Ágoston Kecskés

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January 4, 2012

Blog Entry #2: The plot thickens

As the second day of my CEEP selective kicks into high gear, the assigned readings[1] [2] [3] have served to deepen my understanding of the medical education literature.

One thing has become abundantly clear: details matter. For example, the details of definitions matter. Torgerson’s article is supposed to be an ardent defence of randomized control trials (RCTs) in the medical education literature. The argument quickly degenerates, however, in no small part owing to Torgerson’s failure to define RCTs. In fact, she uses the terms RCT and RCT methods interchangeably. While I recognize RCT methods as referring to a stylized stereotype of a gold standard for determining types and sizes of effects, Torgerson’s failure to clarify the terms simply serves to fuel the fires of her detractors. For example, blinding is not a necessary condition of RCTs. The same is not true of ‘RCT methods,’ assuming blinding is possible and practical. The details of quotes also matter. Half or more of the assigned readings over the last two days have featured arguments triggered or at least spurred on by misquotes or quotes taken out of context. These quotes are clearly useful in establishing the extremeness of the author’s position. However, they often also lead to rehashing of old familiar debates with little or no progression of thought. For instance, Krupat dedicates half a page of his article to describing Kurt Lewin’s ‘action research.’ Besides the fact that Lewin’s ‘action research’ is little more than a call for increased focus on practice over theory, Krupat’s blurb is essentially a focused job description. On the other hand, Krupat makes no such efforts to detail exactly what he means by ‘serious conceptual analysis’ and how it is supposed to advance the medical education literature.

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[1] Carole Torgerson, “Educational research and randomized trials,” Medical Education, http://www.mendeley.com/research/educational-research-randomised-trials/; accessed 4 January 2012

[2] Geoff Norman, “RCT = results confounded and trivial: The perils of grand educational experiments,” Medical Education, http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2923.2003.01586.x/abstract; accessed 4 January 4, 2012

[3] Edward Krupat, “A call for more RCTs (Research that is Conceptual and Thoughtful),” Medical Education, http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2923.2010.03682.x/abstract; accessed 4 January 4, 2012