Life sciences education
My intention in creating these 'education pages' is to assemble materials from several disciplines to investigate how they are handling common sense ideas, folk ideas, naive ideas, whatever they might get called, that are inconsistent with the scientific ideas in that particular discipline. The prime example is the folk physics of pupils that is frustrating their learning the classical mechanics of Newton, while most programs or teachers do not explicitly handle this problem, or even are aware of it. While this kind of problem evidently is frustrating the efficiency of education, it also touches on what is valid assessment of knowledge of physics. Designing physics tests should touch on this issue.
The inventory will contain studies, web pages etc. that in one way or another might touch on the topic of designing test items in the life sciences.
Sandra Waxman (2005). Why is the concept of &lquot;living thing&rquot; so elusive? Concepts, languages, and the development of folkbiology. In Woo-kyoung Ahn, Robert L. Goldstone, Bradley C. Love, Arthur B. Markman, and Philip Wolff: Categorization inside and outside the laboratory (49-68). American Psychological Association.
Florencia K. Anggoro, Sandra R. Waxman, and Douglas L. Medin (2008). Naming Practices and the Acquisition of Key Biological Concepts. Evidence From English and Indonesian. Research report. Psychological Science pdf [retrieved May 2009]
Helen de Cruz & Johan De Smedt (2006). The Role of Intuitive Ontologies in Scientific Understanding – the Case of Human Evolution. Biology and Philosophy, 22, 351-368.
- abstract Psychological evidence suggests that laypeople understand the world around them in terms of intuitive ontologies which describe broad categories of objects in the world, such as ‘person’, ‘artefact’ and ‘animal’. However, because intuitive ontologies are the result of natural selection, they only need to be adaptive; this does not guarantee that the knowledge they provide is a genuine reflection of causal mechanisms in the world. As a result, science has parted ways with intuitive ontologies. Nevertheless, since the brain is evolved to understand objects in the world according to these categories, we can expect that they continue to play a role in scientific understanding. Taking the case of human evolution, we explore relationships between intuitive ontological and scientific understanding. We show that intuitive ontologies not only shape intuitions on human evolution, but also guide the direction and topics of interest in its research programmes. Elucidating the relationships between intuitive ontologies and science may help us gain a clearer insight into scientific understanding.
John T. E. Richardson (1989). Cognitive skills and psychology education. In John Radford and David Rose:. A liberal science. Psychology education past, present and future (pp. 61-70). Buckingham: SRHE/Open University.
drug taking in medicine
Common sense ideas about sickness and health, 'folk medicine, 'naive medicine,' might interfere with with compliance in drug taking. In about just the same way folk physics might interfere with learning the classical mechanics offered by one's teacher in school. Look at the discussion about compliance or concordance in medicine as an analogon for the problems experienced in physics education. Be aware that in the medical realm there is no abundance of facts or siple experiments as tere is in school physics.
Iona Heath (2003). A wolf in sheep's clothing: a critical look at the ethics of drug taking. BMJ, 327, 856-858 (11 October) html
- About compliance and concordance in drug taking.
- "Compliance is indeed a pernicious concept which devalues patients and leaves the hubris of doctors dangerously exposed. It derives from the foundation of medical science within a modernist rationality, which seeks to identify general rules that can be applied to standardised situations. However, in the care of patients, doctors attempt to apply general rules to particular individuals in situations that are never standard and where there is no single right answer. "
- "In 2002 the Department of Health responded to the recommendations of the Royal Pharmaceutical Society's report by endorsing the concept of concordance and creating the Medicines Partnership Task Force (http://www.npc.co.uk/med_partnership/index.htm). (...) While paying lip service to the view that the patient's version of truth is as valid as the doctor's, the rhetoric of the website clings to the conviction that there is, after all, a single objective account of reality and that this account is provided by medical science. The notion of compliance is at least explicitly coercive; the danger of concordance is that the coercion remains but is concealed."
I understand that the point of the last remark is that concordance is taken to mean that scientific facts etcetera have to be explained more forcefully. That reminds strongly of the physics teaching problems: better explaining Newtonian physics does not really help pupils to make the transisiton from their Aristotelian beliefs to the Newtonian ones. What is missing in the 'concordance approach' is an analysis of what the patient beliefs might be that threaten their compliance to the drug taking regime proposed to them.
This is however not the line of reasoning followed by Iona: she emphasizes that medical knowledge is way too insecure to demand blind obedience to whatever the medical practitioner says is best for the patient. And patients are fully aware of the limitatons of medical science. At least this is an analysis of patient beliefs; I think it is way too narrow, though.
- The next item in the essay is excessive drug taking / prescribing. Well, this surely is another aspect of patient beliefs, and doctors' beliefs as well, and Iona does not forget to add market forces driving overconsumption in the Western world. In the end, however, Iona comes up with little more then the admonition to better explain " the limitations of medicine and the uncertainties of medical knowledge." That is not bad, of course. Who can be against it? And she emphasises how difficult medical decisions are, not in the least for the patients themselves. That is not very helpful in itself, though. I would like to know whether there are particular common sense ideas, personal beliefs, that make it more difficult for the patient to understand whatever message the medical examiner is trying to get across. What are the possibilities to handle them in a respectful way, serving the health interests of the the persons concerned?
- I thank Gilles for the Iona Heath reference.
Derjung M. Tarn and others (2006). Physician Communication When Prescribing New Medications. Arch Intern Med. 2006;166:1855-1862. abstract Another one-way directed communication study. "Conclusions: When initiating new medications, physicians often fail to communicate critical elements of medication use. This might contribute to misunderstandings about medication directions or necessity and, in turn, lead to patient failure to take medications as directed."
- Claudia Cooper and others (2005). The AdHOC Study of Older Adults' Adherence to Medication in 11 Countries. Am J Geriatr Psychiatry 13:1067-1076, December 2005. This study does not address patient beliefs. "Objective: Authors investigated, cross-nationally, the factors, including demographic, psychiatric (including cognitive), physical, and behavioral, determining whether older people take their prescribed medication. (...) Conclusion: People who screen positive for problem drinking and who have dementia (often undiagnosed) are less likely to adhere to medication. (...)"
J. L. Donovan (1995). Patient decision making. The missing ingredient in compliance research. Int. J. Technol Assess health Care, 11, 443-55. This one looks promising. Regrettably, there is no free online version of the artcle. "abstract Medical noncompliance has been identified as a major public health problem that imposes a considerable financial burden upon modern health care systems. There is a large research record focusing on the understanding, measurement, and resolution of noncompliance, but it is consistently found that between one third and one half of patients fail to comply with medical advice and prescriptions. Critically absent from this research record has been the patient's role in medical decision making. For patients, particularly those with chronic illnesses, compliance is not an issue: they make their own reasoned decisions about treatments based on their own beliefs, personal circumstances, and the information available to them. The traditional concept of compliance is thus outmoded in modern health care systems, where chronic illness and questioning patients predominate."