I'm about to deliver this presentation at the NJAFP annual scientific assembly in Atlantic City. It's a pdf of the keynote file that I used to present. I also have a powerpoint version if you want to email me for it. Feedback is welcome.
A recent NEJM podcast notes interest in US students travelling overseas to gain international experience. "In 2003, 1 in 5 US students participated in an international experience" the moderator states.
One of the students interviewed comments on their experience: "The most important question asked in Uganda was whether they had money to pay for medicine. If so, they were given medicine, if not, they weer sent home to die...It Taught me the importance of perspective in global health."
Given the recent spate of articles describing how the US healthcare market is 'stealing' nurses, physicians and other health care workers from developing countries I wonder whether this 'send student doctors back' phenomenon will help stem the tide by opening the minds of medical decision makers to international training.
I know that in the residency that I direct I have little ability to pay for residents to travel or train overseas. Do other payors feel they're getting their money's worth? Anyone up for a cost-benefit analysis of exchange training?
One of the problems facing product manufacturers who want to get their product in front of your eyes is the tension between grabbing your attention by inserting ads in an entertainment experience vs. making the information 'so valuable' that someone actually seeks it out - e.g. 'must watch media' vs. 'must watch ads'.
Of course the 'watch' metaphor in today's attention economy isn't the right verb for the ADHD generation. You know the type; a teenager doing homework while simultaneously holding online chats, playing a MMORPG, talking to someone else on the phone, answering mom who's calling for dinner and playing poker (and winning).
That's why ads in SecondLife (product placements if you will) or other social networking venues work so well. They take advantage of an alreay established social network to interject their product in context; if there is real value in the product there will be real value in the network, with all the viral marketing implications intact.
Tom Friedman's book (The World is Flat) includes the forces that are flattening the world. One that stands out to me is homeshoring. We have a small call center in our department that has equipment and people in cubbies. Office Space cubbies. All expensive, all calls tracked relentlessly by a system that tells us everything we could ever want. Unfortunately, we rarely use the call metrics. Instead we continue to ignore them. The result is a continued 15-20% abandoned call rate, in part due to busy Mondays where we don't have staff to cover the phones.
Why don't we contract for our high demand days on some volume/quality basis to qualified and trained folks who work from home? If Jetblue can do it why can't we?
My chair has challenged me to come up with metrics that go above and beyond publication number or 'impact' as measured by ISI citation index. Promotions here and elsewhere betray their own peculiar mix of culture, politics and tradition. Here are my thoughts.
The basic premise is that academic productivity ought be judged on the basis of defined principles. Boyer's categories of discovery, integration, application and teaching have been quantified by promotions committees in traditional terms such as publication volume, publication influence, patents, grants, courses taught and advising undertaken. The context for these discussions is often one of promotion or tenure in academic environments, concepts themselves with questionable external validity that are increasingly under scrutiny.
While variation in and of itself isn't a problem, not examining the variation is certainly problematic. What I'm most concerned about is decisions where the lack of analysis dampens innovation or worse, hampers scholarship.
Computing and communications advances have created novel means of visualing qualitative and quantitative relationships in real time, which in turn brings variation in promotion and tenure decisions within and between organizations into sharp relief. Unfortunately I don't have answers, but did come up with some questions for myself.
If the nature of scholarship is changed by how it's measured, then scholarship in a web 2.0 world has more to do with the new tools to measure it. Visualizing the role of an academic and the relationships in academia over time takes on new meaning when you can do so in real time. Why don't promotion committees use academic tag clouds? Is ISI really a snobbish technorati? Where's my touchgraph ?(You must have java for the touchgraph applet to launch - what's a touchgraph?)