A ( RELATIVELY ) JUNIOR DOCTOR ’ S PERSPECTIVE ON MEDICAL STATISTICS Carl Ilyas CT1 Anaesthetics...

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

Annie Herbert

Would go for italics rather than capitals here, less agressive! Same for slide 24.

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.

Annie Herbert

Statisticians unlikely to know these abbreviations. I'd write them out as the full term if you won't use it again later or if you'll repeatedly use it, state it the first time and put abbreviation in brackets and use the abbreviation from then on. Same for throughout the presentation.

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

Annie Herbert

Change to resuscitate - knew what it meant but had to think a sec. Same as abbreviation comment on slide 5.

Annie Herbert

Make same font size and colour as 'C)' and 'D)'

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

Annie Herbert

I'd explain what this is as you talk alongside the presentation.

Annie Herbert

Suggestion for comments to make:- what type of research - e.g., project options- which year typically- do students get opportunity to do this as an aside if they're keen? - Manchester doesn't have the intercollated option like you guys did, but think Keele did, so think this can vary. State that this is another way to end up doing research and needing stats.

Annie Herbert

Which others are these?

Annie Herbert

Suggestion for comments to make alongside this slide: - sort of topics covered- were equations used?- Was critical appraisal carried out as group discussions/PBL?

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’

Annie Herbert

They'll like this bit.

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.

Annie Herbert

Is it that stats makes up 5% of these and most people don't bother with the revision? I remember you saying that you did.

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”

Annie Herbert

They'll like this too. I'd state what seemed to come up the most and what sentences only one person said really.

“ 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

Annie Herbert

Need to move title up or text down. Same for slide 24.

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

Annie Herbert

In the discussion afterwards, they may ask where this can be fitted in, so I'd think of one or two practical answers on how this could be integrated which isn't done right now.

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?

Annie Herbert

Just nice, innit.

A ( RELATIVELY ) JUNIOR DOCTOR ’ S PERSPECTIVE ON MEDICAL STATISTICS Carl Ilyas CT1 Anaesthetics...

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