Complex educational interventions demand complex and appropriate evaluations

How can we ever be sure that educational approaches such as problem based learning are better than traditional ones? Change merely for the sake of change is futile. Changes in medical education should lead to better outcomes, but what is the best way to show cause and effect?

For simple research questions straightforward methods suffice, but more complex questions require more complicated study designs. A question such as “Is drug A more effective than a placebo?” is highly relevant, and the methods needed to answer it may be relatively straightforward. However, the question “Why does drug A lead to a better outcome than a placebo?” is more complicated, and “Does using drug A lead …