Tag: behaviorism

Learn health, but beware of the behaviorist trap
The global health community has long grappled with the challenge of providing effective, scalable training to health workers, particularly in resource-constrained settings.

In recent years, digital learning platforms have emerged as a potential solution, promising to deliver accessible, engaging, and impactful training at scale.

Imagine a digital platform intended to train health workers at scale.

Their theory of change rests on a few key assumptions:
1. Offering simplified, mobile-friendly courses will make training more accessible to health workers.
2. Incorporating videos and case studies will keep learners engaged.
3. Quizzes and knowledge checks will ensure learning happens.
4. Certificates, continuing education credits, and small incentives will motivate course completion.
5. Growing the user base through marketing and partnerships is the path to impact.
On the surface, this seems sensible.

Mobile optimization recognizes health workers’ technological realities.

Multimedia content seems more engaging than pure text.

Assessments appear to verify learning.

Incentives promise to drive uptake.

Scale feels synonymous with success.

While well-intentioned, such a platform risks falling into the trap of a behaviorist learning agenda.

This is an approach that, despite its prevalence, is a pedagogical dead-end with limited potential for driving meaningful, sustained improvements in health worker performance and health outcomes.

It is a paradigm that views learners as passive recipients of information, where exposure equals knowledge acquisition.

It is a model that privileges standardization over personalization, content consumption over knowledge creation, and extrinsic rewards over intrinsic motivation.

It fails to account for the rich diversity of prior experiences, contexts, and challenges that health workers bring to their learning.

Most critically, it neglects the higher-order skills – the critical thinking, the adaptive expertise, the self-directed learning capacity – that are most predictive of real-world performance.

Clicking through screens of information about neonatal care, for example, is not the same as developing the situational judgment to adapt guidelines to a complex clinical scenario, nor the reflective practice to continuously improve.

Moreover, the metrics typically prioritized by behaviorist platforms – user registrations, course completions, assessment scores – are often vanity metrics.

They create an illusion of progress while obscuring the metrics that truly matter: behavior change, performance improvement, and health outcomes.

A health worker may complete a generic course on neonatal care, for example, but this does not necessarily translate into the situational judgment to adapt guidelines to complex clinical scenarios, nor the reflective practice to continuously improve.

The behaviorist paradigm’s emphasis on information transmission and standardized content may stem from an implicit assumption that health workers at the community level do not require higher-order critical thinking skills – that they simply need a predetermined set of knowledge and procedures.

This view is not only paternalistic and insulting, but it is also fundamentally misguided.

A robust body of scientific evidence on learning culture and performance demonstrates that the most effective organizations are those that foster continuous learning, critical reflection, and adaptive problem-solving at all levels.

Health workers at the frontlines face complex, unpredictable challenges that demand situational judgment, creative thinking, and the ability to learn from experience.

Failing to cultivate these capacities not only underestimates the potential of these health workers, but it also constrains the performance and resilience of health systems as a whole.

Even if such a platform achieves its growth targets, it is unlikely to realize its impact goals.

Health workers may dutifully click through courses, but genuine transformative learning remains elusive.

The alternative lies in a learning agenda grounded in advances of the last three decades learning science.

These advances remain largely unknown or ignored in global health.

This approach positions health workers as active, knowledgeable agents, rich in experience and expertise.

It designs learning experiences not merely to transmit information, but to foster critical reflection, dialogue, and problem-solving.

It replaces generic content with authentic, context-specific challenges, and isolated study with collaborative sense-making in peer networks.

It recognizes intrinsic motivation – the desire to grow, to serve, to make a difference – as the most potent driver of learning.

Here, success is measured not in superficial metrics, but in meaningful outcomes: capacity to lead change in facilities and communities that leads to tangible improvements in the quality of care.

Global health leaders faces a choice: to settle for the illusion of progress, or to invest in the deep, difficult work of authentic learning and systemic change, commensurate with the complexity and urgency of the task at hand.

Image: The Geneva Learning Foundation Collection © 2024
June 30, 2024
Why gamification is a disaster for humanitarian learning

Is gamification an advantageous strategy that can help increase knowledge and application when it comes to humanitarian responses? What are these advantages? Can gamification contribute to better humanitarian preparedness?

