Numeracy among trainees: Are we preparing physicians for evidence-based medicine?

Timothy V. Johnson, Ammara Abbasi, Evan D. Schoenberg, Rachel Kellum, Lisa Deann Speake, Christopher Spiker, Anna Foust, Alexandra Kreps, Chad W.M. Ritenour, Otis Brawley, Viraj A. Master

Research output: Contribution to journalArticle

Abstract

Introduction In the era of evidence-based medicine, all physicians who communicate with patients need numerical literacy (numeracy). Single-institution studies suggest imperfect numeracy among medical students. Therefore, we sought to examine numeracy and understanding of risk analysis among medical students and surgical residents at several institutions. Methods Following a validated 3-item numeracy questionnaire, 308 medical students and 50 surgical residents from 4 institutions were asked whether they would recommend adjuvant chemotherapy for a patient based on presented survival data. Main outcome measures included numeracy, understanding of risk with a question requiring simple calculation of risk reduction, and confidence in understanding risk reduction using a Likert score (0 = no confidence and 7 = complete confidence). Binary logistic regression analysis identified predictors of misunderstanding of risk and Pearson correlation coefficients measured differences in confidence by level of training and numeracy. Results Students across institutions did not differ demographically and were grouped by educational level. Of all participants, 69.0% had perfect basic numeracy (score = 3), with no significant difference in numeracy across training levels (p = 0.433). Mean (standard deviation) confidence in recommending treatment increased from 4.5 (1.6) for first-year medical students to 4.8 (1.1) for fourth-year medical students, and 4.9 (1.5) for surgical residents (p = 0.580). Controlling for other demographics, poorly numerate students had a 7-fold increased likelihood (odds ratio: 7.330; 95% confidence interval: 1.384-38.809) of misunderstanding risk compared with more numerate students. Conclusions A significant number of students at various levels of medical training lack numeracy skills, which increases misunderstanding and miscommunication of risk that can be communicated to patients and families. This deficiency could potentially affect patient safety and care.

Original languageEnglish (US)
Pages (from-to)211-215
Number of pages5
JournalJournal of surgical education
Volume71
Issue number2
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Evidence-Based Medicine
trainee
literacy
physician
medicine
Physicians
Medical Students
confidence
medical student
evidence
Students
Risk Reduction Behavior
resident
student
Literacy
first-year student
Adjuvant Chemotherapy
Patient Safety
Patient Care
regression analysis

Keywords

  • decision making
  • medical education
  • medical students
  • numerical health literacy
  • risk assessment

ASJC Scopus subject areas

  • Surgery
  • Education

Cite this

Johnson, T. V., Abbasi, A., Schoenberg, E. D., Kellum, R., Deann Speake, L., Spiker, C., ... Master, V. A. (2014). Numeracy among trainees: Are we preparing physicians for evidence-based medicine? Journal of surgical education, 71(2), 211-215. https://doi.org/10.1016/j.jsurg.2013.07.013

Numeracy among trainees : Are we preparing physicians for evidence-based medicine? / Johnson, Timothy V.; Abbasi, Ammara; Schoenberg, Evan D.; Kellum, Rachel; Deann Speake, Lisa; Spiker, Christopher; Foust, Anna; Kreps, Alexandra; Ritenour, Chad W.M.; Brawley, Otis; Master, Viraj A.

In: Journal of surgical education, Vol. 71, No. 2, 01.01.2014, p. 211-215.

Research output: Contribution to journalArticle

Johnson, TV, Abbasi, A, Schoenberg, ED, Kellum, R, Deann Speake, L, Spiker, C, Foust, A, Kreps, A, Ritenour, CWM, Brawley, O & Master, VA 2014, 'Numeracy among trainees: Are we preparing physicians for evidence-based medicine?', Journal of surgical education, vol. 71, no. 2, pp. 211-215. https://doi.org/10.1016/j.jsurg.2013.07.013
Johnson TV, Abbasi A, Schoenberg ED, Kellum R, Deann Speake L, Spiker C et al. Numeracy among trainees: Are we preparing physicians for evidence-based medicine? Journal of surgical education. 2014 Jan 1;71(2):211-215. https://doi.org/10.1016/j.jsurg.2013.07.013
Johnson, Timothy V. ; Abbasi, Ammara ; Schoenberg, Evan D. ; Kellum, Rachel ; Deann Speake, Lisa ; Spiker, Christopher ; Foust, Anna ; Kreps, Alexandra ; Ritenour, Chad W.M. ; Brawley, Otis ; Master, Viraj A. / Numeracy among trainees : Are we preparing physicians for evidence-based medicine?. In: Journal of surgical education. 2014 ; Vol. 71, No. 2. pp. 211-215.
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abstract = "Introduction In the era of evidence-based medicine, all physicians who communicate with patients need numerical literacy (numeracy). Single-institution studies suggest imperfect numeracy among medical students. Therefore, we sought to examine numeracy and understanding of risk analysis among medical students and surgical residents at several institutions. Methods Following a validated 3-item numeracy questionnaire, 308 medical students and 50 surgical residents from 4 institutions were asked whether they would recommend adjuvant chemotherapy for a patient based on presented survival data. Main outcome measures included numeracy, understanding of risk with a question requiring simple calculation of risk reduction, and confidence in understanding risk reduction using a Likert score (0 = no confidence and 7 = complete confidence). Binary logistic regression analysis identified predictors of misunderstanding of risk and Pearson correlation coefficients measured differences in confidence by level of training and numeracy. Results Students across institutions did not differ demographically and were grouped by educational level. Of all participants, 69.0{\%} had perfect basic numeracy (score = 3), with no significant difference in numeracy across training levels (p = 0.433). Mean (standard deviation) confidence in recommending treatment increased from 4.5 (1.6) for first-year medical students to 4.8 (1.1) for fourth-year medical students, and 4.9 (1.5) for surgical residents (p = 0.580). Controlling for other demographics, poorly numerate students had a 7-fold increased likelihood (odds ratio: 7.330; 95{\%} confidence interval: 1.384-38.809) of misunderstanding risk compared with more numerate students. Conclusions A significant number of students at various levels of medical training lack numeracy skills, which increases misunderstanding and miscommunication of risk that can be communicated to patients and families. This deficiency could potentially affect patient safety and care.",
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