SPSS Hands-on Training for Data Analysis

How to analyze open-ended questions

Dr Tin Myo Han MBBS, M.Med.Sc (P.H), M.P.H ( Belgium)
31st March 2011, Kuantan

How to apply SPSS soft-ware for openended questions analysis?

Learning Objectives:
To know the basic principles of open-ended questions analysis To understand how to do the open-ended question analysis by doing hands-on exercise with own data To apply the experiences got from hands-on exercise on semi-qualitative data ( open-ended question) analysis of their research project

Contents of Lesson Plan

Date Time
9:00-9:30 AM

Activities
Basic Principles of Open Ended Question Analysis A presentation for open-ended question hands on Exercise : ( MICAP) notation system

Responsible person Dr TMH

9:30 -10:00 AM

24.12.2012

10 minutes- Break
10:10 10:30 AM 10:30 10:45 AM 10:45-11:00 AM Data Collecting & Analysis Presentation on group assignment openended questions analysis Discussion and Q & A section Dr TMH & Students Students Dr TMH & Students

Basic Principles of Open Ended Question Analysis

Types of Epidemiological study

Quantitative Study
Study Design
All aspects of study are carefully designed before data is collected

Qualitative Study
Design emerges as the study unfolds. (Flexible to allow for unseen problems that may arise during research process)

In form of numbers & In form of words, pictures Data statistics or objects

Researcher uses tools, such as Data questionnaires (or) equipment to Collection collect numerical data

Researcher is the data gathering instrument Subjective - individuals interpretation of events is important ,e.g., uses participant observation, in-depth interviews etc

Objective seeks precise Objective measurement & analysis of target or concepts, e.g., uses surveys, Subjective questionnaires etc

8/18/2011

Dr TMH " Epidemiological study Designs"

Open- ended Vs Closed questions

Open
Respondents express freely and given the huge response use own words is difficult to compare the meanings of the responses. actually reflect their real feelings/ explanation/ reasons Post coding ---!!!

Closed
Pre coding Limit participants response
(T/F , choose one, fill in other)

more specific, thus more likely to communicate similar meanings. Easy to code & enter into data Management soft-ware

 don t have to use closed-ended or open-ended questions exclusively.  a combination of closed and open questions should be used !!

Quantitative

Qualitative

Open-ended questions

Analysis on Open-Ended Questions

Semi-qualitative Find key words/ key phrase in the answers Based on themes/(themes is set based on KWs/ KPs) Code the answers (post coding) ( number/ string)

Enter SPSS data file Analyze

Steps : Analyzing Open-Ended Question

Steps : Analyzing Open-Ended Question

1. Read through the responses.

Read through each response to get a feeling for the data. Will probably see some common themes emerging.

2. Create response categories.

Develop categories for the different themes you are seeing.
For example, with a question asking for patient s feedback on a dental treatment/ denture , you will probably be able to group comments into categories such as services , structure , facilities , outcome , etc.

3. Label each comment with one or several categories.

Assign at least one category to each response. This is what is called post-coding and the best done in an excel sheet with responses in one column.

4. Look at what you have.

In the example about feedback for a dental treatment / denture might label half of your patients response as services . The responses are divided on services into smaller categories, e.g. services provided by receptionist , Dentist and dental nurse , etc. Start to see what are the trends in the data and the main issues raised by your respondents.

5. Think what are the responses about?

Categorize and code data, it doesn t do you much credit just to say some half of patients spoke about services; most of these people spoke about the outcomes of treatment . Must be able to explain what is being said about the subject or theme. For example in the case of services what were patients saying about services ?

6. Identifying the patterns and trends:

The data has been studied and categories determined, the next step is to see what categories are related and where can trends and patterns be identified: are there common themes emerging? Or are there a series of unrelated points being mentioned?

7. Writing up the analysis:

After analyzing the data and identifying the major patterns and trends , next step is to write a summary of what you have found. This would normally be a descriptive text incorporating comments directly from the respondents.

Writing up the analysis

Use terms such as some half , main issues and to a lesser extent to illustrate the magnitude of the trends identified. Some prefer to transfer such an analysis into quantifiable terms such as some 50% or under 30% Dealing with very few responses, it s better to mention the precise numbers such as 5 out of 20 responses preferred . Example

Example 1-a :Open ended question analysis

Quantitative
Table (1): Learning preferences of general practitioners on different teaching methods, (n= 78)

Teaching Methods Two-way Discussion Clinic / Scenario-Based Discussion Hospital Attached (Bedside Teaching) One-way Lecturing

Preference
No %

63 44 38 14

81 56 48 18

Reference: Tin Myo Han( et al 2011) Learning preferences of general practitioners on clinical module of CME Course provided by Myanmar Medical Association, The 6th congress of Asian Medical Education , Kuala Lumpur, 2011

