But the No. 1 challenge in ed tech, according to the report, is with teachers themselves and the inadequacy of their preparation and ongoing training.

"The challenge is due to the fact that despite the widespread agreement on its importance, training in digital literacy skills and techniques is rare in teacher education and school district professional development programs," the report said.

The third critical challenge cited by the authors was the failure of both technology and teaching practices to meet demands for differentiated, personalized learning.

In the fourth slot was nothing short of the "fundamental structure of the K-12 education establishment," specifically, as the authors described it, "resistance to any profound change in practice."

The authors said that as long as the thrust of education support is on maintaining the existing system's "basic elements," meaningful change will face resistance.

The lack of congruence between what students are learning outside of school and what they're being taught in the classroom is causing a disconnect in educational practices.

The regulation calls for the state to provide 10 end-of-course exams, beginning with English literature, Algebra 1 and biology in 2010-11, with other English, math, science and social studies subjects being phased in through 2016-17.

School districts would be required to count the exams for at least one-third of a student's final grade or districts could use other options, including validated local assessments or Advanced Placement exams instead. Districts also could set up a project for students who failed exams.

Dr. Townshend: What the hell's this all about? Dr. Kelso: Nothing! I was, uh, just looking over your files and, um...well...your osteoporotic patients aren't on Bisphosphonate; your diabetics aren't on ACE inhibitors. Doug, a lot of your treatments are pretty out of date. Dr. Townshend: Come on, Bob, I'm--guys like us, we're set in our ways. Dr. Kelso: Well, this is not an age thing, Doug. Hell, these days if you've been out of med school five years, half of what you learned is obsolete. Why do you think I spend every other weekend at a seminar in some two-star hotel ballroom that still stinks of last night's prom vomit? I do it because I have to keep up. Dr. Townshend: Also, it gives you two days away from the missus, right? [laughs] Once again, I am sorry I was the one who introduced you in the first place! Dr. Kelso's expressions remains serious. Dr. Townshend: Look, Bob, I just...I don't have the energy for all that stuff. Dr. Kelso: Well...then we got a problem.