English-speaking Research Articles

Lexical bundles in three oral corpora of university students

On the basis of previous lexical bundle studies, this paper examines the forms, structures and functions of 4-word bundles in three corpora of spoken English, one of them of native speakers of English and the remaining two of non-native speakers of English, corresponding to university students in their first year of an English Studies degree and to the same students after two years of university instruction. The study focuses on three major characteristics: the overall distribution of bundles, their typical structures and their functions. The findings show significant differences in the types of lexical bundles used by native and non-native students, as well as in their structure and function. Our results support the idea that lexical bundles are important components in oral discourse. One of the pedagogical implications of this paper is that Spanish students should be exposed to more samples of spoken language.

Communication Quality and the Cost of Language: Evidence from Stack Overflow

The transmission of information is crucial for productivity and growth. However, language differences may limit its effectiveness. This is particularly relevant for knowledge platforms that aim to be global, given the cultural diversity of the pool of users. In this paper, I empirically investigate how the exogenous cost of language affects communication quality and the trade-offs faced by knowledge platforms in implementing their website in multiple languages. I exploit the staggered introduction of websites for languages other than English on a question-and-answer platform to demonstrate two main facts. First, nonnative English speakers who contribute in English increase their answers’ quality once able to use their native language, and their answers are more likely to solve the questioner’s problem. The native-language answers drive the effect, which is larger when the question quality is higher and the incentives are stronger. Second, users who participate in their native language but not in English contribute lower-quality answers compared with those who contribute in English. This suggests that lower language barriers allow users with less expertise in the subject to participate. These results show that the platform should adopt multiple languages to maximise the quality of the information collected, although doing so may also result in an inflow of low-quality content from new users. This paper was accepted by Joshua Gans, business strategy. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2022.01333 .

Salience management

Abstract This article zooms in on metadiscourse resources to explore their salience management in online new product launch (hereafter NPL) conferences, adopting the salience theory of socio-cognitive approach (hereafter SCA) as the theoretical foundation. Drawing on data from 16 online NPL conferences presented by non-native English speakers, it is found that different types of metadiscourse resources are employed to manage the salience of specific contextual factors in metacognitive, metarepresentational and metacommunicative dimensions, motivated by the presenter’s inherent salience and awareness of recipient design. This article not only strengthens the assumption that the salience theory of SCA can provide a new perspective for metadiscourse research, but also sheds light on how to understand the effectiveness of online business communication in the intercultural context.

ANALYSIS OF TEACHER’S STRATEGY IN TEACHING SPEAKING SKILLS TO STUDENTS AT MA MODERN NURUL-AMIN

English is an imperative skill to understand because it has a dominant part in almost the current field in globalization contexts such as in media, technology, science, business, and education. This study was conducted to know the strategies were used by the teacher in teaching speaking skills to students at MA Modern Nurul-Amin Kubu Padi. The subjects of this research were students and the English teacher at MA Modern Nurul-Amin. In conducting the research, the researcher constructs a descriptive qualitative approach. Then, the data were collected through observation checklist, field note and interviews, as well as by questionnaires. The observation checklist and field note were conducted at MA Modern Nurul-Amin during the learning process. Meanwhile, the interviews were conducted with students and the English teacher. Additionally, the questionnaires were distributed to students and the English teacher as the additional or a proponent data of the research. Then, the data were analyzed qualitatively. The findings showed that there were several strategies used by teacher in teaching English speaking skills, the strategies were debate, speech, English class conversation, role play, and group discussion. Moreover, the mostly strategies used by teacher was debate, speech, English class conversation, and group discussion in different level. Keywords : Teacher’s Strategy, Students’ Speaking Skills, Analysis of Teaching

Aphasia therapy software: an investigation of the research literature and the challenges of software development

