Range Of Correct Answers Research Articles

Comprehensibility of South African pictograms by sub-Saharan African prospective-users

ObjectivesThis work aimed to explore the validity of South African pictograms to be comprehended by sub-Saharan migrant populations in Spain. MethodsA quantitative cross-sectional study was carried out. A voluntary survey was conducted among a population ≥ 18 years of age in a Temporary Stay Centre for Immigrants located in Spain, in June 2022. The form included a culturally and linguistically validated version of the Health Literacy questionnaire (HLS-EU-Q16), a brief questionnaire of sociodemographic variables and 10 South African pictograms selected to assess the comprehension. According to the International Organization for Standardization, a pictogram must receive 66.70% correct answers to be acceptable. Mann–Whitney U or Kruskal–Wallis tests were used to assess differences between group variables. Statistical significance was set at P < 0.05. Results55 sub-Saharan migrants who newly arrived in Europe voluntarily agreed to participate. None of the pictograms evaluated met the validity criterion. For the selected pictograms, the range of correct answers was between 52.50% and 20.00%. Neither sociodemographic variables nor Health Literacy level were significantly associated with pictogram comprehensibility. ConclusionNew culturally sensitive pictograms that are easily comprehended by sub-Saharan African population are needed. Practice implicationsThese results may serve as a starting point for future studies that aim to create and evaluate new pictograms or create new culturally adapted versions of existing pictograms involving the target population.

Video-Assisted Informed Consent in a Clinical Trial of Resuscitation of Extremely Preterm Infants: Lessons Learned.

Obtaining informed consent for clinical trials is challenging in acute clinical settings. For the VentFirst randomized clinical trial (assisting ventilation during delayed cord clamping for infants <29 weeks' gestation), we created an informational video that sites could choose to use to supplement the standard in-person verbal and written consent. Using a postconsent survey, we sought to describe the impact of the video on patient recruitment, satisfaction with the consent process, and knowledge about the study. This is a descriptive survey-based substudy. Of the sites participating in the VentFirst trial that obtained institutional review board (IRB) approval to allow use of the video to supplement the standard informed consent process, three elected to participate in the survey substudy. From February 2018 to January 2021, 82 women at these three sites were offered the video and completed the postconsent survey. Overall, 73 of these 82 women (89%) consented to participate in the primary study, 78 (95%) indicated the study was explained to them very well or extremely well, and the range of correct answers on five knowledge questions about the study was 63 to 98%. Forty-six (56%) of the 82 women offered the video chose to watch it. There were no major differences in study participation, satisfaction with the consent process, or knowledge about the study between the women who chose to watch or not watch the video. Watching an optional video to supplement the standard informed consent process did not have a major impact on outcomes in this small substudy. The ways in which audiovisual tools might modify the traditional informed consent process deserve further study. · Informed consent in acute clinical contexts is difficult.. · Videos offer an alternative communication tool.. · Continued research is necessary to optimize the consent process..

Choosing Non-Malignant Hematologic Care Wisely: An Educational Pilot Study for Internal Medicine Residents

