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A functional analysis of phonological knowledge and generalization learning in misarticulating children.

It has been suggested that a child's productive phonological knowledge may be one factor that potentially accounts for individual differences in generalization learning observed among phonologically disordered children (Dinnsen & Elbert, 1984; Elbert, Dinnsen, & Powell, 1984). This paper evaluates the hypothesis that productive phonological knowledge influences generalization. Three related studies involving 6 functionally misarticulating children were conducted. In the first study, a description of each child's phonological system was developed using procedures of standard generative analysis. Based upon these descriptions, each child's productive phonological knowledge of his or her own sound system was determined and then ranked on a continuum ranging from "most" to "least" knowledge relative to the adult target. The second study implemented an experimental treatment program based upon each child's productive phonological knowledge, with treatment sounds selected directly from each child's continuum of knowledge. The third study reassessed each child's productive phonological knowledge following treatment. The results of these three studies indicated that a child's productive phonological knowledge of the sound system influenced the overall amount of generalization learning. However, the extent of generalization learning was associated with the point on the knowledge continuum at which treatment was initiated. These findings are discussed with reference to individual differences in generalization learning.

Articulation Disorders↗

A study to evaluate the pain knowledge of two sub-populations of final year nursing students: Australia and Philippines.

BACKGROUND: Pain management is an essential and important aspect of nursing care. Deficits in pain knowledge and attitudes continue to be reported despite a growth of educational programmes. A lack of basic knowledge of pain at an undergraduate level may limit nurses from effectively developing their knowledge after graduation. AIM OF THE STUDY: To assess the type and level of knowledge of basic aspects of pain mechanisms and treatment principles in complete classes of final year nurses, at three nursing schools. METHOD: Data were collected in 1999, from 150 students (81 Australian and 69 Philippine) via a 23-item pain knowledge test questionnaire, previously used to assess undergraduate health professionals including nurses. RESULTS: The mean score of concordant answers for all students was 38.6%, scores ranged from 0% to 70%, 95% Confidence Interval of the mean was 36-41%. There were few significant differences between the groups for individual questions and no significant difference in overall mean scores. Common questions answered poorly included those related to complex regional pain syndrome, pharmacology and central sensitization. Most students perceived their undergraduate pain education to be minimal. Thirty-six per cent of Australian students compared with 50% Filipino students perceived their pain knowledge was adequate for their clinical needs. Additionally, most students believed that graduating doctors should be able to answer the test questions correctly. CONCLUSION: The results demonstrate consistently low levels of knowledge and also knowledge gaps about basic pain mechanisms, terms and treatment amongst these three final year nursing classes. Such information is useful to define levels of basic knowledge about this topic, and can be explored further as to whether some or all of these facts are deemed necessary for inclusion in nursing curriculum by reference to documents such as the International Association for the Study of Pain curriculum.

Australia↗

Predictive validity of a written knowledge test of skills for an OSCE in postgraduate training for general practice.

PURPOSE: To examine the validity of a written knowledge test of skills for performance on an OSCE in postgraduate training for general practice. METHODS: A randomly-selected sample of 47 trainees in general practice took a knowledge test of skills, a general knowledge test and an OSCE. The OSCE included technical stations and stations including complete patient encounters. Each station was checklist rated and global rated. RESULTS: The knowledge test of skills was better correlated to the OSCE than the general knowledge test. Technical stations were better correlated to the knowledge test of skills than stations including complete patient encounters. For the technical stations the rating system had no influence on the correlation. For the stations including complete patient encounters the checklist rating correlated better to the knowledge test of skills than the global rating. CONCLUSION: The results of this study support the predictive validity of the knowledge test of skills. In postgraduate training for general practice a written knowledge test of skills can be used as an instrument to estimate the level of clinical skills, especially for group evaluation, such as in studies examining the efficacy of a training programme or as a screening instrument for deciding about courses to be offered. This estimation is more accurate when the content of the test matches the skills under study. However, written testing of skills cannot replace direct observation of performance of skills.

Clinical Competence↗

Does problem-based learning lead to deficiencies in basic science knowledge? An empirical case on anatomy.

