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PubMed2003

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↗
PubMed2002

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↗
PubMed2003

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↗
PubMed2003

Knowledge base evaluation of medicine residents on the gastroenterology service: Implications for competency assessments by faculty.

BACKGROUND AND AIMS: Clinician educators are asked to provide both formative and summative evaluations on the medical knowledge of residents. This study evaluated the accuracy of these evaluations and the perception of residents regarding the ability of faculty to assess medical knowledge. METHODS: Gastroenterology knowledge ratings provided by 15 faculty gastroenterologists on 49 internal medicine residents during a required gastroenterology rotation were correlated with performance on the gastroenterology subsection of the In-Training Examination for Internal Medicine. Residents also were surveyed regarding their perception of the ability of faculty to judge their knowledge of medical gastroenterology. RESULTS: The mean correlation (Kendall's tau b) of faculty ratings with performance on the ITE was 0.30 (P < 0.01). The range of correlation values for individual faculty (-0.39 to 0.80) indicated that some faculty were able to assess the medical knowledge of residents better than others. Residents, as well as the faculty themselves, perceived that faculty were able to rate their medical knowledge relatively well. CONCLUSIONS: The ability of faculty gastroenterologists to judge the knowledge of gastroenterology in their resident trainees was quite limited. Residents, as well as faculty, inaccurately perceive the ability of gastroenterologists to render professional judgments on their knowledge base as good. An end-of-rotation written examination would appear to be required to provide an accurate assessment of the medical knowledge of residents.

Adult↗
PubMed1996

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↗
PubMed1999

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↗
PubMed1979

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↗
PubMed2005

Knowledge-based framework for hypothesis formation in biochemical networks.

MOTIVATION: The current knowledge about biochemical networks is largely incomplete. Thus biologists constantly need to revise or extend existing knowledge. The revision and/or extension are first formulated as theoretical hypotheses, then verified experimentally. Recently, biological data have been produced in great volumes and in diverse formats. It is a major challenge for biologists to process these data to reason about hypotheses. Many computer-aided systems have been developed to assist biologists in undertaking this challenge. The majority of the systems help in finding 'pattern' in data and leave the reasoning to biologists. A few systems have tried to automate the reasoning process of hypothesis formation. These systems generate hypotheses from a knowledge base and given observations. A main drawback of these knowledge-based systems is the knowledge representation formalisms they use. These formalisms are mostly monotonic and are now known to be not quite suitable for knowledge representation, especially in dealing with the inherently incomplete knowledge about biochemical networks. RESULTS: We present a knowledge-based framework for hypothesis formation for biochemical networks. The framework has been implemented by extending BioSigNet-RR-a knowledge based system that supports elaboration-tolerant representation and non-monotonic reasoning. Features of the extended system are illustrated by a case study of the p53 signal network. AVAILABILITY: http://www.biosignet.org

Algorithms↗
PubMed2003

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↗
PubMedDate not supplied

Deficient knowledge of genetics relevant for daily practice among medical students nearing graduation.

PURPOSE: The objective of this study was to investigate whether the knowledge of genetics relevant for daily practice among medical students nearing graduation in the Netherlands was sufficient to react appropriately to the change of relevance of genetics in medicine. METHODS: A computer examination validated in a group of clinical geneticists, medical students nearing graduation, and nonmedical students. The examination consisted of 215 genetic questions classified by the designers into three categories of relevance: "essential" knowledge (requirement: > 95% correct answers), "desirable" knowledge (requirement: > 60% correct answers), and "too specialized" knowledge (no requirement). To set an independent standard, the questions were also judged by clinical geneticists and nongenetic health care providers in an Angoff procedure. In total, 291 medical students nearing graduation from seven out of the eight medical schools in the Netherlands participated. RESULTS: As expected, the mean score for "essential" knowledge (71.63%, 95% CI 70.74-72.52) was higher than for "desirable" knowledge (55.99%, 95% CI 55.08-56.90); the mean score for "too specialized" knowledge (44.40%, 95% CI 43.19-45.62) was the lowest. According to passing scores set for "essential" knowledge as defined by the designers, the clinical geneticists, and the nongenetic health care providers, only 0%, 26%, and 3%, respectively, of the participants would have passed. CONCLUSIONS: Medical students nearing graduation lack genetic knowledge that is essential for daily practice. Therefore, changes should be made in the medical curricula.

Analysis of Variance↗
PubMed1996

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↗
PubMed1997

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↗
PubMedDate not supplied

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↗
PubMed2006

Knowledge of first-aid measures of avulsion and replantation of teeth: an interview of 221 Kuwaiti schoolchildren.

The prognosis of replantation of an avulsed tooth is determined by which first-aid measures are taken during the first 15 min after avulsion. Knowledge of the correct first-aid measures is therefore crucial to successful replantation. The aims of this study were (i) to assess the present knowledge level of emergency measures for tooth avulsion in Kuwaiti schoolchildren, and (ii) to design and test an interview form with structured standardized questions. A total of 221 Kuwaiti schoolchildren (aged 7-15 years old) were interviewed by professionals using a standardized method to score several areas of knowledge about tooth avulsion and replantation. Earlier experience of first-aid information and subjection to dental trauma was registered. The following fields of knowledge were assessed: general body injury treatment principles, tooth avulsion and replantation principles, avulsed permanent/primary teeth, cleaning of avulsed tooth before replantation, extra alveolar time and storage media. The form for interviewing children proved to be sufficiently structured in performing the interviews and data management. The results of the interviews showed that 30.3% of the children had been exposed to dental trauma in the past. Among children 7-9 years of age, 25% had received information on general first aid as compared with 75% in children 10 years and older. Children 10 years and older, in general, had a high knowledge level of general principles of how to manage injuries to the body. Regardless of age group, there were generally a low knowledge level regarding tooth avulsion, replantation, extra-alveolar time and storage media. We conclude that first-aid knowledge in Kuwaiti schoolchildren is low on avulsion and replantation of teeth despite a high knowledge level of body injuries. The knowledge level of first-aid measures on avulsion and replantation of teeth could be increased through intervention programs.

Adolescent↗
PubMed1991

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↗
PubMedDate not supplied

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↗
PubMed2004

What does it take to transform mental health knowledge into workplace practice? Towards a theory of action.

The purpose of this discussion paper is to consider the question of a knowledge base that might undergird a systematic approach to transforming mental health knowledge into workplace practice. Drawing on a range of systems-change and related research, the paper begins by contrasting the nature of "workplace" as opposed to "mental health knowledge" systems. On the basis of the Luhmann's concepts, these systems are cast as fundamentally being determined by the types of communication in which they are engaged (business about business matters, and mental health about mental health matters). For information from one to be adopted by the other requires the translation of mental health concepts into language understood by the workplace, by people capable of understanding both. The paper then examines the importance of determining a vision of desired outcome from such knowledge transfer. What is the desired outcome? A workplace free of mental health problems? The role of both values and existing knowledge in determining these is outlined, along with the importance of engaging the most immediately involved actors in developing the vision. Because valid and reliable knowledge is central to the task, a framework is set out in which the most immediately relevant research findings might be considered in relation to each other. Three categories of knowledge are proposed: employer-led preventive measures, employee-focused workplace interventions and community-based resources supportive of workplaces. Knowledge drawn from summative analyses of existing research is matched against these three categories to illustrate the potential for guiding both implementation and research decision making.The final section draws together the key elements of an active approach to promoting and supporting knowledge transformation from mental health research to workplaces.

Health Promotion↗
PubMed1990

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↗