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R Cook. Broadcast.. https://doi.org/10.7748/ns.13.16.28.s41

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Development of a brief, self-administered instrument for assessing sleep knowledge in medical education: "the ASKME Survey".

STUDY OBJECTIVES: This report describes the construction and validation of a brief self-administered scale to assess sleep knowledge in medical education ("ASKME Survey"). Few measures of this type have been developed previously; none have been validated or widely adopted. The current instrument was designed as a standardized assessment measure for use in medical education in sleep. DESIGN: Instrument was developed in four phases: initial item selection, expert panel review, reliability and construct validity assessment, and final item selection. Content validity was assessed in six general domains: basic sleep principles; circadian sleep/wake regulation; normal sleep architecture; sleep disorders; effects of drugs and alcohol on sleep; and sleep in medical disorders. SETTING: N/A. PARTICIPANTS: Medical students at Robert Wood Johnson Medical School (RWJMS) and University of Kentucky College of Medicine; students in clinical psychology, nursing and other health-related professions at Rutgers University; school nurses at Texas Christian University; practicing physicians; accredited sleep specialists. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Individual item analysis of 30-item survey demonstrated a high degree of discriminant validity. Internal consistency for test items was relatively high (KR-20=0.89). Overall mean percentage correct was highest for accredited sleep specialists (85.3%+/-10.8%) and lowest for school nurses (53.1%+/-13.7%). Significant group differences were observed across all question categories (p < 0.0001). Medical students scored significantly higher than the nurses on questions related to sleep architecture (59.5% vs. 42.5%) and narcolepsy (36.4% vs. 21.3%). CONCLUSIONS: "ASKME" demonstrates a high degree of internal consistency and reliability among survey items. It discriminates between samples with varied levels of education, experience, and specialty training. The survey is currently available via the American Academy of Sleep Medicine website (http://www.aasmnet.org).

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Women's interest in genetic testing for breast cancer susceptibility may be based on unrealistic expectations.

We report on results of an interview study assessing women's attitudes toward and hypothetical interest in genetic susceptibility testing for breast cancer. Data are from 246 interviews with women of varying ethnicity (African American, European American, Native American, and Ashkenazi Jewish), family history of breast cancer (negative, positive, and borderline), and educational level. Semistructured interviews included questions on general health beliefs; attitudes, experiences, and concerns about breast cancer; and hypothetical interest in genetic testing. Influence of specific test characteristics was assessed with 14 Likert scales varying negative and positive predictive value, timing of disease, possible medical interventions following a positive result. Results reported include both statistical and qualitative analysis. We found that women had a high level of interest in testing which, in general, did not vary by ethnicity, level of education, or family history. Interest in testing appeared to be shaped by an exaggerated sense of vulnerability to breast cancer, limited knowledge about genetic susceptibility testing, and generally positive views about information provided through medical screening. However, study participants were most interested in a test that didn't exist (high positive predictive value followed by effective, noninvasive, preventive therapy) and least interested in the test that does exist (less than certain positive predictive value, low negative predictive value, and limited, invasive, and objectionable therapeutic options). Our data suggest that without a careful counseling process, women could easily be motivated toward interest in a test which will not lead to the disease prevention they are seeking.

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