More Like Medicine? A Short Critique of Over-Evidence Based Education

First published in 2017.

Introduction: Six Years Ago

It was nine in the morning on a Saturday in early July.  A Teach First session during my second year of the programme after a busy week at school.  A windowless conference hall.  In Hull.  The room was stiflingly hot as I took a sip from my cold bottle of Lucozade in an attempt to stop the now visible sweat dripping down my forehead.  The hangover had hit me hard.  

The room is starting to spin.  My head, pounding.  I am in two minds about what to do - Option A will do immeasurable harm to the profession I love, but will provide a small measure of comfort.  It may reduce my suffering.  Option B will see me suffer as a martyr for the cause I believe in - raising the profession of teaching to standard it deserves.  Option A or Option B?

Option A. I caved in.  Finally understanding that I was not cut out to die for my beliefs, I undid my top button, loosened my tie and even removed my blazer.  As the ‘facilitator’ of the session brought around more highlighters and Post-It Notes, I could feel the look of shame on my face.  I had let her down.

At the break in the session, Mr All-That-Is-Wrong-With-Teaching, bounced up to me in his Hawaiian shirt, shorts and sandals.  He asked me why I was wearing a full suit.  

I replied that the problem with teaching, the reason we are not taken as seriously as we should be, is that we don’t mirror the medical profession.  We need to look more like doctors, act as professionally as top surgeons, and base our actions on research like like doctors are trained to do.  

He replied that his dad was a doctor and had never worn a suit in his life.  

I looked at him with disdain.  He was the reason for my low pay.  

He looked at me confused.  Wondering why someone would choose to wear a buttoned up shirt and tie on the hottest day on record when the invite had clearly stated ‘casual’.  He was wrong.  So was every other saboteur in the room dressed in their weather appropriate attire. We need to be more like doctors!

The Intuitive Desire for an Evidence Led Profession

Medicine is (quite rightly, in most cases) held up as the Gold Standard of a profession.  Teaching is sometimes seen as quite a way behind medicine in many aspects:

• development of new entrants and ongoing training and evaluation

• having a unified Union and overseeing organisation

• use of evidence to inform practice
  

It is this final point I want to focus on:

Many of the books I read in the early years of my career reinforced this.  Geoff Petty’s Evidence Based Teaching contained a comparison with Medieval medicine which stuck with me for a very long time.  He argued that teaching was still in the Dark Ages - we were still drilling holes in heads to try to cure headaches (often unsuccessfully) and trying to figure out what works and what doesn’t all the while gambling with children’s futures.  It seemed to hit the nail on the head (pun intended) for me - to improve, we need to be using the most up-to-date research and carry out our own inquiries to add to the community in order to ensure we give the best education for every child.

John Hattie’s Visible Learning was in vogue.  His meta-analysis was being used to assess how a school / teacher could improve results in the shortest time and at the lowest cost based on thousands of pieces of research.  It seemed waterproof.

After moving to London, I was later involved in running a workshop at the London Festival of Education (windowless room, baking heat, three piece suit with pocket handkerchief.  Again).  My workshop was meant to run four times on a cycle to ensure I was able to meet the huge demand to hear me speak.  After only four people had registered for my session in total and only three showed up on the actual day, the organisers reluctantly decided to pull my workshop after only one session.  

This ill-researched decision, despite being disappointing, allowed me the opportunity to see more of the event.  I forced my way into the very well attended panel ‘discussion’ on whether it is right for teaching to be more and more evidence based.  The ‘panel discussion’ turned out to be a ‘panel agreement’.  The chair, sensing the lack of drama, invited the thronging audience into the debate - did anyone have a challenge?  Not one person could come up with a reason as why to why the teaching profession shouldn’t be more and more based on evidence.

