Basic Science Knowledge and Clinical Applications in Psychiatry: Issue or Artifact?

IntroductionKnowing a disease is crucial for being able to fight it, especially in a region in which COVID-19 caused so many deaths, such as Latin America.ObjectiveTo determine the association between basic knowledge of COVID-19 and education level according to country of residence in Latin America.MethodologyThis is an analytical cross-sectional study. Basic level of knowledge was measured through nine close-ended questions (scale validated in Peru). The score obtained was analyzed through performing a crosstab vs. gender, age, education level, and country of residence.ResultsOf a total of 9,222 respondents, almost all of them knew the common symptoms (99%), modes of transmission (93%), and knew how to recognize which was not a specific symptom (93%). Through the multivariate model, we found that there was no association with gender (p = 0.716) or age (p = 0.059), in comparison with those who had primary or a lower education level. All the other higher education levels had statistically significant scores (all p-values p < 0.001). When comparing knowledge according to countries, and using Peru as reference for comparison, Chile, Paraguay, Mexico, Bolivia, Panama, Ecuador, Costa Rica, and Colombia had a better level of knowledge (all p-values < 0.001); however, only El Salvador had a lower level (p < 0.001).DiscussionThere was lack of knowledge of some topics, difference according to academic degree and country. As Peru was one of countries that obtained the lowest level of knowledge, it could have influenced the fact that it was the most affected country in the world.

Attendings and trainees are expected to use basic science knowledge (BSK) in clinical practice and learning. Evidence of how is scant, and more research situated in clinical learning environments (CLEs) is needed. Our study aimed to characterize use of BSK during patient care in a CLE and the actions, interactions, materials, and beliefs that influence its use, to inform efforts to connect BSK education to clinical workplace learning and patient care. We conducted a constructivist grounded theory study, collecting data from eight inpatient Internal Medicine (IM) teams at one US institution from October 2022 to January 2023. Data included field notes from 27 hours observing inpatient rounds and 24 team member interviews. Iterative data analysis involved coding, memo writing, and constant comparison to develop a theory of BSK use on IM inpatient rounds. We found that BSK can be activated on rounds through social interactions (among team members, with patients), and in contact with materials (e.g. the electronic health record). Our findings describe BSK as activated when team members connect to and test BSK or when they explore uncertainty; and that activation is supported by beliefs that BSK use brings value to patient care. However, team members often left BSK not activated, accompanied by beliefs about it not being a good fit for patient care activities. Actions associated with leaving BSK not activated included delegating responsibility for using it, deferring discussion, or curtailing conversations about it. Much of the literature describes BSK use in the clinical setting as the product of individual cognition. Our findings extend this characterization, illustrating how social and material elements of the inpatient CLE influence BSK use on rounds. These elements can be leveraged to activate BSK to support integration of learning with patient care in the workplace.

Objective: The primary aim of our study, an international web-based survey, is to obtain (I-a) physicians' statistical knowledge and (I-b) how this varies by their focus area (basic, internal and surgical). The secondary aim is to address the following questions: (II-a) to specify when in the medical education biostatistics course should be taught and (II-b) to identify the key statistical methods relevant to medical education. Material and Methods: A total of 278 physicians from 59 countries, who were invited to participate in our survey by e-mail, participated in our study. Physicians' data were obtained via a web-based survey. Results: Most of the physicians stated that biostatistics course should be taken at the undergraduate and at the residency. When we investigated the physicians' knowledge of statistical topics there was no difference between resident, specialist and academic staff. Although there were no differences according to statutes in terms of statistical knowledge level, it was observed that the knowledge levels were so low in all statistical topics, except the parametric tests. Especially it was found that the knowledge level about the sampling techniques was at the lowest degree. Conclusion: When the studies were evaluated, it was seen that statistics is one of the most important factors in respect to the reliability of conducted studies. Therefore researchers should have the basic statistical knowledge and have basic knowledge level on the specific statistical methods which are used in their research areas; also should take consultation from the biostatistics specialist.

