{"id":375,"date":"2008-05-13T15:02:47","date_gmt":"2008-05-13T14:02:47","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/2008\/05\/13\/liz-wager-training-and-the-placebo-effect\/"},"modified":"2014-07-29T10:19:46","modified_gmt":"2014-07-29T09:19:46","slug":"liz-wager-training-and-the-placebo-effect","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2008\/05\/13\/liz-wager-training-and-the-placebo-effect\/","title":{"rendered":"Liz Wager: Training and the placebo effect"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.bmj.com\/site\/blog\/icons\/lizwager.jpg\" alt=\"Liz Wager\" width=\"162\" height=\"110\" align=\"left\" \/>I\u2019ve been at the Vienna School of Clinical Research running a publication workshop for an enthusiastic bunch of doctors, researchers and drug company folk. Back home, catching up on my reading, Diana Wood\u2019s BMJ editorial on <a title=\"Problem based learning\" href=\"http:\/\/www.bmj.com\/cgi\/content\/extract\/336\/7651\/971\">problem based learning<\/a>\u00a0struck a chord. She argues that we don\u2019t really know whether problem based learning works better than other teaching methods. But that\u2019s true of an awful lot of training.<!--more--><\/p>\n<p>A few years ago, the BMJ did a randomized trial of <a title=\"Does declaration of competing interests affect readers' perceptions? A randomised trial \" href=\"http:\/\/www.bmj.com\/cgi\/content\/full\/325\/7377\/1391\">reviewer training<\/a>. This showed that that neither attending a course nor doing a distance learning package had much effect on reviewer performance. But the BMJ carried on offering the face-to-face training sessions for a while because reviewers liked them.<\/p>\n<p>At the time, I thought this was a bit spineless, but I realise I\u2019m in no position to criticize, since I make at least some of my living by peddling unproven training courses. Maybe it\u2019s enough if participants enjoy the course and think it helps them \u2013 but some firmer evidence would be nice.<\/p>\n<p>Still pondering about the effects of training, I was delighted by the study from <a title=\"randomised controlled trial in patients with irritable bowel syndrome\" href=\"http:\/\/www.bmj.com\/cgi\/content\/full\/336\/7651\/999\">Kaptchuk and colleagues<\/a> (May 3, 336:999), showing that warm and encouraging human interaction accounts for much of the placebo effect. It\u2019s maybe not a surprising finding, and it probably goes a long way to explain the success of many complementary therapies and why it\u2019s ridiculous to expect GPs to deal with patients in 7- (or even 10-) minute time slots but it is, nevertheless, useful.<\/p>\n<p>It made me think about the difference between giving information and training. The students attending my workshop in Vienna were smart, keen and well-educated. Most had already published some research and must have read masses of journal articles. Virtually everything I taught them was quite easily available in books and websites. But I was struck that none of the students had heard of the CONSORT statement on trial reporting (<a href=\"http:\/\/www.consort-statement.org\/\">www.consort-statement.org<\/a>) and only a handful were aware of the ICMJE authorship criteria (<a href=\"http:\/\/www.icmje.org\/\">www.icmje.org<\/a>). As well as lectures, the course included practical exercises: these can be a salutory experience for a trainer when you see whether students have really got your message. Confucius certainly knew a thing or two when he wrote \u2018What I hear, I forget; what I see, I remember; what I do, I understand\u2019.<\/p>\n<p>So what\u2019s this got to do with placebos? Only that, for all the possibilities of on-line training and distance learning (which I don\u2019t decry), it still seems that humans respond best to interaction with another human being.\u00a0 Any comments? Have your say on the blog.<\/p>\n<p><strong>\u00a0About Liz Wager<\/strong><\/p>\n<p>Liz Wager is a freelance writer, trainer and publications consultant who works<br \/>\nfor a number of pharmaceutical companies, communication agencies, publishers and<br \/>\nacademic institutions. She is also the Secretary of COPE (the Committee On<br \/>\nPublication Ethics) and a member of the BMJ\u2019s Ethics Committee.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>I\u2019ve been at the Vienna School of Clinical Research running a publication workshop for an enthusiastic bunch of doctors, researchers and drug company folk. Back home, catching up on my [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2008\/05\/13\/liz-wager-training-and-the-placebo-effect\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1404],"tags":[],"class_list":["post-375","post","type-post","status-publish","format-standard","hentry","category-liz-wager"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Liz Wager: Training and the placebo effect - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2008\/05\/13\/liz-wager-training-and-the-placebo-effect\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Liz Wager: Training and the placebo effect - The BMJ\" \/>\n<meta property=\"og:description\" content=\"I\u2019ve been at the Vienna School of Clinical Research running a publication workshop for an enthusiastic bunch of doctors, researchers and drug company folk. 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