ABSTRACT Aphasia therapy software: aninvestigation of the research literature and the challenges of software development Background Digital aphasia therapy has become increasingly popular over the past years. However, not all software described in the literature appears to reach clinical practice. It is currently unclear why this is the case. Aim We had two aims. First, we aimed to create an overview of the digital aphasia therapy described and its clinical availability bysystematically searching and reviewing the research literature. Second, we aimed to investigate the experiences of researchers/developers of aphasia therapy software. Method & Procedures We conducted a systematic search and review, screening references against our inclusion criteria. Clinical availability of the software was established through reading literature, conducting internet searches, and by contacting the researchers/developers who were associated with the software. Researchers/developers of the reported software were surveyed about their experiences with software development. Responses were the matically analysed into themes and subthemes. Outcomes & Results We identified a total of 63 unique pieces of software across 125 references. The software was mainly developed for English speakers and mainly focused on word retrieval or a combination of language skills. We established clinical availability with certainty for 35 pieces of software, with the remaining software (likely) currently clinically unavailable. From the survey data, we identified five recurring themes: 1) software development can be expensive and insufficient funding hinders their clinical availability; 2) commercialisation of software is often new and daunting to researchers but essential for making software available; 3) clinicians and people with aphasia are valuable sources of feedback; 4) working with software developers can be difficult; and 5) aphasia therapy software should combine both the evidence base and current clinical need. Conclusions Aminority of aphasia therapy software described in the literature reaches clinical practice. It is clear that the development and subsequent dissemination of aphasia therapy software requires large amounts of time, energy, and funds but we conclude that this is essential for successful clinical implementation.

Health literacy of rheumatology patients in three clinics in Australia and its association with sociodemographic and clinical characteristics.

To describe and compare health literacy (HL) using contrasting instruments of Rapid Estimate of Adult Literacy in Medicine (REALM) and the Health Literacy Questionnaire (HLQ) in patients attending three Australian rheumatology clinics and their associations with sociodemographic and clinical characteristics. We conducted a cross-sectional study of rheumatology patients at Liverpool (Sydney) and Canberra public hospital clinics and a private Liverpool clinic using the REALM test and HLQ sociodemographic and clinical questionnaires. One-way analysis of variance and multivariate ordinal and binary logistic regressions were used to examine the association between HL and sociodemographic and clinical factors. A total of 278 people participated (111 Liverpool public, 112 private, 55 Canberra public clinic). Compared with Canberra, Liverpool patients were older, non-native English speakers, had less than a tertiary education and were more likely to have comorbidities. A total of 40% of Liverpool public, 29% of private and 13% of Canberra patients had suboptimal REALM HL scores (P < 0.05). Lower REALM scores were associated with male gender, <10 years of education, being born outside Australia/New Zealand and English as a secondary language, but was not associated with clinical characteristics. All nine HLQ domain scores did not differ across sites despite intergroup comparisons as stratified by REALM bands. Completing 10 years of schooling was associated with better scores in three HLQ scales: 'Navigating the healthcare system' (P = 0.009), 'Ability to find information' (P < 0.001) and 'Reading and understanding information' (P < 0.001). Patient HL as measured by the REALM differed across sites, explained by differences in gender distribution, country of birth, English as the primary language and years of education. HL as measured by the HLQ did not differ across sites and was more informative for understanding differing patient HL needs.

Teachers’ Perceptions on Differentiated Learning in Teaching English Speaking Skill Among Upper Secondary School Students: A Conceptual Paper

Teachers’ Perceptions on Differentiated Learning in Teaching English Speaking Skill Among Upper Secondary School Students: A Conceptual Paper

Associations of Primary Spoken Language With Individual Perception of Hearing-Related Disability.

Hispanic/Latino adults are less likely than non-Hispanic White adults to seek treatment for hearing disability. While differential socioeconomic factors may contribute to this finding, differences in phonology and syntax in the Spanish, versus English, language may also influence patient perception of hearing disability. The objective of this study is to investigate the association between primary language spoken and participant perception of hearing disability. This study represents a cross-sectional cohort study using National Health and Nutrition Examination Study cycles 2015-2016 and 2017-2020 data. Multivariable logistic regressions estimated the association between respondent-selected interview language, which was used as a proxy for primary spoken language, and participant perception of hearing disability. Models were adjusted for age, gender, highest degree of education, pure-tone average, and self-reported general health. Participants included 4687 individuals from the United States population who elected to speak English (n = 4083) or Spanish (n = 604) during the interview. Perception of hearing disability was assessed by (1) frequency of reported difficulty in following a conversation in noise, (2) frequency with which hearing caused respondents to experience frustration when talking with members of their family or friends, and (3) participants' subjective overall assessment of their hearing. Speaking Spanish, versus English, as a primary language was associated with a 42% lower odds of reporting difficulty hearing and understanding in background noise (odds ratio [OR]: 0.58, 95% confidence interval [CI]: 0.48 to 0.70). Spanish speakers had 28% lower odds of reporting feeling frustrated when talking to family members or friends due to hearing (OR: 0.72, 95% CI: 0.59 to 0.88) as compared with the English-speaking cohort. Speaking Spanish additionally conferred 31% lower odds of describing their own general hearing as "a little trouble to deaf" than participants speaking English (OR: 0.69, 95% CI: 0.53 to 0.90). These observed associations were independent of age, gender, highest degree of education, better pure-tone average? and self-reported general health. Primary Spanish speakers may be less likely than English speakers to report hearing-related disability, an effect which may be independent of ethnicity. Patient perception of hearing-related disability is an important component of the assessment of and counseling for hearing-related disability and discussion of the need for amplification or other hearing intervention.