Previous attempts to predict resident clinical performance based solely on measures of cognitive skills have been uniformly unsuccessful. For the past 8 years, a formative residency evaluation system has been used that includes yearly comprehensive oral in-training examinations (OITEs) assessing each resident's performance in the three areas of professional competence: cognitive, psychomotor, and affective. The results of these examinations and scores received on the written in-training examination (WITE) given by the American Board of Pediatrics were compared with faculty ratings received during the subsequent year of residency. No significant correlation was found at any level of training between WITE scores and clinical performance. Analysis based on clinical setting did not improve these results. Oral in-training examination scores, however, were highly correlated with clinical performance ratings. In addition, with oral in-training examination scores, the "problem" interns--those whose clinical performance rating placed them in the lower 10% of interns--were predicted with a high degree of significance, sensitivity, and specificity. Predictions based on WITEs were not significant. Simultaneous evaluation of all three areas of professional competence should be done when predictions of resident performance are attempted. The OITE is a powerful formative evaluation tool, providing valuable learning experiences as residents are objectively assessed while they perform patient-centered tasks that represent critical skills in the practice of medicine. It allows early detection and possible amelioration of future problems in the clinical performance of a resident.

The assessment of the elective clerkship at the University of Groningen consists of a written case report, graded by one of four independent reviewers, and a rating of clinical performance by the students’ supervisors. This study analyses the grades of 710 case reports and 189 ratings. The grades were found to be normally distributed, similar for the reviewers and consistent over the years, but inter- or intra-observer variation was not studied. The ratings of clinical performance were skewed towards ‘excellent’. There was a low correlation between the two assessments (Spearman's r = 0.25; p = 0.001). This may be attributed among other things to the large number of supervisors and the face-to-face assessment of clinical performance versus the distant assessment of a written document. A more relevant explanation, however, is that the case reports measure primarily cognitive aspects, as compared with overall clinical performance.

INTRODUCTION. The quality of medical care is largely determined by the professionalism and organization of interaction between doctors and nurses. In this regard, much attention should be paid to the continuing education of nurses at the level of world standards.PURPOSE OF THE WORK. Determination of the basic knowledge level on the theory and practical skills of the nurses-anesthetists and the efficacy of the training seminar as an element of postgraduate education evaluation.MATERIALS AND METHODS. We studied the basic and final level of knowledge of the nurses from the Anesthesiology and Intensive Care department from 23 regions of Ukraine, during the offsite educational courses Program for the nurses-anesthetists in 2017.RESULTS AND DISCUSSION. In the study of the basic level of knowledge in general, the percentage of correct answers was 47.8 ± 26.2%. After training, this indicator rose to 69.2 ± 18.7% (p &lt;0.0001). In particular, on the theoretical part of the initial test, the number of correct answers was on average 57.2 ± 23.7%, at the final – 67.5 ± 18.5%. According to the practical skills of nursing, the percentage of correct answers was initially 68.0 ± 20.6%, and 81.4 ± 14.6% – after the seminar (p &lt;0.05). In the cardiopulmonary resuscitation unit, the number of correct answers before the seminar was only 28.4 ± 18.7%, but after the lectures and master classes this index corresponded to 64.7 ± 20.1% (p &lt;0.0001), so it was more than doubled.CONCLUSIONS. The level of knowledge of medical sister-anesthetists leaves much to be desired, even on topics that relate to fairly common practical skills. Offsite educational courses for nurse-anesthetists, including lecture material and master classes, are relevant and in demand in most areas of Ukraine. Based on the results of the initial and final tests, the dynamics of the anesthetists level of knowledge after the courses increases in all thematic blocks, which indicates their effectiveness and feasibility. There is a need to develop tests with modeling of clinical situations to consolidate the skills of working in a team.

The purpose of this paper was to present an assessment of a series of instructionalactivities that were developed and implemented to improve the basic knowledge level of studentsentering technical systems management undergraduate level classes. Many of the students enrollingin the technical systems management classes do not have the same level of fundamentalunderstanding of the basic principles and knowledge level in technical systems management. Aseries of instructional activities were developed to provide students opportunities to learn thefundamental knowledge as they star and progress through the classes. These instructional activitieswere primarily web-based and offered as supplemental instructional activities that did not requireformal instructional time. The activities were self-paced and student-centered. These activitiesincluded instructional topics such as tool and components identification, safety practices,fundamental scientific principles and applications of instructional practices. All activities arecompleted outside of the formal class and laboratory teaching times. The primary goal of theseactivities was to provide an opportunity for those students who do not have the expected entry levelof fundamental knowledge to develop a baseline of competence.