Example 1-b :Open ended question analysis

Qualitative
Table (2): Reasons of preferences on different teaching methods,

Teachings methods Two-way Discussion (n= 63) Clinic/ Scenario Based Discussion (n= 44) Hospital Attached ( bed side teaching) (n= 38) One-way Lecturing (n= 14)

Reasons for preferences get more interest & absorb in topics because of active participation & friendly sharing experiences assist to solve the problems facing in daily clinical practices get an opportunity to learn (real) hospitalized cases & standard local hospital treatment/ specialists treatment save time to know all in one lecture

Reference: Tin Myo Han( et al 2011) Learning preferences of general practitioners on clinical module of CME Course provided by Myanmar Medical Association, The 6th congress of Asian Medical Education , Kuala Lumpur, 2011

Example -2 Open-ended questions analysis

Qualitative Quantitative

A presentation for open-ended question handson exercise: ( MICAP) notation system

6th Congress of Asian Medical Education Association (AMEA 2011)

23rd March 26th March 2011, Kuala Lumpur , Malaysia

Introducing a new lesson on configuration of teeth identification and communication

By

Ashfaq Akram, Nooreiny Maroof, Nabishah Bt Mohamad Abdel Hamid Zaki

Medical Education Department Universiti Kebangsaan Malaysia (UKM)

Teeth
Adult 32 teeth 16 upper jaw ( 8 right = 8 left ) 16 lower jaw ( 8 right = 8 left ) Children 20 teeth 10 upper ( 5 right = 5 left ) 10 lower ( 5 right = 5 left ) Central Incisor, Lateral Incisor, Canine, 1st premolar, 2nd Premolar, 1st Molar , 2nd Molar , 3rd Molar

Tooth Notation System

Teaching lesson
2nd year of dental courses
Subject: (Dental Anatomy) Degree program (BDS/DDS/DMD)

Practical Application
3rd year , 4th year , 5th year , houseman-ship, lifelong dental practice

Tooth Notation System

It is a system to identify teeth in a specific way To write down the problem/diagnosis and treatment of dental patients To make a referral note for another doctor (specialists) for the sake of wellness of patients To make a referral/claim note for insurance company / financial body for the sake of getting treatment charges

Currently Available Tooth Notation Systems

Central Incisor Lateral Incisor Canine 1st Premolar 2nd Premolar 1st Molar 2nd Molar 3rd Molar

Palmer Notation
UPPER RIGHT UPPER LEFT

87654321 87654321
LOWER RIGHT

12345678 12345678
LOWER LEFT

Currently Available Tooth Notation Systems

FDI Tooth Notation System

Quadrant 1 18 17 16 15 14 13 12 11 48 47 46 45 44 43 42 41 Quadrant 4 Quadrant2 21 22 23 24 25 26 27 28 31 32 33 34 35 36 37 38 Quadrant 3

Universal System
1 2 3 4 5 6 7 8 32 31 30 29 28 27 26 25 9 10 11 12 13 14 15 16 24 23 22 21 20 19 1817

Tooth Notation System

-To write down the problem/diagnosis and treatment of dental patients e.g., Patient has problem(caries) in upper tight 1st molar # 16 (FDI) # 3 ( universal system) # 6 (palmer)

Patient has problem in lower right 1st molar #46 # 30 #6

Problem
Purely based on Arabic numbers when dental information are communicated among dental professionals there is confusion or error in the execution of patients (clinical) condition due to misinterpretation of the tooth notation system used.

1 digit two teeth

Universal system

FDI system

Literature review
Wrong tooth errors usually occur as a result of poor communication within a dental practice or between dentists in different practices. (BBC
News/Health. Dentists warned on tooth extraction. October 4, 2004).

In IRAN, in 410 cases ,157 were the cases where dentists had to pay the rebate about USD350,000, a penalty fee because of the treatment of the wrong tooth due to poor communication of the patients.
Mehrzad Kiani.(2009). A five-year survey for dental malpractice claims in Tehran, Iran. Journal of Forensic &legal medicine ,16(2):76-82.

14% of total malpractice cases reported to insurance company were wrong site tooth extraction and insurance company had to pay rebate in amount of six digits of such malpractice procedures Lee JS, et al.,2007. Prevention of Wrong
Site Tooth Extraction: Clinical Guidelines. J Oral Maxillofac Surg; 65(9): 1793-1799.

Literature review
It is suggested that general dentists and specialists should use the same tooth notification system to prevent an error in the execution of patients treatment. Ricketts DNJ, et al.,2003. Peer review amongst restorative
specialists on the quality of their communication with referring dental practitioners. Br Dent J, 195: 389-93.

