Recent weeks have seen a series of exciting announcements about the results of randomised controlled trials testing the efficacy of vaccines. Beyond the promising headlines, interviews with excited researchers have featured the phrase ‘unmasking’. But what is unmasking, and is it relevant to trials in education?
Unmasking is the stage in a trial when researchers find out whether each participant is in the control or intervention group. In healthcare, there are up to three ways that trials can be masked. First, participants may be unaware whether they are receiving the intervention; second, practitioners leading the intervention, like nurses providing a vaccination, may not know which participants are receiving the intervention; third, the researchers leading the trial and analysing the data may not know which treatment each participant receives.
Each of these masks, also known as blinding, is designed to prevent known biases. If knowledge of treatment allocation changes the behaviour of stakeholders – participants, practitioners, researchers – this may be misattributed to the intervention. For instance, in a trial testing vaccinations, participants who know that they have received the real vaccine may become more reckless, which could increase their risk of infection; practitioners may provide better care to participants they know are not getting the vaccine; researchers may make choices – consciously or sub-consciously – that favour their preferred outcomes.
These various risks are called social interaction threats, and each has various names. Learning the names is interesting, but I find it helpful to focus on their commonalities: they all stem from actors in the research changing their behaviour based on treatment allocation. The risk is that these can lead to apparent effects that are misattributed to the intervention.
- Diffusion or imitation of treatment is when the control group starts doing – or at least attempts – to imitate the intervention.
- Compensatory rivalry is when the control group puts in additional effort to ‘make up’ for not receiving the intervention.
- Resentful demoralisation is the opposite of compensatory rivalry because the control group become demoralised after finding our they will miss out on the intervention.
- Compensatory equalisation of treatment is when practitioners act favourably towards participants they perceive to be getting the less effective intervention.
So what does this all have to do with education?
It is easy to imagine how each threat could become a reality in an education trial. So does it matter that masking is extremely rare in education? Looking through trials funded by the Education Endowment Foundation, it is hard to find any that mention blinding. Further, there is limited mention in the EEF’s guidance for evaluators.
It would undoubtedly help if trials in education could be masked, but there are two main obstacles. First, there are practical barriers to masking – is it possible for a teacher to deliver a new intervention without knowing they are delivering it? Second, it could be argued that in the long list of things that need improving about trials in education, masking is pretty low down the list.
Although it is seldom possible to have complete masking in education, there are practical steps that can be taken. For instance:
- ensuring that pre-testing happens prior to treatment allocation
- ensuring that the marking, and ideally invigilation, of assessments is undertaken blind to treatment allocation
- incorporating aspects of ‘mundane realism’ to minimise the threats of compensatory behaviours
- analysing results blind to treatment allocation, and ideally guided by a pre-specified plan; some trials even have an independent statistician lead the analysis
- actively monitoring the risk of each of these biases
I do not think we should give up all hope of masking in education. In surgery, so-called ‘sham’ operations are sometimes undertaken to prevent patients from knowing which treatment they have received. These involve little more than making an incision and then stitching it back up. It is possible to imagine adapting this approach in education.
We should also think carefully about masking on a case-by-case basis as some trials are likely at greater risk of social threats to validity than others. For instance, trials where control and intervention participants are based in the same school, or network of schools, are likely at the greatest risk of these threats.
In conclusion, a lack of masking is not a fatal blow to trials in education. We should also avoid thinking of masking as an all or nothing event. As Torgerson and Torgerson argue, there are different ways that masking can be undertaken. Taking a pragmatic approach where we (1) mask where possible, (2) consider the risks inherent in each trial and (3) closely monitor for threats when we cannot mask is probably a good enough solution. At least for now.