Last week’s Senate hearing discussed something none of us would have predicted just a few weeks ago… schools may not open in the fall.
“The idea of having treatments available or a vaccine to facilitate re-entry of students into the fall term would be something that would be a bit of a bridge too far”, said Dr. Anthony Fauci, MD.
Denver public schools have indicated, as of early May, that there likely be a mix of in-person and remote learning.
So what can we really expect from educating online… across the full spectrum of education? Is virtual learning a congruent substitute for real classroom interaction?
If we assess online education prior to this COVID pandemic, students already had access to great books, complete libraries, masterpieces of art, and music… but for the overwhelming majority of people, technology was used and valued only for entertainment and social networking. Vast knowledge has been at our fingertips for free for years, yet it was, and is, pervasively ignored.
Interestingly, my Phi Beta Kappa induction ceremony back in 2001 discussed the importance of classroom learning and direct interactions with teachers. Impersonal online education platforms were being incorporated during my undergraduate years (the University of Illinois is now one of the biggest proponents of web-based teaching in the country), but law professor Thomas Ulen prophesized the fallacies of learning in the isolation of a computer screen. Little did I know at the time how I would be reminiscing about that Friday night lecture in 2020. But personally, I had already observed the importance of student-teacher relationships from my earlier education. I started primary school in northwest Indiana, where I was a steady “C” student. When my family moved to the Chicago suburbs of Illinois, where some more interactive teachers were highly motivating, I became an “A” student. My brain didn’t really change… I just started responding to human interactions in the classroom.
From a neurobiology perspective, the brain needs conditions under which it is able to change in response to stimuli and produce new neural connections for optimal learning to occur. The most effective learning involves recruiting multiple regions of the brain to learn a task.
The highest performance requires a moderate amount of stress (extreme stress and low stress appear to be detrimental). This occurs in our amygdala. Cold-calling on an individual student amongst a large group as often occurs in traditional schooling, introduces moderate stress in most. We perceive this with some anxiety, but it is a very effective teaching tool. Sitting in a Zoom meeting at home, greatly limits this stress, as we are protected by a computer screen. Our amygdala’s fall asleep with online boredom. We don’t feel the teacher or other students glaring. Our appearance while considering the answer is largely hidden from their view. And no matter if we answer correctly or incorrectly, the teacher and student response are masked. A proud teacher’s smile, or frustrated teacher’s pursed lips, is concealed. It is these emotional interactions between our amygdala and prefrontal cortex that propels students to succeed. Online educators have little control over the learning environment and stress response.
Learning actually requires failure. Friedrich Nietzsche was right, “what doesn’t kill us makes us stronger”. We learn best when we are challenged to grasp something just outside the bounds of our existing knowledge. When we are not challenged, we don’t learn anything new. When a challenge is too difficult, we fail entirely or give up. So where is the sweet spot? Well, in our brains, “error neurons” exist in the medial frontal cortex. Learning tends to be optimized when we fail about 15% of the time… or succeed 85% of the time. How do individual students land, and then stay, in this zone? The answer is fine-tuning by teachers who have the ability to directly interact and note subtle nonverbal cues. In virtual classrooms, it is difficult for teachers to adjust lessons to meet the individual student’s needs, to achieve this 85% rule.
Social interaction is in itself a process of learning. The importance lies in survival… the individual who adopts and approves the accepted established roles of a particular society easily survives. When children start school, they are socialized to obey authority and how to be a student. Socialization occurs in the orbital prefrontal cortex. Studies show that people engaged in social interaction display higher levels of cognitive performance than control groups. Social interaction “exercises” the mind. Face-to-face education creates personal contact and friendships between students themselves, and their teachers, and provides encounters that increase their knowledge, develop their skills, refine their tastes, and expose them to the unfamiliar. According to many studies, education is more meaningful when contact exists, especially with professors who are not distant figures or only remotely accessible. Many great teachers invoke personal anecdotes to illustrate course topics. Students are encouraged to ask questions and contribute their personal anecdotes throughout the class meetings. There is little-to-no socialization in online classes.
Online education inhibits intellectual maturity, which is fairly confined to adolescence, in the frontal lobes. If this period is missed, it’s gone. It is easier for students to shut off or block opinions or views that might unsettle them or be contrary to their own views while they are hiding behind computer screens. As important, students are more likely to multitask while online… checking email, chatting with friends, viewing other websites, listening to music, or watching television. Multi-tasking adversely affects learning.
Overall, much of the research comparing online education with in-person schooling shows negative effects on outcomes. A 2011 study compared 51,000 community-college students between online and classroom courses. Students in an online course had an 82% chance of completing the course, compared with a 90% change in face-to-face courses. Amongst studies in remedial courses, the gap was even wider- 74% completed the course online and 85% completed face-to-face.
In summary, much of the research predicts that virtual education will have dramatic negative effects on educating our youth.
However, neurosurgery education/ training is not impervious to this either…
Neurosurgery residency involves didactic education for part of the first year, but the remaining majority requires in-person surgical training which is being restricted by COVID. Usually, neurosurgery residents participate in more than a thousand operations. Multiple trainees are sometimes involved in the same procedure. Most hospitals in the United States recently restricted nonessential elective surgeries, drastically reducing surgical opportunities for residents. Now that some elective procedures are resuming, social distancing is limiting the number of people in the operating room. Residents, the midst of their crucial training years, may be exposed to fewer patients and fewer training opportunities. For neurosurgical education, there is no substitute for time in the operating room. Virtual training platforms have been developed to aid in surgical procedure familiarity, but the basis is to expose concepts of surgery and not be the sole instructional method. Since this outbreak and quarantine, organized online video platforms reportedly have shown a greater than 20% increase in site traffic. But again, these virtual resources were intended to supplement, and not replace, the cognitive and mechanical skill set taught from live surgery in the presence of their attending surgeon pedagogues. Overall, the web-based learning resources that supplement a neurosurgical trainee’s education may do for now, but it’s concerning to consider how prepared our future neurosurgeons will be if this is prolonged. How few live-surgeries will be acceptable for a neurosurgical trainee to be competent and transition into their post-graduate career?
It’s worth noting that the very people making the recommendations during this pandemic likely completed their education without restriction, in a live classroom setting. It would be interesting for them to consider how proficient they would be now, if a significant amount or their education, or a critical part of their education, was virtual.
Fine for thee… but not for me?