Introduction: Choosing Wisely ® (CW ®)is an initiative of the American Board of Internal Medicine Foundation created to guide the selection of care that is 1) supported by evidence, 2) not duplicative, 3) free from harm, and 4) truly necessary. Between 2013-14, the American Society of Hematology (ASH) published 10 recommendations in accordance with CW ® principles relevant to hematologic care. Previous studies have demonstrated that clinical exposure to non-malignant hematology (NMH) improves trainee understanding of evidence-based, cost effective care as outlined by ASH CW ®. However, dedicated clinical rotations in NMH for internal medicine (IM) residents are not consistently available. Therefore, we created a condensed educational curricular experience using a small group, case-based structure designed to teach the fundamentals of ASH CW ® in NMH to first year IM residents. With a pilot of 6 sessions, we investigated resident baseline knowledge, evaluated the curricular session, and assessed knowledge retention.Methods: The educational intervention focused on 3 content areas in ASH CW ®: venous thromboembolism (VTE), heparin-induced thrombocytopenia (HIT), and sickle cell disease (SCD) (Table 1). Participants included 21 first year IM residents at a large academic medical center. A 1-hour small group teaching session was scheduled monthly as an assigned didactic for the 2020-21 academic year. A total of 6 sessions were provided, and each session had 2-4 residents assigned. The first 4 sessions were in-person and the final 2 were virtual due to the COVID-19 pandemic. The first author was the instructor at all sessions.To assess baseline knowledge of the 3 content areas, participants completed an online assessment with 5 case-based multiple-choice questions at the beginning of the session. The instructor then guided participants to again complete the questionnaire together, now using internet access via a personal computer and a recommended list of online resources, including ASH Clinical Practice Guidelines and Pocket Guides. The instructor then led discussion on how each correct answer or guideline recommendation achieves the 4 CW ® principles. At the conclusion of the session, participants completed an online survey to evaluate the educational intervention using a modified Likert scale. To assess knowledge retention, participants received the original online multiple-choice assessment by email 3 months later.Results: All participants (21/21, 100%) completed the baseline knowledge assessment. The average number of questions correct out of 5 total was 3.3 (67%), with a range of correct answers from 1 to 5. Table 2 includes the content area of each question and the number of correct responses. The question with the lowest total correct (9/21, 43%) addressed the use of transfusion in an uncomplicated pain crisis in SCD.Seventeen participants (81%) completed the curricular evaluation. All respondents (17/17, 100%) either agreed or strongly agreed 1) that the session filled a gap in their NMH training and 2) that they learned something that would change their clinical practice. Only 1 participant (5%) reported completing a rotation in NMH prior to the session.Six participants (29%) completed the repeat knowledge assessment at 3 months. All respondents (100%) achieved a perfect score on the multiple choice questions. When asked if the knowledge gained had influenced their clinical practice, 3 (50%) strongly agreed, 2 (33%) agreed, 1 (17%) was neutral, and none disagreed or strongly disagreed.Conclusion: Our results demonstrate a successful educational pilot to improve the knowledge of ASH CW ® initiatives in NMH for first year IM residents using small group interactive case-based learning. Participants were overwhelmingly receptive to this intervention, expressed high satisfaction and confirmed that the session positively influenced their clinical practice. Although participation in the repeat assessment of knowledge was limited, those that did participate demonstrated high knowledge retention. We intend to expand this pilot initiative by providing the educational session for all incoming IM residents at our institution. We then plan to assess its impact on clinical practice (i.e. use of transfusion in SCD, use of thrombophilia testing, documentation of 4Ts score calculation) to apply the principles of ASH CW ® for improved patient care. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Knowledge, Attitude, and Behaviours Towards Covid-19 Transmission Among Jakarta-Bogor-Depok-Tangerang-Bekasi Residents

&lt;p&gt;&lt;em&gt;Jakarta-Bogor-Depok-Tangerang-Bekasi (Jabodetabek) is the city with the most populous population in Indonesia. This study aims to explore the knowledge, attitude, and behaviour of Jabodetabek people as an epicentre covid-19 in Indonesia. &lt;/em&gt;&lt;em&gt;This study was a descriptive quantitative online study with a survey design used a self-developed online questionnaire &lt;/em&gt;&lt;em&gt;on 297 &lt;/em&gt;&lt;em&gt;Jabodetabek residents in Indonesia&lt;/em&gt;&lt;em&gt;. The chairman of the neighbourhood was encouraged to roll out the google form (link) to as many participants as possible, and then the link was forwarded to the next participants and so on. &lt;/em&gt;&lt;em&gt;Data were analyzed using descriptive statistics.&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;Among the participants, 72.1 %&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;were female, overall range of correct answers for knowledge&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;questionnaire was 53.2-97.3%, that for attitude was 21.55-93.3% and for behaviors was&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;66.3-98.7 %. In general,&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;participants had a good knowledge about the disease, a positive attitude, and behavior towards protective measures. However, the results showed that only 22.55% participants state Indonesian government can win the battle against covid-19, the rest (78.45%) less optimistic attitudes, and this will impact less good practice toward covid-19 in the future, although currently still 66.3% of participants following Government Indonesian policy.&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;Findings of this study&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;revealed that knowledge among people of Jabodetabek about covid-19 is satisfactory. Yet almost half of participants are lacking belief in the plague. Better trust and behavior is required to tackle Covid-19 in Jabodetabek-Indonesia.&lt;/em&gt;&lt;/p&gt;

A step to infant oral health promotion intervention among parents.

Providing oral health care to children from infant to toddler age can be achieved by educating and informing parents about their children&#x2019;s oral health. The aims of this study were to determine the basic knowledge of oral health and to evaluate the efficacy of an infant oral health education programme among parents in Turkey. Study Design: One hundred and fifty parents of infants between 3 and 12 months of age attending the well-baby clinic, Dr. Behcet Uz Children&#x2019;s Hospital (Izmir, Turkey), participated in the study. A pre-test questionnaire was administered to each parent to assess their infant oral health knowledge. The educational intervention was in the form of a 30-minute interactive explanation of a PowerPoint presentation. The parents completed a post-test after the education in the same session (a questionnaire was administered). The range of correct answers on the pre-test was 7&#x2013;20 of 26 with a mean of 13.7 (SD=2.76). The range of correct answers on the post-test was 12&#x2013;26 of 26 with a mean of 21.2 (SD=3.34). The difference of correct responses between before and after education was found to be statistically significant (p&#x3C;0.01). Under the conditions of this study, educational presentation improved parents&#x2019; knowledge on infant oral health care and provided anticipatory guidance.