Certainly, if you have been forced to maniacally click through 500 screens of a boring “e-learning” from the past – dressed up with multicolored bells and whistles or cute little Flash animation – to finally get to the stupid quiz that is insulting your intelligence by asking you to recall what you will have forgotten tomorrow but that you need to pass to earn your stupid gold certificate before your field deployment, “gamification” sounds enticing. After all, you figured out how to game that e-learning module… so maybe games are the key to the future of humanitarian learning? Not.

Is gamification one of the “current innovations in the field of learning”? Well, arguably, this may have been the case… over a decade ago. And it has long since been debunked. Can gamification help tackle some of the challenges we face in humanitarian learning? These challenges include scale (we need a lot more people ready to face disasters and volunteering to strengthen their communities’ resilience), reach (all the way to the last mile to people on the receiving end of aid), strategic relevance, and using new learning methodologies that model how humanitarians work together with and within communities, solve problems, and grow as leaders.

Is there potential in using game elements for increased engagement and effective training of humanitarian staff? Often, “gamification devolves to just creating competitive experiences based on some sort of point-scoring model that is at-best glorified industrial psychology and not necessarily a great, giant outcome of innovation or game design,” explains Ben Sawyer, the founder of Games for Health. (Ben convinced me five years ago that serious games not gamification are a viable approach for some needs – just an incredibly complex, costly one.)

My twelve-year-old son is a gamer. I observe and ocasionally participate. The immersive qualities of recent games are amazing, and the way they work your psychology is mind-blowing. Game studios understand the intricacies of human behavior and motivation at least as well as casinos do. So, yeah, imagine if we could put that power to use for the good of humanity…

There are three obvious problems.

The first problem is that building quality learning experienced as a game is very expensive. Creating a fully-cognitive experience with a more encompassing model of engagement and interaction starts at 50 million U.S. dollars (Final Fantasy XII) and there is no upper limit (200 million for Star Wars: The Old Republic).

What could you do with the shoestring budgets available for learning and capacity building in the humanitarian sector? At best, try to short circuit the experience and use just a few elements in hopes that creating a ‘game’ or an experience that instills some of the core ideas of what a game is by definition will generate a bump in engagement. And that, my friends, is a recipe for failure in so many ways, but above all because it is disconnected from humanitarian learning needs.

That, in fact, is the second problem. “For all staff, the abilities to learn, to reflect, to negotiate, to critically examine and analyse what they are seeing and hearing, are crucial,” wrote Connell Foley in 2008. Creating a game that is about more than stimulus-response is difficult (requiring talent that does not exist in our sector), costly, and therefore unlikely. As a learning approach, it is not the one you choose if you want to support the development of analytical capabilities or critical thinking.

Increasingly, humanitarians, like other knowledge workers (cf. Robert Kelly’s longitudinal study), can only get things done through collaboration, because the knowledge they need is no longer stored in their brains. This is not the “Social Age” (another dead end I have previously debunked) but part and parcel of the Second Machine Age. Many video games are self-contained worlds, closed systems that fail to model the very complexities that matter the most in the messy real world that we live in – and that can make the difference between life and death when you are working on the edge of chaos.

Robert Kelly: % knowledge stored in your brain needed to do your job from 1986 to 2006

The third problem is that the diverse culture of video games contains a dominant strand that is just awful – full of racism, sexism, and violence that is deeply ingrained. The hottest video game right now is called Battlegrounds. It is a Battle Royale where the ultimate purpose is to kill the other 99 players and be the sole survivor whose reward as a “Winner Winner” is to earn a “Chicken Dinner”. Is this really a culture that can be reshaped to serve humanitarian needs, where a lone individual may be trying to save 99 others?

We undoubtedly need new ways of learning and thinking for humanitarians. This has to include both core abilities and value skills. Gamification cannot deliver either of these, and forces us to work from a culture in which the dominant values are difficult to stomach.

New ways of learning and thinking

Gamification is about behaviorist rewards for selfishness, where you earn points for killing others. It is often innately, to the core, about competition – and contortions to make friendly, peaceful, collaborative forms of gamification are lipstick on the ugly pig of behaviorism that hides beneath the supposedly “innovative” character of gamification.

Behaviorism is a widely-discredited learning theory. It might be relevant for humanitarian workers only if the nature of the work was “do this-do that.” It is not. Problem-solving, navigating the unknown, strengthening the connections between us, developing contextual knowledge that we can use… gamification cannot do any of that. And that happens to be precisely what we need the most.

