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    Research and statistics in the collective unconscious

    Cognitive Dissonance Research Research Engineer Statistics

    Research Engineer will always be free

    Fighting the good fight for statistics and research

    It behooves me to make Research Engineer free to the world.  Statistics and research often cause a "knee-jerk" reaction of anxiety and cognitive dissonance.  I am reminded of this on a daily basis, because I live it on a daily basis.  

    It seems to me that statistics and research, in the most basic applied sense, have acquired a negative connotation within the collective unconscious.  That is scary because researchers communicate the findings of their research using statistics! Other researchers and clinicians are supposed to be able to interpret and generalize the research methods and statistical findings of the studies, denoting possession of the necessary competencies and experience to do so.  

    Research Engineer will always be free, because research and statistics belong to everyone.  Names like Aristotle, al-Haytham, Bacon, Descartes, Bayes, Gauss, Pearson, Fisher, Spearman, Bonferroni, Tukey, Cox, and Cronbach have come before me and have invented the empirical and statistical methods presented in this website.  All I did was take their methods and build THE FIRST decision engine designed to avert the aforementioned anxiety and cognitive dissonance. The brilliant men and women that came before me deserve to be recognized and their methods, which we use in everyday life to make important decisions, should be held in a higher esteem within the collective unconscious.

    I tell my clients that when they feel cognitive dissonance associated with research or statistics, I will be standing there in their unconscious mind, ready to help.  It always gets a reaction, but they always come back and they always receive my best efforts.

    Now, when anyone around the world feels that "knee-jerk" reaction to research and statistics and they want to retreat into their unconscious minds, Research Engineer will be waiting, always free and always able to help.  

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    Evidence-based medicine and its applications

    Acquiring Clinical Evidence Applying Clinical Evidence Appraisal Of The Literature Appraising Clinical Evidence Asking Clinical Questions Assessing Clinical Practice Bloom's Taxonomy Cognitive Dissonance EBM Evidence-based Medicine PICO

    Critical appraisal of the clinical evidence

    The cart before the horse

    I'm getting ready to add an Education section to the website, I decided to go back to first principles.  Bloom's Taxonomy had a pervasive impact on my philosophy of learning, teaching, and cognitive complexity.  I used it back in February of this year for an evidence-based medicine (EBM) presentation at work.  Bloom's Taxonomy* stipulated six levels of "knowing" or cognitive complexity.  The six levels in increasing order were knowledge, comprehension, application, analysis, synthesis, and evaluation.  

    Here is the conundrum that Bloom's Taxonomy exacts upon applied EBM practice:

    There are five steps to EBM:  Asking, acquiring, appraising, applying, and assessing.  

    With asking, the EBM literature posits that clinicians experience "cognitive dissonance" when they have a knowledge gap in their clinical practice.  In order to deter the dissonance, the clinician decides to ask a clinical question to fill that gap.

    With acquiring, the clinician uses the PICO (population, intervention, comparator, outcome) mnemonic to acquire the best clinical evidence, given the resources and time available.

    Now we get to critical appraisal of the literature.  When looking at the nomenclature of the word "appraisal," it is reflective of the highest level of "knowing" or cognitive complexity in Bloom's Taxonomy, evaluation.  EBM stipulates that clinicians must be able to critically appraise the methods and statistical analyses of published studies.  This means that clinicians have to have functioning at a very high cognitive level to do this correctly.

    However, past literature has shown that researchers feel anxious and intimidated by statistics due to a lack of experience and competency.**  Also, undergraduate and graduate medical training rarely equips clinicians with the necessary competencies to conduct and effectively interpret clinical research evidence.***

    So, how can your everyday clinician with limited empirical/statistical training who feels "cognitive dissonance" a second time in the five steps of EBM critically appraise the literature?  Therein lies the conundrum, in my opinion.  

    I'm positing that we need to refocus our efforts on the lower echelons of Bloom's Taxonomy by educating physicians, residents, fellows, faculty, pharmacists, nurses, and staff to better understand (knowledge), recognize (comprehension), choose (application), examine (analysis), and design (synthesis) research studies before we can expect them to critically appraise (evaluation) the literature.  
    *Bloom, B. S.; Engelhart, M. D.; Furst, E. J.; Hill, W. H.;Krathwohl, D. R. (1956). Taxonomy of educational objectives: The classification of educational goals. Handbook I: Cognitive domain. New York: David McKay Company.
    **Marquardt, DW.  Criteria for evaluating the performance of statistical consultants in industry.  The American Statistician 1981; 35; 216-219.
    ***Wegwarth O.  Statistical illiteracy in residents:  What they do not learn today will hurt their patients tomorrow.  Journal of Graduate Medical Education 2013; 5; 340-341.