Cost-consciousness among Iranian internal medicine residents

Background: Study aimed at assessing residents' cost awareness and their attitude about health care costs.Methods: Internal medicine residents at teaching hospitals of Tehran University of Medical Sciences were surveyed during August–December 2016 using a researcher-made questionnaire comprising attitude statements and cost estimation of diagnostic and treatment items.Results: Eighty-nine residents completed the survey (response rate = 56.6%). The results indicate that less than one quarter (23.69%) of cost estimates were in the range of correct answers. The mean (SD) for correct estimation of medications (out of 8 scores), lab tests (out of 20 scores), and total (out of 35 scores) were 1.25 (0.96), 4.92 (0.27), and 7.97 (0.34), respectively. An analysis of variance showed that the level of residency was positively correlated with residents’ correct cost estimation (F (3, 77)=9.98, p = 0.029). There was a significant positive correlation between age of residents with the correct estimate of medication prices (p = 0.018, r = 0.261).Conclusions: The internal medicine residents of Tehran University of Medical Sciences have poor knowledge of health care costs, including medications, diagnostic tests, and hospitalization costs. The results of this study explain the necessity of developing a training program for the transfer of cost information to physicians.

Implementation of shared decision-making in oncology: development and pilot study of a nurse-led decision-coaching programme for women with ductal carcinoma in situ

BackgroundTo implement informed shared decision-making (ISDM) in breast care centres, we developed and piloted an inter-professional complex intervention.MethodsWe developed an intervention consisting of three components: an evidence-based patient decision aid (DA) for women with ductal carcinoma in situ, a decision-coaching led by specialised nurses (breast care nurses and oncology nurses) and structured physician encounters.In order to enable professionals to gain ISDM competencies, we developed and tested a curriculum-based training programme for specialised nurses and a workshop for physicians. After successful testing of the components, we conducted a pilot study to test the feasibility of the entire revised intervention in two breast care centres. Here the acceptance of the intervention by women and professionals, the applicability to the breast care centres’ procedures, women’s knowledge, patient involvement in treatment decision-making assessed with the MAPPIN’SDM-observer instrument MAPPIN’Odyad, and barriers to and facilitators of the implementation were taken into consideration. We used questionnaires, structured verbal and written feedback and video recordings. Qualitative data were analysed descriptively, and mean values and ranges of quantitative data were calculated.ResultsTo test the DA, focus groups and individual interviews were conducted with 27 women. Six expert reviews were obtained. The components of the nurse training were tested with 18 specialised nurses and 19 health science students. The development and piloting of the components were successful. The pilot test of the entire intervention included seven patients. In general, the intervention is applicable. Patients attained adequate knowledge (range of correct answers: 9–11 of 11). On average, a basic level of patient involvement in treatment decision-making was observed for nurses and patient–nurse dyads (M(MAPPIN-Odyad): 2.15 and M(MAPPIN-Onurse): 1.90). Relevant barriers were identified; physicians barely tolerated women’s preferences that were not in line with the medical recommendation. Classifying women as inappropriate for ISDM due to age or education led physicians to neglect eligible women during the recruitment phase.ConclusionDecision-coaching is feasible. Nevertheless, there are some indications that structural changes are needed for long-term implementation. We are currently evaluating the intervention in a cluster randomised controlled trial in 16 breast care centres.

