Today’s Focus on STEM Education Is Missing A Crucial Point
A student in a contemplative pose.
I once saw a fascinating TED talk on 3D printing. As I watched the presenter discuss the custom fabrication, not of plastic gears or figurines, but of living, implantable kidneys, I thought I was finally living in the world of Star Trek, and I experienced a flush of that eager, expectant enthusiasm I felt as a child looking toward the future. I looked at my current career and felt a rejuvenation of my commitment to teach young people the power of science.
The well-rounded education of human beings needs to include lessons learned both from a study of the physical world, and from a study of humanity.
Whether we are teachers or not, those of us who admire technology and innovation, and who wish to support progress, usually embrace the importance of educating the next generation of scientists and inventors. Growing a healthy technological civilization takes a lot of work, skill, and wisdom, and its continued health depends on future generations of competent thinkers. Thus, we may find it encouraging that there is currently an abundance of interest in STEM– the common acronym for the study of science, technology, engineering, and math.
But education is as challenging an endeavor as science itself. Educating youth--if we want to do it right--requires as much thought, work, and expertise as discovering a cure or pioneering regenerative medicine. Before we give our money, time, or support to any particular school or policy, let's give some thought to the details of the educational process.
A Well-Balanced Diet
For one thing, STEM education cannot stand in isolation. The well-rounded education of human beings needs to include lessons learned both from a study of the physical world, and from a study of humanity. This is especially true for the basic education of children, but it is true even for college students. And even for those in science and engineering, there are important lessons to be learned from the study of history, literature, and art.
Scientists have their own emotions and values, and also need financial support. The fruits of their labor ultimately benefit other people. How are we all to function together in our division-of-labor society, without some knowledge of the way societies work? How are we to fully thrive and enjoy life, without some understanding of ourselves, our motives, our moral values, and our relationships to others? STEM education needs the humanities as a partner. That flourishing civilization we dream of requires both technical competence and informed life-choices.
Think for Yourself (Even in Science)
Perhaps even more important than what is taught, is the subject of how things are taught. We want our children to learn the skill of thinking independently, but even in the sciences, we often fail completely to demonstrate how. Instead of teaching science as a thinking process, we indoctrinate, using the grand discoveries of the great scientists as our sacred texts. But consider the words of Isaac Newton himself, regarding rote learning:
A Vulgar Mechanick can practice what he has been taught or seen done, but if he is in an error he knows not how to find it out and correct it, and if you put him out of his road he is at a stand. Whereas he that is able to reason nimbly and judiciously about figure, force, and motion, is never at rest till he gets over every rub.
What's the point of all this formal schooling in the first place? Is it, as many of the proponents of STEM education might argue, to train students for a "good" career?
If our goal is to help students "reason nimbly" about the world around them, as the great scientists themselves did, are we succeeding? When we "teach" middle school students about DNA or cellular respiration by presenting as our only supporting evidence cartoon pictures, are we showing students a process of discovery based on evidence and hard work? Or are we just training them to memorize and repeat what the authorities say?
A useful education needs to give students the skill of following a line of reasoning, of asking rational questions, and of chewing things through in their minds--even if we regard the material as beyond question. Besides feeding students a well-balanced diet of knowledge, healthy schooling needs to teach them to digest this information thoroughly.
Thinking Training
Now step back for a moment and think about the purpose of education. What's the point of all this formal schooling in the first place? Is it, as many of the proponents of STEM education might argue, to train students for a "good" career? That view may have some validity for young adults, who are beginning to choose electives in favored subjects, and have started to choose a direction for their career.
But for the basic education of children, this way of thinking is presumptuous and disastrous. I would argue that the central purpose of a basic education is not to teach children how to perform this or that particular skill, but simply to teach them to think clearly. We should not be aiming to provide job training, but thinking training. We should be helping children learn how to "reason nimbly" about the world around them, and breathing life into their thinking processes, by which they will grapple with the events and circumstances of their lives.
So as we admire innovation, dream of a wonderful future, and attempt to nurture the next generation of scientists and engineers, instead of obsessing over STEM education, let us focus on rational education. Let's worry about showing children how to think--about all the important things in life. Let's give them the basic facts of human existence -- physical and humanitarian -- and show them how to fluently and logically understand them.