Gesture size affects numerical estimates in quantifier comprehension.

People think and talk about numerical magnitude in terms of space, and co-speech gestures reflect this, with English speakers using expansive gestures when talking about greater quantities. Existing gestural research on the spatial conceptualization of number has largely looked at gesture production, but we do not know whether gestures can influence the interpretation of imprecise or underspecified numerical expressions such as quantifiers. Looking at the quantifier several as a test case, this study investigates the influence of manual inwards-directed (i.e., hands move closer the torso) and outwards-directed (i.e., hands move away from the torso) co-speech gestures on comprehenders' conceptualization of quantities associated with several through three preregistered experiments. Our results suggest that gesture modulates the interpretation of several such that speakers moving their hands outwards and thereby creating space between their hands lead to higher quantity estimates, compared to speakers not gesturing, or moving their hands inwards. We discuss the implications of our findings for future work in numerical cognition, multimodal communication, and pragmatics. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Factors Affecting the Listening Skill of Non-Native English Speakers

Factors Affecting the Listening Skill of Non-Native English Speakers

A - 129 Healthcare Disparity between Dominant English Versus Spanish-Speaking Deep Brain Stimulation Candidates with Parkinson’s Disease

Abstract Objective The existence of healthcare disparities is well documented, although data regarding mental health disparities in pre-surgical deep brain stimulation surgery (DBS) patients with Parkinson’s disease (PD) remains emergent. In this study, we compare mood, apathy, and quality of life (QoL) in dominant English and Spanish-speaking PD-DBS candidates. We hypothesized that presurgical PD-DBS Spanish-speakers would have greater disease burden and lower mood and QoL compared to native English-speakers. Method Demographic and disease specific characteristics including disease duration and severity (Unified Parkinsons Disease Rating Scale (MDS-UPDRS)), mood (Beck Depression Inventory-II (BDI-II), Starkstein Apathy Scale (SAS)), and QoL (Parkinson’s Disease Questionnaire-39 (PDQ-39)) were compared. Data were analyzed using independent t-tests and chi-square tests to identify group differences based on language dominance (English (n = 20), Spanish (n = 20)). Results Spanish-speakers had higher disease burden (MDS-UPDRS “on”: p = 0.018; “off”: p = 0.023), but no other statistical significance in demographic or clinical motor characteristics. There were significant group differences in mood (BDI-II: p = 0.046), PDQ-39 Total and subdomain scores (Total: p = 0.017; ADL: p = 0.005; Mobility: p = 0.007; Emotional Wellbeing: p = 0.029; and Bodily Discomfort: p = 0.007) with Spanish-speakers reporting poorer QoL. No significant group differences were found regarding apathy. Conclusion(s) Spanish-speakers demonstrated greater disease burden and endorsed significantly lower QoL and depression symptoms compared to English speakers. These data add to our understanding of healthcare disparities among presurgical PD-DBS candidates and suggest that underrepresented groups, such as dominant Spanish-speakers, may have less access to early intervention, missed PD symptomology, and/or cultural apprehension about seeking medical care, thus increasing disease burden and impacting QoL over time.

