The New Way Doctors Learn; Why You Should Feel Awkward About the ‘Kony2012′ Video

The New Way Doctors Learn

A simple technique dramatically improved the memory recall of Harvard Medical School students. Try it for yourself

Gary John Norman / Getty Images


Paul’s latest book is Origins: How the Nine Months Before Birth Shape the Rest of Our Lives.

Turning a medical student into a doctor takes a whole lot of knowledge. B. Price Kerfoot, an associate professor of surgery at Harvard Medical School, was frustrated at how much knowledge his students seemed to forget over the course of their education. He suspected this was because they engaged in what he calls “binge and purge” learning: They stuffed themselves full of facts and then spewed them out at test time. Research in cognitive science shows that this is a very poor way to retain information, as Kerfoot discovered when he went looking in the academic literature for answers. But he also stumbled upon a method that really is effective, called spaced repetition. Kerfoot devised a simple digital tool to make engaging in spaced repetition almost effortless. In more than two dozen studies published over the past five years, he has demonstrated that spaced repetition works, increasing knowledge retention by up to 50 percent. And Kerfoot’s method is easily adapted by anyone who needs to learn and remember, not just those pursuing MDs.

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The theory behind spaced repetition is simple: when we first learn a fact, our memory of it is volatile, subject to change or disappear. Each time we encounter that fact again, however, the memory becomes stronger and more stable—especially if the encounters are spread out over time. Cramming the night before an exam (or a speech or a presentation) is a sure way to make the information vanish from your head a short while later. But exposing yourself to that same information multiple times over weeks or months fixes it firmly in your brain. Kerfoot’s innovation was to make these spaced-out learning sessions easy and convenient. Starting with the knowledge medical students had to master in his own specialty of urology, Kerfoot devised questions about the curriculum, with multiple-choice answers, that he sent in weekly emails to the students participating in the study. The students took a few minutes to answer the questions on their laptops or smartphones; each week brought a new round of queries, mixing new material with material already covered. At the end of the year, the students who received the spaced emails scored significantly higher on a test of their urology knowledge.

Since that first study, published in the journal Medical Education in 2007, Kerfoot has evaluated the effectiveness of spacing out exposure to a variety of other topics that doctors in training need to learn, such as performing a physical exam, diagnosing medical ailments, and administering a cancer screening test. In each case, the spaced-out information delivered to students on their devices helped them to recall the information better.

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How can you learn like one of Kerfoot’s Harvard Medical School residents? Most email programs allow you to schedule the sending of messages, making it easy to create a spaced-repetition course for yourself. Divide up what you need to know—the text of a speech, the material on an exam—into smaller units, no more than a few sentences long. Then put the information into emails scheduled to be sent to yourself at weekly intervals. To achieve the greatest memory-strengthening effect, mix up old and new material, and put the information in the form of a question to which you’ll have to recall the answer. You’ll find that your email is making you smarter—no all-nighters necessary.

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Why You Should Feel Awkward About the ‘Kony2012′ Video

Stuart Price / AFP / Getty Images

Leader of the Lord’s Resistance Army (LRA), Joseph Kony, answers journalists’ questions in Ri-Kwamba, southern Sudan, Nov. 12, 2006.

Most Americans began this week not knowing who Joseph Kony was. That’s not surprising: most Americans begin every week not knowing a lot of things, especially about a part of the world as obscured from their vision as Uganda, the country where Kony and his Lord’s Resistance Army (LRA) commenced a brutal insurgency in the 1980s that lingers to this day.

A viral video that took social media by storm over the past two days has seemingly changed all that. Produced by Invisible Children, a San Diego-based NGO, “Kony2012″ is a half-hour plea for Americans and global netizens to pay attention to Kony’s crimes — which include abducting over 60,000 children over two decades of conflict, brutalizing them and transforming many into child soldiers — and to pressure the Obama Administration to find and capture him. Within hours of the slick production surfacing on social media, it led to #StopKony trending on Twitter, populated Facebook timelines, was publicized by Hollywood celebrities and has been viewed some 10 million times on YouTube. Suddenly, a man on virtually no Westerner’s radar became the international bogeyman of the moment.

It’s an incredible public relations coup for the NGO, which congratulates itself in the film for spurring U.S. Congress last October to send 100 military “advisers” to aid Ugandan forces in their war against Kony’s Lord’s Resistance Army. The LRA is without a doubt a nasty outfit, responsible for massacres of civilian populations, mass rapes, contemptible acts of mutilation and, most notoriously, the creation of an army of child soldiers, forced to perform gruesome deeds. In 2005, the International Criminal Court in the Hague put Kony at the top of its most wanted list, indicted on 33 counts including war crimes and crimes against humanity. Sure, the U.S. remains in the minority of nations yet to officially recognize the ICC’s jurisdiction, but that, Invisible Children’s members would likely argue, ought not change the need for a moral clarion call: Kony must be brought to justice.

