Sunday, October 28, 2012

Decreasing Classroom Sizes

As a physician, I realize just how crowded our clinics and ERs can be.  Access to see a physician is very difficult on a same day basis, and so many patients resort to Urgent Care facilities or to the ER at their local/regional hospitals.  This is just not optimal care.  Patients and physicians begin the important health care encounter often as strangers.  Many times previous records are unavailable, and so each encounter literally starts from scratch.  This adds increased expenses as redundant or unnecessary tests are done, it adds risk to the encounter as patients are treated by someone who is unknown to them and important parts of their history may not be known, etc.  Quality of care suffers.

To address this problem, many clinics are adding mid-level providers such as physician assistants and Nurse Practitioners to their health care team.  This effectively expands the number of patients who can be seen each day and improves access and quality of care, as it reduces delays in being seen.

Today, our public school classroom sizes are growing and often overcrowded.  I often hear reports from teachers that their students are literally seated on the floor due to lack of space. Furthermore, we know that each year there are thousands of additional students added to the growing ranks of those currently enrolled.  An additional challenge is the increasing number of students for whom English is a second language.  As a result of the overcrowded classes and increasingly diverse student population, excellence in teaching and quality can suffer. Teachers, no matter how hard-working or dedicated, cannot care for these many students as they would like.  Such frustrating conditions lead to lower scores, teacher burnout and attrition of our best teachers.

One remedy would be to use “mid-level providers” in the classes as well.  We should explore using more teacher’s aides, who could assist the teacher and create a team approach.  The teacher’s aides (TAs) could be specialized in math, reading, art etc.  The TAs could then “functionally” decrease the class size and allow the teacher to focus on those who need particular mentoring.  Quality would improve.  Furthermore, teacher’s aides, both part-time and full-time, could be hired at lower cost than full time teachers and allow education budgets to be stretched more effectively. I have heard many reports that aides are also able to foster a better general atmosphere in the class with better communication, less disruptive behavior and in general a more organized and effective experience for the students and the teachers.

Education quality and funding and large classroom sizes remain at the forefront of our challenges as a State.  It is a challenge that we will need to address this upcoming Legislative session.  This is a realistic, practical solution that we can and should implement soon.

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