Some students will become the next generation of creators, and some will follow other careers, but together -- if they are educated properly -- they will continue to grow their inheritance, and to keep our civilization healthy and flourishing, in body and in mind.
In this week's Friday Five, research on a "smart" bandage for wounds, a breakthrough in fighting inflammation, the pros and cons of a new drug for Alzheimer's, benefits of the Mediterranean diet with a twist, and we've learned to recycle a plastic that was un-recyclable.
The Friday Five covers five stories in research that you may have missed this week. There are plenty of controversies and troubling ethical issues in science – and we get into many of them in our online magazine – but this news roundup focuses on scientific creativity and progress to give you a therapeutic dose of inspiration headed into the weekend.
Listen on Apple | Listen on Spotify | Listen on Stitcher | Listen on Amazon | Listen on Google
Here are the promising studies covered in this week's Friday Five:
- Research on a "smart" bandage for wounds
- A breakthrough in fighting inflammation
- The pros and cons of a new drug for Alzheimer's
- Benefits of the Mediterranean diet - with a twist
- How to recycle a plastic that was un-recyclable
Matt Fuchs is the editor-in-chief of Leaps.org. He is also a contributing reporter to the Washington Post and has written for the New York Times, Time Magazine, WIRED and the Washington Post Magazine, among other outlets. Follow him on Twitter @fuchswriter.
Sexually Transmitted Infections are on the rise. This drug could stop them.
Cases of gonorrhea, chlamydia and syphilis soared last year, but researchers are finding that a drug known as doxy seems to reduce the number of infections.
Sexually transmitted infections (STIs) are surging across the U.S. to 2.5 million cases in 2021 according to preliminary data from the CDC. A new prevention and treatment strategy now in clinical trials may provide a way to get a handle on them.
It's easy to overlook the soaring rates of gonorrhea, chlamydia, and syphilis because most of those infections have few or no symptoms and can be identified only through testing. But left untreated, they can lead to serious damage to nerves and tissue, resulting in infertility, blindness, and dementia. Infants developing in utero are particularly vulnerable.
Covid-19 played havoc with regular medical treatment and preventive care for many health problems, including STIs. After formal lockdowns ended, many people gradually became more socially engaged, with increases in sexual activity, and may have prioritized these activities over getting back in touch with their doctors.
A second blow to controlling STIs is that family planning clinics are closing left and right because of the Dobbs decision and legislation in many states that curtailed access to an abortion. Discussion has focused on abortion, but those same clinics also play a vital role in the diagnosis and treatment of STIs.
Routine public health is the neglected stepchild of medicine. It is called upon in times of crisis but as that crisis resolves, funding dries up. Labs have atrophied and personnel have been redirected to Covid, “so access to routine screening for STIs has been decimated,” says Jennifer Mahn, director of sexual and clinical health with the National Coalition of STD Directors.
A preview of what we likely are facing comes from Iowa. In 2017, the state legislature restricted funding to family health clinics in four counties, which closed their doors. A year later the statewide rate of gonorrhea skyrocketed from 83 to 153.7 cases per 100,000 people. “Iowa counties with clinic closures had a significantly larger increase,” according to a study published in JAMA. That scenario likely is playing out in countless other regions where access to sexual health care is shrinking; it will be many months before we have the data to know for sure.
A decades-old antibiotic finds a new purpose
Using drugs to protect against HIV, either as post exposure prophylaxis (PEP) or pre-exposure prophylaxis (PrEP), has proven to be quite successful. Researchers wondered if the same approach might be applied to other STIs. They focused on doxycycline, or doxy for short. One of the most commonly prescribed antibiotics in the U.S., it’s a member of the tetracycline family that has been on the market since 1967. It is so safe that it’s used to treat acne.
Two small studies using doxy suggested that it could work to prevent STIs. A handful of clinical trials by different researchers and funding sources set out to generate the additional evidence needed to prove their hypothesis and change the standard of care.
Senior researcher Victor Omollo, with the Kenya Medical Research Institute, noted, “These are prevention interventions that women can control on their own without having to seek or get consent from another person,” as is the case with condom use.
The first with results is the DoxyPEP study, conducted at two sexual health clinics in San Francisco and Seattle. It drew from a mix of transgender women and men who have sex with men, who had at least one diagnosed STI over the last year. The researchers divided the participants into two groups: one with people who were already HIV-positive and engaged in care, while the other group consisted of people who were on PrEP to prevent infection with HIV. For the active part of the study, a subset of the participants received doxy, and the rest of the participants did not.