B - 124 Neuropsychological Evaluation of Chinese Speaking Patients with Parkinson’s Disease for Deep Brain Stimulation Surgery

Abstract Objective Neuropsychological evaluation is a critical part of standardized workup of candidates with Parkinson’s disease (PD) for deep brain stimulation (DBS), identifying patients with cognitive dysfunction (Okun et al., 2006). Existing literature has primarily involved native English speakers with dementia and mild cognitive impairment (MCI), informing treatment planning (Troster et al., 2018). This case series aims to address the gap for Chinese-speaking patients, by describing Chinese neuropsychological measures and norms sensitive to MCI. Method Six cases of first-generation Chinese immigrants diagnosed with PD considering DBS were included in this study. They identified Chinese as their primary language and English as their second language. Duration of residency in the U.S. ranged from 11 to 44 years. The battery included Chinese version of the MOCA; Chinese WAIS-IV; Boston Naming Test (Cheung et al. 2004); semantic verbal fluency, Auditory Verbal Learning Test, Symbol Digit Modalities Test, and Color Trail Test (Lee and Wang, 2010); and Brief Visuospatial Memory Test, Revised Edition (BVMT-R) or RBANS: Figure Recall. Results Consistent with studies for native English speakers (Foley et al., 2018), cognitive declines were found in attention, memory, and executive function domains. Two of the six cases were diagnosed with MCI, which warrants caution before DBS. Conclusions This case series explores measures for Chinese speakers with PD undergoing evaluation for DBS surgery, highlighting cultural considerations, including Chinese measures and norms. This battery can help to differentiate cognitive impairments before proceeding with DBS. Given the diversity within this population and the scarcity of Chinese tools, more research is urgently needed.

The Association of Cerebrospinal Fluid Biomarkers of Alzheimer’s Disease with Cognitive Intra-Individual Variability

Abstract Objective Cognitive intra-individual variability (IIV) is a sensitive predictor of cognitive decline and disease severity in Alzheimer’s disease (AD). Despite its sensitivity, whether IIV is merely a psychometric artifact or disease pathology biomarker remains unknown. The present study evaluated the association between IIV and cerebrospinal fluid (CSF) biomarkers of AD. Method Participants included 422 individuals from the National Alzheimer’s Coordinating Center Unified Dataset 3.0 who completed baseline neuropsychological assessment and had CSF data. All participants were adult monolingual English speakers. Participants with vision or hearing impairments were excluded. Cases were stratified into cognitively normal (n = 267) and AD groups (n = 155; mild cognitive impairment = 50, dementia = 105). Cross-sectional IIV was calculated by obtaining the individual standard deviation (iSD) of ten cognitive tests. Finally, the coefficient of variation (CoV) was computed by dividing iSD by the participant’s overall test battery mean. Non-parametric Spearman-rank correlations were used to assess the relation between CoV and CSF biomarkers, including beta-amyloid 1–42, total tau (t-tau), and phosphorylated tau (p-tau181). Results In the AD group, CoV was positively correlated with p-tau181 (r = 0.285, p = 0.003) and t-tau (r = 0.241, p = 0.009), and negatively correlated with beta-amyloid 1–42 (r = −0.314, p &amp;lt; 0.001). Correlations between CoV and CSF biomarkers were not significant in the cognitively normal group for beta-amyloid 1–42 (r = 0.076, p = 0.215), p-tau181 (r = −0.014, p = 0.840), and t-tau (r = −0.046, p = 0.485). Conclusions In people with mild cognitive impairment and dementia of presumed AD etiology, cognitive IIV is associated with CSF biomarkers. These findings provide preliminary evidence that IIV is not merely a statistical artifact, but is associated with AD neuropathology.

“ChatGPT seems too good to be true”: College students’ use and perceptions of generative AI

This study investigates how U.S. college students (N = 1001) perceive and use ChatGPT, exploring its relationship with societal structures and student characteristics. Regression results show that gender, age, major, institution type, and institutional policy significantly influenced ChatGPT use for general, writing, and programming tasks. Students in their 30s–40s were more likely to use ChatGPT frequently than younger students. Non-native English speakers were more likely than native speakers to use ChatGPT frequently for writing, suggesting its potential as a support tool for language learners. Institutional policies allowing ChatGPT use predicted higher use of ChatGPT. Thematic analysis and natural language processing of open-ended responses revealed varied attitudes towards ChatGPT, with some fearing institutional punishment for using ChatGPT and others confident in their appropriate use of ChatGPT. Computer science majors expressed concerns about job displacement due to the advent of generative AI. Higher-income students generally viewed ChatGPT more positively than their lower-income counterparts. Our research underscores how technology can both empower and marginalize within educational settings; we advocate for equitable integration of AI in academic environments for diverse students.

