Wednesday, October 29, 2014

Education Is Not Medicine

One of the popular new reformster talking points is to compare standardized testing to diagnostic testing at the doctor's office (you can find examples here and here). This comparison is total baloney, and reformsters need to retire it immediately. They are just making themselves look silly. Let's break it down.

Students are not patients.

Students are not patients who need to be "cured" of the "disease" of not knowing stuff. There is nothing about that comparison that holds up. Disease attacks a healthy body and breaks down tissues and functions that were previously fine. Which part of that sounds like a student not understanding how to multiply doubly digit numbers or misunderstanding how to find verbs?

Doctors choose the tests.

The doctor uses her professional judgment to determine which tests will be administered. The doctor uses her professional judgment looking at the symptoms, the nature of the patient, and the possible issues that might be involved. And then the doctor decides which test to order because

There are many tests.

Doctors do not have a single one size fits all diagnostic test that is given to all patients, regardless of whether they are complaining about a sore chest, a broken leg, or a high fever. The test is chosen to fit the situation (again, using the doctor's professional judgment). For that matter, for every test the doctor chooses to give a patient, the doctor also choose NOT to give a large number of tests to that patient. There is no medical analog for a high stakes one size fits all test to be given to all students.

Doctors can still see.

When I went to the doctor with the flesh of my knee split open, my doctor did not say, "Well, it looks like the flesh of your knee is split open, and I might be looking at the patella right there, but let me run some tests, first." He definitely didn't say, "First, I have to give you this exact same test that we give every single patient who enters the hospital no matter what the issue seems to be." Because, as it turns out, my doctor has A) eyes and B) sense. So he sewed up my knee. Some times the correct diagnostic test is no test at all, because A) eyes and B) sense.

Results are timely.

Depending on the urgency of the situation (as determined by the professional judgment of the doctor), the results will come back in a timely manner. If you get your broken leg x-rayed in May, your doctor expects to see the images before September.

Judgment beats test

When the test results return, the doctor makes a diagnosis and prescription based on his professional judgment. The test provides data; it does not make a prescription. "The test says I have to prescribe paxil for you," said no doctor ever. The doctor's judgment is not subordinate to the test results.

Doctors know when to quit

My doctor does not shorten my treatment so that he has time to give me more tests. If he has to make a choice between more treatment for my problem and more testing, more testing does not automatically win.

No stakes tests.

The diagnostic tests that a doctor orders do not become part of the job evaluation of the doctor. The hospital board does not call a doctor in and say, "100% of the limbs you ordered x-rays for this year were broken. Therefor we find you ineffective and you're fired." Nor do we use the test results to judge the hospital. And we especially don't use the test results to judge people in some other department who never even saw the patient.

So stop comparing high stakes standardized tests to diagnostic medical tests. They are not comparable and the analogy is extraordinarily weak. Find something else better to compare high stakes standardized tests to, like cumquats or people who insist on talking loudly on their cell phones in public places.



  1. was a little sketchy and unconvincing throughout, but meme. Nailed it!

    Kidding, this makes total sense.

  2. Yep, there's a semantic and lack of critical thinking/analysis/deep structure problem here (testing=testing). All the things the reformsters say should be taught but don't appear to know how to do themselves (or they're willfully conflating.) Brilliant, insightful analysis. Actually, if they really wanted us to do testing like doctors do, the analogy could work, but obviously (once one has read your analysis) once again the problem is one-size-fits-all doesn't work for real human beings.

  3. And whatever happened to "It takes a village"? I am both a parent and a teacher, and I do a TON of work at home with my son, in partnership with his teacher, to help him learn as well as he can - and this a kid with no learning disability. When the finger gets pointed at the teacher for a kid not knowing something YET (or worse, at the kid himself), all the partnering breaks down. Tests should be used by the teacher and parent to determine what needs to be done next, nothing else. And the emphasis should ALWAYS be, " Hey, we're not there yet, but let's keep working. We are here to support you, student."

  4. As I read this excellent piece, I did think of one way doctors are being treated like teachers. When the insurance companies come in and say that the meds the doctor prescribed (via their professional judgement) will not be covered because money.