A pragmatic trial of online interactive webtools for teaching biostatistics to first-year medical students: a constructivism-informed approach

Abstract

Background: Statistical reasoning is an important clinical skill that informs evidence-based medicine and is desirable for 21st century practice. Yet many physicians struggle to apply biostatistical techniques correctly, potentially undermining patient care decision-making and adversely affecting outcomes. The overarching concepts of foundational biostatistics and probabilistic reasoning can be challenging to teach and hard for students to internalize given time constraints, lack of intrinsic motivation, and varied pre-existing knowledge or cognitive schema. We investigated how supplemental, interactive online webtools affected first-year medical students’ learning of sensitivity, specificity, negative/positive predictive values, and prevalence. Methods: Online webtool design was informed by constructivism and sought to have learners 1) build conceptual representations by connecting new information to existing knowledge, 2) interact with primary sources of biostatistical data, and 3) begin with whole concepts then explore component parts. A total of 59 students were assigned randomly to two cohorts that had access to the webtools before or after in-class teaching; an additional 35 students had no access and served as the control cohort. Access metrics, summative exam scores, prior knowledge measurements, and qualitative data on learners’ experiences from three focus groups (n = 6/group) were collected. Results: Mean exam scores were 87.5 ± 10.8%, 90.7 ± 11.2%, and 88.9 7 ±12.9% for the before, after, and control cohorts (p = 0.49). Students repeatedly accessed the online webtools: mean access was 4.3 (± 2.6) (before) and 2.6 (± 1.5) (after). Qualitative data showed the webtools facilitated learning in a time-efficient manner. Conclusions: Online interactive webtools facilitated a constructivism-informed learning model and were found by first-year medical student to supplement and enhance their learning experience without detracting from established biostatistical teaching or negatively affecting summative assessment outcomes.