After Ben Goldacre’s intervention about the need for greater evidence in education, I thought it best to speak to someone who reads a great deal of medical research for a living and knows a bit about the research process too. Paul Simpson is the Deputy Editor of PLOS Medicine and a former researcher at Cambridge and Birmingham. As I peppered him with questions over what should have been a very relaxing lunch about a year ago, he recommended that I read Trisha Greenhalgh’s ‘How To Read a Paper’. Targeted at medical and nursing students, it gives the basics of evidence-based medicine, the issues to consider when reading research papers, and the arguments for and against an evidence-based approach.
I believe that the science of finding, evaluating and implementing the results of medical research can, and often does, make patient care more objective, more logical and more cost-effective…Nevertheless, I believe that when applied in a vacuum (that is, in the absence of common sense and without regard to the individual circumstances and priorities of the person being offered treatment or to the complex nature of clinical practice and policymaking), ‘evidence-based’ decision-making is a reductionist process with real potential for harm. p. xvii
One clear line of argument made by Greenhalgh’s is that the research used is ‘research on populations to inform decisions on individuals.’ As stated near the end of the book:
But as many others before me have pointed out, a patient is not a mean or a median but an individual, whose illness inevitably has unique and unclassifiable features. Not only does over-standardisation make the care offered less aligned to individual needs, it also de-skills the practitioner so that he or she loses the ability to customise and personalise care (or, in the case of recently trained clinicians, fails to gain that ability in the first place. p,236
This is an important point to remember as we think about using research in our classrooms/schools. One useful comparison is student baseline data. The baseline scores give an idea of what someone with the same score might achieve, but it does not tell us about the individual. Although not aimed at the education sector, with the growing call for research to inform/influence decision-making on pedagogy/pastoral care and well-being, it should be read, especially if you really want to ask some interesting questions at the forthcoming ResearchEd conference or your next inset day when a speaker is parachuted in and starts talking about the research papers they have used as the basis for their talk.
Greenhalgh provides a number of checklists to help you on your way and the chapters provide a variety of nuggets and fascinating stories. I found the diagram below to be particularly interesting.
Note that anecdote, case studies and personal opinion are still useful despite the lack of quality when compared to other forms of evidence.
The book also considers the issues involved in applying research in the ‘real world’, recognising that possessing evidence is not enough because the difficult job of influencing/changing behaviour has to occur (your habits and that of other people). The comparison with ‘eLearning’/ICT in schools is instructive. As many have pointed out (often in favour for research in education), all the new tech (iPads/IWBs/VLEs) in the world is not going to create change by itself. If the use of research evidence in schools is not planned and thought about in a sensible way, especially when it comes to engaging colleagues and being realistic about timeframes, I can foresee that the ‘research champions’ and their projects for change may look like many of the ‘eLearning’/ICT projects in schools. Ignored, unloved and an easy target for when the next ‘revolution’ in education occurs.