Fast and Slow Ideas

On igniting change

Two major revolutions in medicine took off in the 1800s: one fast and one slow. 

In October 1846, recounts MacArthur Genius surgeon-writer Atul Gawande, Henry Jacob Bigelow used an ether-based gas to put a man to sleep and surgically removed a tumor from his patient’s jaw. That patient remarkably didn’t make a fuss. 

Prior to that moment, surgery patients would writhe, flail, and scream in pain while a surgeon performed a procedure as rapidly as possible. Bigelow published his report and within eight months, nearly every region of the world was utilizing some form of anesthesia. That was one fast idea!

But good ideas can also be slow to catch on. During that same period, in 1867, Edinburgh surgeon Joseph Lister had figured out a way to combat the biggest killer in medicine: sepsis (and yes, your mouthwash is named after him). 

A rational person would assume that Lister’s groundbreaking antiseptic method would have taken off just as anesthesia had. But it didn’t. Even twenty years after his journal article, some doctors still wouldn’t wash their hands before surgery. Another 60 to 70 years would pass before antisepsis was taken seriously. 

I first learned about this concept of slow ideas from Eric Mazur, a Harvard physics professor responsible for spearheading peer instruction, a method by which students gain mastery of subject matter by teaching their classmates. 

Mazur has flipped his classroom so that students read through the materials that Mazur used to present during his lecture—before class. When they come to class, Mazur poses questions and has his students find someone else in the classroom with a different answer. That student must then try to convince the other of what they believe is the correct answer. They repeat this process over and over again. 

It turns out that the students who correctly understand the concept win over their peers because they’re even better teachers than the professor himself. Their recent grasp of new knowledge enables them to explain concepts better to one another. 

Mazur created this method when in the middle of a semester, a student raised his hand and asked a question that made it obvious that he had not understood any of the fundamental concepts from the first week of class. That was a lightbulb moment for Mazur: Everything he thought he knew about teaching went out the window. 

Since switching to peer instruction, Mazur has been able to demonstrate a tripling of learning gains for his students. When I asked Mazur why more professors at Harvard don’t use peer instruction in their classrooms, he brought up Gawande’s essay and this concept of slow ideas:

Only one of those two problems makes life better for the surgeon: the anesthesia. If I have to operate on somebody and that person is kicking and screaming, it’s no fun. If that person is asleep and all of a sudden, I can focus on what I’m doing, it’s much better, right? 

So, translate that to education. It’s like hygiene, right? [Sub-par teaching is] going to affect my students 40 years from now, 20 years from now, or however many years, right? It’s not in my face. Why would I change anything? What is the incentive for changing? … There’s very little incentive because of the system we have. And unfortunately, it’s true from community colleges to research-one universities like Harvard. What incentive is there to change? 

How fast or slowly ideas catch on depends on who is being affected. And in academia, there is zero incentive for a professor to change what has been working just fine. Why would a professor de-prioritize seeking funding or writing journal articles or books for tenure and promotion—the equivalent of the screaming patient—in favor of the invisible problem of how new teaching methods translate into profound learning gains? Professors have little to gain from overhauling their courses. 

Change could mean risking failure. How well students can grasp and apply new knowledge is not even part of an instructor’s performance evaluation. In fact, when students get Cs, Ds, or Fs, or withdraw, that’s not the professor’s fault; that’s on the students. There’s no urgency in “solv[ing] a problem that is not in [their] face yet.”

We respond slowly to problems that are invisible to us.

Indeed, we are responding very slowly to a huge, invisible problem coming fast upon us. The number of enrollments of traditional 18- to 24-year-old students is plateauing, and in many states, dwindling. We’ve known for a long time now that there will be an enrollment cliff in the mid-2030s. There will not be enough butts to fill the seats of our 4,000+ colleges and universities in the U.S. 

Are we doing anything about it? Are we changing our methods and services to attend to a larger universe of adult learners who are going to need to skill up and retool for an ever-evolving future of work? Are we transforming our methods of engaging learners and cultivating the best problem solvers in the world to contend with AI that will only advance exponentially over time?

I think we know the answers. 

Even Mazur, who has been using the peer instruction method for over 25 years now, demurs at the innovativeness of his own model, sharing, “What I’d actually done was take a very failed approach—the lecture—and put a band-aid over it. Yes, the improvement was pretty dramatic, but it was still a band-aid.” 

We know that whenever humans solve any problem in the world, our problem-solving chops must cut across disciplines. We, as learners, therefore, need to build the habits of mind that help us stretch and transfer concepts across disciplinary boundaries. 

So, the question is: Are we going to move fast or slow?

My sincere thanks to Professor Eric Mazur for these extended interviews that took place in the spring of 2019 in Cambridge, MA.