soapbox
Learning Is Brain Science
Why the AI-enabled workforce needs an evidence-based
approach to education. BY ULRIK JUUL CHRISTENSEN, M.D.
A
rtificial intelligence (AI) and other ad-
vanced technologies are raising the stakes
on lifelong learning. Employers today
must prepare their workforce for the AI-enabled
world, where people increasingly work along-
side machines that augment human capabilities.
Business leaders are beginning to recognize that
the differentiator will not just be the technology,
but also the capability of people to use it.
The demands of the 21st century workforce
necessitate an equally advanced approach to
Ulrik Juul
training and development. Adaptive learning
Christensen, M.D.,
—a personalized, software-enabled teaching
is the executive
approach—has a crucial role in helping learners
chairman for Area9 develop new skills and become more proficient
Lyceum (https:// on a continuous basis.
area9lyceum.com) But not all learning technology is created equal.
and the former It is no longer enough for learning companies to
senior fellow, Digital make unsubstantiated claims about their systems
Learning, on the and then spend marketing dollars to promote
executive leadership their solutions. Instead, education companies
team for McGraw-Hill need to invest in the necessary science to develop
Education. an evidence-based approach for both higher
education and corporate education. Evidence
of efficacy then can become the basis for
purchasers of education solutions to make their
buying decisions.
LESSONS LEARNED FROM HEALTH CARE
In adopting an evidence-based approach, edu-
cation can learn a vital lesson from health
care, particularly the pharmaceutical indus-
try. A seismic shift occurred among medical
researchers in the 1990s, away from heavy re-
liance on peer-reviewed articles that often
were based on anecdotal observations of small
groups of patients, to a broader standard of
evidence-based medicine (https://muse.jhu.edu/
article/211661). The objective was to define opti-
mal treatments and drug therapies using current
best evidence from a variety of statistical meta-
analyses, including randomized clinical trials.
Today, the majority of drugs that have health val-
ue are used because the pharmaceutical industry
is being held responsible to secure the research
that generates the science around them.
Such research is crucial because what might
10 | SEPTEMBER/OCTOBER 2018 training
otherwise look like a good solution—e.g., a drug
that is cheaper and readily available—may not,
in fact, be optimal. For example, a study of anti-
hypertensive medications (https://www.ncbi.nlm.
nih.gov/pmc/articles/PMC4225910/) found that
the most expensive treatment option worked
the best, while the cheapest option was the least
effective. One can imagine how, without such
scientific research, doctors might be reluctant to
prescribe a costly blood pressure medicine over
less expensive options, and payers would most
certainly balk at paying for it. Only scientific
evidence proves the point.
Similarly, education companies must invest
the necessary time and money to develop an
evidence-based approach to demonstrate effica-
cy of educational tools and interventions, and to
compare the success rates of different systems.
Admittedly, this is not easy and the costs will
not be inconsequential. Nonetheless, for educa-
tion companies to be considered truly scientific
in their approach, they must become more sys-
tematic, so educators, schools, and districts can
make the best purchasing decisions among the
programs and content being offered.
Education is big business. According to a
Georgetown University study, some $1.1 trillion
is spent annually in the U.S. by postsecond-
ary institutions, government agencies, and
employers on formal and informal higher edu-
cation and training (https://cew.georgetown.edu/
wp-content/uploads/2015/02/Trillion-Dollar-Train-
ing-System-.pdf). Of that, employers spend an
estimated $413 billion a year on informal train-
ing, and another $177 billion on formal training.
Despite these huge dollars, the only common
measurement among training programs is the
cost per student. Occasionally, they track job
placement rates and even less frequently on-the-
job retention.
As a recent Harvard Business Review article not-
ed, “These metrics are useful but miss the big
picture, in part because they mistake a program’s
cost for its value,” (https://hbr.org/2017/02/a-better-
metric-for-the-value-of-a-worker-training-program).