To prevent future disputes or claims, there is a strong need to improve communication between health care providers and patients. Noriaki et al.2008 Impact of
miscommunication in medical dispute cases in Japan. International Journal for Quality in Health Care 20(5):358-362.

MICAP lesson
What is MICAP How it is constructed How it is different from other systems Clinical usage Assessment

MICAP- based on teeths name Upper right INCISOR CANINE MOLAR PREMOLAR
M- Molar I - Incisor C - Canine A - Ashfaq P - Premolar
MOLAR PREMOLAR INCISOR CANINE

Upper left

Lower right
Tooth Notation Systems

Lower left
36

Methodology

Upper right quadrant

Upper Left quadrant

Lower right quadrant

Lower left quadrant

Tooth Notation Systems

37

Methodology

Maxillary ri t quadrant

Maxillary left quadrant

Mandibular ri

t quadrant

Mandibular left quadrant

Tooth Notation Systems

38

How to read MICAP text

#M3 is pronounced as upper left 3rd molar.
as maxillary left 3rd molar.

Methodology

MICAP Tooth Notation System

Comparison
Tooth Class / Types Maxillary right first premolar Mandibular right canine Maxillary left 1st Molar Maxillary left 3rd molar Maxillary right central incisor Maxillary left lateral incisor FDI system Palmer notation Universal System MICAP system

#14 #43 #26 #28 #11 #22

#4 #3 #6 #8 #1 #2

#5 #27 #14 #16 #8 #10

#1P
#1C

#M1
#M3

#1I
#I2

Advantages of MICAP
Based on Standard names of the teeth Universal standard Oral examination, Referral note Insurance claims

MICAP Application
Dental curriculum as a Teaching lesson Dental practice in dental charting referral notes insurance claim as a dental software

Results Description of MICAP Notation System for referring a patient

Composite filling has been done #1C on datedExtraction is advised #2P2. Patient is getting root canal treatment and #M1.Patient has been referred to oral surgeon for #M3

Assessment
Formative and summative assessments
Multiple Choice Questions(MCQs) Modified Essay Questions(MEQs) e.g.,
A 35 years old female patient attends a dental clinic, complaining of gradual discoloration of her upper right central incisor tooth over the last two years. It is presently symptom free but she is unhappy about its appearance and wants it to be improved. 1-How would you record her problems by using MICAP? 2- How would you make a referral note?

Recommendation by research

Research project - to validate this theory

Thank you

Assignment to the Students

After MICAP tooth notation system presentation, a questionnaires is distributed to 42 dental students to assess their opinion on MICAP tooth notation system ; whether this MICAP tooth notation system should be created or not? - All students are encouraged to answer the questionnaires - 10 minutes break is given after collection data from the students

Data collecting tool: the Questionnaire to assess the opinion of 4th year dental students on MICAP?

Should MICAP tooth notation system be created?

Assignment to the Students

During break time, filled questionnaires are divided into 3 groups depend on the their opinions; - positive group ( strongly agreed/ agreed) - Negative group ( strongly disagreed/ disagreed) - Neutral group ( no comment)

Assignment to the Students

-42 students are also grouped into 3 by systematic sampling method - Each group have to analyze the response of assigned filled questionnaries ( Positive, Negative & Neutral ) - First , SPSS data file is created to enter the pre-coded data ( age, sex, opinion on MICAP tooth notation system) & post-coded data: reasons for their respective opinions on MICAP

30 minutes Data Collection & Analysis

Good luck with your analysis!

Assignment to students: Data Collection & Analysis Opinion and reasons of the students on MICAP project implementation are analyzed by applying the principles of open-ended question analysis After analysis, fill the results in the dummy tables provided by lecturer And then, one representative of each group have to do 5 minutes presentation for their results

Dummy table: Opinion of 4th year dental students on creation of MICAP notation system by gender (n= 42) Quantitative Opinion of 4th year dental students on creation of MICAP notation system , n= 42
Male Female Total (%)

Positive response

Neutral

Negative response

42 (100%)

Opinion of 4th year dental students on creation of MICAP notation system (n= 42)
Qualitative
Positive Neutral Negative

Key words/ phrase

Dummy table: Opinions & reasons of 4th year dental students on creation of MICAP notation system by gender (n= 42) Quantitative Qualitative Opinion & Reason of 4th year dental students on creation of MICAP notation system , n= 42
Male Female Total (%)

Positive response (n= ) ( key words/ phrase) Neutral (n= ) ( key words/ phrase ) Negative response ( n= ) ( key words/ phrase )

42 (100%)

Writing up for Presentation : Reason of 4th year dental students on creation of MICAP notation system by gender (n= 42) Quantitative Qualitative Reasons of 4th year dental students on creation of MICAP notation system , n= 42
Positive response ( theme) Male (n= ) Neutral ( No comment) ( theme) Negative response (theme )

Female (n= )

Good Luck!