The researchers intentionally chose to do the study in a population at the highest risk of having STIs, who were very health oriented, and “who were getting screened every three months or so as part of their PrEP program or their HIV care program,” says Connie Celum, a senior researcher at the University of Washington on the study.
Each member of the active group was given a supply of doxy and asked to take two pills within 72 hours of having sex where a condom was not used. The study was supposed to run for two years but, in May, it stopped halfway through, when a safety monitoring board looked at the data and recommended that it would be unethical to continue depriving the control group of the drug’s benefits.
Celum presented these preliminary results from the DoxyPEP study in July at the International AIDS Conference in Montreal. “We saw about a 56 percent reduction in gonorrhea, about 80 percent reduction in chlamydia and syphilis, so very significant reductions, and this is on a per quarter basis,” she told a later webinar.
In Kenya, another study is following a group of cisgender women who are taking the same two-pill regimen to prevent HIV, and the data from this research should become available in 2023. Senior researcher Victor Omollo, with the Kenya Medical Research Institute, noted that “these are prevention interventions that women can control on their own without having to seek or get consent from another person,” as is the case with condom use, another effective prevention tool.
Antibiotic resistance
Antibiotic resistance is a potentially big concern. About 25 percent of gonorrhea strains circulating in the U.S. are resistant to the tetracycline class of drugs, including doxy; rates are higher elsewhere. But resistance often is a matter of degree and can be overcome with a larger or longer dose of the drug, or perhaps with a switch to another drug or a two-drug combination.
Research has shown that an established bacterial infection is more difficult to treat because it is part of a biofilm, which can leave only a small portion or perhaps none of the cell surface exposed to a drug. But a new infection, even one where the bacteria is resistant to a drug, might still be vulnerable to that drug if it's used before the bacterial biofilm can be established. Preliminary data suggests that may be the case with doxyPEP and drug resistant gonorrhea; some but not all new drug resistant infections might be thwarted if they’re treated early enough.
“There are some tradeoffs” to these interventions, Celum says, and people may disagree on the cost of increased resistance balanced against the benefits of treating the STIs and reducing their spread within the community.
Resistance does not seem to be an issue yet for chlamydia and syphilis even though doxy has been a recommended treatment for decades, but a remaining question is whether broader use of doxy will directly worsen antibiotic resistance in gonorrhea, or promote it in other STIs. And how will it affect the gut microbiome?
In addition, Celum notes that we need to understand whether doxy will generate mutations in other bacteria that might contribute to drug resistance for gonorrhea, chlamydia or syphilis. The studies underway aim to provide data to answer these questions.
“There are some tradeoffs” to these interventions, Celum says, and people may disagree on the cost of increased resistance balanced against the benefits of treating the STIs and reducing their spread within the community. That might affect doctors' willingness to prescribe the drug.
Turning research into action
The CDC makes policy recommendations for prevention services such as taking doxy, requiring some and leaving others optional. Celum says the CDC will be reviewing information from her trial at a meeting in December, but probably will wait until that study is published before making recommendations, likely in 2023. The San Francisco Department of Public Health issued its own guidance on October 20th and anecdotally, some doctors around the country are beginning to issue prescriptions for doxy to select patients.
About half of new STIs occur in young people ages 15 to 24, a group that is least likely to regularly see a doctor. And sexual health remains a great taboo for many people who don't want such information on their health record for prying parents, employers or neighbors to find out.
“People will go out of their way and travel extensive distances just to avoid that,” says Mahn, the National Coalition director. “People identify locations where they feel safe, where they feel welcome, where they don't feel judged,” Mahn explains, such as community and family planning clinics. They understand those issues and have fees that vary depending on a person’s ability to pay.
Given that these clinics already are understaffed and underfunded, they will be hard pressed to expand services covering the labor intensive testing and monitoring of a doxyPEP regimen. Sexual health clinics don't even have a separate line item in the federal budget for health. That is something the National Association of STI Directors is pushing for in D.C.
DoxyPEP isn't a panacea, and it isn't for everyone. “We really want to try to reach that population who is most likely going to have an STI in the next year,” says Celum, “Because that's where you are going to have the biggest impact.”