Assessment of Critical Reading Ability in Cardiology Residents

Background: In recent years there has been a strong emergence of the outcome-based education concept emphasizing the benefit of clearly establishing the professional capabilities to be achieved. Current regulations specify the ability to interpret the results of a research and make a critical reading of scientific publications as one of the cardiologist’s competencies. Objective: The aim of this study was to investigate the capacity of residents to interpret the statistical tests most frequently used in research studies. Method: A questionnaire of 17 multiple-choice questions, developed and validated by Pizarro et al. was used. The maximum possible score was 17 points. Four levels of critical reading skills were established according to the number of correct answers: none (less than 5 points), deficient (between 5 and 9 points), good (between 10 and 14 points) and very good (15 points or more). Results: In May 2016, 169 cardiology residents answered the questionnaire anonymously and voluntarily. In 29% of cases they mentioned previous training in the subject and 88% of them said that bibliographic meetings are regularly carried out in the residency. - Range of correct answers: 0-15. - Mean: 7.56±1.66. - Median: 7 (interquartile range 4-8.5). - Cronbach: 0.81. On average, 44% of the questionnaire was answered correctly, with no significant differences between men and women (45% vs. 43%, p=0.34) or between those who had or did not have previous statistics training (45% vs. 43%, p=0.39). A significant difference was found between Argentine and foreign university graduates (45% vs. 36%, p <0.045). Conclusions: In 73% of the residents, the level of necessary knowledge to interpret research studies was unsatisfactory. The results are similar to those of other published studies. It would be interesting to review teaching strategies and analyze their effectiveness.

A Guttman Scale to Assess Knowledge About Sexually Transmitted Diseases in Adults with Cerebral Palsy

Sexuality issues are a core aspect of human development and still remain a challenging theme for professionals working with people with disabilities. Health literacy, which includes the individual knowledge about Sexually Transmitted Diseases (STDs), is a factor with influence in safe behaviors regarding own sexual living and It assessment is often neglected in services for adults with Cerebral Palsy (CP). The purpose of this study was to develop a simple, easily administered scale to assess the knowledge about STDs for adults with CP, in Portugal. Forty-two participants (28 men, 14 women), aged 18–53 years, with CP were interviewed with a structured questionnaire about sexuality knowledge, where questions about STDs were used as basis for Guttman scale development. From the eighteen items of the questionnaire, 10 were considered as related to STD and a valid Guttman scale containing 8 items was derived (CR = 0.92, MMR = 0.80, CS = 0.61). The median score of the summed items from the developed scale was 6 (IQ1–IQ3 = 5.0–8.0) and the range of correct answers was between 3 and 8. The proportion of correct answers to each question ranged between 97.6 and 47.6 %. The results of this study suggest that it is possible to combine questions that represent diverse aspects of STDs knowledge in an ordered scale and be used in an assessment, including self-administered tools, of adults of CP. This measure is time effective and can be used in with advantages both for health professionals and persons with CP.

Awareness of a Rape Crisis Center and Knowledge about Sexual Violence among High School Adolescents

Study ObjectiveThis study examined awareness among adolescents of a local rape crisis center as well as their knowledge about sexual violence. DesignThe Cleveland Rape Crisis Center (CRCC) conducts sexual violence prevention programs for high school students. A written, anonymous survey was distributed to students prior to the start of the program. Students were asked if they had heard of the CRCC; knowledge about sexual violence was assessed with a series of 7 statements (rape myths) that participants identified as true or false. Surveys were reviewed retrospectively. Analyses were carried out for individual questions and frequencies compared using chi-square analysis. ResultsA total of 1633 surveys were collected; 1118 (68.5%) participants were female and 514 (31.5%) were male; ages ranged from 12 to 19 years. Respondents described themselves as being of European descent (45.9%), African descent (26.2%), or mixed race (17.7%). Just over half (863, 52.9%) of survey respondents had heard of the CRCC. Over half (950, 58.2%) of participants answered 5 or more questions correctly (range of correct answers 0 to 7). In general, more participants who were aware of the CRCC were able to identify statements about rape correctly (P < .01 for statements 1, 4, 5, 6, and 7, P < .001 for ≥5 correct). Age, gender, and race were all significantly associated with knowledge about rape. Females were consistently more likely to get an answer correct, as were participants of European descent. ConclusionAwareness of the CRCC was associated with increased knowledge about sexual violence.

The effect of a class in medical ethics on first-year medical students

To assess the effect of a class in medical ethics on first-year medical students. A test instrument was developed to measure the attitudes of medical students toward certain ethical questions and to assess their factual knowledge regarding particular legal and ethical issues. The instrument was administered in 1992-93 to 110 first-year students at the University of Virginia School of Medicine before and after the students took a required course in medical ethics. The instrument employed clinical vignettes as well as multiple-choice, true-false, and Likert-scale questions. Its reliability and validity were assessed. The required course in medical ethics had little influence on the students. There was only one significant change (p = .05) in the pattern of responses to any of the clinical vignettes. In a few of the attitude-oriented queries, there were statistically significant changes (p < .05) after the course. Although there were statistically significant changes for only four of the factual-knowledge questions, for all such questions more students identified the correct answers after the class (before the course the range of correct answers was 43% to 99% compared with 64% to 100% after the course). The class in medical ethics seemed to have little effect on the first-year students, probably because students arrive at medical school with well-established ethical perspectives.