The Negligent Treatment of Medical Anecdote Revisited

Nearly ten years ago a doctor (of the medical kind) emailed us a short piece from the prestigious British Medical Journal entitled The Negligent Treatment of the Medical Anecdote.

It read as follows:

‘It is hard to know why anecdote is now treated so lightly by doctors. First hand, actual, original observation should still be part of the doctor’s way of working. Clinical trials are not oracular. However sophisticated, they do not stop at publication. They start at publication. There is nothing, not even the legislature of fashion, which should disbar or absolve doctors from being curious. But that habit of curiosity, of critical regard and appraisal of their work, is, as we have seen, being lost…

…The following three questions, their brevity enabling their use even by the busiest doctor, should be asked each time a patient receives medical attention. Did the patient benefit? Did the patient not benefit? Was the patient made worse?’

Pickering, W. The negligent treatment of medical anecdote. BMJ. 1992; 304: 1516

Our correspondent was becoming increasingly concerned that education was going the way of medicine with wisdom, experience and professional judgement becoming sidelined by the 'what works' agenda.

An agenda with an agenda all of its own.

After a decade of apparently research-driven reforms in English education, it is interesting that an article entitled 'Schools are using research to try to improve children’s learning – but it’s not working' caused such a stir when it was published this month.

According to the research, doing what the research tells you in the classroom is not enough.

'A series of randomised controlled trials, including one looking at how to improve literacy through evidence, have suggested that schools that use methods based on research are not performing better than schools that do not.

In fact, research by a team at Sheffield Hallam University have demonstrated that on average, these kinds of education initiatives have very little to no impact.'

As is often the case, the research is finally catching up with what great teachers have known all along.

Education is a complex business and involves 'the sum total of trillions of interactions' as the article puts it. 

Research is, of course, important and many of our Associates have Masters degrees and doctorates to back up their work.

But ensuring great teachers are free to use their professional wisdom too, even if 'what works for me' is off script from 'what works'.

Perhaps we should repurpose the advice from the BMJ above?

• • • Did the student learn?
    • Did the student not learn?
    • Was anything made worse by the experience?

[ITL]