DOI 10.1515/jpm-2014-0009 J. Perinat. Med. 2014; 42(3): 269–271
Academy’s Corner Asim Kurjak*
Global education in perinatal medicine: will the bureaucracy or smartocracy prevail? *Corresponding author: Asim Kurjak, Vice-President of International Academy of Perinatal Medicine, Rector of DIU Libertas International University, J.F. Kennedy square 6b, 10000 Zagreb, Croatia, E-mail: [email protected]
Human beings change continuously as the result of biological and cultural evolutions. Human beings change the world they live in, indeed so much so that it has been suggested that the current geological epoch be named the Anthropocene epoch [6]. As knowledge now increases exponentially with a doubling time of 5–10 years, education cannot be time limited, it has to be life-long. The Millennium Development Goals state that by the year 2015 everybody should be educated [8]. Perinatal education is not an ectopic part of global education, it is its integral part. Indeed, contemporary education is education of a person that is changing and for the world that rapidly changes. Globalization has a complex influence on perinatal health. The bonds that link perinatologists together transcend geographic, political, religious, and lingual differences, resulting in a globalization that optimizes perinatal care [2–4]. However, more than ever we need to develop education and training for physicians who provide the care and research in perinatal medicine. The USA developed its own system. The American College of Obstetrics and Gynecology is responsible for the education and practice standard. In the UK, the Royal College of Obstetricians and Gynaecologists has the unique position of providing education, developing standards, and determining how many specialists and sub-specialists are trained. In other countries, there are various levels of development and planning. The European Board and College of Obstetrics and Gynaecology, for instance, are working on the accreditation of European hospitals, not only for obstetrics and gynecology standards of care, but also for setting the training and teaching rules or the subspecialties, such as maternal fetal and perinatal medicine, reproductive medicine, gynecological oncology, and urogynecology. There is, therefore, enormous need for the advanced medical education and health care delivery systems to serve as
models for developed and developing countries. To this end, the World Association of Perinatal Medicine and the International Academy of Perinatal Medicine serve as leading organizations that could become a major perinatal force for the further improvement of perinatal care throughout the developing world. Congresses of perinatal medicine in developing countries are excellent examples of how all of these ideas can be put into practice [2].
Global requirements of education The triangle of knowledge in modern society is composed of education, research, and patents [9]. A country aspiring to a good standing in the international arena should perform well in all three corners of this triangle. Governments, universities, and firms together spend around $1.4 trillion a year on research and development, more than ever before. World trends in knowledge and new idea creation demonstrate that the EU has overtaken the US in idea creation but is still lagging behind in patents and applied ideas. Asian countries are closing the gap rapidly and the world knowledge scene is witnessing an extremely competitive and interdependent race [5]. An overview [5] of published articles in 2009 shows that the EU is still a world leader in scientific articles published with 31% of the total production followed by the USA on 26.5%, China on 9.4%, with Japan on 6.3%, and South Korea on 2.8%. In the last decade, Iran and China have had fastest growth of 25% and 16%, respectively, although this was from a low base, followed by Turkey and South Korea with 10%. The EU had growth of 1.4% while the USA had 1%. When it comes to citations, in 2010, the USA was the leader with 36.4%, the EU was in second place with 32.8%, and China was in third place with 6%, followed by Japan 5.7%. This citation indicator, together with the well-known fact that the EU has been following the USA in number of patents for years, clearly demonstrate that transfer speed, into patents and operational and economic value, of EU articles is still lagging behind the effectiveness of the USA [9].
