### Testing and Scores

Bill Gates (so I've read) makes it a point to read magazines or newspapers. Completely. Cover-to-cover. He says he may be tempted to only read the technology or business sections, but then he would be no different than when he started reading. By making himself branch out, he grows.

This is what I love about BIG bookstores. Not all bookstores -- just the proud stores that take up a whole city block. There is usually a token bookstore wedged into your local mall. That's not the same. They hide books there. Sure, they put up a small display with this week's best sellers, but the other books are lined up one after the other in narrow aisles and shelves that scale eight feet up the wall. Browsing is not encouraged. If you don't know exactly what you're looking for, good luck.

The big stores are different. Tables are scattered about with stacks of books displaying their whole cover. Displays create all sorts of groupings: local authors, memoirs, memoirs made into films, memoirs exposed as fictions, and so on.

It was one of these tables where I found a curious pair of books. The theme on this table was, "Buy 1, Get 1 for Half Price." I found two books written by Atul Gawande, a general surgeon with a long resume. The books, Complications: A Surgeon's Notes on an Imperfect Science, and Better: A Surgeon's Notes on Performance, at first made me think of Robert Sacks' books of case studies. I expected intriguing stories of the human body's complexities, but instead I found something deeper. Dr. Gawande explores the issues facing medical professionals -- continuing education, ethics, malpractice, communication, etc. And, of course, we discover that doctors face the same basic issues as other professionals.

He describes how the Apgar score revolutionized obstetrics and increased survival rates among newborns. If you've watched a few episodes of er, you've seen the Apgar score in action. A baby is scored on a 10-point scale based on color, breathing, crying, movement, and heart rate. Dr. Gawande describes the result as the scoring system was widely accepted:

...[T]he score turned an intangible and impressionistic clinical concept--the condition of new babies--into numbers that people could collect and compare. Using it required more careful observation and documentation of the true condition of every baby. Moreover, even if only because doctors are competitive, it drove them to want to produce better scores--and therefore better outcomes--for the newborns they delivered. ... The Apgar score changed everything. It was practical and easy to calculate, and it gave clinicians at the bedside immediate feedback on how effective their care was.So, was this a sort of "No Newborn Left Behind" that hospitals implemented beginning in 1953? There are some curious similarities. Dr. Gawande asserts that the score has resulted in a sort of industrialization of obstetrics. Instead of training doctors on techniques that require specialization and an artisan's skill, they rather teach options that are simpler and can be more widely applied. The result is lower death rates and many more Caesarian sections.

I would assert that standardized basic skills tests have some parallels. Teachers now focus on methods that will bring the greatest number of students to the level deemed, "acceptable." For the Apgar score, an infant is acceptable if he or she exhibits that signs that indicate a significant chance at survival. On the NCLB score, a student is acceptable if... well, that varies.

The Apgar is easily measured because it tests essential skills: Can you breathe? Can you move all four limbs? The Texas 8th-grade Math TAKS is difficult to measure because it tests 48 different skills at many different levels of thinking. Everything from, Can you add decimals? to Can you describe how the Pythagorean Theorem is applied to architecture? While the Apgar uses the same five questions to rate each newborn in a matter of seconds, the 8th-grade TAKS uses a selection of 50 questions (interspersed with 10 non-scored questions) over the course of several hours to rate each 13-year-old student.

It has changed how teachers teach. Educators do strive to get each student to that "acceptable" level. There is certainly a competition to improve your school's numbers. There is a focus on the methods that are proven to work. There is another side to the story. The attention on scoring is intense. And, of course, there is the question of what to test. I am concerned when students are deemed acceptable according to a NCLB assessment, but they can't divide.

I would love to see an assessment that measures a handful of essential math skills: add decimals with whole numbers, subtract with borrowing, multiply decimals, divide and round. By 8th grade we should also convert fractions to decimals and work with negative numbers. These are the skills that are most likely to make a student successful in high school mathematics, and these skills are easily, quickly assessed. The study of these skills can explore meaningful mathematics that is immediately applicable to a student's life.

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