Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr;55(4):455-461.
doi: 10.1111/medu.14420. Epub 2020 Dec 6.

Demonstrating equivalence and non-inferiority of medical education concepts

Martin Klasen  1 , Saša Sopka  1   2
Affiliations

Demonstrating equivalence and non-inferiority of medical education concepts

Martin Klasen et al. Med Educ. 2021 Apr.

Abstract

Context: In medical education, there are often several didactic methods for teaching and learning a specific medical skill. For educators, there are often pragmatic reasons to decide for one or another of them, such as costs, infrastructural requirements, time expenditure or qualification of the teacher. However, a central aspect to consider is the learning outcome: Does a new method achieve a similar learning success as an established standard method? To answer this question, we need an appropriate method to assess comparability of learning outcomes.

Methods: In this paper, we present two essential statistical concepts that can address the issue of comparability of learning outcomes: Equivalence and non-inferiority testing. We explain the ideas behind these concepts and illustrate them with an example data set. To clarify several concepts, we use theoretical examples from one selected field: the teaching and assessment of Basic Life Support (BLS).

Conclusions: Equivalence and non-inferiority tests can be powerful tools for comparing teaching and assessment methods. However, their correct application requires adequate knowledge about their strengths, pitfalls and application fields. The aim of this paper is to deliver this knowledge and to provide clinician researchers with a practical guidance to a successful application of these methods.

Keywords: Medical education; Medical skills; Teaching concepts; equivalence; non-inferiority.

PubMed Disclaimer

References

REFERENCES

    1. García-Suárez M, Méndez-Martínez C, Martínez-Isasi S, Gómez-Salgado J, Fernández-García D. Basic life support training methods for health science students: a systematic review. Int J Environ Res Public Health. 2019;16:768. https://doi.org/10.3390/ijerph16050768
    1. Deakin CD, Nolan JP, Soar J, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 4. Adult advanced life support. Resuscitation. 2010;81(10):1305-1352. https://doi.org/10.1016/j.resuscitation.2010.08.017
    1. Berg RA, Hemphill R, Abella BS, et al. Part 5: Adult basic life support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(18_suppl_3):S685-S705. https://doi.org/10.1161/CIRCULATIONAHA.110.970939
    1. Garattini S, Bertele' V. Non-inferiority trials are unethical because they disregard patients’ interests. Lancet. 2007;370(9602):1875-1877. https://doi.org/10.1016/S0140-6736(07)61604-3
    1. Gates S, Ealing E. Reporting and interpretation of results from clinical trials that did not claim a treatment difference: survey of four general medical journals. BMJ Open. 2019;9(9):e024785. https://doi.org/10.1136/bmjopen-2018-024785

Publication types

LinkOut - more resources