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June 21, 2017
Great books. (Unsplash/Roman Kraft)
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Written by
Peter Marber
June 21, 2017

College is supposed to help young people prepare for the future. But as headlines warn that automation and technology may change—or end—work as we know it, parents, students, and universities are grappling with a new question: How do you educate a new generation for a world we can’t even imagine?

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of 1,408 technology and education professionals suggested that the most valuable skills in the future will be those that machines can’t yet easily replicate, like creativity, critical thinking, emotional intelligence, adaptability and collaboration. In short, people need to learn how to learn , because the only hedge against a fast-changing world is the ability to think, adapt and collaborate well.

But many American college students may not be learning them at all. In the 2011 book Academically Adrift: Limited Learning on College Campuses , Richard Arum and Jarip Roksa chronicled how few American students really improved cognitively–and learned to learn–during their undergraduate education. Few bachelor’s programs require sufficient amounts of the reading, writing, and discourse needed to develop critical thinking skills. In fact, forty percent of American undergraduates now major in business and management-related subjects, reading mainly textbooks and short articles, and rarely writing a paper longer than three pages. Further, the social bonds and skills formed in college today often center on extracurriculars that have little connection to cognitive development and collaborative problem-solving.

But perhaps instead of reinventing higher education, we can give students what they need for the future by returning to the roots of liberal arts. Consider St. John’s College , America’s third-oldest institution of higher education, founded in 1696. With fewer than 700 students between two campuses in Annapolis and Santa Fe, St. John’s is a bit under the radar. But it’s emerged as one of the most distinctive colleges in the country by maintaining a strict focus on the classics of the Western canon.

The Program

Many fine schools in the US organize classes and curriculum around Western classics, and St. John’s two campuses look much like hundreds of small colleges across America. So what makes St. John’s unique? First, as David Brooks of the New York Times recently wrote , the college has the “courage to be distinct” amid a marketplace of more than 5,000 colleges and universities in the US. A big part of that distinction is due to a strict adherence to its own curated curriculum and teaching methods, know simply as “the Program” implemented back in 1937.

The progestogen is injected into a muscle or under the skin and then is gradually released into the bloodstream. It works mainly by stopping the release of the egg from the ovary (ovulation). It also thickens the mucus made by the neck of the womb (cervix) which forms a mucous plug. This stops sperm getting through to the womb (uterus) to fertilise an egg. It also makes the lining of the womb thinner. This makes it unlikely that any egg that has managed to be fertilised will be able to implant in the womb.

Dr Rosemary Leonard

It is very effective. Between 2-60 women in every 1,000 using it will become pregnant after two years. Compare this to when no contraception is used: more than 800 in 1,000 sexually active women who do not use contraception become pregnant within one year.

Some women find that having unpredictable or irregular periods can be a nuisance. However, if you do develop irregular bleeding while receiving the injection then you should inform your doctor or nurse. You may be able to have your next injection early or be given other treatment to stop the bleeding. Irregular bleeding can sometimes be due to another reason, such as an infection. This may need to be treated.

Apart from changes to periods, side-effects are uncommon. If one or more should occur, they often settle down over a couple of months or so. One possible side-effect is weight gain. This seems to be a particular problem for young women (under 18 years) who are already overweight when they start the injection. Some women also report fluid retention, worsening acne, headaches and breast discomfort. However, there is little evidence to say that the injection causes these symptoms.

The most common reason for women to stop having the injections is because of irregular bleeding.

The injection can lead to some 'thinning' of the bones. This does not usually cause any problems and the bones go back to normal when the injections are stopped. Using injectable contraception for many years might lead to more bone thinning. It is therefore recommended that you have a review every two years with your doctor or nurse. They will discuss if this method is still the best one for you.

Very occasionally, the injection can cause some pain or swelling at the site where the injection was given, particularly with Sayana Press®. You should see your doctor or nurse if you have any signs or symptoms of infection at the site of injection (for example, redness or swelling).

Most women can have the contraceptive injection. Your doctor or family planning nurse will discuss any current and past illnesses. For example, you should not have it if you have recently had breast cancer or have hepatitis .

If you have risk factors for 'thinning' of the bones (osteoporosis) then it is normally advisable to use another method of contraception. Examples of risk factors include:

If you’re interested in a longer, more in-depth article on observational studies, take a look at Gary Taubes long piece in the New York Times a few years ago. I’ve tried to take a little different slant than he did so that my post and his article would cover all the bases.

