The impact of mental models on the treatment and research of chronic infections due to biofilms.

Abstract

Research on biofilms is predominantly made ininvitrocontexts. However, invivoobservation of biofilms in human chronic infections shows distinct differences compared toinvitrobiofilm growth.This could imply the use of an inadequate mental model both in research and healthcare practices. Drawing on knowledge from the cognitive sciences, we hypothesise that the predominance of invitro research on biofilms is skewed towards a mental model promoting wrong inferences for researchers and healthcare professionals (HCPs) in the invivo context. To explore the prevalence of such a mental model, we carried out a qualitative image analysis in which biofilm illustrations from a Google image search were coded for typical invitro or invivo characteristics. Further, to investigate potential misinformed and unhelpful clinical interventions related to biofilms, we conducted a quantitative questionnaire among HCPs. The questions were designed to test whether knowledge about invitro biofilms was used in an invivo context. This questionnaire was analysed through a chi-squared test. Most biofilm illustrations were consistent with the invitro model. A statistical analysis of survey responses revealed that HCPs have adequate knowledge about biofilm but often respond incorrectly when asked to apply their knowledge to invivo contexts. The outcome of this research points to a prevalent and consolidated mental model derived from invitro observations. This model has likely been made dominant by HCPs' frequent exposure to visual depictions in articles and presentations. The prevalence of the invitro model sets up the possibility of erroneous claims when the invitro model is inadequately applied to invivo contexts. This has potential implications for HCPs working in fields involving biofilm, such as wound care treatment.