A few weeks ago, Dr. H. Gilbert Welch of Dartmouth College published an Op-Ed article in The New York Times critiquing the pervasive use of screening tests for early diagnosis in medicine. The rationale for widespread screening — to catch disease early, before people get really sick — is intuitively appealing.
But Dr. Welch cites evidence that aggressive screening often does more harm than good, saving few lives while dragging many others into “needless appointments, needless tests, needless drugs and needless operations.”
This continuing debate about early detection versus overdiagnosis in medicine is surprisingly relevant to a similarly critical debate in education: how to identify and “treat” students who enter college underprepared for college-level coursework.
Most community colleges and many nonselective four-year institutions require students to take placement exams in reading, writing and math before initial registration, even if they had good grades in high school, and even if they have done well in college courses at another institution.
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