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Learning and teaching
Published in Jenny Gavriel, The Self-Directed Learner in Medical Education, 2005
Differentiation is a word that strikes fear into the heart of many teachers mostly because it involves providing personalised learning experiences for up to 30 pupils in a classroom. Fortunately, in medical education, this is a rarer situation, more often it is a one to one or small group context where differentiation or personalisation of the learning is more realistic. It is undeniably important to make adjustments to learners’ ability level and also to the level they are expected to achieve. Essentially, this comes back to goal setting and making them realistic but challenging; too difficult or too easy and the learner may become demoralised. However, there is a note of caution (isn’t there always?) when you are setting your expectations of your learners. Known as the Pygmalion effect and the Golem effect, our expectations can impact upon the learner’s actual achievement. The Pygmalion effect is the increase in achievement by the learner (or employee) when the educator (or manager) has high expectations - a potentially powerful tool. The Golem effect is the opposite, and this is where we need to be careful; if we set our expectations too low we may actually cause our learner to achieve lower than their potential. There is a significant amount of literature about these effects, but it is a tricky area in which to carry out research, simply because the ethics involved in deliberately trying to negatively affect an individual’s achievements are rather grey to say the least.
Efficacy of antidepressants: bias in randomized clinical trials and related issues
Published in Expert Review of Clinical Pharmacology, 2018
Sheng-Min Wang, Changsu Han, Soo-Jung Lee, Tae-Youn Jun, Ashwin A. Patkar, Prakash S. Masand, Chi-Un Pae
Hawthorne effect may be an important factor affecting the generalizability of DBRPCT to clinical practice. Clinical trials have a more strict follow-up guidelines than the routine practice. A study showed that more intensive follow-up of individuals in a placebo-controlled clinical trial resulted in a better outcome than minimal follow-up. Thus, the assessment protocols may result in a greater Hawthorne Effect [55]. In addition, researchers, by knowing treatment group that the patient was allocated to, may expect antidepressant group to perform better or improve more. This can lead to Pygmalion effect, or Rosenthal effect, which is the phenomenon whereby higher expectations of the therapist lead to better improvement in depression symptoms [56]. In addition, researcher may also rate HAM-D score of patients in the antidepressant group more positively. This sort of halo effect may also inflate efficacy of an antidepressant [57]. In contrast, the researcher may expect patients in the placebo group to have a poorer performance or less improvement in their depression symptoms which is called the Golem effect [58].