Wednesday, July 9, 2008

Skewed? I Get That!

image There is a simple education principle for instruction of adults in professional education (my education education surfaces frequently being a student). Instructional design must start with the end-point in mind. In other words, design the education for the intent of the education. If you train car mechanics, you have to understand the real world job of the car mechanic and work backwards from those "needs."

Take medical statistics for example. What is the role of a clinician? 1) Understand and apply the "evidence" presented in the medical literature (research primarily) to the practice of medicine, and 2) take care of patients in an efficient, effective, and ethical manner without doing harm. Given that end point, what is the value of statistics?  Instruct us how to read the literature, how to interpret the literature, and how to judge the value of the results of the literature. Instruct clinical application of statistics in normal ranges of lab values, predictive values of differential diagnosis, and the many core patient care and decision making processes. Show me that 95% confidence intervals can be applied to the understanding of lab ranges on my hospital lab printouts. It is very simple. Make it applicable to the function.

That is NOT what I'm hearing. I am getting, for the umpteenth time in my career, another lecture in the mechanics of statistics. WHY!! Tell me how statistics is valued in clinical practice, patient care and the literature. Tell me what I need to know for the boards. But if I need more, I'll hire a statistician or a research firm to do this. Clinicians don't need another stats course. We need to understand how to make good decisions using stats.

Academic freedom: the misguided perception of instructors that they can do whatever they want to do because they, in their infinite wisdom, believe that what they teach is important or they are interested in without due consideration for the end-point of the instruction in which they are involved. Equivalent value = tenure. Range: Useless to more useless.

"Education must satisfy a person's needs and wants, and in a way that it makes the person ready to use it." (Steadism #173, pg 56) I don't need this. I don't want this and I won't be ready to use it without the help of the Department of Research or a journal staff, if I ever write again. Sometimes I wish I didn't know so much. I'm so skewed...probably left.