This brings us right back to the boring e-learning of the past. Clicking through screens and taking a quiz also contains behaviorist assumptions. And, in fact, some of gamification’s strongest advocates in the humanitarian space spent years building boring, one-dimensional, and ultimately ineffective media-heavy content before becoming enthralled with gamification.

The fascination with the video games industry is easy to understand. This industry is already bigger than Hollywood and growing much faster. The potential of virtual (VR) and augmented (AR) reality, artificial intelligence, and other emerging technologies show that this it just the beginning. But “gamification” is precisely not what will help us harness this potential to support humanitarian work.

The fetichization of gamification in learning is akin to that for “story-telling” in communication. Yes, humans play games and tell stories. That both are part of our experience and cultures poses a challenge for learning leaders, certainly. But gamification zealots seem to see every problem through their single, reductive lens – and what was originally an innovative idea full of potential becomes one more rote, knee-jerk response set of blinders.

We need to say “game over” to gamification and commit resources to approaches that foster new learning and leadership to support humanitarian work – not sink precious resources into what was once a fad in the corporate learning space, more than a decade ago.

Featured image: Sinistar Wallpaper – Beware — I Live! (Retroist.com)

March 7, 2018
Thinking about learning technology: is the product metaphor obsolete?

In my work, I am constantly discovering and evaluating new web sites and online services related to learning in some way. Increasingly, I’m wondering if there can be an underlying method for assessing them that is different from the prevailing consumerist, product metaphor.

What I mean is that we tend to look at a learning technology as if it were a product that we will consume if we adopt it in our learning/teaching practice. This is not necessarily a bad thing. Ultimately, we do have to make pragmatic, practical decisions: do I use Schoology or Edmodo or Scholar for my project? It seems to me like we are quite “naturally” thinking as *consumers* of learning technology, as we do in our daily lives making choices about whether we use Facebook or Twitter (or neither), keep our e-mail on Hotmail or GMail, etc.

One limitation I see with this product approach is that thinking about learning is quickly reduced to listing and comparing technical features. The traditional IT approach in choosing a technology involves building 1) use cases and 2) requirements and then trying to find the software package, platform, or service that most closely matches these. I have seen the most disastrous outcomes from this classical kind of analysis.

I’m not saying that we shouldn’t think about feature sets, requirements or use cases. I just question that they come up first in discussion. I think this happens because “detecting” the underlying learning theory that underpins a learning system is much more difficult. And it’s not only about understanding what the project proponents grounded themselves in, but also looking at the gap between the intended theoretical underpinning and the live product. A good example is Moodle: I love the concepts, the history, the open access and the open source. But I fail to recognize the constructivism claimed by its authors when I see how mechanistic, do-this-get-that it quickly becomes. Doing peer review is outside its boundaries. Multiple-choice quizzes are inside. Scary — and not very constructivist, sorry. From reading Moodle case studies, I can see that good teachers are able to squeeze constructivism out of Moodle — but a good teacher can probably do that with just about any system, and I fail to see how Moodle is making it easier.

From my own experience in search of the holy grail of learning systems, I’ve drawn the frightening conclusion that we live in a world in which we can expect an exponentially growing number of online systems for learning, propelled by various ideas which have less and less to do with learning, more and more with corporate takeover and control of education, and less and less likely to meet our specific needs, much less be grounded in the specific remix of learning theories that we see as relevant to our learning community.

One implication: we need to give up on the idea of a centralized platform that can meet all our needs — and be grounded in coherent learning theory that leads to sensible teaching and learning practice.

Fortunately — and not just because I tend to be an optimist — I also believe that as the online world becomes increasingly fragmented, we are also developing the tools to pick and choose useful tools from the chaos, to which we can then creatively add identity (this is where visual design is important, as with the badges, etc.) to make a stable learning system. Most important, we need make these choices informed by a specific set of theories which we use as tools to make decisions on how we set up a course, how we determine its content, who “we” are (is it teachers, students, or both?), etc.

Philipp Schmidt from P2PU.org recently showed me The Mechanical MOOC, a good prototype for this kind of thinking and its application. It is a mashup or remix that relies on multiple platforms and tools, with technological scaffolding to glue the tools together, branding to give it identity. We know about *scaffolding* learning. We may want to think about *scaffolding* technology. (NYT article about this latest P2PU project)

September 18, 2012