AimThis study aimed to determine if participation in a preceptorship programme affected newly hired experienced professional nurses’ self-efficacy in clinical practice and whether their perceived competence was related to respondents’ demographic profiles at a university hospital in Saudi Arabia. BackgroundFormal preceptorship programmes are initiated with the aim of improving the characteristics related to new workplace adaptations, such as reducing stress and anxiety, improving effective communication, enhancing clinical performance and competencies, and learning new clinical skills. These programmes’ effectiveness in improving nurses’ self-efficacy in clinical practice is seldom measured, especially among newly hired experienced professional nurses. MethodsA quasi-experimental, quantitative pre- and post-test one-group study design with convenient sampling was used. ResultsSelf-efficacy post-test scores were significantly higher than pre-test scores (p<0.001). The programme positively influenced the respondents’ self-efficacy scores. As perceived by the respondents, the preceptorship programme had a positive effect and improved their clinical performance in the nursing process. There was no relationship between perceived competence and respondents’ demographic profiles. ConclusionsReporting on self-efficacy in clinical practice may not be the most effective, reliable or accurate measure or evaluation of clinical performance since self-scoring may be affected by existing cultural implications and a strong sense of self-efficacy. The self-scoring results may be followed by qualitative information, like interviews, to determine respondents’ knowledge of the nursing process, direct observation of performance in the clinical area and care outcomes, and confirm if the respondents’ clinical performance matches the obtained results.

The events of the World War II play a special role in the contemporary social discourse as the basis of collective memory and civil culture. The current attempts of some Western countries to misrepresent and rewrite the history of the World War II and to belittle the role of the Red Army in the rout of Nazism pursue serious geopolitical goals. Effective opposition to the falsification of history depends on the quality of youths knowledge about that period (active historical memory) and the younger generations emotional association with the war winner. The article presents the results of the sociological study conducted on the eve of the 75th anniversary of the Great Victory. First, there was a survey at the Moscow State Institute of International Relations (students aged 18-23) to identify the level of historical knowledge and assessments, sources (fiction and movies) of representations, ideas about reasons for the falsification of the World War II history and measures to oppose it. The questions were divided into three groups: historical (the level of basic knowledge), cultural-pedagogic, or emotional (questions about books and movies) and evaluative-predictive (reasons for the falsification of history and measures to oppose it). The study also aimed at comparing the results of the survey with all-Russian opinion polls and foreign surveys. Second, the author analyzed estimates of the reasons for the falsification of the war history and suggestions to oppose this negative trend, which were provided by leading experts from Russian and foreign universities and analytical centers. The comparison of the students and experienced researchers opinions revealed both similarities and differences in generational estimates, and allowed to identify some general ways to resist the intensified trend of the falsification of the war history.

This study examined the relationship of grades earned in paired theory and clinical courses. Data collected during academic years 1997 to 2002 confirmed that grade inflation exists in clinical nursing courses. Problems involved in awarding grades for clinical performance are discussed (e.g., standards of clinical performance, methods used in evaluation of clinical performance, the impossibility of faculty omnipresence, the influence of student effort in grading, the effect of recency, the challenges of keeping good anecdotal records). Solutions to grading problems are proposed, including dividing up performance into agreed-on elements, measurement of these elements on a grading scale that allows for more differentiation of quality in evaluating clinical performance, assigning grades from the beginning of a clinical course, emphasizing all three domains of clinical practice, and evaluating student performance in both laboratory and, clinical settings.

Learning about science is still important.

To what extent do medical undergraduate students retain basic science knowledge after they learned about its clinical application 6–8 weeks later? To explore this, items of the basic science exams were repeated in the clinically oriented exam. Generally, results on these test items improved, but major differences were observed per item.

Prior studies suggest that students on a longitudinal integrated clerkship (LIC) have comparable academic performance to those on a rotation-based clerkship (RBC); however, most of these studies did not adjust for preclerkship academic performance. The objective of this study was to compare the academic performance of LIC and RBC students matched on prior academic performance over a three-year period. Each LIC student in the University of Calgary classes of 2009, 2010, and 2011 (n = 34) was matched with four RBC students (n = 136) of similar prior academic performance. Knowledge and clinical skills performance between the streams was compared. Knowledge was evaluated by internal summative examinations and the Medical Council of Canada Part 1 licensing exam. Clinical skills were evaluated via in-training evaluation report (ITERs) and performance on the clerkship objective structured clinical examination (OSCE). Meta-analysis was used to compare knowledge evaluations and clinical performance for all core clerkship disciplines, and pooled effect sizes from the fixed-effect models were reported. Meta-analyses showed no statistically significant heterogeneity. There were no differences between LIC and RBC students on knowledge evaluations (pooled effect size 0.019; 95% confidence interval [-0.155, 0.152], P = .8), ITERs (pooled effect size -0.015 [-0.157, 0.127], P = .8), or mean OSCE ratings (67.9 [SD = 4.6] versus 68.6 [SD = 5.8], P = .5). After matching on prior academic performance, LIC and RBC students at one school had comparable performance on summative evaluations of knowledge, clinical performance, and clinical skills over three years.