INTRODUCTION: Problem-based learning (PBL) is supposed to enhance the integration of basic and clinical sciences. In a non-integrative curriculum, these disciplines are generally taught in separate courses. Problem-based learning students perceive deficiencies in their knowledge of basic sciences, particularly in important areas such as anatomy. Outcome studies on PBL show controversial results, sometimes indicating that medical students at PBL schools have less knowledge of basic sciences than do their colleagues at more traditional medical schools. We aimed to identify differences between PBL and non-PBL students in perceived and actual levels of knowledge of anatomy. METHODS: Samples of Year 4 students in all eight medical schools in the Netherlands completed a questionnaire on perceived knowledge and took part in a computerised anatomy test consisting of both clinically contextualised items and items without context. RESULTS: Problem-based learning students were found to have the same perceived level of anatomy knowledge as students at other medical schools. Differences in actual levels of knowledge were found between schools. No significant effects on knowledge levels were found for PBL schools versus non-PBL schools. CONCLUSION: The results of this study show that PBL does not result in a lower level of anatomy knowledge than more traditional educational approaches. It remains to be ascertained whether the levels students attain are adequate. Subjects for further study are the desired level of anatomy knowledge at the end of undergraduate medical education and the effectiveness of basic science learning within a clinical context and with repetition over the course of the curriculum.

Adult↗

Expert-novice knowledge of computer programming at different levels of abstraction.

Computer programming knowledge can be classified into five levels of abstraction: objective, conceptual, functional, logical, and physical. An experiment was carried out to determine whether the mastering of knowledge at different levels of abstraction changed with the level of skill. Ten experts and ten novices in C computer programming participated in the experiment. The subjects' knowledge at the five levels of abstraction was tested through 20 multiple-choice questions. The experimental results indicated that knowledge differences between experts and novices at an abstract level or a concrete level depended on what abstract or concrete knowledge was implied. Experts had better abstract knowledge than novices at the conceptual and functional levels but not at the objective level. Experts had better concrete knowledge than novices at the physical level but not at the logical level. The classification of computer programming knowledge in levels of abstraction and the experimental results helped in clarifying a general finding from previous studies that experts had better abstract knowledge than novices.

Cognition↗

Relationship between sport knowledge, sport performance and academic ability: empirical evidence from GCSE Physical Education. General Certificate of Secondary Education.

The literature concerning links between sport knowledge, sport performance and academic ability is reviewed and related to empirical evidence obtained from a GCSE examination in Physical Education, together with GCSE Mathematics and GCSE English grades. For most sports examined, there was a small but significant positive correlation between sport performance and GCSE Mathematics and English grades, confirming the findings of most previous research. Using a multilevel multivariate model, average sport performance, academic ability and sex were important explanatory variables for sport knowledge, yet only academic ability was an important explanatory variable for the concept of physical education knowledge. Ability in game sports, rather than athletics, were related to sport knowledge. Males scored higher for sport knowledge than females, after taking into account sport performance and academic ability. The effects of sport performance and academic ability on sport knowledge were stable across schools, but there was some evidence that the effect of sex varied across schools. These findings support theories of a role for sport knowledge in sport performance; that such a role should be greater in game sports; that academic ability is important for gaining such knowledge; and they highlight differences in sport knowledge between the sexes.

Achievement↗

Knowledge and belief in nutrition.

In a nutrition questionnaire, subjects have been given the options of answering questions with yes, no, or don't know. From these responses it has been possible to calculate the levels of their "correct knowledge," their "perceived knowledge" (that is the knowledge that each subject believed he had) and the "accuracy of knowledge". Questions about common nutritional problems were given to physicians, medical students, nurses, and theology students. All groups had a high level of "perceived knowledge," generally greater than 80% for the questions asked, but the accuracy of the knowledge was alarmingly low. The highest level was in physicians, in whom 79% of the perceived knowledge was accurate, but in theology students only 36% of the perceived knowledge was accurate. Two thirds of the "knowledge" of nutrition held by theology students was therefore false by current scientific standards. These findings have implications for future nutrition education.

Educational Measurement↗

Family practitioners' attitudes and knowledge about irritable bowel syndrome: effect of a trial of physician education.

