CAT | Speed to Proficiency

Randall Munroe’s XKCD cartoon today illustrates the power of a well-executed simulation.

To be fair, my job at NASA was working on robots and didn't actually involve any orbital mechanics. The small positive slope over that period is because it turns out that if you hang around at NASA, you get in a lot of conversations about space.

Kerbal Space Program is a game in which players create and manage their own space program. It came to our house this Christmas when my son, Jim, the logistics guy, gave it to my husband the wannabe astronaut.  We had a merry night of family fun exploring (and blowing up) our first launches. At one point, we managed to miss the moon, and achieve solar orbit instead!

KSP has spawned an active community with lively forums and a wiki, maintained primarily by players. At first glance, this is sort of a dream scenario for those of us in adult learning — all these people, voluntarily spending their spare time teaching each other things that used to require a Ph.D. in physics to acquire! If only we had the budget to produce an immersive claim-adjusting scenario!  But I think, if we look closer, it becomes clear why that limitation isn’t really the problem…

Our other son, Steve, is a third year medical student who has taken to KSP with a vengeance which leaves his fiancé puzzled.  When I sent the cartoon above to him, he responded, “what I really need is an equally addictive game for primary care medicine…”

There is a ton of technology being applied to medical education these days.  For $34, my daughter was able to download an app to her android tablet which permits her to view human anatomy in cross section, by layer, and to flip the body around to look from any angle she chooses. She’s a first-year med student, still in the classroom the majority of the time. She can re-run the lectures on video, speeded up. There are multiple chemistry simulations out there.  She can play what-if games with molecules to her hearts content.

But there’s a reason that an “equally addictive game for primary care medicine” eludes us. It’s because any field which requires interaction with other human beings has to account for a vast array of individual biological, psychological, and behavioral responses which defy complete cataloging. The rule sets which define orbital mechanics and chemistry are only the beginning of what it takes to describe, let alone simulate, human healing.

Fortunately, humans are able to absorb subtle tacit knowledge through hands-on experience.  So we continue to address this challenge in the time-honored way.   Beginning in the third year, U.S. medical students spend most of their time as apprentices, rotating through the various medical services, learning from those senior to them, and from the patients who are being treated, the nuances of how one applies what is known about best treatment practices.  Internship and residency continue this process.

Medicine is not alone in facing this kind of challenge.  So many jobs in our organizations require much more than the knowledge we’ve been able to codify about “how we do this.” Skillfulness and later, proficiency, require experience, including exposure to the war stories of veterans, and coaching by veterans through how one makes the various judgment calls which new and unusual situations invariably require.

Fortunately, here in the 21st century, we can give our learners these kinds of experiences during their training phases even when they are not co-located.  At Q2, our learning paths allow organizations to structure programs which blend codified content with interactions with peers and senior staff, and even permit the joint construction of new learning resources.  It’s a bit of “back to the future” – bringing portions of the apprenticeship experience on line.   We’d love to talk to you about how we can help you build proficiency among your people.  Call us at 877-751-2200. Or drop a line to Bill Bruck –


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