By Cody Dashiell-Earp
The first time I read Better
by Atul Gawande, I was inspired by his advice: “Count something…it doesn’t really matter what you count. You don’t need a research grant. The only requirement is that what you count should be interesting to you.” Then I went to medical school, and I got scared. I learned about selection bias, recall bias, and the dreaded lead-time bias. Truth, it seemed, came only from a randomized controlled trial or a petri dish, and numbers, which I once understood so well, seemed unrecognizable under a veil of p-values and ROC curves.
All this made me nervous when Leah
, my friend and one of the leaders of our newly minted PCP chapter at Penn
, suggested we send out a survey for Primary Care Week. I reluctantly agreed to put something together, but then I put it off, anticipating the many hours of research it would take to create a scientifically sound questionnaire. Of course, I did not have many hours, I had exactly one hour, so this is what I did.
I started by thinking about what information we wanted from the survey, then I designed seven questions
that targeted those goals (See Figure 1). I used SurveyMonkey to put the whole thing online (although in the future I’ll use the Google Docs “form” function, since it is free), and I sent the link to all four medical school classes under the subject line “1 minute of your time = Good Karma for Life.” Within hours I had 144 responses.
What did our survey find?
A whopping 57% of respondents expressed an interest in a career in primary care. Does this mean 57% of Penn students are interested in primary care? Sadly it does not. Why? Because given our response rate of only 24%, selection bias is clearly rearing its ugly head. At the same time, 57% of 144 represents 82 students who we know are interested, which is 80 more than Leah and I knew about. This is a powerful number, and one that we have been using to show faculty that, contrary to popular belief, there is genuine interest in primary care among medical students at Penn. We also found that students really wanted to learn more about career pathways and clinical innovation, two topics we are focusing on next semester. Finally, those students that filled out our final “free response” question had some really interesting insights about how to improve primary care education, which we have brought to the attention of faculty in the Internal Medicine, Pediatrics and Family Medicine departments.
Our survey was by no means perfect, but it did provide us with valuable information that not only enabled us to tailor our Primary Care Week programming to the needs of our constituents, but also helped us communicate student interest to the resident and faculty leadership of our chapter. Counting something, it turns out, was not as hard as I imagined.
Cody Dashiell-Earp is an MD/MBA student at the University of Pennsylvania with an interest in clinical innovation in primary care. She is currently applying to residency in internal medicine, and hopes to use her business degree to improve patient care in the outpatient setting. Cody is also a founder and leader of the University of Pennsylvania PCP Chapter.
Want to survey your own primary care community? Click here for a toolkit on creating, disseminating, and analyzing a survey based on the UPenn chapter's experience.