I have been fascinated by the science and results of Placebo Medicine for a long time. I remember being very struck by a documentary on the Placebo Surgery on knees done by Dr Bruce Moseley back in the 1990s. I was brought back to this by an excellent and fascinating article in The Conversation (‘Placebo’ or ‘sham’ surgery is not a cruel trick – it can be very effective (theconversation.com)).

This has led me to wonder what Placebo Education might look like. It is a phrase I have used and written about before, but further thinking has led me to a clearer idea of how this powerful concept relates to educational practice and methodology and how it might lead to a better understanding of how to improve schools.

First let’s review some of the fundamental principles of Placebo Medicine, particularly surgery. 

1. A patient has or perceives they have an ailment. This can include a knee problem that seriously impedes standing or walking, migraines or gastrointestinal bleeding. These examples are mentioned in the article referenced above.
2. There is a standard surgical treatment for the problem. It could be arthroscopic knee surgery, brain implants or laser surgery. There are also alternative treatments that are available such as physiotherapy, drugs etc.
3. The patient undergoes a “surgical” treatment that does everything except the surgery. The care, the build up, the discussions, the arrival at the moment that the surgery might happen, and the follow up all take place, but there is no actual invasion of the body. There is no surgery.
4. The results in terms of improvement are practically identical whether the surgery has taken place or not. The rates of improvement and recovery are about the same. It is very important to understand that placebos do not need to be secret. Improvement rates are just as good when people know what they are getting is a placebo treatment.

I am not making this up. There are many replicated studies since Dr Moseley’s accidental findings back in the 80s and 90s.

Here are the more generalised points I want to extract.

1. People have needs for improvement and change that require help from others for them to move forward.
2. There are standard ways of leading people forward, and there may well be alternatives to these standards and questions about which way forward is the best for each individual.
3. It may well be that the way people improve has little to do with the actual vector of improvement (surgery, placebo, therapy or drugs), but more to do with the mindset and attitude of the person themself which may indeed be induced by the vector in question.

What might this mean for education? 

Well, we have many debates in education about whether direct instruction is better or worse than discovery learning. We argue over assessment methods, the use of IT, the amount of time spent on each thing, the value of groupwork, the place of AI and so many other things. What if the actual conclusion of these arguments is irrelevant? Any educational vector can work and the value lies in the fact that we are having the debate. What if we include as many people as possible in the discussion, the debate and ownership of the conclusion that it really doesn’t matter what the conclusion is?

For teachers, the conclusion is that we must get them as involved as possible in the discussion and let them take the decisions on the methods because they will do it better the more they are in control and the less the authorities make the decisions for them. It doesn’t matter what decision they come to.

For children, the same is true. If they are engaged in deciding how they learn and what they learn, they will be better learners and better people because of it. The actual decisions they make are completely irrelevant.

So here is a definition:

Placebo Education is when we do not care about the methodology of teaching or learning or the contents of the curriculum. We care about engaging adults and children in actions and discussion about learning so they can make the decisions.

It is important to note that Placebo Education is very far from just doing nothing. Just as Placebo Surgery works when all the preparation, discussion, follow up and care are done fully, Placebo Education requires active engagement from the teachers and the students on how they will teach and learn and what they will teach and learn. All it avoids is a dogmatic imposition of one particular method of teaching and learning and one particular set of content.

There is a lot of trust involved in this. That is very threatening to authorities and leaders and the gurus who are convinced The Only Way is Essex or whatever their particular brand is called. I apologise to the offended.

Chris Binge

June 2024