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Their fear (for their own professional standing and income stream) is justified, but the objections to measuring performance are special pleading. 1) "Each pat

Their fear (for their own professional standing and income stream) is justified, but the objections to measuring performance are special pleading. 1) "Each patient is unique" just like "each student is unique"...but we still give standardized tests (to the grumbling of below-average teachers and administrators) 2) If the sample size is too small because the disease is rare, there may be a genuine measurement problem. If the doctor or hospital's sample size is too small but the illness is common, then they should be referring those patients to providers/facilities with the requisite experience levels.

zaarn 9y ago
If a common disease has not sufficient experience in a hospital I'd argue they should pull in experts from elsewhere and try to gain the experience necessary, otherwise you just end up exporting the problem.
Fordrus 9y ago
There is substantial argument that our focus on standardized testing is literally ruining the advantages traditionally associated with a Western Education. But then, perhaps I would be a "below-average" teacher, and my opinion might therefore similarly be discarded as worthless. We'll never know for certain, because I don't make a habit of boarding sinking ships - especially when I'm slated to receive blame for their sinking after boarding them. (And I did at one point very much want to enter the field of secondary school education.) (Slight modification: I won't board a sinking ship and take blame for it's sinking after the fact without some substantial advantage, such as excellent remuneration, being offered as well - teaching offers no such advantage, except perhaps self-actualization, and I can neither eat nor sleep in that.)
- tinokid 9y ago
  Sure, bad comparison. It's consistent to support standardized rating of doctors but not teachers. Teaching exists to enrich, whereas medicine properly understood only exists to solve problems. (I find it curious that another poster takes the opposite tack, claiming that teaching exists only to maximize the financial success of students, whereas medicine has a more nuanced end. I confess to finding this position truly bizarre.)
deleted 9y ago
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Fomite 9y ago
Having worked a little bit on #2, even for relatively common conditions, stochasticity still plays a major role in outcomes. For example, I have a simple model that ends up showing that an ICU doing everything it's supposed to do (patient isolation, high hand hygiene compliance, perfect diagnosis, etc.) can have a four-fold difference in MRSA infections over a year by chance alone.
Steuard 9y ago
For what it's worth, I've heard a whole lot of above-average teachers complain about standardized testing, too. The things that one does in a classroom to optimize standardized testing performance are often not the same things one would do to optimize creative problem solving, or independent learning, or good citizenship, none of which are captured by (existing?) standardized tests. For that matter, the things that a third-grade teacher would do to optimize third-grade standardized test scores aren't necessarily the same things that the same teacher would do to optimize twelfth-grade standardized test scores.

zaarn 9y ago

If a common disease has not sufficient experience in a hospital I'd argue they should pull in experts from elsewhere and try to gain the experience necessary, otherwise you just end up exporting the problem.

Fordrus 9y ago

There is substantial argument that our focus on standardized testing is literally ruining the advantages traditionally associated with a Western Education. But then, perhaps I would be a "below-average" teacher, and my opinion might therefore similarly be discarded as worthless. We'll never know for certain, because I don't make a habit of boarding sinking ships - especially when I'm slated to receive blame for their sinking after boarding them. (And I did at one point very much want to enter the field of secondary school education.) (Slight modification: I won't board a sinking ship and take blame for it's sinking after the fact without some substantial advantage, such as excellent remuneration, being offered as well - teaching offers no such advantage, except perhaps self-actualization, and I can neither eat nor sleep in that.)

tinokid 9y ago
Sure, bad comparison. It's consistent to support standardized rating of doctors but not teachers. Teaching exists to enrich, whereas medicine properly understood only exists to solve problems. (I find it curious that another poster takes the opposite tack, claiming that teaching exists only to maximize the financial success of students, whereas medicine has a more nuanced end. I confess to finding this position truly bizarre.)

deleted 9y ago

[deleted]

Fomite 9y ago

Having worked a little bit on #2, even for relatively common conditions, stochasticity still plays a major role in outcomes. For example, I have a simple model that ends up showing that an ICU doing everything it's supposed to do (patient isolation, high hand hygiene compliance, perfect diagnosis, etc.) can have a four-fold difference in MRSA infections over a year by chance alone.

Steuard 9y ago

For what it's worth, I've heard a whole lot of above-average teachers complain about standardized testing, too. The things that one does in a classroom to optimize standardized testing performance are often not the same things one would do to optimize creative problem solving, or independent learning, or good citizenship, none of which are captured by (existing?) standardized tests. For that matter, the things that a third-grade teacher would do to optimize third-grade standardized test scores aren't necessarily the same things that the same teacher would do to optimize twelfth-grade standardized test scores.