TEACHING MEDICAL STATISTICS TO HEALTH PROFESSIONALS: A MODIFIED PROBLEM-BASED LEARNING APPROACH

BURWALLS 2015

Abdel Douiri

Problem-based learning (PBL)

PBL originates in the educational philosophy of the French educationalist Célestin Freinet in the 1920s

introduced for the first time in medical education at McMaster University (Canada) in the late 1960s

Bland JM. (2004) Teaching statistics to medical students using problem-based learning: the Australian experience. BMC Medical Education 4, 31.

Problem-based learning (PBL)

“learning that results from the process of working toward the understanding or resolution of a problem” (Barrows & Tamblyn, 1980)

PBL is a self-directed approach that uses a scenario as the starting and motivating point for student learning (Silen, 2008).

The problem acts as a trigger to define students’ own learning objectives before the lecture (Wood, 2003)

The process of PBL generally involves many key elements including prior knowledge, problem solving, critical thinking and reflection on learning (Maudsley, 1999)

The aim of the study

Investigate the possibility of the development of a simplified PBL approach to the learning of medical statistics

Examine and evaluate this mPBL approach in teaching medical statistics to PG students

Materials and Methods

Intervention

Two single intervention experiments using a modified PBL approach were undertaken in two different postgraduate lecture-based medical statistics modules (academic year 2010-2011 at KCL)

Diagnostic Test (DT) under the Advanced Quantitive Research Method module 2h Lecture

Hypothesis Testing (HT) under the basic statistics module2h Lecture + 1h tutorials

PBL material: pre-session problem

Information on the session prior to the Lecture was provided

A scenario extracted from a published paper was sent by email to the students and they were invited to work through the problem prior to the lecture

Sample of the prior Lecturer scenario

The session/Lecturer

The learning objectives of the session were presented

Extra time were given to re-look at these scenarios, in order not to disadvantage students who did not look at the problem prior to the lecture

New terms and concepts (from the scenarios) with which they were not familiar were explained (defined in an interactive way)

The majority of the session was led by student questions and discussion, the lecturer guided the session by providing more information, definitions and other examples

Ethics

Ethical approval was not sought as this was an opportunistic sample from volunteers who agreed to take part of this study by giving their feedback on their appreciation of a PBL method. They were informed at the outset that participation in the questionnaire was entirely voluntary and anonymous. As part of the teaching, a short assessment test was given during the session and students were invited to complete the test and the feedback questionnaire during the final 10 minutes. The material was collected shortly after the end of the class.

Results

Respondents

Diagnostic test:14 out 24 students returned the assessment and feedback2 respondents did not report their views on the PBL

Hypothesis testing:26 respondents out of 426 respondents did not report their views on the PBL

The average respondent rate in the two experiments was approximately 60%

Student feedback

The majority of students valued the PBL approach:

92%, 95% CI [61.5-99.8] in the DT class

90%, 95% CI [56.3-94.3] in the HT class

Some respondents feedback that this approach helped them to focus, to work through problems and to understand them

Others stated that they did not have time to study the problem prior the session

One respondent found statistics difficult and this approach did not appear to make any difference!

Student feedback

Positive: Negative: Began to think about the

logic prior to the lecture which helped focus.

Helps you prepare for the lecture

Helps you to work through problems and understand them; being practical about a problem helps reinforce learning rather than rote learning

I learn better when exposed to practical examples

It provides background information and aids understanding of the topic.

No, because I didn’t know enough to complete the task. Nonetheless, I attempted the task in the Lecture and found it much easier

No, I didn’t have time to tackle [the problem] ahead of class

I find statistics difficult, so do not feel able to say if this approach makes any difference.

Assessments

A positive change in student participation in the class

The accuracy of students’ answers was very high

78%, 95% CI [62.9-92.6] in the “diagnostic test”

98% %, 95% CI [92.3-100] in the “Hypothesis testing”

Performance of students is not consistent between the two different courses

Exam and motivation

Students in HT cohort are MPH with some quantitative background

Summary

PBL approach requires commitment and increased participation for students and lecturers

The lecturer needs to find practical problems in the light of the learning objectives of the module, and on the level of students’ background

Students need to take time to work through the problem prior to session

The proposed mPBL approach balances the use of PBL concept with the available time and resource commitments

Conclusion

mPBL approach can have a positive effect on students’ conceptual understanding of statistics

Students engaged positively, both with the learning process and with knowledge acquisition

Could be implemented alongside the traditional passive learning for teaching PG medical statistics.

QUESTIONS/SUGGESTIONS?