EBM for under 18s: equipping the next generation to think critically about healthcare

The Association for Science Education (ASE) is a community of educational professionals interested in supporting science education with the aim to make a positive and influential difference to the teaching and learning of science.  Their flagship event is the Annual Conference, and at this year’s conference, in Liverpool, we conducted a seminar and a workshop on ‘Evidence-Based Medicine (EBM) for under 18s.’

The aim of our EBM for under 18s work is to:

1. to equip the next generation with the critical thinking skills to make informed healthcare choices;
2. and to emphasise opportunities to teach critical thinking using health claims, opportunities that may be lost in the need to stress factual knowledge in such topics.

As active seekers of healthcare information students require - at the very least - a basic understanding of EBM to inform complex healthcare decisions. Particularly so to deal with the barrage of healthcare information on the internet that is mostly untrustworthy, riddled with inaccuracies and often contains overinflated treatment effects. 

What type of evidence do you require to inform treatment decisions, where might you find such evidence and how would you trust the evidence you have to hand?  All of these and more are questions that lend themselves to an EBM approach. Developing an evidence-informed society who can make better-informed choices, actively engage in self-care activities and participate in their health is essential for effective, affordable healthcare. Once you make this connection, then it seems evident that the place to start teaching EBM is in schools.

The UK science curriculum - as it currently stands - also offers a unique opportunity for students to become critically aware of health care claims. As an example, in one of last year’s exams, student understanding was tested with a 'thoroughly scurrilous' piece of journalism. Unfortunately, nearly half of the students found the evidence compelling and were unable to offer any criticism of it. Some students exercised scientific criticism and pointed out that there were no controls in the investigation and that just because there was a correlation, this did not necessarily prove a causal link.

The answers from the majority of students indicated that they have a great deal to learn about critical evaluation of data. The current curriculum also asks students to evaluate risks both in practical science and the broader societal context, including the perception of risk in relation to data and consequences. Examples of what students might be asked to do in an exam include:

• Give examples to show that there are hazards associated with science-based technologies which have to be considered alongside the benefits.
• Suggest reasons why the perception of risk is often very different from the measured risk (e.g. voluntary vs imposed risks, familiar vs unfamiliar risks, visible vs invisible hazards).

With this in mind, in Oxford University's Centre for Evidence Based Medicine, we are developing resources to equip the next generation to think critically about healthcare and health claims and are developing and testing curriculum-linked lesson plans with our contacts in schools. At the policy level, we are trying to influence the education system's agenda to take a wider view of the type of evidence that can and does inform healthcare decisions.

EBM for under 18s: Bad Science and the Science curriculum
Sarah Pannell, Elizabeth Spencer, Carl Heneghan
ASE 6th Jan 2018, Liverpool University

Try out our Lesson plans

“For students and all brain workers - Take one glass Coca-Cola at night to keep the brain clear and active until eleven.”

What claim is being made? How could we test this? Is this the right type of study to answer the question?

• Pdf overview of lesson Evidence-Based Medicine for Under 18s
• Cola RCT Workshop – Presentation
• Cola RCT Workshop – Lesson Plan
• Cola RCT Workshop – Wordsearches

Acknowledgements:

Sarah Pannell, a school teacher, was funded by the McCall MacBain Foundation to develop and test the lesson plans.