Sarah Pannell, Science Teacher
It would be fair to say that I’m an over-enthusiastic science teacher. I seem to have a complete inability to say no to projects that sound interesting. This trait has lead me to writing up my A Level science Journal Club idea for other teachers to use (resources are here, on the SAPS website), which in turn got me an invite to a Centre for Evidence Based Medicine meeting last summer, discussing the value of teaching EBM principles in school. It would be fair to say that I felt overwhelmingly underqualified at that meeting, but it was a delight to be able to discuss how we could go about introducing new ideas into schools. As a result, Carl Heneghan, Kamal Mahtani, David Nunan and Ruth Davis from the CEBM, along with Sir Iain Chalmers, came along to the Association for Science Education national conference in January to share their expertise with more enthusiastic science teachers.
Getting EBM in to schools seems like quite a long road, with potential boulders of different sizes in it, but here is how I’ve used some of the resources that Kamal and David shared in their workshop to make a small start to encouraging my pupils to challenge the headline-grabbing claims they see. The session described below was a workshop that I ran for our ‘scholars’ – students in Years 9 and 10 (aged 13-15) who are considered to be particularly academically able, though not necessarily in science.
I had previously asked them do download a pedometer app (I hadn’t specified which one, but suggested that they didn’t pay for it), and then use it through the day on their phones. By the time the session started they had identified some of the shortcomings of these apps, and were upping their step-count by waving their phones around! We started the session by thinking about how we make decisions and what informs our choices. Using the X Box vs PlayStation debate as a starting point (for the record, I have an X Box), the group decided that they would use opinions from people they trusted – both friends and experts – and may look at published data and past experience to make their decision. Linking this to the headline grabbing claims of some scientific articles was a logical leap for them to make, which lead to a discussion of the quality of headlines compared to scientific papers, and where evidences behind headline claims comes from.
An example relevant to the group (a BBC online article with the headline “Exercise ‘boosts academic performance’ of teenagers”) started our consideration of how to ask clinically meaningful questions. Having introduced them to the PICO (Patient, Intervention, Comparison, Outcome) question development framework, they worked in pairs to come up with a clinical question to ask based on the article. We discussed the idea that before launching into new research, we should look at other existing work of a similar nature. As Kamal and David had demonstrated in their workshop at the ASE conference, I then gave everyone a copy of Glynn and co-workers’ paper on the SMARTMOVE RCT, published in the British Journal of General Practice in July 2014. The pupils were able to use the paper’s abstract to identify the PICO criteria without much help, which encouraged me to push on with independent group working for the next part of the workshop.
What I should have done at this point was to emphasise the title of the paper more heavily before splitting up into small groups to analyse the paper in detail. This would have lead to a neater wrap-up at the end, but wasn’t too big a problem. Using a question framework that Kamal and David had shown in their workshop, pupils split into different groups to look at aspects of the paper. My big coup here, and one that really made the session work effectively, was having some Sixth Formers’ help to work with the small groups. I had trained the Sixth Formers earlier in the week, running through the workshop ourselves to check they understood each question and where the answers could be found in the paper. Making use of the Sixth Formers meant that I was sure that each group was on-task and was able to find what they needed from the paper. It also allowed me to listen in on the discussion from each group and ask prompt questions here and there, without having to intervene too much. Answering the questions took different amounts of guidance, but each group was able to identify the limitations of the paper in response to the questions being asked.
To draw the group work back together, we evaluated the paper based on each group’s research question. Sharing the answers to each question allowed the pupils to see that although the claims made by the paper seem grand, the effect of the intervention was minimal. We were then able to compare this paper to our original clinical question and discuss how a RCT could be carried out. The pupils were able to use their critical evaluation of the earlier paper, along with their own experiences using a pedometer app, to identify methodological shortcomings and suggest ways it might be improved.
Linking this back to the evidence quality pyramid concluded the session, which took just under an hour in total. We could have easily used an hour and a half, which would have given the pupils more opportunity to analyse the paper and compare ideas with other groups in more detail. The length of the session made it fast paced, with meaningful discussion taking place without opportunities to go off topic.
My top tips for running the session:
– Get help! I couldn’t have done it nearly as successfully without my pre-prepared Sixth Formers, as I would have been stretched to move around each group.
– Let pupils think for themselves. It’s very easy to give them the answers, but pointing out the relevant parts of the paper and letting them discover the answers for themselves was much more rewarding.
– Give time to discuss each analysis question together. We did this by going through each question in turn as a whole group, but it would also have worked effectively if each ‘question group’ split up and new groups formed with one or two representatives from each question. If we had more time I think I would have drawn the ideas out this way, possibly with each new group chaired by a Sixth Form helper.
– Enjoy it! I had a great time running this session, and it was obvious that the pupils and the Sixth Formers did too.
EBM scholars workshop
Sarah Pannell is a Biology teacher at Lingfield Notre Dame School in Surrey, having completed her DPhil in Biochemistry at the University of Sussex and then worked at STEM Sussex (University of Brighton) on schools outreach. She continues to encourage her students to think creatively about science, technology, engineering and mathematics (STEM), and really doesn’t mean to get involved in quite so many interesting projects, honest!