Monday, April 2, 2012

An Introduction to “Made to Stick”

My friend and colleague Bill Meeker has been singing the praises of the book “Made to Stick,” by Chip and Dan Heath (1). Having just finished reading the book, I understand why. Before I dive into the book, in next week’s post (or my next post, given next week we are off on Monday for Spring break), I want to tell a story to position how this book could inform education and, more specifically, what we do in the classroom or clinic.

I teach a course in evidence-based chiropractic practice. I frame the entire class around this idea: there is a patient in your office who presents you with a new challenge, one that you are unsure what to do about. And over the course of the term, we look at what evidence-based practice is, what evidence itself is, how to locate evidence, and then how to extract information from various kinds of papers (research reports, literature reviews, case reports, epidemiological papers, and diagnostic studies). In the third week of class, the topic is how to conduct a literature search (i.e., locating evidence). Since this is a late trimester course, students look forward to this lecture with about as much excitement as they would look forward to a visit to the dentist; they think they already know how to do a literature search.

Before I launch into the lecture, I ask the class how they might look for information on some new band they just heard on the radio. As expected, they usually will say that they go to either google or, for a few, to Wikipedia. And I follow up by noting that yes, most people these days typically use google for their initial information needs, chiropractic students not excepted. So, I ask, how many links would you find on google, to, say, chiropractic? They will say over a million. And how many can you trust? They laugh quietly, knowing that not all the information is good. Hold that thought, I tell them.

I then ask them how many use pubmed? Many do, but oddly, not very often. This leads me to the question I have been waiting to ask: if we did a search on brain ct, how many links on pubmed would we find? Students will guess anywhere from a few hundred to several thousand. Now, go do that search; I’ll wait…

When they see the results, I make my point: pubmed is not google. It does not work the same way. It uses different algorithms for how it searches information, and clearly, you are not aware of them. But look at the query box… So, I then ask, what if we did a search for “spinal stenosis CT?” And again, the results are not what students expect- here because to pubmed, CT does not mean “computed tomography” but “contraindications.”

What I have done in this exercise is to use one of the key ideas in “Made to Stick.” Be unexpected. This engages learning in unique ways. Next week, let’s look at this a bit more.

1. Heath C, Heath D. Made to stick: why some ideas survive and others die. New York; Random House, 2008

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