Tuesday, May 15, 2007

No Child or Dentist Left Behind

No Child Left Behind

Perhaps the most talked about and controversial topic in public education today is the No Child Left Behind legislation. For most people, the biggest bone of contention in this law is the provision requiring high-stakes testing for students. The premise behind the testing is reasonable: since the federal government provides local school districts with federal tax dollars, the federal government tries to hold local schools accountable. Simply put, the feds require us to test our kids to prove we’re using all that money to provide the public with effective schools. Nearly every public educator I know is frustrated with the No Child Left Behind Act. So am I. This frustration is well illustrated by the following story written by John S. Taylor, a school superintendent.

No Dentist Left Behind
My dentist is great! He sends me reminders so I don't forget checkups. He uses the latest techniques based on research. He never hurts me, and I've got all my teeth. When I ran into him the other day, I was eager to see if he'd heard about the new state program. I knew he'd think it was great.

"Did you hear about the new state program to measure effectiveness of dentists with their young patients?" I said.

"No," he said. He didn't seem too thrilled. "How will they do that?"

"It's quite simple," I said. "They will just count the number of cavities each patient has at age 10, 14, and 18 and average that to determine a dentist's rating. Dentists will be rated as excellent, good, average, below average, and unsatisfactory. That way parents will know which are the best dentists. The plan will also encourage the less effective dentists to get better," I said. "Poor dentists who don't improve could lose their licenses to practice."

"That's terrible," he said.

"What? That's not a good attitude," I said. "Don't you think we should try to improve children's dental health in this state?"

"Sure I do," he said, "but that's not a fair way to determine who is practicing good dentistry."

"Why not?" I said. "It makes perfect sense to me."

"Well, it's so obvious," he said. "Don't you see that dentists don't all work with the same clientele, and that much depends on things we can't control? For example, I work in a rural area with a high percentage of patients from deprived homes, while some of my colleagues work in upper middle-class neighborhoods. Many of the parents I work with don't bring their children to see me until there is some kind of problem, and I don't get to do much preventive work. Also, many of the parents I serve let their kids eat way too much candy from an early age, unlike more educated parents who understand the relationship between sugar and decay. To top it all off, so many of my clients have well water which is untreated and has no fluoride in it. Do you have any idea how much difference early use of fluoride can make?"

"It sounds like you're making excuses," I said. "I can't believe that you, my dentist, would be so defensive. After all, you do a great job, and you needn't fear a little accountability."

"I am not being defensive!" he said. "My best patients are as good as anyone's, my work is as good as anyone's, but my average cavity count is going to be higher than a lot of other dentists because I chose to work where I am needed most."

"Don't' get touchy," I said.

"Touchy?" he said. His face had turned red, and from the way he was clenching and unclenching his jaws, I was afraid he was going to damage his teeth. "Try furious! In a system like this, I will end up being rated average, below average, or worse. The few educated patients I have who see these ratings may believe this so-called rating is an actual measure of my ability and proficiency as a dentist. They may leave me, and I'll be left with only the most needy patients. And my cavity average score will get even worse. On top of that, how will I attract good dental hygienists and other excellent dentists to my practice if it is labeled below average?"

"I think you are overreacting," I said. “Complaining, excuse-making and stonewalling won't improve dental health.”

"Spare me," he said, "I can't believe this. Reasonable people won't buy it," he said hopefully.

The program sounded reasonable to me, so I asked, "How else would you measure good dentistry?"

"Come watch me work," he said. "Observe my processes."

"That's too complicated, expensive and time- consuming," I said. "Cavities are the bottom line, and you can't argue with the bottom line. It's an absolute measure."

"That's what I'm afraid my parents and prospective patients will think. This can't be happening," he said despairingly.

"Now, now," I said, "don't despair. The state will help you some."

"How?" he asked.

"If you receive a poor rating, they'll send a dentist who is rated excellent to help straighten you out," I said brightly.

"You mean," he said, "they'll send a dentist with a wealthy clientele to show me how to work on severe juvenile dental problems with which I have probably had much more experience? BIG HELP!"

"There you go again," I said. "You aren't acting professionally at all."

"You don't get it," he said. "Doing this would be like grading schools and teachers on an average score made on a test of children's progress with no regard to influences outside the school, the home, the community served and stuff like that. Why would they do something so unfair to dentists? No one would ever think of doing that to schools." I just shook my head sadly, but he had brightened. "I'm going to write my representatives and senators," he said. "I'll use the school analogy. Surely they will see the point." He walked off with that look of hope mixed with fear and suppressed anger that I, a teacher, see in the mirror so often lately.

Unfortunately, No Child Left Behind is here and we have to deal with it. So far, our strategy seems to be to “teach the test.” A few years ago I actually heard a school board member say that all we needed to do was get a copy of the state tests and study them. Our strategy misses the point. The goal is not to improve test scores. The goal is to improve education. A few years ago I was lucky enough to win a Fullbright Fellowship to travel to Japan and study their school system first hand. Japanese schools are widely regarded among the world’s best. Their test scores go through the roof. Like most people, I suspected they were obsessed with test scores and made their students drill, drill, DRILL! I was wrong. Their philosophy is to teach the whole child. They concentrate on curriculum integration, problem-based learning, classroom projects, and other student-centered learning strategies.

I agree with the dentist in our story: When asked how he would measure good dentistry he said, "Come watch me work. Observe my processes." Yes, it is complicated and time consuming. But that’s how you improve education. You observe classroom teachers and help them get better. The school principals should be the best teachers in their schools. They should be willing to take the time, and have the ability, to show teachers how to improve classroom instruction. They should see to it that curriculum integration, problem-based learning, classroom projects, and other student-centered learning strategies are the rule rather than the exception.

As Superintendent of Schools I pledge to get out of the office and into the schools. I will work with principals to improve classroom instruction. If you’re considering other candidates for superintendent, ask them to tell you about the various instructional strategies they are familiar with. Ask them if they’ll work with principals to ensure that best practices are used in our classrooms. If they’re not, find another candidate.

Until next time, may God bless you and your children.
Bob Mamrak

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