decent traction, and the better treads you have, the better.  When I grew up, most people even had a special set of “Snow Tires” they put on the car every fall.  While this isn’t as important in Philadelphia or Washington DC as it is in Buffalo or Vermont, it’s also further evidence that having tires with low treads ups your chances for an accident substantially when driving in adverse conditions.

2. Speed is not your friend.   In fact, when driving in snowy and icy conditions, going slowly and leaving decent distance between your car and the one in front of you is critical. I can’t tell you how many people I saw the other day, even in cars meant for snow, like 4WD SUV’s, that were still getting into trouble for going too fast or simply riding up on the bumper of other vehicles, assuming their car was invincible.  These are the folks spending the next few days in a rental, as their car gets fixed at the collision shop.

3.  Hills, especially downhill slopes, will require you to brake early, consistently and be prepared to swerve on the shoulder if necessary.  Even following all these rules, I was travelling at a cautious speed down a hill near home, and started to brake.  Unfortunately, the road under the snow was icy, and my tires weren’t gripping, causing me to make a turn to a small road to the right to avoid skating into the intersection.  Making sure you have an exit strategy by staying in the slow lane could save you time, money and injury.  It saved me.

4.  Intersections are universally icy, especially if temperatures are below freezing, but get markedly worse when the temperature is lower than 25 degrees.  Between melting snow and ice off of cars, and the cars sitting there for more than a few moments, snow at intersections has a tendency to melt, freeze, remelt and refreeze, making it difficult to pull out of a secondary road onto a main road without risking slipping and sliding like a hockey player.  Making sure you give all cars adequate warning, using turn signals, and taking it slow rather than trying to accelerate too quickly to get into a spot on the main road is the best way to handle it.  You may feel like a Grandma driving this way, but you’ll stay safe.

5. Practice.  On weekends, corporate and school parking lots are great for this- as well as smaller neighborhood type roads.  Practice driving, stopping suddenly, steering out of a slide, and getting used to the feel of the “chatter” of ABS brakes while driving in the snow.  By getting used to the feel of driving and sliding, you will take the fear out of it, and then avoid panicking if you have a problem driving during an actual snowstorm.  (We used to actually try to slide and do “donuts” in parking lots, but ABS has taken the fun out of this winter sport for kids in the north.)

6. If your car has problems going up hills in good weather, think about NOT driving in the snow at all.  Unless its absolutely necessary, if your car doesn’t handle hills and slopes without groaning in good weather, snow will only make the problem worse.  I can’t tell you how many little cars, like my son’s Prius, were stuck on the side of the road, unable to go up hill or down in the rapidly falling snow.  It was made worse by these cars then stopping traffic, and aggravating the problem for other little cars trying to get through.    Sometimes it’s better to just not go out, than go out and get stuck, or worse, have a crash.

7.  If you know it might snow, pack a few essentials in your car.  Make sure you have a snow brush and ice scraper.  Have extra windshield wiper fluid in your car.  Consider a can of windshield de-icer for your emergency kit.  Have a blanket, and keep your cell phone charged and/or have a back up battery for your phone in the car.  I also often have

8.  Snow Gear to Consider Keeping in the car:  If you have to park outside, consider a snow and ice windshield cover.  For $6.99, this baby can save you some serious time and heartache.  There are little traction mats like these which can help get you or someone stuck out of trouble in no time flat.  (Some people swear kitty litter works as well, but I’d hate to have to clean that up later on.)  For deep snow, I also like putting the snow broom in the car- it deals with deep snow in just a few seconds.  And of course, having reusable or even disposable emergency heat packs are fantastic, and can even help warm up your gloves or any part of you that might need it.  An extra pair of gloves, to keep you warm after you’ve de-iced your windshield wipers, will always be a great idea.

Even if you think you know how to drive in the snow, others who don’t will cause you problems.  A typically 20 minute drive took me 3 and a half hours on Tuesday, mostly because other drivers were having problems related to not knowing how to drive in the snow, as well as everyone trying to “beat” the snow by leaving all at once, making it difficult for both plows and emergency vehicles to get through.

Don’t be part of the problem- stay safe, and practice handling the snow and ice now that we have it, and help teens practice as well.  A little bit of practice goes a long way, and don’t forget to get some in before the winter leaves for good.  Otherwise, we’re all going to have this same problem the next time it snows, next week or next year.

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Three Words for 2014

Chris Brogan started a tradition a number of years ago, to find three words to use to focus goals for the New Year.  Many friends have adopted this practice as well, as it’s a great exercise to find out what’s really important to you, at least at this point in time.  Last year, I set out three mission statements instead of three words, and they were:

1. I will not take on any more volunteer projects without dropping one that I already have (one for one switch)

2. I will do a SWOT (strengths, weaknesses, opportunities and threats) analysis- written down and saved to Evernote- before accepting new projects.

3. I will do a list of things to be accomplished, at least once a week, and hold myself accountable for getting them done, one by one.  No more leaving things on the back burner indefinitely.

Looking back on things, I did fairly well on these goals.  I also set out to try at least one new thing a month, which included making cheese, making my own mustard and butter (yeah, it was a little like Amish Fantasy Camp around here for a bit…), trying french press coffee, yoga, ordering new things at restaurants, going new places.  Looking back on 2013, what I think I learned most is that change isn’t always comfortable, but it’s inevitable and necessary.

By experimenting, we try something outside our comfort zone and end up figuring out what we really do like, or at least appreciate things that aren’t the best a bit more in the process.   I actually had a couple of epic culinary fails this year, and while that hasn’t happened in a very long time, I learned a lot in the process.  (Let’s just say my mustard could go head to head with straight wasabi, and let’s not really discuss the multiple bean chili-soup incident ever again- that pot will never be the same.)

For this year’s three word/mission statement exercise, I’ve been mulling over choices for a few weeks.  This is what I’ve come up with:

1. Run My Own Race, or Pacing:  I can get really competitive sometimes.  But comparing myself to others and holding myself up as either more or less isn’t really all that useful.  I need to be able to set my goals and achieve them steadily, day to day, without being so worried about the competition, but instead about being consistent and persistent on my own path.

2.  Building:  It’s time to start building and sharing resources, new habits, relationships, and projects.  It’s time to get my hands dirty and make things happen.  After a year that was defined by change, including my first child going off to college, it’s now time to build more for the future.

3. Exploring: Like last year, I’d like to continue exploring new options, and adding them into the building part of my goals.  Exploring and experimenting are closely related, but I’d like the exploration to feed into building more directly.  I like the sense of fearlessness that exploration incorporates, and I want to continue to have the guts to go “all in” on projects that are worth it, even if they don’t all work out.  In the end, I can say I don’t have any regrets, because I did my best and didn’t hold back.

I think I can live with that.

What are your goals for the next year?  Whether they are words, or sentences, or even feelings, taking a moment to write them down is powerful, and helps me, at least, to be accountable.  Being accountable to yourself for your hopes and dreams is probably the most important thing of all.  Otherwise, you might just find you are selling yourself short or let yourself off the hook, and that’s  one way to make sure that you fail to move forward to where you really want to go.

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