The 16 Mark "Factors" Question: Health & the People (Q4) (AQA GCSE History)

Revision Note

Zoe Wade

Written by: Zoe Wade

Reviewed by: Bridgette Barrett

Summary of Question Four

  • Question Four requires you to evaluate one of the seven factors in Health and the People

  • There are also four available marks for Spelling, Punctuation and Grammar (SPaG)

Amount of marks 

16 + 4 SPaG

The time that you should spend on the question 

Around 25 minutes 


5 minutes to plan

20 minutes to write your answer

  • An example of the type of question you may encounter can be seen below:

Question Four for Britain: Health & the People, c1000 to the Present Day
An example of Question Four in Paper 2A
  • In previous years, this question has focused on the following topics in Health and the People:

Year of Exam 

Question Topic 

2018

Has the role of the individual been the main factor in developing the treatment of disease in Britain?

2019

Have governments been the main factor in the development of public health in Britain?

2020

Has science and technology been the main factor in improving the treatment of disease?

2021

Has war been the main factor in the development of surgery and anatomy?

2022

Has the role of the individual been the main factor in the development of public health in Britain?

Sample 1

Has religion been the main factor in the development of medicine in Britain since Medieval times?

Sample 2

Has science and technology been the main factor in understanding the causes of disease in Britain?

Making Judgements in History

  • The 16-mark question is reliant on your ability to weigh all the evidence and state your opinion. Students often find this part the hardest to do 

  • Common mistakes with judgements include:

    • Not giving a clear judgement. This includes making judgement statements such as:

      • "I kind of agree that..."

      • "I don't agree or disagree..."

    • Contradicting your judgements

      • Students sometimes haven't planned their answers properly. They begin their answer with one judgement and then change their opinion halfway through

      • Doing this means that there is not a substantiated judgement. This type of answer cannot access Level 4 (13-16 marks)

  • Good judgements will:

    • Either agree or disagree with the statement

      • There is no "right" or "wrong" answer in history

    • If you are unsure of your opinion, pick the side of the argument that you have better or more evidence to support

      • For the example question, there is more evidence that science was the main factor in developing the treatment of disease in Britain

    • Use words like "partially" and "fully" to explain the extent of their opinion on the question

    • Consider the other side of the argument

      • Even if you fully agree with the statement, you still need to present some evidence from the opposite opinion. A great way to introduce this is to write "Some historians think that..."

What Makes a Great Conclusion in GCSE History? 

  • Conclusions are usually where most of your judgement marks will be awarded

  • Students often rush their conclusions so they are not as developed as they could be

  • All great conclusions have these three elements:

    • Judgement – Start with your opinion. Try to include the words from the question. Consider second-order concepts like short- and long-term consequences, change and continuity and significance

    • Counter – Give an example from the other side of the argument to show your awareness of this

    • Support – Explain why, after considering all the evidence, you have reached your judgement. Use your best piece of evidence to show your opinion

How to get Full SPaG Marks

  • In Paper 2A, students have access to an additional four marks for answering Question 4

  • This is awarded for SPaG (Spelling, Punctuation and Grammar)

  • SPaG marks are allocated in the following categories:

SPaG mark

Reason for this mark

0

  • The student does not attempt the question

  • The student writes something irrelevant to the question

  • The spelling, punctuation and grammar mean that the answer is too hard to understand

1

  • The spelling, punctuation and grammar have a lot of mistakes but the answer can be understood

  • The student has used a small range of specific historical terms

2-3

  • The spelling, punctuation and grammar are good with some mistakes

  • The student has used a good range of specific historical terms

4

  • The spelling, punctuation and grammar are perfect with no mistakes

  • The student has used a wide range of specific historical terms

  • You can boost your SPaG marks by:

    • Ensuring key terms mentioned in the question are spelt correctly in your answer

    • Making sure that you use paragraphs in your answer

    • Allowing yourself an appropriate amount of time to re-read your answer to check for mistakes

    • Reading the answer in your head as if you were speaking it. Where you would take a breath, make sure there is a comma or full stop

How to Answer a “Factors” Question

  • The thematic study is divided into four different time periods

    • Medieval 

    • Renaissance 

    • 19th century 

    • 20th century to the present day

  • Seven factors connect the time periods. For Health and the People, these are:

    • War

    • Superstition and religion

    • Chance

    • Government

    • Communication

    • Science and technology

    • The role of the individual in encouraging or inhibiting change

  • When answering a "Factors" question you need to: 

    • Read the question carefully

      • Make sure that you fully understand which factor the question is asking you about

      • For the example question. the factor identified is chance

    • Annotate the question to find the key demands of the question 

    • Plan your answer. This will help you to: 

      • Decide which factor you will support

      • Have a logical and concise argument 

      • Have a substantiated judgement 

      • Achieve higher levels

        • Examiners argue those who plan their answers, achieve higher marks

    • Your plan should include:

      • What key knowledge you wish to use

      • An outline of your argument

    • To achieve Levels 3 and 4 (9-16 marks), you must discuss the stated factor in the question 

      • If the question was on how war developed surgery, you must discuss this factor in one of your paragraphs 

