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The Montessori method of education is a type of educational method that involves children's natural interests and activities rather than formal teaching methods. A Montessori classroom places an emphasis on hands-on learning and developing real-world skills. It emphasizes independence and it views children as naturally eager for knowledge and capable of initiating learning in a sufficiently supportive and well-prepared learning environment. It also discourages some conventional measures of achievement, such as grades and tests. The method was started in the early 20th century by Italian physician Maria Montessori, who developed her theories through scientific experimentation with her students; the method has since been used in many parts of the world, in public and private schools alike. A range of practices exist under the name "Montessori", which is not trademarked. Popular elements include mixed-age classrooms, student freedom, long blocks of uninterrupted work time, specially trained teachers, and prepared environment. Scientific studies regarding the Montessori method are mostly positive, with a 2017 review stating that "broad evidence" exists for its efficacy.