No sane person would disagree with this. Yet for the video’s demonstrable zeal and passion, there are some obvious problems. Others more expert in this arena have already done a bit of fact-checking: the LRA is no longer thought to be actually operating in northern Uganda, which “Kony2012″ seems to portray still as a war-ravaged flashpoint — instead, its presence has been felt mostly in disparate attacks in the Democratic Republic of Congo, a nation with its own terrible history of rogue militias committing monstrous atrocities. Moreover, analysts agree that after concerted campaigns against the LRA, its numbers at this point have diminished, perhaps amounting to 250 to 300 fighters at most. Kony, shadowy and illusive, is a faded warlord on the run, with no allies or foreign friends (save perhaps, in one embarrassing moment of blustering sophistry, for American radio shock jock Rush Limbaugh.) The U.S. military’s African command (AFRICOM) has deployed its assets against Kony since at least 2008 — a fact that goes conveniently unmentioned in Invisible Children’s video.

In a terrific explainerForeign Policy cites a scathing critique of the video by leading Ugandan journalist Angelo Izama:

To call [Kony2012’s] campaign a misrepresentation is an understatement. While it draws attention to the fact that Kony, indicted for war crimes by the International Criminal Court in 2005, is still on the loose, it’s portrayal of his alleged crimes in Northern Uganda are from a bygone era. At the height of the war between especially 1999 and 2004, large hordes of children took refuge on the streets of Gulu town to escape the horrors of abduction and brutal conscription to the ranks of the LRA. Today most of these children are semi-adults. Many are still on the streets unemployed. Gulu has the highest numbers of child prostitutes in Uganda. It also has one of the highest rates of HIV/AIDS and Hepatitis.

If six years ago children in Uganda would have feared the hell of being part of the LRA, a well documented reality already, today the real invisible children are those suffering from “Nodding Disease”. Over 4000 children are victims of this incurable debilitating condition. It’s a neurological disease that has baffled world scientists and attacks mainly children from the most war affected districts of Kitgum, Pader and Gulu.

(You can read chilling depictions of ‘nodding disease’ here.)

This is a crisis of public health and governance that can’t be laid at the feet of one vile militia leader, skulking in the jungle. Not once in the half-hour film do we hear the name of Uganda’s President Yoweri Museveni, whose quasi-authoritarian rule has lasted over 25 years. Arab Spring-inspired protests last year were ruthlessly suppressed and the country’s opposition complains bitterly about the entrenched corruption of the Museveni state. The U.S. State Department voiced its concern over Uganda’s rights record last November. Speaking to the Washington Post, Jedediah Jenkins, a member of Invisible Children, shrugs off charges that the NGO is too much in bed with the status quo in Kampala:

There is a huge problem with political corruption in Africa. If we had the purity to say we will not partner with anyone corrupt, we couldn’t partner with anyone.

Sure. It’d be churlish to rebuke Invisible Children for wanting to help those afflicted overseas, while moving tens of thousands of previously apathetic Americans (at least to hit the re-tweet button) at home. But there’s a thin, perilous line between the organization’s brand of righteousness and simple self-aggrandizement. The film makes little mention of ongoing activism by people in northern Uganda. I’m not the only one to feel a bit queasy about the film’s perhaps unintended, yet inescapable white man’s burden complex, with filmmaker-cum-protagonist Jason Russell framing the horrors wrought by Kony and the need to stop him through an overly precious discussion with his blonde, cherub-cheeked toddler son.

In this telling, to simply “know” about Kony — a figure, as others have already written, of Kurtz-like darkness — would be enough to bring him down. That quest takes place in a world of moral simplicity, of good and evil, of innocence and horror. It is a world where governments would supposedly anchor policy on the emotional tides of their citizens. It is a world, as Elliot Ross at the excellent Africa is a Country blog writes, that does not exist:

To ask people to climb down from the soaring heights of “Kony 2012” (remember how we fall down into Uganda from the heavenly realms of Jason Russell’s Facebook page?) a place where they get to feel both sanctified and superior, and truly descend into the mire of history and confusion is simply too big an ask. It would be boring and difficult and it would not be about Facebook or Angelina Jolie or coloured wristbands or me. When the euphoria evaporates and the Twittersphere has dried its tears (probably by the end of this week), all that remains will be yet another powerful myth of African degradation.

Kony should be found and made to answer for his crimes. But justice is about much more than manhunts and viral video crusades.

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