270 Kurjak, Global education in perinatal medicine There are many obstacles present, some of them being typical for the EU, that is, bureaucracy and untimely action. International universities represent a new update to globalization. Universities should think globally. They should use €400 million per year that the EU will make available to European universities to strengthen their collaboration with partners worldwide from January 2014. Every year, 45% of the 4 million international students come to study in Europe. EC estimates are that by 2030, there will be about 400 million higher education students, and by 2020, there will be 7 million mobile students. The Europe 2020 strategy is about delivering growth that is: (i) smart, through more effective investments in education, research and innovation; (ii) sustainable, thanks to a decisive move towards a low-carbon economy; and (iii) inclusive, with a strong emphasis on job creation and poverty reduction. The strategy is focused on five ambitious goals in the areas of employment, innovation, education, poverty reduction, and climate/energy. Unlike the past, the Europe 2020 strategy has a strong and effective system of economic governance that has been set up to coordinate policy actions between the EU and national levels to ensure that the Europe 2020 strategy delivers. Therefore, we have to go humbly back to the basics at individual and society level and remember that creativity is based on playing with things and ideas. Society with time resistant and rigid education systems, red tape, and oceans of rules, often helps us to grow out of creativity instead of growing into creativity. This sensitive bird called creativity should not be kept in a cage but seduced from distance with patience and nice songs. Only then, can the happy inventor tape her voice and sell it to the market for other people to enjoy, business to make profit, and the state to prosper. Only then, smartocracy prevails [9]. How much of what we formally learn is ever useful in real life? Some studies show that it is only between 8%–12% [7]. The existing educational system is not very useful as far as the quality of its outcome is concerned. Education is slow in moving from bureaucracy towards entrepreneurship and creativity. Separation between learning and working should be abandoned. Learning is important, but so is unlearning; teachers must be able to teach the rational material in a cool and inspirational way. The students should be trained for attitude, not just knowledge and skills; education must reestablish the lost connection between art and science, wisdom and practicality. Education should go lower on theory, and higher on applicability. If we want to create a better educational system, changing culture is by far more important than changing curricula.
Metaphorically speaking, education systems must re-embrace the real transdisciplinarity, the notion that everything is both art and science, wisdom and pragma. Education and training aimed at producing insensitive and professional “fach-idiots” must give way to multidisciplinary concepts aimed at producing a good, competent person with empathy and social responsibility. Finally, there is a tendency in education to be too “scientific”, which most often means a lack of applicability. To paraphrase Albert Einstein, there is nothing more practical than good theory. Too many obsolete and old-fashioned theories are still central parts of curricula. The educational systems of the future will be more successful if they manage to go low on (irrelevant) theory and higher on useful practice. We enjoy seeing things clearly. We like our (educational) world to be structured, organized, rational, and predictable. The reality, however, seems to be quite different. More often than not, our clear images fail us and we end up being confused. Creativity is defined as an ability to solve complex problems in an original way; likewise, it is an ability to produce ideas. Conversely, innovation can be described as applied creativity or successful implementation of ideas. What do we do wrong in problem solving and education? We serve solutions, approaches, and concepts to students to memorize, and not to challenge and reinvent. Creativity means freedom and lack of creativity equals a lack of freedom. Instead of learning by studying, we must go back to the traditional idea of learning by doing, experiencing, and creating. We keep talking about life-long learning, but in practice, the concept is far from being operational. First, a separation between learning and working is not natural. The “students” of the future should work and study throughout their lifetime, and not, as it is now often the case, spend decades “studying”, and then, after earning a diploma, move into the practical world and spend the rest of their life “working”. The EU has come up with a new framework called “Education and Training 2020” (ET 2020) [1]. The document points out four strategic objectives: (i) making lifelong learning and mobility a reality, progress is needed in the implementation of lifelong learning strategies; (ii) improving the quality and efficiency of education and training, all levels of education and training need to be made more attractive and efficient; (iii) promoting equity, social cohesion and active citizenship, education and training should enable all citizens to acquire and develop skills and competencies needed for their employability and foster further learning; and (iv) enhancing creativity and innovation, including
