The core way of framing the issue is this. We observe something (doctors who use chaperons, for example). We ask: what explains this observation? (Gawande himself explains this as both a deterrent to illicit behavior and as a signal to the patient that there is no intent of illicit behavior.) Are there unintended consequence? (Gawande says yes. The chaperon can make the patient feel uncomfortable.)
While we should take Gawande at his word, in general there can be more than one plausible reason that "explains" what we observe. Then the question is whether we have additional evidence that lets us sort between the candidate explanations (which is why I've pushed some of you on drill down, so you can get to some of that evidence). The reason you want to do this sorting is that if what you observe appears to be a problem, then addressing the problem requires addressing the true cause.
We discussed cheating on tests at some length yesterday but rather than consider it specifically let me take on malfeasance and serious crime more generally. There are two basic possible explanations for malfeasance; one places the onus on "the system" the other identifies the source as personal weakness or, more seriously, out and out evil present in the offending individual. One can then build up more complex explanations via interplay of the two basic explanations and interaction of those with other factors. Making ever more complex explanations helps in getting to the nuance of the particular circumstance, but it makes it harder to identify among the candidates.
A really great movie from the Depression era, I Am A Fugitive From A Chain Gang, is an indictment of the penal system in Georgia at the time. The story, which is based on fact, is about an innocent person getting mistakenly sent to prison, finding that horrible so he has reason to escape, and then with great irony turning into a thief because that was his only way to survive.
In contrast, movies with a prison theme based on stories by Stephen King, The Shawshank Redemption and The Green Mile are two excellent films in this genre, offer up morality plays where the characters are either good or evil. These characters shape how the system operates, not vice versa. The stories are all the more interesting because they feature role reversal where it is the prisoners who are cast as the virtuous ones.
Returning to our discussion, for cheating you might very well ask which of the two is the primary explanation and are there interaction effects? Our discussion yesterday observed that class size matters. To the extent that the same individual cheats in a large class but not in a small class, that suggests a system explanation. Our discussion also suggested that absent instructor commitment to deterrence (diligent proctoring) students will cheat. I don't believe we pushed this enough to ask whether all students will cheat in this case or only some. If only some, you can explain the difference in student behavior via personal weakness. In turn, you can do a similar analysis to get at why the instructor doesn't proctor.
We did also talk about unintended consequence. Most students in the class who talked about it said they preferred informality with their instructor and produced their best work in that circumstance. (There was a dissenting view on this where I believe we concluded that some formality can help in setting ground rules that facilitates good work to be done.) The need to create distance between instructor and student to enforce the deterrents in the large class setting can then have a pernicious (alienating) effect on student learning.
I also mentioned, right at the end, a different sort of system impact because the large classes are typically taken early on. At some later point in the semester I'd like to discuss, either in the full class or at break, how you see AP classes. If you had the opportunity to take those courses here in a small class setting rather than in High School, would there have been value from that?
Let me close by bringing up a movie I mentioned yesterday The Paper Chase (the full movie is here with some commercials) which casts Harvard Law School circa 35 years ago as something of a Darwinian competition among the students, with the faculty personified in the character of the Contracts Professor Charles Kingsfield, quite willing to let the students agonize in his classroom by calling on them when they weren't prepared and otherwise indifferent to the emotional stress that approach created. The author of the novel, John Osborn, was actually a student in Harvard Law School a few years earlier and wrote the book while a student, perhaps as a way to cope and to critique the experience he was going through.