CHANGING APPROACHES AND PERCEPTIONS: BIOSTATISTICS AND ITS ROLE IN TEACHING THE STELLENBOSCH DOCTOR

The role of Biostatistics in Medicine and Health Care is sometimes only fully understood and appreciated by medical practitioners once they are fully qualified. Biostatistics and Epidemiology are also subjects in the medical curriculum that are disliked by most undergraduate students. The 'Profile of the Stellenbosch doctor' is a set of professional characteristics that every successful graduate possess, once they have qualified. The curriculum is therefore designed around this profile, where the Department of Statistics and Actuarial Science at Stellenbosch University in South Africa was one of the role players, especially with the introduction of a 'golden thread. ' The negativity of our medical students towards Biostatistics is real and a lot of that blame can be assigned to the way we teach and what biostatisticians think should be covered in a syllabus. Students normally struggle with probability and its applications and by introducing Bayesian approaches to the analyses will further complicate their understanding thereof. INTRODUCTION AND BACKGROUND The medical practitioner in the 21 st century will need a far greater ability to evaluate new information and technologies than in the past. A good understanding of Biostatistics and Epidemiology can improve clinical decision-making, programme evaluation and medical research with regard to both individuals and groups of people. The teaching and inclusion of Biostatistics in the medical curriculum at Stellenbosch University is regarded by the Medical Faculty and the South African Medical Council as fundamentally important. It is common practice that Biostatistics is included in the curricula at Medical Schools all over the world. In the last 15 years at Stellenbosch University, a few changes have been implemented regarding the teaching of Biostatistics. The first big change was made about six years ago, after feedback from students and a proper needs analysis, done by the curriculum development committee. Students fail to understand the link between Biostatistics and Medical Health Care and we as statisticians were solely to blame for that. Previously, Biostatistics was used in the module name and the module content was strictly statistical with here and there medical applications. Feedback from students showed that they were very negative towards Biostatistics, mainly because it was not really integrated into Medicine and Health Care, unlike their other first year modules of Biology, Physics and Chemistry. Students had to calculate by hand all the relevant descriptive statistics, draw by hand the relevant descriptive graphs, did an extensive course in probability theory and conduct by hand hypothesis tests and general statistical inference. Computer literacy formed part of the curriculum, but in a very limited form before 2000, due to the lack of availability of computers in an electronic classroom scenario. Currently, Biostatistics is covered in the module: Data Management and is a compulsory module in the first year (phase I: Foundation) for the degree MB.ChB. Students have refresher courses on Biostatistics in their third year of the clinical rotation subject of Community Health, where the focus is more on Statistical Epidemiology. In the fifth year, students have their last encounter with certain topics of Biostatistics. The role of Biostatistics in Medicine and Health Care is sometimes only fully understood and appreciated by medical practitioners and doctors once they are fully qualified, for a number of reasons. Biostatistics and Epidemiology are also one of those subjects in the medical curriculum that is possibly disliked by the majority of undergraduate students. Most students only realise at a tertiary level that there exists a science that involves statistical concepts. The medical curriculum is also revised every couple of years to ensure that it adhere to the basic principles of medical care, national interests of the medical profession and the demands of the 21 st century with