Kurjak, Global education in perinatal medicine 271
entrepreneurship, at all levels of education and training. The acquisition of transversal competences by all citizens should be promoted and the functioning of the knowledge triangle (education-research-innovation) should be ensured. It is puzzling as to what kind of education system gave us Plato, Aristotle, Archimedes, and Socrates? [10]. Their teachings make the base of our civilization. Many of us wondered how this had happened, when they did not have schools, black boards, computers, or notebooks. Why is the model of education better in the USA than in rest of the world, especially Europe? The USA has never had a clear model of education, exclusively oriented to technical knowledge and economic growth. Can this model be appropriate for the globalization age, which is necessarily being developed? Can people with pure “technical knowledge”, without humanistic education be “the citizens of the world”? Is Samuel Huntington correct when he writes about a “clash of civilization”? In other words, is today’s education system the base of this clash of civilization? It seems that the world lies, not only on a nuclear bomb, but on an “education bomb” as well. The fact that the USA has never had an education system, which is clearly oriented to one specific profession, has made the US education system superior over education systems in the rest of the world, especially Europe. The USA had and still has the model of free skills built-in education systems; instead of specializing for one particular field, students are required to take different
humanities courses. In addition to it, students are put in a position to examine facts and make research. In order to understand this approach, a reader has to learn two starting points [10]. First, knowledge is individual; it is spread in the head of individuals. There is no such thing as the collective knowledge. This is emphasizing the role of the individual in the education system, that is, the need of education system to focus on an individual. Secondly, how can we understand knowledge from the perspective of individual and individual competences? In my opinion, knowledge is everything we have taken from other people. Knowledge is not something that comes out of us; we are taking it from other people. We adopted our knowledge about relativity theory from Einstein; Pythagoras’s theorem from Pythagoras; knowledge about class struggle is taken from Marx; our knowledge about lighting rods comes from Benjamin Franklin. Thomas Man said, “all I know is not mine, but it is mine”. Education encompasses teaching and learning of knowledge, acquiring skills and values as well as mental, moral, and aesthetic development of human beings. A right to education is one of the basic human rights as declared by the United Nations Universal Declaration of Human Rights. Education has to focus primarily on how to research, how to ask questions, to stimulate participants to propose new, out-of-the-box ideas, often sounding crazy. Education has to stimulate paradigmatic changes, to think the unthinkable. Most important is that education is intellectually stimulating, fun, and a pleasure [6].
References [1] Education and Training 2020 (ET 2020). http://europa.eu/ legislation_summaries/education_training_youth/general_ framework/ef0016_en.htm. Accessed December, 2013. [2] Kurjak A, Di Renzo GC, Stanojevic M. Globalization and perinatal medicine – how do we respond? J Matern Fetal Neo Med. 2010:23:286–96. [3] Kurjak A, Dudenhausen J, Chervenak FA. Does globalization and change demand a different kind of perinatal research. J Perinat Med. 2008;36:273–5. [4] Kurjak A, Stavljenic Rukavina A, Zaputovic S, Stanojevic M, Raic N, Zuzul M. Higher education internationalization: DIU Libertas response. Donald School J Ultrasound Obstet Gynecol. 2013;7:231–8. [5] National Science Board. Science and Engineering Indicators 2012. Arlington National Science Foundation; 2012.
[6] Slaus I. Entering global knowledge society: role of education. Donald School J Ultrasound Obstet Gynecol. 2013;7:239–47. [7] Srica V. Ten deadly sins of education. Donald School J Ultrasound Obstet Gynecol. 2013;7:261–7. [8] The EFA Global Monitoring Report Team. EFA Global monitoring report 2008. UNESCO; 2008. [9] Turcinovic P. EU knowledge triangle: renaissance or ocean of papers? Donald School J Ultrasound Obstet Gynecol. 2013;7:272–7. [10] Vukotic V. Why S = z.i2? Donald School J Ultrasound Obstet Gynecol. 2013;7:313–22.
The author stated that there are no conflicts of interest regarding the publication of this article.