A - 80 Moderating Effect of Age on the Relationship between Mood and Executive Functioning among South Asians

Abstract Objective This study investigated whether depression and anxiety are associated with executive functioning (EF) performance among South Asians living in the United States (US). Further, we explored whether age moderated this relationship. Method This retrospective chart analysis study included 28 South Asians referred for a neuropsychological evaluation within multiple northeast US-based outpatient clinics. Participants completed the Beck Depression Inventory-2nd edition (BDI-II), Beck Anxiety Inventory (BAI), Stroop Color Word Test- Color-Word Trial (SCWT-CW), and Verbal Fluency (FAS). Participants were dichotomized by age threshold (age 50 cut-off). Logistic regression analysis was used to determine the moderating effect of age on mood and EF. Results The sample comprised 13 younger adults and 15 older adults (50+), with 60.7% male (Meducation = 16.0, SD = 2.3). Regression analysis indicated a significant overall model between age, BDI-II, and SCWT-CW (F(1,25) = 3.01, p &amp;lt; 0.05, ΔR2 = 0.27). Further interaction analysis showed a stronger positive interaction effect between BDI-II and SCWT-CW (β = 5.39, F(1,24) = 4.91, p &amp;lt; 0.05, ΔR2 = 0.15) in the younger adult group. Conclusions Findings suggest that South Asian older adults with lower levels of depression have worse performance on EF than younger adults. This is one of the first studies to identify links between age, mood, and EF. Interpretation is challenging given that the mean scores of depression and SCWT-CW were in the mild range. Future studies are needed to understand how factors, such as English speaking proficiency and acculturation, may moderate the association and impact clinical relevance.

Self-Assessment to Improve English Speaking Skills: an action research with Elementary School Ecuadorian students

This study aimed to determine the impact of self-assessment on speaking skills among A2 movers’ students. The data analysis revealed that its use has a favorable effect on students' speech skills and showed that they could use the content in a real context. They incorporated reflection to be aware of their learning, understood their mistakes, and tried to improve their level of preparation for better results. At that time, they took responsibility for all the steps planned in innovation because they tested their effort and progress in each activity. In addition, the improvement demonstrated in the results of the evaluation carried out by the teacher with the rubric in the posttest was significant in the final part of the unit. The self-assessment helped students take the necessary corrective measures to be more prepared to do speech exercises. According to the students' perspectives, self-evaluation helped them improve their skills because they were able to identify areas of speech that needed to be improved and gradually, could reinforce their discourse to give better descriptions of places and people.

Antenatal depression and drug use among deaf and hard-of-hearing birthing parents: results from a U.S. National Survey.

This study aimed to investigate antenatal depression and drug use among deaf and hard-of-hearing (DHH) birthing parents who use American Sign Language (ASL), spoken English, or bilingually both ASL and English. DHH participants in the United States responded to the Survey on Pregnancy Experiences of Deaf and Hard-of-Hearing Women. Respondents self-reported their antenatal depression diagnoses and drug use (i.e., pain relievers, cannabis, or illicit drugs) during their last pregnancy. Poisson regression models were used to estimate prevalence ratios, adjusting for age, race/ethnicity, education, marital status, and parity. The average age of respondents (n = 587) was 35 years. Respondents were predominantly non-Hispanic white (80%), college educated (60%), and married (74%). Relative to DHH English-speakers, DHH ASL-users had lower prevalence of reporting antenatal depression diagnosis (aPR = 0.40, 95% CI: 0.23 to 0.72). DHH people who reported antenatal depression diagnosis had higher prevalence of reporting antenatal drug use (PR = 2.34, 95% CI: 1.65 to 3.33). There were no significant associations between preferred language and antenatal drug use. DHH ASL-users are less likely to report receiving an antenatal depression diagnosis compared to DHH English-speakers. Given well-documented patient-provider communication barriers among DHH ASL-users, it is unclear if the lower prevalence observed in this study is the result of inadequate or inaccessible screening during pregnancy. Future work should consider universal use of linguistically appropriate screening tools for DHH birthing parents in both clinical and research settings.

