By David Topps, Rachel Ellaway

Many medical education studies pursue a measurement approach to demonstrate the efficacy of a learning intervention. Researchers, steeped in the belief system that positions randomized controlled trials as the ultimate form of inquiry, try to apply this methodology in the confounded world of education research. As Cook et al have repeatedly shown, many compare their educational intervention with a control. We already know that something is better than nothing for promoting learning.

We often focus excessively on ontology, epistemology or methodology, yet forget to assess the axiology of a study? More specifically, is it worth doing and what is the value of doing it? In this, we run into the classic challenge in cost-benefit analysis: it is easy to count costs but hard to assess benefit.

Consider this clinical research comparison example: antidepressant studies, which commonly compare new agents with amitriptyline, showing at least as good an effect, but with improved safety and side effects. The relative effect, which is hard to measure, is still open to comparison.

When assessing real world effectiveness, we should consider the economics of the intervention, while comparing learning designs that show equivalent outcomes. Is there less total cost or greater scalability and sustainability?


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David Topps, Rachel Ellaway



Published: 29 May, 2017

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