Cartoon above from: Smith, G. D. et al. Int. J. Epidemiol. 2001 30:1-11

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Hi Dr Eades,

I love your sense of humour and how you write. I was already beginning to chuckle out loud at the start of this blog when you wrote “To demonstrate my profound gratitude for all the blog topic selections, I’m going to put up a post that absolutely no one asked for.” ! And later I just had to start reading the blog out to my husband so he could laugh. So funny when you commented “we would all probably be a lot better off if all the researchers doing observational studies had followed my lead and fallen asleep mid study.”

You explain things so well and make your points in these very amusing ways….and then the very serious ending that studies on cholesterol levels are just as observational as that shaving one…very sobering. You are such a good writer ! Why don’t you write some more books ? Why not publish a book of your blogs ? I would buy it right away.

all the best, Anne

Reply
says:

Wouldn’t you say that astronomy is a science based upon observational studies?

Although one may make hypothesis based upon the finding, I would think it quiet hard to do an experiment on the solar system. Yet we have learned a lot from the observational studies, to the degree that we were able to design a space program.

I don’t like to throw out observation studies simply because we cannot do an experiment on the findings.

Reply
says:

Dr. Mike, I read a very fascinating article here about low carb diets and the breathalizer. Are you familiar with the hcg diet? I have a question for you and wondered if I can contact you directly? Donna

Reply
says:

Once again, great post. You’re quite the wordsmith. When I grow up I want to write like you do!

I find that counting backwards from infinity helps me go to sleep….

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And by “cover all the bases” you mean everything you could think of?

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This reminds me of an old observational study, French I think, which conclusively demonstrated that an untidy socks draw was associated with a significantly better sex life (in males I think, though the improvement may have had a knock on effect for partners).

Before you go and mess up your socks draw; no, it was never tested in an intervention study.

Peter

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Your childhood game sure sounds more interesting than counting sheep!

As far as the media jumping on these studies, am I right in assuming that the majority of the ones they choose to publish are the observational studies, that if we read that “shaving causes heart disease” in the news, that it’s most likely not going to be a legitimate randomized, placebo-controlled trial? How can we know what kind of study it was (it surely won’t be brought out with the news story), where do we go to find out? And where do we find an easily understood synopsis of the trial or study, that the average person can grasp? (Other than asking you for the answers!)

BTW, thanks for the explanation of the differences in these studies. It really does help us to see that we need to take a lot of the media reporting with a huge grain of salt.

Here’s an example.

Analysis of covariance
Animal research, 1:

Animal research, 1: 29–35

natural experiments in, 2:
observational methods in, 2: 885–886 , 949–950
operant conditioning in, 1: , 1649–1650
reporting on, 2:
Rosenthal effect and, 3: 1290–1291
Anonymity of participants, 1:

Anonymity of participants, 1: , , , ,

Confidentiality of participants
ANOVA. See

ANOVA. See

Analysis of variance
APA. See

APA. See

American Psychological Association
APA style. See

APA style. See

American Psychological Association style
A posteriori analysis, 1:

A posteriori analysis, 1:

Post hoc analysis
Post hoc comparisons
A priori Monte Carlo simulation, 1:

A priori Monte Carlo simulation, 1: 37–38

Monte Carlo simulation
Arguments, logical. See

Arguments, logical. See

Inference: deductive and inductive
Arithmetic mean. See

Arithmetic mean. See

Assent, 1:

Assent, 1: 44–46 , , ,

Informed consent
Association, measures of, 1:

Association, measures of, 1: 46–51

chi-square test, 1: ,
correlation analyses, 1: 46–48 , , ,
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Agreement
Causal-comparative design
Cause and effect
Correlation
Interaction
Attenuation. See

Attenuation. See

Correction for attenuation
Attitude measurement. See

Attitude measurement. See

Likert scaling
Theory of attitude measurement
Thurstone scaling
Attrition, 2:

Attrition, 2:

Government Ministries
Government Ministries

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: in accordance with article 17.1 of the Catalan Law 19/2014, the © Government of Catalonia permits the reuse of content and data provided that the source and the date of updating are cited and that the information is not distorted (article 8 of Catalan Law 37/2007) and does not conflict with a specific license.