Education| Volume 37, ISSUE 3, P313-318, October 2009

Download started.


Emergency Medicine Residents and Statistics: What is the Confidence?


      The objective of this study was to assess whether residents have the essential tools and a sense of competency when evaluating published studies, especially the statistics. Questionnaires were mailed to emergency medicine (EM) residency programs in the United States querying residents' demographics and training in statistics as well as their impressions and use of statistics in the current literature; a five-question statistical quiz was also included. Possible responses of—almost always, more than ½ time, ½ time, less than ½ time, almost never—were tallied individually as well as compared in groups of polarized answers: over 1/2 time (almost always + more than ½ time) vs. under ½ time (less than ½ time + almost never). There were 495 questionnaires returned from 42 centers. No significant difference was found when comparing quiz performance with participants' self-reported statistical knowledge. There were considerable differences in the polarized answers (Over vs. Under), whether statistics: were used appropriately (40% vs. 15%, respectively); were used to enhance weak data (54% vs. 13%, respectively); enhanced their understanding of information (38% vs. 24%, respectively); simplified complex data (26% vs. 41%, respectively); were understood by them (23% vs. 38%, respectively); confused them (37% vs. 24%, respectively); were skipped (52% vs. 23%, respectively). Participants felt there should be more statistical training (49% vs. 22%, Over vs. Under, respectively). There was no difference in respondents who did or did not read the statistics (39% vs. 34%, Over vs. Under, respectively). Many EM residents surveyed do not trust, read, or understand statistics presented in current journal articles. Residency programs may want to consider enhanced training in statistics.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Gore S.M.
        • Jones I.G.
        • Rytter E.C.
        Misuse of statistical methods: critical assessment of articles in British Medical Journal from January to March 1976.
        Br Med J. 1977; 1: 85-87
        • Hoffmann O.
        Application of statistics and frequency of statistical errors in articles in Acta Neurochirurgica.
        Acta Neurochir (Wien). 1984; 71: 307-315
        • Cruess D.F.
        Review of use of statistics in the American Journal of Tropical Medicine and Hygiene for January–December 1988.
        Am J Trop Med Hyg. 1989; 41: 619-626
        • McGuigan S.M.
        The use of statistics in the British Journal of Psychiatry.
        Br J Psychiatry. 1995; 167: 683-688
        • White S.J.
        Statistical errors in papers in the British Journal of Psychiatry.
        Br J Psychiatry. 1979; : 336-342
        • Macarthur R.D.
        • Jackson G.G.
        An evaluation of the use of statistical methodology in the Journal of Infectious Diseases.
        J Infect Dis. 1984; 149: 349-354
        • Kanter M.H.
        • Taylor J.R.
        Accuracy of statistical methods in Transfusion: a review of articles from July/August 1992 through June 1993.
        Transfusion. 1994; 34: 607-701
        • Bland J.M.
        • Altman D.G.
        Misleading statistics: errors in textbooks, software and manuals.
        Int J Epidemiol. 1988; 17: 245-247
        • Olsen C.H.
        Review of the use of statistics in infection and immunology.
        Infect Immunol. 2003; 71: 6689-6692
        • Avram M.J.
        • Shanks C.A.
        • Dydus M.H.M.
        • Ronai A.K.
        • Stiers W.M.
        Statistical methods in anesthesia articles: an evaluation of two American journals during two six-month periods.
        Anesth Analg. 1985; 64: 607-611
        • Davies J.
        A critical survey of scientific methods in two psychiatry journals.
        Aust N Z J Psychiatry. 1987; 21: 367-373
        • Anderson B.
        Methological errors in medical research.
        Blackwell, Oxford, UK1993
        • Anthony D.
        A review of statistical methods in the Journal of Advanced Nursing.
        J Adv Nurs. 1996; 24: 1089-1094
        • Plummer W.
        Screening for depression in primary care.
        BMJ. 2003; 326: 982
        • Mcnamara D.A.
        • Grannell M.
        • Watson R.G.K.
        • Bouchler-Hayes D.J.
        The research abstract: worth getting it right.
        Ir J Med Sci. 2001; 170: 38-40
        • Goodman N.W.
        • Hughes A.O.
        Statistical awareness of research workers in British anaesthesia.
        Br J Anaesth. 1992; 68: 321-324
        • Wang Q.
        • Zhang B.
        Research design and statistical methods in Chinese medical journals.
        JAMA. 1998; 280: 283-285
        • Ambrosano G.
        • Reis A.
        • Giannini M.
        • Pereira A.
        Use of statistical procedures in Brazilian and international dental journals.
        Braz Dent J. 2004; 15: 231-237
        • Hart A.
        Towards better research: a discussion of some common mistakes in statistical analysis.
        Complement Ther Med. 2000; 8: 37-42
        • Murphy J.
        Statistical errors in immunologic research.
        J Allergy Clin Immunol. 2004; 114: 1259-1263
        • Buderer N.M.F.
        • Plewa M.C.
        Collaboration among emergency medicine physician researchers and statisticians: resources and attitudes.
        Am J Emerg Med. 1999; 17: 692-694
        • Goodman S.N.
        • Altman D.G.
        • George S.L.
        Statistical reviewing policies of medical journals: caveat lector?.
        J Gen Intern Med. 1998; 13: 753-756
        • Altman D.G.
        Statistical reviewing for medical journals.
        Stat Med. 1998; 17: 2661-2674
        • Berdie D.R.
        • Anderson J.F.
        • Niebuhr M.A.
        Questionnaires: design and use.
        2nd edn. Scarecrow Press, Metuchen, NJ1986
        • Freed M.
        In quest of better questionnaires.
        Pers Guid J. 1964; 43: 187-188
        • Oppenheim A.
        Questionnaire design and attitude measurement.
        Basic Books Inc, New York1966
        • Hubbard R.
        • Little E.
        Promised contributions to charity and mail survey responses.
        Public Opin Q. 1988; 52: 223-230
        • Sprent P.
        • Smeeton N.C.
        Applied nonparametric statistical methods.
        3rd edn. Chapman & Hall/CRC, Boca Raton, FL2001
        • Chapman D.M.
        • Hayden S.
        • Sanders A.B.
        • et al.
        Integrating the Accreditation Council for Graduate Medical Education core competencies into the model of the clinical practice of emergency medicine.
        Acad Emerg Med. 2004; 11: 674-685
        • Thomas H.A.
        • Binder L.S.
        • Chapman D.M.
        • et al.
        The 2003 model of the clinical practice of emergency medicine: the 2005 update.
        Acad Emerg Med. 2006; 13: 1070-1073
        • Accreditation Council for Graduate Medical Education
        Emergency medicine menu.
        (Accessed May 20, 2007)