The Problem with Evidence Based Schools: Specialisation and Measures

There is a problem with over-reliance on evidence and it comes, appropriately, from medicine.   Atul Gawande in one of his many excellent books, Being Mortal, offers a critique of specialisation within medicine.  He argues that the sole aim of medicine has been to keep the patient alive.  This, in many institutions, is how surgeons are judged - how many times did someone die during their procedures.  

This has resulted in ever more specific specialisation.  Surgeons who know a huge amount about a specific organ in the body and know literally thousands of ways of keeping it working.  When a patient is brought into surgery, it is to work on a specific organ.  This, on the surface, of course, seems fantastic.  Life expectancy continues to rise across the developed world.  

However, that hasn’t translated into an increased quality of life.  Surgeons are (understandably, given the circumstances) not thinking about the entire human, they are focussed on keeping their specific organ working.  Many people are kept medically alive, with very a very low quality of life.  Would the research be different if the goal posts were moved?  What if the measure of success for surgeons was not keeping someone alive but rather the quality of life that person had after recovering?  These outcomes require different approaches?

Is this the same in education?  Is the over reliance on an ‘evidence based approach’ the cause of this?

Many schools now have literacy co-ordinators, numeracy co-ordinators and SENCOs.  This is on top of a plethora of subject specialists.  All are (hopefully) expert and well meaning in their intentions.  However, have we lost focus of the whole child?  Have we reduced the vast task of educating a child to results in the only objective measure we have of quality of education - external standardised testing?  Test results are getting better, but is the quality of education?  Are we developing the whole child?  Have we reduced a good quality of education into a grade in a subject area?

The Problem with Evidence Based Teaching: Side Effects

The second challenge also comes from medicine.  Medical research is incredibly rigorous and long term.  It takes years of testing, and billions of dollars worth of time and equipment, before a drug is allowed to be used on humans.  This is because they don’t just test the effectiveness of the drug, but also all the negative side effects it might have.  

‘This pill is effective at curing headaches in most cases, but can cause diarrhea and a skin rash in some people.  Use for 3 weeks only and do not take more than four pills in one day as this may have serious health consequences’.

Yong Zhao in a fantastic recent article talks about the lack of information regarding ‘side effects’ of different educational approaches.  Yes, a certain literacy intervention may improve the sounding out of words, but as it takes place during History lessons, it may reduce the cultural capital needed to understand the text which, Hirsch, Willingham, Lemov and many others, have proven is the key to strong literacy skills.  We simply aren’t presented with the side effects of the ‘evidence’.

This is not a new critique.  Wiliam, Nuthall and others have argued for years that context is vital in research.  We should not be asking what works, but what works in this context.  I would add, for our vision for education.  We also need to be open that, as time is the constraint, we will be sacrificing things in order to achieve our aims.  My hope is that research helps us to make thoughtful conscious decisions, rather than leaving it to chance.

Conclusion: Surface Change

Evidence based teaching, like me wearing a suit, on the surface it seems like a simple way to improve the profession, but when you dig a little deeper, you see flaws in the argument.  At first glance, using evidence as a base for teaching appears to be an obvious way to improve quality of teaching, but it also has its flaws.  The main one being that we are not united in the goals of education.  If the goal of good education is good test results then we can research how effective something is at achieving that specific goal.  Just as medicine was focussed only on keeping someone alive.  If however we have different goals then we need to consider the side effects.  I recently saw a primary study investigating the effectiveness of Philosophy for Children in raising SATS results.  What if the aim of P4C is not SATS results?

Education is incredibly complex.  That is why we are a profession.  Biesta, in the Beautiful Risk of Education, sums up this problem.  He argues that as education is not the interaction between robots with programmed inputs and outputs, each human is different and therefore unpredictable.  Teachers need to think on their feet, look at their own context and their own aims for education.

I am not at all suggesting that evidence should be ignored, it makes a vital contribution to the education profession and hopefully enables leaders at all levels to make better decisions.  I just think we should be a little more critical of the strength of the argument it creates, not use it as a broad hammer to crush debate and to not become over-reliant on the evidence it presents.