Feb 27 2017

The Death of Expertise

fox-globalwarmingTom Nichols’ book, “The Death of Expertise: The Campaign Against Established Knowledge and Why it Matters,” is currently on the Amazon bestsellers list. The book discusses a topic I have delved into many times here – what are the current general attitudes of the public toward experts and expertise, and how did we get here?

He mentions various aspects to this war against experts:

“The United States is now a country obsessed with the worship of its own ignorance. Many citizens today are proud of not knowing things. Americans have reached a point where ignorance, especially of anything related to public policy, is an actual virtue.”

The culture and our educational system have created a generation that has little experience being told they are objectively wrong. Everyone feels they are entitled to be right. Combine this with the illusion of knowledge provided by Google, and everyone thinks they are their own expert in anything.

Interestingly, as Nichols also points out, people are arbitrarily selective in which experts they respect. Sports is a great example. No one really thinks they should play for the NFL and begrudges recognizing that NFL players are the result of a combination of natural talent and years of developing physical ability and specific skills.

There are also many highly technical jobs where expertise is so obvious it cannot be denied. Most people would not try to fly a jet, wire their own house, or even fix their computer without the appropriate knowledge and skill in these areas.

I think that is the key – is there an immediate and obvious effect of the expertise? Would you watch a tutorial on Youtube, and then attempt to do coronary bypass surgery on a family member?  The outcome is immediate and often binary – the plane lands safely or crashes, the patient lives or dies, the computer works or doesn’t work.

When there isn’t an objective outcome on the table, however, people are more likely to substitute their own ignorance for expertise that has taken years to develop. Do you really know how to interpret ice-core data? Can you read the primary literature and understand how best to determine the safety and efficacy of vaccines? You won’t do surgery, but you will diagnose yourself and prescribe a course of treatment, even though these two tasks require the same level of training and experience.

In these situations people are often confronted with the fact that the experts disagree with them. That should give a reasonable person pause. I always check my own understanding against the experts, and if they differ I assume I am wrong or missing something. Too often, however, the reaction is to either assume that the experts are incompetent or there is a conspiracy (or both). That is the war on experts and the death of expertise.

Of course, as a physician, I encounter this all the time. I once had an acquaintance “explain” to me, after I disagreed with them over a medical topic (and here I am paraphrasing a little), “I know that is what you were trained to think, but I read in a magazine that the opposite is true.”

Think about the implications of that conclusion. I was just mindlessly “trained” (you can substitute “brainwashed”) to uncritically accept the party line, which must exist for nefarious purposes that don’t actually serve patients. They, without even a college education let alone a medical education or any experience interpreting the medical literature or practicing medicine, knew better because they read an article in a popular magazine (or on a website).

So how did we get here?

I think Nichols hits all the big factors. He places part of the blame on the internet and social media. He argues that we don’t just have access to lots of information, we are overwhelmed with low-grade information. This is crowding out high-grade curated information.

He argues that the public was better informed when we had three networks than they are now with hundreds of channels and millions of websites.

“I’ve been asked, do I really think people were better-informed when there were only three television networks. And my answer is emphatically ‘yes,’ in part because there was a filter on the news. Arms-control treaties with Russia were not competing with which Kardashian is pregnant. It was not a constant stream.”

While he has a point, I think the situation is more nuanced. A recent Pew survey finds that the public thinks they are better informed. This, however, is probably just the illusion of knowledge the internet creates.

A 2007 study comparing knowledge of current events between 1989 and 2007 (pretty much before and after the information explosion) found no overall difference.  A 2012 update found the same thing.

So the overall effect seems to be – no change in actual knowledge but with people falsely feeling they are better informed.

My read of the data is that there are two big things going on here. The first is that the internet has been like jet fuel to the Dunning-Kruger effect – which is a disconnect between one’s self-assessment of knowledge and their actual knowledge.

The other factor is that people are more separated. We are no longer all watching the same curated news. People are separating out into various groups depending on how they access information.

In a widely cited study, researchers found dramatic differences among groups of people depending on their primary news source. This became known as the “Fox News Effect” because of the amazing result that those who watch Fox News had worse knowledge of current events than people who said they don’t follow the news at all. In other surveys Fox News watchers did score at the bottom, but not lower than those who do not watch the news at all.

Of course, this is correlational data, and we cannot infer causation. These are self-selective groups. I do think this data is tapping into a core feature of our modern internet and mass media society, however.

While average knowledge may not have changed in the last 30 years, the data suggests there is a greater difference among groups. Those who have critical thinking skills, and internet skills – those who know how to access and evaluate information, are probably better informed than they were 30 year ago. Access to detailed information is immediate. I lived before and after the web revolution, and the difference is stark.

But – people are curating their own information by choosing outlets that serve their existing biases. There are people in my life with whom I was able to politely disagree over political issues, or we could come to some understanding based on facts. Now, we are literally living in different worlds. We no longer share a common frame of reference. We cannot agree on basic and easily verifiable facts. There is no longer any common ground for discussion.

I don’t think the internet is entirely to blame either. I do wonder about the changes I have seen in our educational system. As faculty, I teach students, which means I regularly have seminars about how to do so. They teach a lot of useful information and skills and I do feel it has helped me become a better teacher.

However, one aspect of the current educational culture is that students should never be told they are wrong. In fact we are told to never ask straight factual questions where there is a right or wrong answer. Just ask them what they think. Don’t praise a student for giving a good answer, because then other students will feel slighted if they are not equally praised.

This is in stark contrast to my own medical education (I graduated in 1991), which was perhaps too far the other way. We were “pimped” – asked a series of increasing difficult factual questions, and then told in no uncertain terms when we were wrong. We were often publicly embarrassed by our errors, and informed that we just “killed the patient.”

I am not advocating for this former standard, but something in the middle feels right. I do not doubt the studies which show that when students are taught according to the current non-confrontational standard they learn the material better. Let’s assume that is correct. I also see no reason to strike terror in students.

But I think the current standard is missing something – teaching students what it feels like when they are wrong. They need to learn how to accept and correct their errors, and not be made to feel that whatever they think about a topic is equally valid to what anyone else thinks. They may be learning the lesson better, but are failing to learn the meta-lesson about knowledge and expertise itself.

We then see the results of this non-confrontational style later in their educational arc, when they are actually practicing medicine. Now we are getting closer to the objective and immediate outcome situation. The meta-lessons about expertise have to be taught at this later stage, because the first 21 years of their education did not prepare them for it.

I have had this experience outside of medicine as well. I have often had the experience of discussing an issue with an acquaintance or even stranger, and when I politely and without judgement make a simple statement of fact, I am met with outrage and the accusation that I have just personally attacked them. Being told that you are factually wrong is now a personal insult of the highest order. It’s as if no one had ever told them they were wrong before.

I don’t have the quick or magically solution to all of this. These are complex cultural trends that are changing quickly. We do need to closely examine what is happening in our society, however, and think carefully about how best to balance all of the forces at work. I do not think we are in a good place right now collectively. We need to do better.

At the very least we need to each work individually to be more critical and less defensive. At least recognize the Dunning-Kruger effect (which applies to everyone), the effects of bias and the echochamber effect. Back up, slow down, and think critically.

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