Copyright of Journal of Perinatal Medicine is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
Academy’s Corner Asim Kurjak*
Global education in perinatal medicine: will the bureaucracy or smartocracy prevail? *Corresponding author: Asim Kurjak, Vice-President of International Academy of Perinatal Medicine, Rector of DIU Libertas International University, J.F. Kennedy square 6b, 10000 Zagreb, Croatia, E-mail: [email protected]
Human beings change continuously as the result of biological and cultural evolutions. Human beings change the world they live in, indeed so much so that it has been suggested that the current geological epoch be named the Anthropocene epoch [6]. As knowledge now increases exponentially with a doubling time of 5–10 years, education cannot be time limited, it has to be life-long. The Millennium Development Goals state that by the year 2015 everybody should be educated [8]. Perinatal education is not an ectopic part of global education, it is its integral part. Indeed, contemporary education is education of a person that is changing and for the world that rapidly changes. Globalization has a complex influence on perinatal health. The bonds that link perinatologists together transcend geographic, political, religious, and lingual differences, resulting in a globalization that optimizes perinatal care [2–4]. However, more than ever we need to develop education and training for physicians who provide the care and research in perinatal medicine. The USA developed its own system. The American College of Obstetrics and Gynecology is responsible for the education and practice standard. In the UK, the Royal College of Obstetricians and Gynaecologists has the unique position of providing education, developing standards, and determining how many specialists and sub-specialists are trained. In other countries, there are various levels of development and planning. The European Board and College of Obstetrics and Gynaecology, for instance, are working on the accreditation of European hospitals, not only for obstetrics and gynecology standards of care, but also for setting the training and teaching rules or the subspecialties, such as maternal fetal and perinatal medicine, reproductive medicine, gynecological oncology, and urogynecology. There is, therefore, enormous need for the advanced medical education and health care delivery systems to serve as
models for developed and developing countries. To this end, the World Association of Perinatal Medicine and the International Academy of Perinatal Medicine serve as leading organizations that could become a major perinatal force for the further improvement of perinatal care throughout the developing world. Congresses of perinatal medicine in developing countries are excellent examples of how all of these ideas can be put into practice [2].
Global requirements of education The triangle of knowledge in modern society is composed of education, research, and patents [9]. A country aspiring to a good standing in the international arena should perform well in all three corners of this triangle. Governments, universities, and firms together spend around $1.4 trillion a year on research and development, more than ever before. World trends in knowledge and new idea creation demonstrate that the EU has overtaken the US in idea creation but is still lagging behind in patents and applied ideas. Asian countries are closing the gap rapidly and the world knowledge scene is witnessing an extremely competitive and interdependent race [5]. An overview [5] of published articles in 2009 shows that the EU is still a world leader in scientific articles published with 31% of the total production followed by the USA on 26.5%, China on 9.4%, with Japan on 6.3%, and South Korea on 2.8%. In the last decade, Iran and China have had fastest growth of 25% and 16%, respectively, although this was from a low base, followed by Turkey and South Korea with 10%. The EU had growth of 1.4% while the USA had 1%. When it comes to citations, in 2010, the USA was the leader with 36.4%, the EU was in second place with 32.8%, and China was in third place with 6%, followed by Japan 5.7%. This citation indicator, together with the well-known fact that the EU has been following the USA in number of patents for years, clearly demonstrate that transfer speed, into patents and operational and economic value, of EU articles is still lagging behind the effectiveness of the USA [9].
