Teaching a statistical program in emergency medicine research rotations: Command-driven or click-driven?

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Teaching a statistical program in emergency
medicine research rotations Command-driven or
click-driven?

• Muhammad
  Waseem, MD
• Research Director
• Emergency Medicine
• Lincoln Medical Mental Health Center
• Bronx, New York

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Disclosure

• Financial disclosures None

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Background

• Stata is a command-driven program
• It is a general-purpose statistical software
  package used by people of different backgrounds
  and professional disciplines
• Most Stata users are non-physicians

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Background

• No matter which book you choose or which course
  you attend.
• Since Stata is used by people in many fields,
  most training programs offered are geared toward
  programmers and non-physicians

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Background

• Although Stata has simple commands, these may be
  difficult for non-programmers
  to use
• Generally, physicians are familiar with clicking
  on rather than writing commands

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Background

• Research is an important part of curriculum of
  emergency medicine residency training
• A Research Project is necessary for graduation of
  EM residents

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Background

• In order to fulfill this requirement EM residents
  have a mandatory research rotation

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Background

• ACGME fully accredited 3 year Emergency Medicine
  Residency Training Program
• 33 EM residents (11 / year)

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EM Research Rotation

• Formulating a research question
• Basic research design
• Protocol writing and submission to IRB
• Data Collection
• Basic statistical concepts

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EM Research Rotation

• Data recording
• Data entry
• Data analysis

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Background

• First step is to organize the raw data into a
  format which is compatible with Stata

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Objectives

• Does introduction of a Statistical program (such
  as Stata) improve the accuracy of data recording
  and data entry?

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Methods

• Design Observational
• Setting Emergency Department of an Urban
  Teaching Hospital
• Participants Emergency Medicine Residents

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Methods

• Research Elective
• Two blocks of 14 days each
• 1-2 per month (11 learning)

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Methods

• Emergency Medicine Stata Manual describing basic
  operation of Stata created with version 10

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Methods

• This manual was developed keeping in mind the
  needs of in-training Emergency Medicine Residents
• EM residents may have some basic knowledge of
  statistics but no knowledge of Stata
• Emphasis on data entry and data import

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Emergency Medicine Stata Manual

• Just an introduction designed for first time
  users

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Methods

• Teaches EM residents the essential skills for
  successful data entry and data import to Stata
• Purpose is to reduce the number of incorrect
  entries and make the data set usable to Stata
• Hands-on experience using Stata

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Methods

• Strengths
• Tailored to the needs of a specific audience (EM
  residents)
• Discusses only simple and basic operation of
  Stata

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Methods

• Weaknesses
• Tailored to the needs of a specific rotation (EM
  residents research elective)
• Does not teach residents detailed statistical
  analysis
• Does not discuss programming

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Methods

• Keep it simple
• Utilize pull-down menus (rather than commands)
• No discussion on commands

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Methods

• Getting started
• Stata screen
• 4 Windows, 9 Tabs

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Methods

• 4 Windows
• Review
• Variables
• Results
• Command

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Methods

• 9 Tabs
• File, Edit, Prefs, Data, Graphics, Statistics,
  User, Window, and Help

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Methods

• Basic commands with pull-down menus
• Describe and summarize data
• Data input and output
• Data Import
• Saving files

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Methods

• Describe data
• Data editor
• Data browser

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Conclusions

• Basic operation of Stata can be learned quickly
  by EM residents
• Teaching Stata to the EM residents expanded their
  research related knowledge
• Providing introduction of Stata prior to data
  entry improve accuracy of data recording and
  facilitates data analysis

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Limitations

• Observational study
• No standardized method
• Small sample
• Single center study

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Implications

• It is necessary to develop a training program
  that addresses the needs of physicians