BACKGROUND: Primary physicians care for most patients with irritable bowel syndrome (IBS), but data on their attitudes and knowledge about the disorder are limited to research in the UK. OBJECTIVE: The purpose of the present study was to assess US family practitioners' attitudes and knowledge about IBS and determine the effect of a single education class on these measures. METHODS: In a large health maintenance organization (HMO), a baseline group of family practitioners twice completed a questionnaire on attitudes and knowledge about IBS, 3 months apart. A class group completed it pre-class, immediately post-class and 3 months post-class. RESULT: Thirty-five physicians ranked IBS among five chronic, painful syndromes as highest in difficulty satisfying patients, tied with headache for highest in difficulty in practice strategy decision, second in time required, and fourth in diagnostic confidence and satisfaction in caring for patients. IBS and heartburn had widely separated rankings in all five attitudes. The correct answer rate on seven of 13 knowledge questions was <50%, and a majority did not identify the Rome II symptom criteria as typical and lacked other important knowledge. Of the 30 class physicians, the knowledge scores (mean +/- SD; maximum possible, 13) of 29 increased from 5.59 +/- 1.84 pre-class to 10.21 +/- 1.76 immediately post-class (P < 0.0001); 3 months later, the scores were lower (8.93 +/- 0.36) than post-class (P < 0.0001), but still higher than pre-class (P < 0.0001). Their attitude rankings were nearly identical pre-class and 3 months later (P > 0.05). In the 19 baseline physicians, IBS attitude rankings and knowledge scores did not change significantly over 3 months (P > 0.05). CONCLUSION: These US family practitioners had attitudes about IBS patients and lacked knowledge that could interfere with patient care. A single class improved short-term knowledge but had little effect on attitudes about IBS.

Adult↗

An international comparison of knowledge levels of medical students: the Maastricht Progress Test.

The increasing international mobility of medical students has inspired the search for an international assessment format. As one step along this line, kinetics of knowledge acquisition and final cognitive levels of students were compared among one Dutch, one German and four Italian medical faculties. For this comparison, the Maastricht Progress Test (MPT) was used. For four out of the six participating faculties, it was possible to compare the level of knowledge of sixth-year students. These data showed no significant differences on the test as a whole. On the other hand, as judged from cross-sectional data on students from all study years, the kinetics of knowledge acquisition showed different trends. In one school applying problem-based learning, acquisition of knowledge by students occurred almost linearly. In another school, over the first 2 years, acquisition of knowledge occurred only in the basic sciences but not in clinical or public health/behavioural sciences. In two other schools over that same period, students seemed to gain no knowledge at all. In some faculties, a marked boost in knowledge was noted with third- or fourth-year students. These findings may be explained by peculiarities of the respective curricula, selection of students during their studies, and national or local assessment procedures. It is preliminarily concluded that the different educational approaches and assessment systems in medical education in Europe seem to have only limited influence on the final level of knowledge of the graduates. On the other hand, these differences may influence the kinetics of knowledge acquisition, especially in distinct domains like basic or clinical sciences. Therefore, the MPT may not be suitabe to solve the problem of assessment of individual international exchange students, but it may be helpful in identifying corresponding cognitive levels on, for example, basic sciences for students in different curricula.

Clinical Competence↗

Does knowledge of drug prescribing predict drug management of standardized patients in office practice?

Drug prescribing for the elderly is an important area of medical knowledge since inappropriate prescribing may lead to significant adverse drug events. The objective of this study was to evaluate the association between knowledge of drug use and quality of drug management by general practitioners in practice. A cross-sectional study design was used to evaluate a sample of 37 GPs in practice. A set of common musculoskeletal problems was chosen to evaluate doctors' knowledge of non-steroidal anti-inflammatory drug use, while performance in practice was assessed using elderly standardized patients. The reliability of knowledge test scores was evaluated using measures of internal consistency. The relationship between knowledge of drug use and quality of therapeutic management in practice was evaluated by rank order and linear correlation analysis. Demographic characteristics of participating and non-participating doctors were similar. The reliability of the knowledge test was 0.55. The reliability of performance scores was 0.66. The correlation between overall performance on the standardized patient cases and total knowledge test score was 0.22 (95% confidence interval = 0-0.63). Knowledge test scores were poorly correlated with quality of therapeutic management in office practice. This indicates that knowledge tests alone cannot predict quality of performance with regard to drug prescribing for the elderly in primary care office practice.

Clinical Competence↗

Attitudes, knowledge and blood glucose control.

The hypothesis that management-related diabetes knowledge and attitudes may be more directly related to diabetic control than general knowledge of or general attitude towards diabetes is examined. Sixty Type 1 diabetic patients were studied using an itemized knowledge questionnaire and an attitude scale measuring a general attitude to diabetes but containing a previously defined subgroup of items concerned with attitudes to management. A significant linear correlation was found between management-related knowledge (r = -0.39; p less than 0.01) and HbA1c. However, knowledge of insulin, diet, footcare, and glucose monitoring were not significantly correlated with HbA1c, poor control being associated with both very low and very high knowledge status. A significant linear correlation was found between management-related attitudes (but not general attitude) and HbA1c (r = -0.47; p less than 0.01). The multiple regression correlation between HbA1c and both management knowledge and attitudes was -0.51. Most (63%) of the association between knowledge and HbA1c was attributable to attitude. This study provides support for education strategies based upon achieving improved patient attitudes and motivation rather than comprehensive knowledge as the most effective way of improving patient diabetic control.

