Information Age Education
   Issue Number 48
August, 2010   

This free Information Age Education Newsletter is written by David Moursund and Bob Sylwester, and produced by Ken Loge. The newsletter is one component of the Information Age Education project. See and the end of this newsletter.

The Information Age Education web site now includes a blog. Access the
blog and comment on blog entries at

Education and Health Care Part 4:
The Human Element

Nursing homes and schools evoke very different imagery and purposes. To compare them would seem to be a case of mixing apples and oranges. However, let us not forget they are both fruit whose appearance, taste, and nutrition depends on who takes care of them (Seymour Sarason, 2007).


This is the fourth in an IAE Newsletter series discussing the disciplines of Education and Health Care. The goal is to draw on ideas from both disciplines as we work to improve our educational system.

Education and Health Care are human endeavors. They serve the needs of a very large number of students and patients. They make use of a large number of employees who provide direct as well as indirect services to students and patients.

Students and patients are human beings. You have undoubtedly interacted with teachers and health care providers who have excellent people skills and communicated effectively with you. You may have experienced others who have weaker human-to-human empathy and communication skills.

As Information and Communication Technology systems gradually play a larger role in teaching, we need to be aware that computer systems and computer brains are not human. Currently, they are quite poor in human-to-human types of interaction and communication skills. They lack understanding of empathy and the “human condition.”

This issue of the IAE Newsletter focuses on the human element of delivery of services to students and patients.

Seymour Sarason

Seymour Sarason had a very long and productive career in education and public service. His 1993 book, The predictable failure of educational reform, focused on the need to empower students and their teachers. In this book he argues that without substantial increases in the power given to students and their teachers, educational reforms will fail.

Here is a brief description about his 2007 book, Centers for endings: The coming crisis in the care of aged people.  This book is available free on the Web.

[The book] is a rallying call to action that comes from knowledge, from experience and from the heart. Revered psychologist, Seymour Sarason builds on years of association with both the medical and educational establishments, plus recent personal experience, to describe and diagnose the problems and prescribe remedies.

Sarason is interested in the education and training that the front line workers provide to students and patients. His main focus is on long-term nursing treatment and care facilities. However, quoting from Sarason’s 2007 book:

It may surprise the reader that I initially gave serious thought to writing a long chapter to show the comparison between the inadequacies and low quality of care in nursing homes with the failures of reform efforts to improve educational outcomes of our schools whose self-proclaimed mission is to help every child develop his or her potential. … At the risk of being too succinct here is what schools and nursing homes have in common.
  1. In our schools students spend all of their time with teachers who are products of preparatory programs which ill prepared them for the realities of the culture of the school; in fact few (if any) teachers have ever denied it. In their hierarchy, teachers are at the bottom of the pyramid of status and influence. …
  2. For all practical purposes nursing home aides are neither selected nor trained; they are undereducated, have few alternatives for employment, and are regarded by nurses and administrators as undependable and as harmful or neglectful. Their rate of pay is low. They have no power or influence at all in almost every aspect of their work.
In both schools and health care facilities, the staff mentioned above tend to be caring people. Also note that Sarason’s comments about status in schools do not talk about aides, secretaries, cooks, janitors, and so on who are often still low in the hierarchy than teachers.

Head Start

In his 2007 book, Sarason draws on his knowledge of the Head Start program to help analyze problems in nursing care facilities.  Quoting from U.S Department of Health and Human Services (2010):

Since its beginning in 1965 as a part of the War on Poverty, Head Start‘s goal has been to boost the school readiness of low-income children. Based on a “whole child” model, the program provides comprehensive services that include preschool education; medical, dental, and mental health care; nutrition services; and efforts to help parents foster their child‘s development.

Quoting from Sarason’s 2007 book:

Implicit in the rhetoric of proponents for Head Start is what I have called the medical conception of contagion. Concretely, Head Start was viewed as preventing poor minority children from catching the “disease” of lack of motivation for and disinterest in matters of subject matters when they entered schools. … Head Start was intended to inoculate its preschoolers against the “diseases” of disinterest and dislike of boring, unstimulating classrooms. Head Start was not the educational equivalent of the Salk vaccine! [Bold added for emphasis.]

The Head Start program currently reaches about a million children a year. The program has received a lot of praise and a lot of criticism. The 420-page report U.S Department of HHS (2010) points to modest levels of success. Sarason (2007) cites research on failures, and argues that the lack of success is due to underpaid, poorly prepared people serving as teachers and aides in the program.

He compares and contrasts this with the poor care that many nursing home facilities provide, and cites considerable research evidence supporting his claims about nursing home care. He is particularly concerned about the mass production, with great emphasis on following the rules, types of care that many nursing care facilities provide. He argues that they indeed administer to the body—but they tend to downplay the human-to human empathy and intellectual needs of the patients.

Factory Models of Education and Health Care

The previous issue of this newsletter included a forecast that some combination of progress in artificial intelligence and in highly interactive intelligent computer-assisted learning (HIICAL) will eventually lead to profound changes in our educational system. Right now we have a factory model of education—a mass production system aiming at considerable uniformity and that makes extensive use of standards and standardized testing.
Our health care system has some of the same features, but it makes much more use of what educators call differentiated staffing. The current level of health care knowledge and skills allows very well educated and trained specialists and general practitioners to do a substantial amount of one-on-one diagnosis and initial treatment. After that, some combination of drugs, physical therapy, care by nurses and aides, and so on clicks in, and this is supplemented with an occasional follow up interaction with a doctor.

Here we see a major current difference between education and health care. Although schools make some use of specialists, a majority of the teaching is done by teachers with a bachelor’s or master’s degree (or more) of formal education, working with a class of perhaps 20 to 35 students. Students in school are watched over by (supervised by) adults in a face-to-face manner nearly all of the time. There is limited emphasis on students deciding for themselves what they want to learn and then pursuing their own interests.

Final Remarks

Most of the K-12 curriculum is focused on introducing students to elements of their culture that they can't easily pick up in parental/peer/mass media interaction, such as deeper levels of language, math, science, cultural history, etc. It thus makes some sense to have an adult-directed curriculum. Young people have many out-of-school hours to pursue individual interests.

Here is some food for thought. A human body is designed to be self-repairing. A human brain is naturally curious and has a great capacity for learning. Learning takes pace within one’s brain through biological changes in the brain. From time to time the self-repairing body receives the help of our health care system.

However, our educational system seems to feel that learning requires substantial ongoing supervision and “treatment” by teachers. The teaching of reading, along with the mass production of books and the development of libraries, has not been sufficient to change this educational model. Will better access to books (electronic books) and libraries (the Web), along with readily available HIICAL be sufficient to change the basic design of our educational system? Your authors are enjoying watching and participating in this unfolding story.


Sarason, Seymour (1993). The predictable failure of educational reform: Can we change course before it's too late? NJ: Jossey-Bass Wiley. Learn more about Seymour Sarason at

Sarason, Seymour (2007). Centers for endings. The coming crisis in the care of aged people. Retrieved from

U.S. Department of Health and Human Services, Administration for Children and Families (January 2010). Head Start impact study. Final report (420 pages). Retrieved 8/4/2010 from

About Information Age Education, Inc.

Information Age Education is a non-profit organization dedicated to improving education for learners of all ages throughout the world. IAE is a project of the Science Factory, a 501(c)(3) science and technology museum located in Eugene, Oregon. Current IAE activities include a Wiki with address, a Website containing free books and articles at, and the free newsletter you are now reading.

To subscribe to this twice-a-month free newsletter and to see back issues, go to To change your address or cancel your subscription, click on the “Manage your Subscription” link at the bottom of this e-mail message.