Audiovisual speech perception of multilingual learners of Japanese

ABSTRACT Due to the complex nature of languages and the way they are used, it is often difficult to research multilinguals because of the considerable variation in the ways their spoken languages may impact their perceptions. For this reason, foreign language education research has largely been focused on English L2 speakers, overlooking how different languages might impact perception in multilingual speakers. Focusing on Japanese as a Second Language (JSL) learners, this research investigated how multilinguals responded to audiovisual cues in Japanese and English. Utilising web-based eye-tracking technology facilitated by WebGazer.js. Participants were asked to complete a novel phonetic distinction task while their gaze behaviour was measured. Contrary to initial theoretical expectations, the findings did not reveal significant mediation by gaze behaviour on the relationship between multilingualism and task performance. However, the study found that when looking at the duration of fixation on the mouth, there's a significant difference between native English speakers and native speakers of Asian languages when listening to English or Japanese. These findings indicate that further research that explores the nuances of gaze behaviour among multilingual learners of non-English languages (such as Japanese) is necessary.

The brief mind wandering three-factor scale (BMW-3)

In recent years, researchers from different fields have become increasingly interested in measuring individual differences in mind wandering as a psychological trait. Although there are several questionnaires that allow for an assessment of people’s perceptions of their mind wandering experiences, they either define mind wandering in a very broad sense or do not sufficiently separate different aspects of mind wandering. Here, we introduce the Brief Mind Wandering Three-Factor Scale (BMW-3), a 12-item questionnaire available in German and English. The BMW-3 conceptualizes mind wandering as task-unrelated thought and measures three dimensions of mind wandering: unintentional mind wandering, intentional mind wandering, and meta-awareness of mind wandering. Based on results from 1038 participants (823 German speakers, 215 English speakers), we found support for the proposed three-factorial structure of mind wandering and for scalar measurement invariance of the German and English versions. All subscales showed good internal consistencies and moderate to high test–retest correlations and thus provide an effective assessment of individual differences in mind wandering. Moreover, the BMW-3 showed good convergent validity when compared to existing retrospective measures of mind wandering and mindfulness and was related to conscientiousness, emotional stability, and openness as well as self-reported attentional control. Lastly, it predicted the propensity for mind wandering inside and outside the lab (as assessed by in-the-moment experience sampling), the frequency of experiencing depressive symptoms, and the use of functional and dysfunctional emotion regulation strategies. All in all, the BMW-3 provides a brief, reliable, and valid assessment of mind wandering for basic and clinical research.

Estimates of eskd risk and timely kidney replacement therapy education

BackgroundKidney replacement therapy (KRT) needs preparation and its timing is difficult to predict. Nephrologists’ predictions of kidney failure risk tend to be more pessimistic than the Kidney Failure Risk Equation (KFRE) predictions. We aimed to explore how physicians’ risk estimate related to referral to KRT education, vs. the objective calculated KFRE.MethodsProspective observational study of data collected in chronic kidney disease (CKD) clinics of the Veterans Affairs Medical Center San Diego and the University of California, San Diego. The study included 257 participants who were aged 18 years or older, English speaking, prevalent CKD clinic patients, with estimated glomerular filtration rate (eGFR) < 60 mL/min per 1.73 m2 (MDRD equation). The exposure consisted of end stage kidney disease (ESKD) risk predictions. Nephrologists’ kidney failure risk estimations were assessed: “On a scale of 0–100%, without using any estimating equations, give your best estimate of the risk that this patient will need dialysis or a kidney transplant in 2 years.” KFRE was calculated using age, sex, eGFR, serum bicarbonate, albumin, calcium, phosphorus, urine albumin/creatinine ratio. The outcomes were the pattern of referral to KRT education (within 90 days of initial visit) and kidney failure evaluated by chart review. The population was divided into groups either by nephrologists’ predictions or by KFRE. Referral to KRT education was examined by group and sensitivity and specificity were calculated based on whether participants reached kidney failure at 2 years.ResultsA fifth were referred for education by 90 days of enrollment. Low risk patients by both estimates had low referral rates. In those with nephrologists’ predictions ≥ 15% (n = 137), sensitivity was 71% and specificity 76%. In those with KFRE ≥ 15% (n = 55), sensitivity was 85% and specificity 41%.ConclusionsAlthough nephrologists tend to overestimate patients’ kidney failure risk, they do not appear to act on this overestimation, as the rates of KRT education referrals are lower than expected when a nephrologist identifies a patient as high risk.Clinical Trial NumberNot applicable