Adolescent↗

Oral health knowledge and habits of senior elementary school students.

Despite improvements in children's dental health, and significant resource allocation to health education programs, few recent studies have investigated the associations of oral health knowledge, behaviors, and status. This study of 11-year-old children (N = 6,329) in northeastern Ontario used a supervised self-complete questionnaire and a clinical examination to gather baseline data on, and test associations of, caries and periodontal knowledge, self-reported oral health behaviors and source of knowledge, and oral health status. Results show the children had poor knowledge of caries preventive measures such as water fluoridation, dental sealants, and choice of snack foods. Periodontal knowledge was better, but children confused plaque and calculus. Respondents claimed good oral health habits, with 73 percent claiming to brush at least twice daily, 88 percent claiming to use toothpaste, 42 percent claim to floss at least twice weekly, and 84 percent claiming an annual dental visit. Children with the best knowledge claimed dentist and school as the sources. High knowledge was associated with good oral health habits (P less than .001) and low DMFT score (P less than .001). Good habits were not related to DMFT score (P = .1095). Logistic regression showed high knowledge was associated with English cultural status, urban school area, good habits, having a dental sealant, and attending a fluoride-rinse school (P less than .05). Findings suggest a need to reinforce caries preventive teaching, to investigate the effect of cultural status, dental experience, and residence status on oral health knowledge, and to further test the efficacy of different oral health education programs delivered by different sources.

Analysis of Variance↗

Trends in students' knowledge, opinions, and experience regarding dental informatics and computer applications.

OBJECTIVE: This study investigated knowledge, opinions, and experience regarding dental informatics and computers among first-year dental students (D1s) and fourth-year dental students (D4s). DESIGN: First-year (N = 95) and fourth-year (N = 91) students in 1990 and first-year (N = 97) and fourth-year (N = 91) students in 1993 at a school of dentistry were surveyed. MEASUREMENTS: Demographic characteristics and computer ownership were assessed. Knowledge was measured using an 18-item scale (range 0-18). Opinions were measured using a 13-item scale (range 13-65; alpha = 0.81). Experience was measured using a 28-item scale (range 28-140). RESULTS: Response rates were all nearly 100%. Computer ownership by the D1s increased from 17.9% to 43.8% in the three years between surveys. Knowledge and opinions of the 1990 and 1993 D1s were similar, although the latter reported more experience with hardware and software. Experience with dental informatics applications was lacking in both groups. The 1993 D4s had completed more computer courses than had the 1990 D4s (2.3 vs 0.9), and demonstrated significantly more knowledge and experience. Opinion scores were nearly identical for these groups. The D4s in 1993 who had been D1s in 1990 had increased their knowledge of and experience with informatics applications during dental school. A difference in computer knowledge between the entering D1 males and females was observed in 1990, but was essentially gone by 1993 for the same individuals. CONCLUSIONS: Entering students had more computing knowledge and skill than their predecessors. Informatics knowledge and experience increased during dental school, and knowledge disparities between genders disappeared.

Adult↗

Differences in the technical and applied nutrition knowledge of older adults.

Although elder adults are much more knowledgeable about nutrition than ever before, diet behavior is not consistent with nutrition knowledge. One of the reasons for this inconsistency may be that the ability to apply technical nutrition knowledge is still inadequate. To test the hypothesis that technical nutrition knowledge is superior to applied nutrition knowledge, 96 volunteer seniors were given technical nutrition knowledge tests associated with heart disease, cancer, and high blood pressure. After the technical knowledge tests, subjects were asked to choose from among pairs the item that contained: (a) cholesterol, (b) more saturated fat, (c) more polyunsaturated fat, (d) substances that help to lower blood cholesterol, (e) more fiber, and (f) less sodium. Results support the notion that, in general, elder ability to apply nutrition knowledge is not as adequate as their technical nutrition knowledge.

Aged↗

Sexuality of the aged and the attitudes and knowledge of nursing students.

