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I have 2 groups of medical students (50 in each group) that have each used 3 different techniques to undertake a procedure on 12 patients. So, 3,600 data points but accepting that they are not truly independent.

I would like to compare the performance of the two groups of students undertaking each of the 3 techniques. The outcome measures are (1) success as yes/no, (2) time in seconds, and (3) self-reported confidence on a 1-10 scale.

As there are 3 different techniques, I couldn't make a 2x2 table for (1) so used Kruskal-Wallis, which seems to permit comparison of more than 2 groups. My feeling is that I could do the same for the continuous outcome data in (2). However, when I try to read about this online, I understand that ordinal data (e.g. the confidence data in (3)) isn't appropriately analysed using Kruskal-Wallis.

Can anyone

  1. comment on whether I am on the right track with (1) and (2)

  2. and/or suggest an alternative approach to analysing the data in (3).

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  • $\begingroup$ Is your interest in differences between the two groups of students, or between the three techniques, or both? What you would you do with a conclusion that the six things being tested (students$\times$techniques) suggesting they are not all the same? $\endgroup$
    – Henry
    Commented Jul 6, 2021 at 10:50
  • $\begingroup$ I am interested in both comparisons - types of student (who were randomised to the two groups then taught to perform the procedure either remotely or in-person) and types of technique. I would hope to be able to determine whether or not there is evidence to support (1) either in-person or remote training and/or (2) any of the three techniques for completing the procedure. $\endgroup$
    – David
    Commented Jul 6, 2021 at 11:08

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Kruskal-Wallis is fine for ordinal Y. The only concern is whether it handles excessive ties accurately enough. You might instead use the proportional odds ordinal logistic model for all 3 outcomes. It reduces to the binary logistic model for (1) and handles arbitrarily many ties. It also leads to a more insightful Bayesian analysis.

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    $\begingroup$ Thank you very much and to Nick Cox for editing my post. I had no idea that my amateur question would attract the attention of two people whose work I have relied upon many times in the past! Thanks for sharing your time. $\endgroup$
    – David
    Commented Jul 6, 2021 at 14:12

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