A spider diagram and table demonstrating how to plan a 16-mark question for Britain Health and the People. The table and spider diagram demonstrate how to plan the question "Was war the primary factor in surgery development". Including details on specific individuals, science and technology, and the conclusion that war was crucial for innovation.
A table and spider diagram displaying an example of how to plan a 16-marker "Factors" Question
  • The question states that you need to “use a range of examples from across your study”

    • You should aim to use three examples across three time periods throughout your answer to cover this aspect of the question

      • For the example question, the answer covers Alexander Fleming (20th century), Louis Pasteur (19th century) and Ambroise Paré (Renaissance)

How to Structure a “Factors” Question

  • Your answer should consist of: 

    • Specific knowledge 

    • Relevant evidence 

    • Substantiated judgement 

    • A conclusion 

  • If you want to include an introduction you can, but it is not necessary 

  • Your answers could be written in PEEL paragraphs: 

    • P - Make a point about the question

      • This should include your judgement 

    • E - Use evidence that supports the point that you have made

      • Evidence needs to be relevant and specific 

    • E - Explain why this evidence supports your point

    • L - Link your explanation back to the question by stating how it is more or less important than the other factors

  • You should aim to have three well-explained paragraphs and a conclusion

Worked Example of the “Factors” Question

Worked Example

Has chance been the main factor in developing the treatment of disease in Britain? 

Explain your answer with reference to chance and other factors. 

Use a range of examples from across your study of Health and the People: c1000 to the present day

[16 marks + 4 SPaG]

Answer:

Chance played a small role in the development of disease treatment in Britain, but it was not the main factor. A notable example of chance impacting medical treatment is Alexander Fleming's discovery of penicillin in 1928. Fleming left a petri dish to discover a mould that had killed bacteria growing in his petri dish. This accidental discovery led to the development of the first antibiotic, penicillin. The development of penicillin under Florey and Chain in the 1940s revolutionised medicine by providing an effective treatment for bacterial infections. We still use penicillin as an antibiotic today. While chance played a role in Fleming's discovery, it did not impact many other discoveries in Britain. Penicillin only dealt with bacterial infections. In addition, many more treatments were discovered using other factors. Therefore, chance had a limited impact on the development of treatments

Science was the main factor in advancing disease treatment. The work of Louis Pasteur and Robert Koch in the late 19th century significantly impacted the treatment of disease. Pasteur developed the concept of Germ Theory. This disproved the previous idea of spontaneous generation. Instead of moulding objects producing bacteria, Pasteur proved that bacteria caused rotting to occur. As a result, Pasteur and Robert Koch applied Germ Theory to disease. Koch identified specific pathogens that caused diseases. This improved the treatment of diseases because both Koch and Pasteur now understood why diseases occurred. With this knowledge, they created vaccinations for diseases like chicken cholera. They also encouraged antiseptic surgery which improved the treatment of patients. Unlike chance, scientific research and experimentation have had a profound and lasting impact on disease treatment. The understanding of Germ Theory has addressed a wide range of illnesses and improved public health. Therefore, the main factor in the development of treating diseases has been science, because the effects have been widespread and have continued to help develop treatments today.

The role of individuals has also influenced the treatment of diseases. Ambroise Paré, a 16th-century French surgeon, introduced innovative techniques in wound treatment. Paré used ligatures to tie blood vessels and stop bleeding. He also covered gunshot wounds with egg yolk, rose oil and turpentine. This improved treatment because more patients did not suffer blood loss and healed after serious battlefield injuries. However, Paré as an individual only had a limited impact on improving disease treatment. Individuals relied on the technology and knowledge available in the time period. In the Renaissance, people like Paré started to question the accepted disease treatments. However, a lack of technology and understanding of disease limited the impact that individuals like Paré could have. Therefore, whilst individuals had a bigger impact than chance, science remained key to the development of the treatment of disease throughout British history.

In conclusion, I believe that science is the most important factor in the improvement of the treatment of disease. While chance discoveries like Fleming's penicillin have made important contributions to disease treatment, science has contributed to a bigger number of treatments. Investigations like Pasteur’s Germ Theory and technological advancements like the microscope have enabled researchers to understand the causes of diseases. With this knowledge, scientists have developed effective treatments and improved public health on a large scale. Therefore, the role of science is the main reason for significant progress in the treatment of disease in Britain since Medieval times.

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Zoe Wade

Author: Zoe Wade

Expertise: History

Zoe has worked in education for 10 years as a teaching assistant and a teacher. This has given her an in-depth perspective on how to support all learners to achieve to the best of their ability. She has been the Lead of Key Stage 4 History, showing her expertise in the Edexcel GCSE syllabus and how best to revise. Ever since she was a child, Zoe has been passionate about history. She believes now, more than ever, the study of history is vital to explaining the ever-changing world around us. Zoe’s focus is to create accessible content that breaks down key historical concepts and themes to achieve GCSE success.

Bridgette Barrett

Author: Bridgette Barrett

Expertise: Geography Lead

After graduating with a degree in Geography, Bridgette completed a PGCE over 25 years ago. She later gained an MA Learning, Technology and Education from the University of Nottingham focussing on online learning. At a time when the study of geography has never been more important, Bridgette is passionate about creating content which supports students in achieving their potential in geography and builds their confidence.