270 Kurjak, Global education in perinatal medicine There are many obstacles present, some of them being typical for the EU, that is, bureaucracy and untimely action. International universities represent a new update to globalization. Universities should think globally. They should use €400 million per year that the EU will make available to European universities to strengthen their collaboration with partners worldwide from January 2014. Every year, 45% of the 4 million international students come to study in Europe. EC estimates are that by 2030, there will be about 400 million higher education students, and by 2020, there will be 7 million mobile students. The Europe 2020 strategy is about delivering growth that is: (i) smart, through more effective investments in education, research and innovation; (ii) sustainable, thanks to a decisive move towards a low-carbon economy; and (iii) inclusive, with a strong emphasis on job creation and poverty reduction. The strategy is focused on five ambitious goals in the areas of employment, innovation, education, poverty reduction, and climate/energy. Unlike the past, the Europe 2020 strategy has a strong and effective system of economic governance that has been set up to coordinate policy actions between the EU and national levels to ensure that the Europe 2020 strategy delivers. Therefore, we have to go humbly back to the basics at individual and society level and remember that creativity is based on playing with things and ideas. Society with time resistant and rigid education systems, red tape, and oceans of rules, often helps us to grow out of creativity instead of growing into creativity. This sensitive bird called creativity should not be kept in a cage but seduced from distance with patience and nice songs. Only then, can the happy inventor tape her voice and sell it to the market for other people to enjoy, business to make profit, and the state to prosper. Only then, smartocracy prevails [9]. How much of what we formally learn is ever useful in real life? Some studies show that it is only between 8%–12% [7]. The existing educational system is not very useful as far as the quality of its outcome is concerned. Education is slow in moving from bureaucracy towards entrepreneurship and creativity. Separation between learning and working should be abandoned. Learning is important, but so is unlearning; teachers must be able to teach the rational material in a cool and inspirational way. The students should be trained for attitude, not just knowledge and skills; education must reestablish the lost connection between art and science, wisdom and practicality. Education should go lower on theory, and higher on applicability. If we want to create a better educational system, changing culture is by far more important than changing curricula.
Metaphorically speaking, education systems must re-embrace the real transdisciplinarity, the notion that everything is both art and science, wisdom and pragma. Education and training aimed at producing insensitive and professional “fach-idiots” must give way to multidisciplinary concepts aimed at producing a good, competent person with empathy and social responsibility. Finally, there is a tendency in education to be too “scientific”, which most often means a lack of applicability. To paraphrase Albert Einstein, there is nothing more practical than good theory. Too many obsolete and old-fashioned theories are still central parts of curricula. The educational systems of the future will be more successful if they manage to go low on (irrelevant) theory and higher on useful practice. We enjoy seeing things clearly. We like our (educational) world to be structured, organized, rational, and predictable. The reality, however, seems to be quite different. More often than not, our clear images fail us and we end up being confused. Creativity is defined as an ability to solve complex problems in an original way; likewise, it is an ability to produce ideas. Conversely, innovation can be described as applied creativity or successful implementation of ideas. What do we do wrong in problem solving and education? We serve solutions, approaches, and concepts to students to memorize, and not to challenge and reinvent. Creativity means freedom and lack of creativity equals a lack of freedom. Instead of learning by studying, we must go back to the traditional idea of learning by doing, experiencing, and creating. We keep talking about life-long learning, but in practice, the concept is far from being operational. First, a separation between learning and working is not natural. The “students” of the future should work and study throughout their lifetime, and not, as it is now often the case, spend decades “studying”, and then, after earning a diploma, move into the practical world and spend the rest of their life “working”. The EU has come up with a new framework called “Education and Training 2020” (ET 2020) [1]. The document points out four strategic objectives: (i) making lifelong learning and mobility a reality, progress is needed in the implementation of lifelong learning strategies; (ii) improving the quality and efficiency of education and training, all levels of education and training need to be made more attractive and efficient; (iii) promoting equity, social cohesion and active citizenship, education and training should enable all citizens to acquire and develop skills and competencies needed for their employability and foster further learning; and (iv) enhancing creativity and innovation, including