Clearly, the time has come for providers of high-
er education and corporate education to take an
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evidence-based approach to gathering and ana-
lyzing data to measure how learners benefit from
the money being spent.
MEASURING THE IMPACT OF LEARNING TOOLS
One example is The New England Journal of
Medicine (NEJM Group) and its efforts to
systematically measure the impact of learning
tools (https://knowledgeplus.nejm.org/how-we-help/
adaptive-learning/). The NEJM Group has sought
to redefine the evaluation process with an
evidence-based approach (http://www.nejm.org/
doi/full/10.1056/NEJMra054784#t=article). A re-
cent survey study (https://www.mededpublish.org/
manuscripts/1788) found that the majority of re-
spondents rated the NEJM Knowledge+ adaptive
learning platform as helpful and the content as
good for exam preparation and relevant to their
learning needs. The study also found that, among
NEJM Knowledge+ users in the 2014-2016 time
period, a significantly higher proportion reported
passing the American Board of Internal Medicine
Certification Examination on their first attempt
compared to the national average (95 percent vs.
89 percent).
To respond to learners’ needs, NEJM offers
an adaptive learning process designed not only
to help people pass the board examination, but
also to be used as a lifelong learning tool (https://
knowledgeplus.nejm.org /how-we-help/adaptive-
learning/). Thanks to its adaptive approach, the
system can target areas of incompetence—first,
by making students aware of what they don’t
know, and then providing resources to close this
gap in understanding. The adaptive approach
supports the notion that it is far better to learn
continuously than to attempt to cram as much
information as possible just before taking a high-
stakes test. Even if the learner passes the test, a
significant amount of learning is not retained
and/or is replaced with misperceptions, of which
the learner is unaware. The result is “unconscious
incompetence,” which, in the medical sector, can
gravely impact patients.
As we find in our work with employers across
every industry and sector, there is a greater
need than ever to improve employee
proficiency, to identify and address their compe-
tency gaps. In the best-case scenario, employees
will be aware—sometimes painfully so—of what
they don’t know. Such “conscious incompe-
tence” may motivate them to engage in training
that will help them be more relevant in an
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evolving workplace.
In the worst-case scenario, which is becoming
all the more common, employees are unaware
of the gaps in their understanding. They are un-
consciously incompetent, for example, in the
use of certain technologies or in critical steps in
processes. Such ignorance can be costly to the
company, its reputation, and the satisfaction of
its customers.
Adaptive learning can target this problem by
helping uncover what each person does and does
not know. Over time, this shapes their meta-
cognitive skills to become more consciously
incompetent—that is, becoming aware of what
they don’t know.
OUTCOMES-BASED LEARNING
As a physician who understands how the brain
functions and the complexity of biological varia-
tion, I have devoted 20 years to studying how
people learn. I can attest that there is no “one-
size-fits-all” approach to acquiring skills. To be
effective, learning needs to be adaptive—molded
to each individual’s needs by probing what he or
she knows and doesn’t know.
Adaptive learning is outcomes-based; it is
geared toward acquisition and retention of
knowledge and skills, rather than mere com-
pletion of content. An adaptive approach is
supportive of overall learning. Charles Fadel, the
founder of the Center for Curriculum Redesign,
put forth a four-dimensional learning frame-
work, composed of knowledge, skills, character,
and meta-learning (or learning how to learn).
Adaptive learning can improve performance
in the knowledge dimension while supporting
meta-learning. Once students have acquired
the “table stakes” knowledge, they are better
prepared to make gains in the other domains. As
a result, the time it takes learners to become pro-
ficient is reduced.
Education, just like the pharmaceutical indus-
try, deals with humans and the brain. Learning is
brain science! By taking the same evidence-based
approach as the pharmaceutical industry, educa-
tion companies can become more systematic in
their approach to using science to prove effica-
cy. By engaging in research to determine the best
evidence, education companies can help school
districts, administrators, and teachers, as well
as corporations, make the informed decisions
about what programs and content are truly worth
paying for. Qt
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