Best Practices, As Defined By Whom?

Larry Cuban offers an important critique of the notion of “best practice” in the field of education that is especially important to bear in mind as we move forward in teacher evaluations and observations. In “The Sham and Shame of “Best Practices”,  Cuban draws from the medical field to delineate what can constitute a standardized “best practice”:

According to Groopman, experts who recommended “best practice” treatments (and their advice became Medicare mandates to all physicians) “did not distinguish between medical practices that can be standardized and not significantly altered by the condition of the individual patient, and those that must be adapted to a particular person.” He gives the example of putting a catheter into a blood vessel, a procedure that involves the same steps for every patient to avoid infection. This “one-size-fits-all” mechanical procedure differs from prescribing a “best practice” for a complex disease such as diabetes, congestive heart failure, or breast cancer. Not making this critical distinction leads experts to overreach in their recommendations to practitioners and, in time, turn a “best practice” such as hormone replacement therapy for women into a fad. A similar situation plagues school reform. . . .

I am not the first educator, nor the last, to make the point that school reform is a value-driven (not research-driven) business where policymakers depend far more on faith than facts and far more on uniformity than context.

This distinction between what is purely mechanical and procedural versus what is complex and based upon highly contextualized factors is a very useful one to make.

There is a movement in teacher education to begin teaching routine pedagogical methods that can be observed, practiced, and mastered. This is a move in the right direction, in that these practices are based on moves that are mechanical and can be scaled, wielded effectively by any educator dependent on the lesson and the moment.

But the remainder of what an educator does in and outside of a classroom is complex, based on a numerous array of factors, from the leadership in the school and school district, the policies of the state, the relationships between the teachers, between the students, and between the community, the physical constraints of the building, the levels of prior knowledge and ability of the students, the curricular demands of the content and calendar, and so on. This is where the values that Cuban speaks of come into play, and why many educators roll their eyes when they learn that their school is being judged by a rubric which states that teaching should be a “evidence based.”

In order to gain an insight into just how solidly “research” can guide us into our decisions in schools, take a gander at What Works Clearinghouse and see just how much solid, evidence-based research we have on anything. Essentially, we have some promising leads, but nothing substantial, much less anything that can tell us exactly what to do with a given child in a given situation.

Rather than quixotically claiming that there is currently exists any such scientific body of knowledge as “evidence-based practice” in the realm of education, I think we would do much better to seek to expand opportunities to gather “practice-based evidence.”

In this article advocating for practice-based evidence in physical therapy, “Practice-Based Evidence” by Anne Swisher, some insight is provided into why this is critical:

In the concept of Practice-Based Evidence, the real, messy, complicated world is not controlled. Instead, real world practice is documented and measured, just as it occurs, “warts” and all. It is the process of measurement and tracking that matters, not controlling how practice is delivered.

If there’s one way of describing a school, “messy” and “complicated” would certainly be words that would suit that description.

But if we can’t control how practice is delivered in a school, how can we ensure a high quality in service? The article on physical therapy also provides some insight into this:

Recently, the Cardiovascular and Pulmonary Section has been approached to develop clinical guidelines in our content areas. Here we can learn from our orthopedic physical therapy colleagues. They have systematically collected real world data and synthesized them into guidelines for practice, such as clinical prediction rules for diagnosis. Clinical practice guidelines provide the practitioner with a valuable starting place when faced with a patient scenario. These are extremely important and helpful. Some practitioners have viewed these guidelines as restrictive to practice or a “cookbook” approach that removes clinical reasoning and decision-making. However, I argue that these protocols in themselves do not fully address the issue of the patient in front of you—with his or her own unique physical, psychological, emotional, environmental, and cultural perspective. The skilled practitioner must take these guidelines and make decisions regarding the appropriateness for the individual patient. However, this is not an excuse to throw out the guidelines entirely and utilize a “guru” approach. As practitioners, it is our responsibility to measure what we do and the outcomes for all patients to create an even richer database of clinical scenarios to improve the guidelines.

Creating protocols or guidelines based on a synthesis of practice-based evidence, in other words, can provide direction for the practitioner, but without pretending to control the actual delivery of service.

However, even when drawing up such protocols or guidelines, it may be helpful to bear in mind the caution that Cuban asserts: that education can be viewed primarily as a value-driven—rather than research-driven—enterprise.

So when “best practice” is defined, it is incumbent upon us to ask, “Who has defined this as best practice?” and furthermore, “What values do they hold?”

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