Purpose: The evaluation of clinical performance is a critically important issue in PA education, yet the validity of clinical evaluation tools utilized by PA programs has not been systematically analyzed in the literature. Studies of medical students and residents have raised questions about the validity of several evaluative mechanisms. This study investigated the extent to which scores on preceptor evaluations, objective examinations, and patient management problems (PMP) correlated with a variety of measurements of performance in the clinical and didactic curriculum. Methods: The individual components of each evaluative tool were separated by the competency they were designed to measure. Competencies included in this analysis were: medical knowledge base, history-taking ability, physical examination skills, diagnostic ability, plan for treatment, and various personal attributes evaluated by the preceptor. Results: The preceptor evaluation of student knowledge did not correlate with grades in the didactic curriculum or clinical-year objective examination scores. The end-of-rotation objective examinations significantly correlated with the end-of-program final examination (p<0.05) and several course grades from the didactic year. The preceptor evaluation of history-taking did not correlate with the PMP history score. The physical examination scores from the preceptor evaluation and the PMP weakly correlated (p<0.01). The differential diagnosis scores from the preceptor evaluation and the PMP did not correlate, nor did the scores on treatment plans. The preceptor evaluation of patient rapport negatively correlated with scores from the didactic curriculum (p<0.05) and the end-of-program final examination (P<0.05). Conclusions: This study raises questions about the validity of various measurement tools utilized by PA programs to evaluate clinical performance. Further correlative studies are needed to determine the extent to which existing clinical evaluation tools actually measure the competencies they were designed to measure.

BackgroundLevels of knowledge about diabetes mellitus (DM) among newly diagnosed diabetics in Bangladesh are unknown. This study assessed the relationship between knowledge and practices among newly diagnosed type 2 DM patients.MethodsNewly diagnosed adults with type 2 diabetes (N = 508) were selected from 19 healthcare centers. Patients’ knowledge and self-care practices were assessed via interviewer-administered questionnaires using a cross-sectional design. Knowledge questions were divided into basic and technical sections. Knowledge scores were categorized as poor (<mean – 1 SD), average (mean ± 1 SD), good (>mean + 1 SD). Chi square testing and multivariate logistic regression were conducted to examine the relationship between diabetes-related knowledge and self-care practices.ResultsApproximately 16%, 66%, and 18% of respondents had good, average, and poor (GAP) basic knowledge respectively and 10%, 78%, and 12% of respondents had GAP technical knowledge, about DM. About 90% of respondents from both basic and technical GAP did not test their blood glucose regularly; a significant relationship existed between basic knowledge and glucose monitoring. Technical knowledge and foot care were significantly related, though 81% with good technical knowledge and about 70% from average and poor groups did not take care of their feet. Approximately 85%, 71%, and 52% of the GAP technical knowledge groups, consumed betel nuts; a significant relationship existed between technical knowledge and consumption of betel nuts. Around 88%, 92%, and 98% of GAP technical knowledge groups failed to follow dietary advice from a diabetes educator. About 26%, 42%, and 51% of GAP basic and technical sometimes ate meals at a fixed time (p < 0.05). Approximately one-third of respondents in each basic knowledge group and 29%, 32%, and 32% of GAP technical knowledge groups partially followed rules for measuring food before eating. Total basic knowledge (TBK) and business profession were significant independent predictors of good practice. OR for TBK: 1.28 (95% CI: 1.03 to 1.60); OR for business profession 9.05 (95% CI: 1.17 to 70.09).ConclusionsNewly diagnosed type 2 diabetics had similar levels of basic and technical knowledge of DM. Health education and motivation should create positive changes in diabetes-control-related self-care practices.