Kurjak, Global education in perinatal medicine 271
entrepreneurship, at all levels of education and training. The acquisition of transversal competences by all citizens should be promoted and the functioning of the knowledge triangle (education-research-innovation) should be ensured. It is puzzling as to what kind of education system gave us Plato, Aristotle, Archimedes, and Socrates? [10]. Their teachings make the base of our civilization. Many of us wondered how this had happened, when they did not have schools, black boards, computers, or notebooks. Why is the model of education better in the USA than in rest of the world, especially Europe? The USA has never had a clear model of education, exclusively oriented to technical knowledge and economic growth. Can this model be appropriate for the globalization age, which is necessarily being developed? Can people with pure “technical knowledge”, without humanistic education be “the citizens of the world”? Is Samuel Huntington correct when he writes about a “clash of civilization”? In other words, is today’s education system the base of this clash of civilization? It seems that the world lies, not only on a nuclear bomb, but on an “education bomb” as well. The fact that the USA has never had an education system, which is clearly oriented to one specific profession, has made the US education system superior over education systems in the rest of the world, especially Europe. The USA had and still has the model of free skills built-in education systems; instead of specializing for one particular field, students are required to take different
humanities courses. In addition to it, students are put in a position to examine facts and make research. In order to understand this approach, a reader has to learn two starting points [10]. First, knowledge is individual; it is spread in the head of individuals. There is no such thing as the collective knowledge. This is emphasizing the role of the individual in the education system, that is, the need of education system to focus on an individual. Secondly, how can we understand knowledge from the perspective of individual and individual competences? In my opinion, knowledge is everything we have taken from other people. Knowledge is not something that comes out of us; we are taking it from other people. We adopted our knowledge about relativity theory from Einstein; Pythagoras’s theorem from Pythagoras; knowledge about class struggle is taken from Marx; our knowledge about lighting rods comes from Benjamin Franklin. Thomas Man said, “all I know is not mine, but it is mine”. Education encompasses teaching and learning of knowledge, acquiring skills and values as well as mental, moral, and aesthetic development of human beings. A right to education is one of the basic human rights as declared by the United Nations Universal Declaration of Human Rights. Education has to focus primarily on how to research, how to ask questions, to stimulate participants to propose new, out-of-the-box ideas, often sounding crazy. Education has to stimulate paradigmatic changes, to think the unthinkable. Most important is that education is intellectually stimulating, fun, and a pleasure [6].
References [1] Education and Training 2020 (ET 2020). http://europa.eu/ legislation_summaries/education_training_youth/general_ framework/ef0016_en.htm. Accessed December, 2013. [2] Kurjak A, Di Renzo GC, Stanojevic M. Globalization and perinatal medicine – how do we respond? J Matern Fetal Neo Med. 2010:23:286–96. [3] Kurjak A, Dudenhausen J, Chervenak FA. Does globalization and change demand a different kind of perinatal research. J Perinat Med. 2008;36:273–5. [4] Kurjak A, Stavljenic Rukavina A, Zaputovic S, Stanojevic M, Raic N, Zuzul M. Higher education internationalization: DIU Libertas response. Donald School J Ultrasound Obstet Gynecol. 2013;7:231–8. [5] National Science Board. Science and Engineering Indicators 2012. Arlington National Science Foundation; 2012.
[6] Slaus I. Entering global knowledge society: role of education. Donald School J Ultrasound Obstet Gynecol. 2013;7:239–47. [7] Srica V. Ten deadly sins of education. Donald School J Ultrasound Obstet Gynecol. 2013;7:261–7. [8] The EFA Global Monitoring Report Team. EFA Global monitoring report 2008. UNESCO; 2008. [9] Turcinovic P. EU knowledge triangle: renaissance or ocean of papers? Donald School J Ultrasound Obstet Gynecol. 2013;7:272–7. [10] Vukotic V. Why S = z.i2? Donald School J Ultrasound Obstet Gynecol. 2013;7:313–22.
The author stated that there are no conflicts of interest regarding the publication of this article.
Copyright of Journal of Perinatal Medicine is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
