Harvard School of Public Health - Yearbook (Cambridge, MA)

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INNOVATIONS IN EDUCATION By JOHN C. SNYDER, M.D. Dean of the School of Public Health In October at the annual meeting of the American Public Health Association, I was invited to give the Delta Omega address on the subject, The Education of Health Experts for the 1970’s. The paper will be published in the American Journal of Public Health later this year. Since part of the talk dealt with some general aspects of educa¬ tion and since the Class of 1963 has shown keen interest in the current review of the School ' s curriculum, 1 offer herewith some excerpts from the Delta Omega address for inclusion in the Yearbook. It can be noted with considerable satisfac¬ tion that the quality of the collegiate and professional education received by the men and women who are now arriving for matriculation in schools of public health is generally superior to that of two decades ago. As in the past there are a few truly excellent students at the top of each new group, but the important change is that the group as a whole is better prepared today than was the case two decades ago. This is a tribute to the colleges and universities which have up¬ graded requirements, standards of performance and quality of instruction. Schools of public health must now move in the same direction, and without delay. This conclusion is reached even more decisively from another viewpoint. The rate of change in many matters affecting our lives is increasing almost exponentially. A moment of reflection is enough to evoke deep concern over the increasing complexities of urban life and the flood of technological advances now affecting the highly industralized societies. These changes will soon impinge upon the new nations which are determined to leap into advanced eco¬ nomic status in a decade or less. But of particular relevance is the extraordinary increase in the amount of knowledge which is literally flooding the libraries. In 1941 approximately 500 journals arrived in the major medical libraries of this country, journals dealing with the sciences directly contributing to medicine and public health. In 1965 the number will be at least 2,500, an in¬ crease of fivefold in this short span. 1 The Na¬ tional Library of Medicine expects to receive 16,- 000 journal issues this year, with a total number of articles related to the health sciences number¬ ing approximately 160,000. 2 Zinsser has analyzed certain phases of the impact of technology on medicine. 3 He notes that there are approximately 2,000 diseases with which every physician should be thoroughly familiar; furthermore, that there are 90,000 items of factual information currently being taught in an American medical school. In his opinion this number should be increased by a factor of five to encompass the actual bits of in¬ formation likely to be present, concealed beneath these titles and subheadings ' (3, p. 917). Whether the total number is 90,000 or 450,000, the mass of facts being presented to the medical student is awesome indeed. These are the figures of today—several multi¬ ples larger than the figures of two decades ago. If data were available for the health sciences other than medicine, I think there would be similarly striking increases in the volume of information. In the foreseeable future it is probable that the rate of accumulation of new knowledge will con¬ tinue to accelerate. Unless the length of time al¬ lotted for the education of practitioners, teachers and research personnel is greatly extended, which seems neither feasible nor acceptable, the conclu¬ sion is inescapable that the educational process 10

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Administrative Assistant Librarian, Schools of Medicine, Dental Director, Medical Area to the Dean Medicine, and Public Health Health Service Left to right —Marilyn Lunch, Jean Haley, Irene Huber, Margaret Penrose, Irene Forbes, William Claff, Margaret Barnaby, Richard Daggy, John Snyder, Roger Spaulding, James Whittenberger, Colette Farragher, Beverly Laskey, Gail Stocker, Betty Ann Stephens, Judy Godden, Judy Grossman. Mrs. Margaret D. Penrose Administrative Assistant to the Dean Miss Beverly Laskey Registrar

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itself must be vastly improved. Otherwise the health sciences and professions will fall far be¬ hind their potential for public service in the future. The danger is real, and is clearly described by John Gardner in his book ' Self Renewal: The Individual and the Innovative Society.’ ' We are witnessing changes so profound and far reaching that the mind can hardly grasp all the implications ... A society that has reached heights of excellence may already be caught in the rigidities that will bring it down. An institution may hold itself to the highest standards and yet already be entombed in the complacency that will eventually spell its decline . . . Unless we foster versatile, innovative, and self-renewing men and women, all the ingenious social arrangements in the world will not help us.’ (4, pp. xiii-xvi). “To Make the Curricula . . . More Challenging ' In my opinion, it is the responsibility of policy makers in education for the health professions (a) to accept the fact that many facets of con¬ temporary systems of instruction are outmoded and inadequate; (b) to concentrate their best re¬ sources and their wisest minds on an intensive search for more effective educational technics; and (c) to have the courage to experiment even though some of the experiments may be failures. Again, Gardner has stated this succinctly: ' We pay a heavy price for our fear of failure. It is a powerful obstacle to growth. It . . . pre¬ vents exploration and experimentation. There is no learning without some difficulty and fumbling. If you want to keep on learning you must keep on risking failure—all your life.’ (4, p. 15) An or¬ ganization may avoid experimental ventures be¬ cause it fears to damage its reputation for sound¬ ness . . . Many an established specialist fears the loss of his reputation if he ventures beyond the territory where he has proved his mastery. Indeed this fear is the greatest obstacle to intellectual breadth in the scholarly world.’ (4, p. 52) It is my conviction that the intellectual chal¬ lenge of careers in public health should be pre¬ sented more clearly to the students in our colleges and universities. Dr. Weller in his essay on ' Ques¬ tions of Priority’ 5 gave emphasis to this point: ' There is little general appreciation of the breadth, vitality and social significance of modern public health—or of the intellectual stimulus in¬ herent in a rapidly evolving process of synthesis and integration of knowledge wherein medicine and the biologic sciences, the social sciences and the physical sciences meld for the benefit of man.’ The schools of public health will accomplish two purposes if they move swiftly now to make their curricula more effective and more challeng¬ ing to the able and well-prepared university grad¬ uates: they will attract the men and women who are gifted in administration, policy formation, education, and research; and in the process they will also attract the innovators who are citizens of crucial importance to our future.” REFERENCES 1. Esterquest, R. T. (Librarian, Harvard Schools of Med¬ icine and Public Health), Personal communication, 1964. 2. Rogers, F. B., The Medlars Story, U. S. Dept. H. E. W., p. 4, 1963. U. S. Government Printing Office. 3. Zinsser, H. H., The Impact of New Technology on Medicine. Trans. N. Y. Acad. Sci. Ser. II, 26: 914-22, 1964. 4. Gardner, John W., Self Renewal: The Individual and the Innovative Society. Harper and Row. New York, 1963, 1964. 5. Weller, T. H., Questions of Priority. New Eng. J. Med. 269 673-678, 1963. 11