Sexuality of the aged is one area of particular concern to nurse educators, because students' lack of knowledge and negative attitude can have far-reaching effects on nursing care of the elderly. This study examined the relationship of the dependent variables, attitude and knowledge, to the independent variables of ethnicity, age, experience in health care, family income, religious affiliation, religiosity, living arrangements, and level of education. One hundred fifty-eight female nursing students completed White's Aging Sexuality Attitude and Knowledge Scale. The study found that higher knowledge was related to more positive attitude scores (r = .25, P less than .004). Age was also significantly related to both positive attitude (r = .44, P less than .001) and higher knowledge (r = .54, P less than .001). Older students had a more positive attitude toward the elderly and were more knowledgeable about aged sexuality than younger students in the sample. One-way analysis of variance was used to test the significance between means of the dependent and independent variables. A statistically significant difference was found between ethnicity and attitude (f = 33.09, P less than .001) and ethnicity and knowledge (f = 18.36, P less than .001). Asian students in this study had a more negative attitude and were less knowledgeable about aged sexuality than Caucasian students. The study suggests that nurse educators need to pay special attention to the age and ethnicity of students when planning gerontological learning experiences designed not only to facilitate knowledge acquisition, but to promote positive attitudes toward the elderly.

Adult↗

Healthcare knowledge acquisition: an ontology-based approach using the extensible markup language (XML).

The healthcare enterprise requires a great deal of knowledge to maintain premium efficiency in the delivery of quality healthcare. We employ Knowledge Management based knowledge acquisition strategies to procure 'tacit' healthcare knowledge from experienced healthcare practitioners. Situational, problem-specific Scenarios are proposed as viable knowledge acquisition and representation constructs. We present a healthcare Tacit Knowledge Acquisition Info-structure (TKAI) that allows remote healthcare practitioners to record their tacit knowledge. TKAI employs (a) ontologies for standardisation of tacit knowledge and (b) XML to represent scenario instances for their transfer over the Internet to the server-side Scenario-Base and for the global sharing of acquired tacit healthcare knowledge.

Artificial Intelligence↗

Knowledge and attitude of undergraduate students towards sexually transmitted infections in Tirana, Albania.

AIM: To assess the knowledge and attitude of undergraduate students in Tirana, Albania, towards sexually transmitted infections (STI). METHODS: A sample of 729 students (76% women) at the University of Tirana were surveyed by the use of an anonymous questionnaire with 10 multiple-choice questions testing their knowledge and 27 statements testing their attitude towards STI (adapted to a 1-5 Likert scale, with a low score indicating poor attitude). Socio-demographic data were also collected. The survey was carried out in October and November 2002. Multiple regression analysis was used to assess the associations between socio-demographic factors on the one hand and attitude towards and knowledge about sexually transmitted infections, on the other. RESULTS: Men had poorer knowledge and attitude toward STI than women (beta= -4.59, p<0.001 for attitude, and beta= -0.38, p=0.006 for knowledge). Higher parental education and urban origin were strongly associated with better STI knowledge. After adjustment for age, sex, marital status, religion, income, and number of siblings, students whose parents had low and middle education level had a mean STI knowledge score of <1.16 (95% confidence interval [CI], 0.85-1.47) and <0.98 (95% CI, 0.74-1.23), respectively, which was significantly lower than the score of students with highly educated parents (p<0.001 for linear trend). Also, students born in rural areas had significantly lower mean STI knowledge score (<0.70, p=0.003) than students born in urban areas. CONCLUSION: Parental education and origin are strongly associated with knowledge and attitude of undergraduate students in Tirana towards sexually transmitted infections.

Adolescent↗

"Desktop knowledge": a new focus for medical education and decision support.

Physicians today are faced with "data overload" and, paradoxically, "information underload"--the inability to locate pertinent, needed knowledge in a sea of data with which they are inundated. Increasingly, the professional functions of the physician are becoming focused on the desktop workstation, in terms of its ability to provide "windows" into local databases and knowledge resources, and to serve as an access port to other networked resources. A challenge we now face is to develop means for structuring the vast potentially available knowledge resources in such a manner that access to pertinent knowledge can be facilitated, and to develop acceptable interfaces to the knowledge resources so that a user can effectively navigate through them. The complexity of this task is due to the nature of the knowledge resources--knowledge can be in a variety of forms, ranging from textual and pictorial material, to structured representations, to more dynamic embodiments in the form of procedures. In the Decision Systems Group we have focused on the development of a prototype desktop knowledge management environment known as Explorer-2, with the objective of providing a consistent interface for access to a wide variety of knowledge. Our accomplishments to date encompass the incorporation into the Explorer-2 environment of adaptations of textbook chapters and books, image data bases, simulations, and expert systems. Navigational aids are provided by a semantic net browser using both MeSH and augmented taxonomies and by a graphical overview map.(ABSTRACT TRUNCATED AT 250 WORDS)

Artificial Intelligence↗