A profile of statistics and research training of undergraduate medical students at South African universities

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Date
2005-12
Authors
Dommisse, Jean
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Publisher
University of the Free State
Abstract
English: Statistics and research methodology are important components of a medical curriculum, since statistical analysis features in the majority of research papers published in medical journals. Medical practitioners need a basic understanding and knowledge of statistics and research principles. Evidence Based Medicine has given an enormous opportunity for statisticians to teach critical appraisal, and to orientate future doctors towards evidence-based practice. Literature on the teaching of statistics and research methodology are available for the United Kingdom, United States and elsewhere in the world but not for South Africa. It is therefore important to do this study on the profile of research methodology and statistics training for undergraduate medical students at South African universities in terms of the following: (1) What subjects (topics) are medical students taught? (2) Who does the teaching? (3) When is the learning programme / contact sessions taught during the medical students’ curriculum? (4) How is the learning programme / contact sessions taught to the students? I contacted the heads of the eight medical schools in South Africa via email to ask them whether they would give consent for the university to participate in my study. Thereafter I contacted the relevant persons of all the medical schools via email and asked them if they were willing to participate. They needed to complete a questionnaire and checklist. The checklist covered topics taught and the questionnaire the other research questions. The checklist and questionnaire were compiled based on the literature, and tested in a pilot study. One university did not respond, one university does not teach a formal Biostatistics course, one does the Biostatistics course as an elective programme and 5 universities teach the Biostatistics course during the medical curricula. Seven universities completed a checklist and six universities completed the questionnaire. I also requested the learning programme material from the universities to see what the aims and objectives of their courses are. Five universities supplied me with their learning program materials. In South Africa the specific statistics or research methodology courses show a vast variety of implementation dates at the different universities. Only one university reinforced the course during the 3rd and 5th year, after it had been taught during the 1 st year. For the other, 4 universities teac h the course in the 1st year, 1 in the 2nd year and 1 in the 3rd or 4th year, depending on when it is selected as an elective programme. The class sizes vary from 40 to 320 students. Four universities use practical classes and 3 universities use tutors. Three universities use research projects during their medical education. Five of the universities expose the students to Excel, directly in practical classes and indirectly through the research projects that the students must do. The aims and objectives of the South African universities seem on par with what is proposed in the literature. The persons responsible for the teaching of the statistics / research methodology courses are a doctor (2 universities), statistician (6 universities) and Applied Mathematics lecturer (1 university). The following topics are taught to the medical students at most universities in South Africa: (1) Study designs in medical research. (2) Exploring and presenting data. (3) Summarising data. (4) Probability. (5) Sampling. (6) Statistical inference. (7) Analysis of cross tabulation. (8) Critical reading. Four universities teach the topic “From sample to population”, “Analysis of the means of small samples”, scatter diagrams and correlations. Only three universities teach the topic of regression. Survival ana lysis and multiple comparisons are not seen as a core topic in the medical curricula. Recommendations are made for inclusion of topics in the courses, and for future studies in this field.
Afrikaans: Statistiek en navorsingsmetodiek is belangrike komponente van ‘n mediese kurrikulum omdat statistiese analise in die meederheid van navorsingstudies in mediese joernale voorkom. Mediese dokters benodig ‘n basiese begrip en kennis van statistiek en navorsingsbeginsels. Bewysgebaseerde Geneeskunde verskaf ‘n uitstekende onderriggeleentheid in kritiese ontleding vir statistici en om toekomstige dokters te orienteer in die rigting van Bewysgebaseerde praktyk. Literatuur oor die onderrig van statistiek en navorsingsmetodiek is beskikbaar vir die Verenigde Koninkryk, Amerika en elders in die wêreld, maar nie vir Suid-Afrika nie. Dit is dus belangrik om hierdie studie oor die profiel van navorsingsmetodiek en statistiek onderrig vir voorgraadse mediese studente by Suid-Afrikaanse universiteite in terme van die volgende te doen: (1) Watter onderwerpe word die mediese studente in onderrig? (2) Wie doen die onderrig? (3) Wanneer word die program of kontaksessies aangebied? (4) Hoe word die program of kontaksessies aangebied? Ek het die hoofde van die agt mediese skole in Suid-Afrika via epos gekontak en hul versoek om hul toestemming te verleen vir die universiteit se deelname aan my studie. Daarna het ek die relevante persone by al die mediese skole gekontak via epos en hulle gevra of hulle bereid sal wees om deel te neem aan my studie. Hulle moes ‘n vraelys en kontrolelys voltooi. Die kontrolelys het die verskeie onderwerpe gedek terwyl die vraelys die ander navorsingsvrae gedek het. Die vraelys en kontrolelys was saamgestel uit die bronne van die literatuur en is deur ‘n loodsstudie getoets. Een universiteit het nie deel geneem aan die studie nie, een universiteit bied nie ‘n formele Biostatistiek kursus nie, een doen dit as deel van ‘n elektiewe program. Die ander 5 universiteite bied almal ‘n Biostatistiek kursus aan gedurende die studente se mediese opleiding. Sewe universiteite het die kontrolelys voltooi en ses die vraelys. Ek het ook die leerprogrammateriaal van die universiteite aangevra om vas te stel wat die doel en doelwitte van hulle kursusse is. Vyf universiteite het dit vir my gestuur. In Suid-Afrika is daar ‘n groot variasie in datum van implementering van die huidige statistiek / navorsingsmetodiek kursusse by die verskillende universiteite. Slegs een universiteit het aangetoon dat hulle in die derde en vyfde jaar gedeeltes van die kurses herhaal om die studente se kennis te versterk nadat hulle in hul eerste jaar daarmee kennis gemaak het. Vir die ander universiteite word die kursus in die 1ste jaar (4 universiteite), 2de jaar (1 universiteit) en die 3de/4de jaar gedurende die elektiewe program aangebied (1 universiteit). Die klas groottes wissel van 40 tot 320. Vier universiteite bied praktiese klasse aan en 3 maak gebruik van tutors. Drie universiteite verplig studente om navorsingsprojekte te doen. Vyf va n die universiteite gee hul mediese studente blootstelling aan Excel, direk in praktiese klasse, of indirek deur navorsingsprojekte. Die doelwitte en oogmerke van die Suid-Afrikaanse universiteite is in lyn met wat voorgestel word in die literatuur. Die persone wat verantwoordelik is vir die onderrig van die statistiek / navorsingsmetodiek kursusse is ‘n dokter (2 universiteite), statistikus (6 universiteite) en ‘n toegepaste wiskunde dosent (1 universiteit). Die volgende onderwerpe word by die meeste mediese skole in Suid-Afrika aan die studente aangebied: (1) Studie-ontwerpe in mediese navorsing. (2) Verkenning en voorstelling van data. (3) Opsomming van data. (4) Waarskynlikheid. (5) Steekproewe. (6) Statistiese inferensie. (7) Analise van kruistabulasie. (8) Kritiese leeswerk. Vier universiteite bied die onderwerpe “Steekproef tot populasie”, “Analise van die gemiddeldes van klein steekproewe”, spreidingsdiagramme en korrelasies aan. Slegs drie universiteite bied regressie aan. Oorlewingsanalise en meervoudige vergelykings word nie as deel van die kern van die mediese opleiding gesien nie. Aanbevelings word gemaak vir die insluiting van sekere onderwerpe in die kursusse, en vir verdere studies in die veld.
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Physicians -- Training of -- South Africa, Medicine -- Research -- Statistical methods, Medical statistics -- Study and teaching -- South Africa, Dissertation (M.Med.Sc. (Medical Science)) University of the Free State, 2005
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