Plastic Surgery Residents' Understanding and Attitudes Toward Biostatistics A National Survey

Background: An understanding of biostatistics is a critical skill for the practicing plastic surgeon. The purpose of the present study was to assess plastic surgery residents' attitudes and understanding of biostatistics. Methods: This was a cross-sectional study of plastic surgery residents. A survey assessing resident attitudes regarding biostatistics, confidence with biostatistical concepts, and objective knowledge of biostatistics was distributed electronically to trainees in plastic surgery programs in the United States. Bivariate and regression analyses were used to identify significant associations and adjust for confounders/effect modifiers. Results: One hundred twenty-three residents responded to the survey (12.3% response rate). Respondents expressed positive attitudes regarding biostatistics in plastic surgery practice, but only moderate levels of confidence with various biostatistical concepts. Both attitudes and confidence were positively associated with the number of plastic surgery journals read monthly and formal coursework in biostatistics (P < 0.01). Resident attitudes were positively correlated with confidence (r = 0.33, P < 0.01). The mean percentage of correct responses on knowledge-assessments was 43.6% (20.8%). Integrated residents performed better than independent track residents (P = 0.04). Residents had difficulty with study design, the correct use of analysis of variance, regression analysis, and identifying a statistically significant result. Resident confidence was moderately correlated with performance (r = 0.31, P = 0.01). Conclusions: Plastic surgery residents place a high degree of importance on knowledge of biostatistics in the practice of plastic surgery but have only a fair understanding of core statistical concepts.