A (RELATIVELY) JUNIOR DOCTOR’S PERSPECTIVE ON MEDICAL STATISTICSCarl Ilyas

CT1 Anaesthetics Leeds

CONTENTS

Medical stats teaching: - Undergraduate Postgraduate

A small survey

What YOU can do to get the message across

6 WEEKS LATER… You are an F1 doctor providing medical ward cover

overnight. You are fast bleeped to MAU as a 45 year old man

has started profusely vomiting blood. He is an IVDU, has hepatitis C , and a previous endoscopy showed varices.

He is tachycardic, is hypotensive, and has a reduced GCS.

WHAT DO YOU DO?

A) PanicB) Find the nearest enclosed space, throw your bleep away, and begin to emotionally and mentally unravelC)Commence immediate resus efforts, contact a senior and the anaesthetistD)All three of the above

UNDERGRAD EXPERIENCE

• Hull York Medical School (HYMS)

• Formal critical appraisal and stats teaching throughout the course

• Theme C examination

• Further access to a stats consultancy service, mainly for students doing research

• Very variable focus throughout med schools in the region

FOUNDATION YEARS

• First 2 years

• Foundation syllabus – 86 page document

• No formal teaching on stats – PDP days

• Opportunity for research and stats experience – ‘ CV stacking’

CORE TRAINING – THE NEXT STEP…

• First steps into speciality training

• Formal examinations – MRCP, MRCS, FRCA etc

• MCQ based knowledge – mandatory

• More opportunity/encouragement re. research, especially in certain specialities.

REGISTRAR TRAINING

• Further examination on stats

• Greater involvement/emphasis on research

• Access to courses, closer work with statistical departments

• Honing of career path….

Consultant doctor plus…

…..or ‘just a jobbing’ doctor?

Teaching interests

Management

Research interests

SO, WHAT DO DOCTORS THINK OF STATS TEACHING?

A survey of 42 doctors experiences and opinions of training in medical statistics.

IN YOUR OPINION, HOW COULD POSTGRADUATE TEACHING IN MEDICAL STATISTICS BE IMPROVED?

“Any teaching welcome/more teaching” ad nauseum…

“Teaching, not necessarily by statistics experts”

“Optional formalised teaching – some enjoy, others hate”

“ Weekly journal clubs, with critical appraisal by trainees”

“ It doesn’t need to be great, as we don’t use stats very often”

“ Teaching of stats beyond basic level is probably best reserved for those using them on a regular basis i.e research clinicians”

“ Include stats in regional teaching days”

“ Journal club meetings and to explore stats techniques”

“ Needs to be more clinical orientated”

“ Regular talks from statisticians in departmental meetings with relevant examples from journals”

“Make it more understandable, enjoyable and interesting”

“Include in matrix/ PDP days”

“ Sign up sessions”

SURVEY OUTCOME Generally poor view of statistics teaching throughout all levels

Many doctors having minimal, if any, formal teaching on stats until later stages of training

Many not comfortable doing basic appraisal

So what’s to be done?

SUGGESTIONS FROM SURVEY Not all doctors need to be able to perform stats

calculations, but all require appraisal skills

For greater statistical literacy, widespread changes necessary from early stages of training

Greater incorporation of statistics into formal teaching programmes, and in the CME matrix

WHAT CAN YOU DO? Greater levels of work with doctors from an early stage

offering teaching on basic appraisal and statistical methods

Departmental/formal teaching utilising relevant clinical scenarios and journal articles to help make information more accessible

For those junior doctors interested in research, access to courses to improve ability to understand and perform statistical analysis

Using/developing online resources for convenient access

SUMMARY Stats teaching often neglected, especially in early

stages of training

No formal foundation teaching, variable medical school delivery, out of context content at core level

Generally perceived poor standard of delivery/accessibility of stats teaching

Doctors keen to learn about stats if given opportunity

Thanks for your attention.

Questions/comments?