Learning Is Brain Science

Why the AI-enabled workforce needs an evidence-based approach to education.

Artificial intelligence (AI) and other advanced technologies are raising the stakes on lifelong learning. Employers today must prepare their workforce for the AI-enabled world, where people increasingly work alongside machines that augment human capabilities. Business leaders are beginning to recognize that the differentiator will not just be the technology, but also the capability of people to use it.

The demands of the 21st century workforce necessitate an equally advanced approach to training and development. Adaptive learning —a personalized, software-enabled teaching approach—has a crucial role in helping learners develop new skills and become more proficient on a continuous basis.

But not all learning technology is created equal. It is no longer enough for learning companies to make unsubstantiated claims about their systems and then spend marketing dollars to promote their solutions. Instead, education companies need to invest in the necessary science to develop an evidence-based approach for both higher education and corporate education. Evidence of efficacy then can become the basis for purchasers of education solutions to make their buying decisions.


In adopting an evidence-based approach, education can learn a vital lesson from health care, particularly the pharmaceutical industry. A seismic shift occurred among medical researchers in the 1990s, away from heavy reliance on peer-reviewed articles that often were based on anecdotal observations of small groups of patients, to a broader standard of evidence-based medicine (https://muse.jhu.edu/article/211661). The objective was to define optimal treatments and drug therapies using current best evidence from a variety of statistical metaanalyses, including randomized clinical trials. Today, the majority of drugs that have health value are used because the pharmaceutical industry is being held responsible to secure the research that generates the science around them.

Such research is crucial because what might otherwise look like a good solution—e.g., a drug that is cheaper and readily available—may not, in fact, be optimal. For example, a study of anti-hypertensive medications (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225910/) found that the most expensive treatment option worked the best, while the cheapest option was the least effective. One can imagine how, without such scientific research, doctors might be reluctant to prescribe a costly blood pressure medicine over less expensive options, and payers would most certainly balk at paying for it. Only scientific evidence proves the point.

Similarly, education companies must invest the necessary time and money to develop an evidence-based approach to demonstrate efficacy of educational tools and interventions, and to compare the success rates of different systems. Admittedly, this is not easy and the costs will not be inconsequential. Nonetheless, for education companies to be considered truly scientific in their approach, they must become more systematic, so educators, schools, and districts can make the best purchasing decisions among the programs and content being offered.

Education is big business. According to a Georgetown University study, some $1.1 trillion is spent annually in the U.S. by postsecondary institutions, government agencies, and employers on formal and informal higher education and training (https://cew.georgetown.edu/wp-content/uploads/2015/02/Trillion-Dollar-Training-System-.pdf). Of that, employers spend an estimated $413 billion a year on informal training, and another $177 billion on formal training. Despite these huge dollars, the only common measurement among training programs is the cost per student. Occasionally, they track job placement rates and even less frequently on-thejob retention.

As a recent Harvard Business Review article noted, “These metrics are useful but miss the big picture, in part because they mistake a program’s cost for its value,” (https://hbr.org/2017/02/a-bettermetric-for-the-value-of-a-worker-training-program). Clearly, the time has come for providers of higher education and corporate education to take an evidence-based approach to gathering and analyzing data to measure how learners benefit from the money being spent.


One example is The New England Journal of Medicine (NEJM Group) and its efforts to systematically measure the impact of learning tools (https://knowledgeplus.nejm.org/how-we-help/adaptive-learning/). The NEJM Group has sought to redefine the evaluation process with an evidence-based approach (http://www.nejm.org/doi/full/10.1056/NEJMra054784#t=article). A recent survey study (https://www.mededpublish.org/manuscripts/1788) found that the majority of respondents rated the NEJM Knowledge+ adaptive learning platform as helpful and the content as good for exam preparation and relevant to their learning needs. The study also found that, among NEJM Knowledge+ users in the 2014-2016 time period, a significantly higher proportion reported passing the American Board of Internal Medicine Certification Examination on their first attempt compared to the national average (95 percent vs. 89 percent).

To respond to learners’ needs, NEJM offers an adaptive learning process designed not only to help people pass the board examination, but also to be used as a lifelong learning tool (https://knowledgeplus.nejm.org/how-we-help/adaptivelearning/). Thanks to its adaptive approach, the system can target areas of incompetence—first, by making students aware of what they don’t know, and then providing resources to close this gap in understanding. The adaptive approach supports the notion that it is far better to learn continuously than to attempt to cram as much information as possible just before taking a high-stakes test. Even if the learner passes the test, a significant amount of learning is not retained and/or is replaced with misperceptions, of which the learner is unaware. The result is “unconscious incompetence,” which, in the medical sector, can gravely impact patients.

As we find in our work with employers across every industry and sector, there is a greater need than ever to improve employee proficiency, to identify and address their competency gaps. In the best-case scenario, employees will be aware—sometimes painfully so—of what they don’t know. Such “conscious incompetence” may motivate them to engage in training that will help them be more relevant in an evolving workplace.

In the worst-case scenario, which is becoming all the more common, employees are unaware of the gaps in their understanding. They are unconsciously incompetent, for example, in the use of certain technologies or in critical steps in processes. Such ignorance can be costly to the company, its reputation, and the satisfaction of its customers.

Adaptive learning can target this problem by helping uncover what each person does and does not know. Over time, this shapes their metacognitive skills to become more consciously incompetent—that is, becoming aware of what they don’t know.


As a physician who understands how the brain functions and the complexity of biological variation, I have devoted 20 years to studying how people learn. I can attest that there is no “one-size- fits-all” approach to acquiring skills. To be effective, learning needs to be adaptive—molded to each individual’s needs by probing what he or she knows and doesn’t know.

Adaptive learning is outcomes-based; it is geared toward acquisition and retention of knowledge and skills, rather than mere completion of content. An adaptive approach is supportive of overall learning. Charles Fadel, the founder of the Center for Curriculum Redesign, put forth a four-dimensional learning framework, composed of knowledge, skills, character, and meta-learning (or learning how to learn). Adaptive learning can improve performance in the knowledge dimension while supporting meta-learning. Once students have acquired the “table stakes” knowledge, they are better prepared to make gains in the other domains. As a result, the time it takes learners to become proficient is reduced.

Education, just like the pharmaceutical industry, deals with humans and the brain. Learning is brain science! By taking the same evidence-based approach as the pharmaceutical industry, education companies can become more systematic in their approach to using science to prove efficacy. By engaging in research to determine the best evidence, education companies can help school districts, administrators, and teachers, as well as corporations, make the informed decisions about what programs and content are truly worth paying for.

Ulrik Juul Christensen, M.D., is the executive chairman for Area9 Lyceum (https://area9lyceum.com) and the former senior fellow, Digital Learning, on the executive leadership team for McGraw-Hill Education.

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