Monday, July 26, 2010

Dunning-Kruger: Pre Med Students

This is a continuation of the post here on the Dunning-Kruger effect, which can be summarized as follows:

"When people are incompetent in the strategies they adopt to achieve success and satisfaction, they suffer a dual burden: Not only do they reach erroneous conclusions and make unfortunate choices, but their incompetence robs them of the ability to realize it."

In order to ground our discussion of the Dunning-Kruger effect and show its practical side, it is time to make the effect personal. One of the many things I do to earn money is teach MCAT, the standardized test all medical school students take, a sort of SAT for the pre-med. The MCAT is broken into three parts, a verbal part, a physical sciences part which tests the students' knowledge of two semesters of college chemistry and two of physics, and a biological sciences part which tests the easier parts of about seven semesters of college organic chemistry and a variety of biology disciplines. Each section is scored from 1-15 for a possible total of 45 points. Generally 10's on each section, a 30, is required to get into a decent school. A score lower than a thirty or a poor split (i.e. 11/11/8) often relegates a student to a lesser school, some of which only grant a DO degree (Doctor of Osteopathy) instead of an MD. (You'd be surprised how many general practitioners, the doctor you're most likely to see first in the course of an illness, do not have an MD.)

I get a wide swath of students. The best come in scoring about a 30, while the worst come in scoring about a 15. The majority sit right around 24. This most common type of student would probably score about a 27 if she studied on her own outside of a formal review course. She's right on the cusp. She knows she isn't the smartest student, she knows she needs help and that's usually why she's signed up for the course I teach.

In my years teaching MCAT, I've observed a strange phenomenon. My students work very hard, they are very motivated. They really want to become doctors, to the point that they're willing to devote eight hours a day for a whole summer and $2000 or more to getting into medical school. But the most common outcome for this student who comes in scoring a 24, and who could score a 27 studying on her own, is that she scores a 28. The smallest of improvements. Watching this story play out course after course has led me to wonder what's going wrong, why is the course not helping a student who is so motivated to succeed?

Before I answer that, let me discuss the students who come in scoring a 30 or a 15. The typical student who comes in scoring a 30 is a good student who really doesn't need my class to get into medical school, but who prefers the structure of a class to studying on her own. She asks few questions during lectures, nods her head often, is less stressed then everyone else, and typically scores about a 36 on the real MCAT, an impressive 6 point improvement, all the more impressive because she has less to learn. In other words, the student who goes from a 24 to a 28 does so by improving on medium difficulty questions whereas the one who goes from 30 to 36 learns to answer the difficult questions right.

On the other side of the equation is the student who comes in scoring a 15. This student usually doesn't end up taking the MCAT. He will end the course still scoring about a 15, realize that it isn't good enough, and decide to save the $200 test fee. The typical 15-scorer always comes to any extra help sessions I give and sometimes even takes the course again. From what I can gather, motivation is not the issue for this student.

Thinking about the best and the worst students in my class has led me to realize is that most students who come in scoring a 24 think that they are not getting the score they want either because they need more practice or because they don't know the material well enough. Depending on their perception, they will either spend countless doing practice exams and practice questions or spend countless hours studying. They are partially right, and that is why they improve from a 24 to a 28. But they are mostly wrong. What they miss is that there is some deficiency either in the way they take a test or the way they study. It is not a matter of practice, but a matter of approach. Almost all of them are poor problem solvers. Some calculate carelessly. Others read the questions too fast and answer a different question than the one they are asked. Others lack confidence, or have jumpy minds, and are always second-guessing the answer they get. Many have poor reading comprehension, they study the textbooks but the information doesn't get into their head. Or they don't understand that reading and memorization are different tasks and mistakenly assume that if they read everything, of course they must know it.

Thus, the problems these students face are entirely results of a sophisticated form of the Dunning-Kruger effect. They know, as they should, that their scores are lacking. But they assume the flaw is that they are not working hard enough. This assessment leads them in a circle. When their score doesn't improve, they simply put their head down and decide they must work harder still. However, what they need is to change the way they work, to lift their head up and learn to work smarter instead of harder. This is what they should know, but don't.

Hopefully that is where I come in, but it is not easy to get them to make the next step. These students have been at the back of the pre-med pack for three or four years of college. They know there are students who are more advanced than they are but often they've chalked it up to simply not being as smart as those other students. They need to have it rammed into their heads that those other kids aren't any smarter, intrinsically, they just know how to learn. They need to be reached by someone, hopefully me, who can teach them the best methods to solve problems, how to read and retain information better, exactly which pieces of information must be memorized. They need, in other words, to re-evalute their self-image and to re-learn how to learn. It is not easy, it is not the work for a single course. Still, if they succeed, they will be better for the rest of their lives. Med school will be easier for them, they will become better doctors, hopefully they will even become better citizens.

That is my analysis of my students. In a reassuring yet forceful manner, I try to convey my observations to them, to point out to them that the reason they continue to perform poorly despite hard work is a flaw in they way they evaluate themselves. My results are, to say the least, mixed. Next time, I'll explain how, despite understanding what is going on, as a teacher I too am caught up in the Dunning-Kruger effect and its consequences.

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