Recent studies suggest that testing on prior material enhances subsequent learning of new material. Although such forward testing effect has received extensive empirical support, it is not yet clear ...how testing facilitates subsequent learning. One possible explanation suggests that interim testing informs learners about the format of an upcoming test and consequently allows them to adopt study strategies in accordance with the anticipated test format. Three experiments investigated whether the beneficial effects of testing are due to learners’ expectation with the test format or due to testing experience itself in inductive learning by varying when and how learners were informed about the format of an upcoming test. The results showed that informing learners about the test format via an interim test, but not a pretest, enhanced subsequent learning (experiment 1), and it was effective only when combined with actual test-taking experience (experiment 2). Testing appeared to enhance subsequent learning of new material when learners had an opportunity to evaluate their mastery over previously studied information. Experiment 3 further showed that these beneficial effects of testing were yielded even in the absence of feedback. Taken together, the findings suggest that mere exposure to the test format, not combined with actual testing, is not sufficient to enhance subsequent learning.
Abstract
Nonrandomized evaluation designs are an important part of social work research because randomization is not always feasible in social work settings. Although randomly assigned groups are ...assumed to be equivalent, nonrandomly assigned groups are not. In nonrandomized settings, designs with multiple waves are ideal, but two-wave designs are still widely used. A common method for estimating a treatment effect in nonrandom two-wave designs is the pretest–posttest model. However, depending on relationships among participants and the method of assignment to treatment groups, researchers should consider a difference-in-differences approach to testing treatment effects. Authors describe and compare the pretest–posttest and difference-in-differences approaches and assumptions and offer guidelines, developed from a literature review, about the conditions under which each model is likely to be best. Authors also demonstrate the decision-making process and application of the methods in an evaluation of an elementary school intervention program.
Purpose:
This study evaluated the potential effectiveness of a tablet-based, volunteer-led intervention (Lok Chi In-home Training) for cognitively impaired older people in improving cognitive and ...emotional health.
Method:
A one-group pretest and posttest design was adopted, involving 57 community-dwelling older people with cognitive impairments (Montreal Cognitive Score between 13 and 22, without neuropsychiatric behavioral problem). Trained volunteers performed eight in-home training sessions using a tablet to facilitate. Outcome measures include cognitive function, depression, activity of daily living, and instrumental activity of daily living.
Results:
A paired sample t test indicated that after receiving Lok Chi In-home Training, participants showed significantly large improvements on cognitive ability, moderate improvements on depression, and small improvements on instrumental activity of daily living.
Conclusions:
This study demonstrated the feasibility and potential benefits of Lok Chi intervention for improving cognition and emotion.
Current guidelines recommend the use of the updated Diamond–Forrester (DF) method and Coronary Artery Disease (CAD) Consortium models to assess the pretest probability of obstructive CAD. The present ...study aimed to compare the performance of these models among patients with chest pain evaluated in an emergency department (ED).
We compared three scores (DF, CAD consortium basic, and clinical) among 1247 consecutive patients with chest pain who underwent coronary computed tomographic angiography (CTA). Invasive angiography was performed to confirm the stenosis for those who showed obstructive CAD on CTA, if clinically indicated. Primary outcome was the presence of obstructive CAD (≧50% stenosis).
Overall, 426 (34.2%) patients were diagnosed with obstructive CAD. The expected prevalence of CAD was underestimated by the CAD consortium clinical model (23.4%) and overestimated by the DF model (53.1%). For the prediction of obstructive CAD, the CAD consortium clinical model had superior area under the receiver-operating curve (0.754), followed by the CAD consortium basic (0.736), and finally, the DF model (0.718). Whereas the CAD consortium models more accurately classified patients without any CAD or nonobstructive CAD as low-risk patients, the DF model more accurately classified high-risk patients with obstructive CAD. The net reclassification improvement of CAD consortium basic and clinical models were 24.7% and 27.9%, respectively.
Compared with the DF model, the CAD consortium clinical model appears to improve the prediction of low-risk patients with <15% probability of having obstructive CAD. However, this model needs caution when using in high-risk population.
This article considers the use of pretest probability in non-small cell lung cancer (NSCLC) and how its use in EGFR testing has helped establish clinical guidelines on selecting patients for EGFR ...testing. With an ever-increasing number of molecular abnormalities being identified and often limited tissue available for testing, the use of pretest probability will need to be increasingly considered in the future for selecting investigations and treatments in patients. In addition we review new mutations that have the potential to affect clinical practice.
In the United States, Black cisgender women account for one in five new HIV infections with Black Americans, accounting for 57% of new diagnoses in the South. Pre-exposure prophylaxis (PrEP) is 99% ...effective at preventing HIV. Still, Black women's uptake remains at 2% due to multiple documented barriers, including lack of awareness and knowledge, mistrust, stigma, and low perceived risk. Culturally relevant interventions leveraging trusted venues, such as beauty salons, can overcome these barriers. This article reports preliminary results of an intervention to improve PrEP knowledge and awareness, PrEP stigma, PrEP trust, and uptake among Black cisgender women. This multilevel, mixed-methods study used a community-engagement approach to develop and pilot a salon-based intervention, Using PrEP and Doing it for Ourselves (UPDOs) Protective Styles. The intervention improved knowledge, awareness, and trust around PrEP among Black cisgender women. PrEP use stigma within interpersonal relationships decreased, but low perceived risk and social stigma remained constant. Culturally and socially acceptable interventions like UPDOs Protective Styles can model health care delivery to improve trust, thus improving uptake over time for this population.
The purpose of this review is to draw attention to the presence and significance of murmurs other than the murmur of aortic regurgitation, in patients with aortic dissection. For that purpose, a ...literature search was conducted using Pubmed and Googlescholar. The search terms were “dissecting aneurysm of the aorta”, “systolic murmurs”, “ejection systolic murmurs”, “holosystolic” murmurs, “continuous murmurs”, and “Austin-Flint” murmur. Murmurs other than the murmur of aortic regurgitation, which were associated with aortic dissection, fell into the categories of systolic murmurs, some of which were holosystolic, and continuous murmurs, the latter attributable to fistulae between the dissecting aneurysm and the left atrium, right atrium, and the pulmonary artery, respectively. Mid-diastolic murmurs were also identified, and these typically occurred in association with both the systolic and the early diastolic murmurs. Among patients with systolic murmurs clinical features which enhanced the pre-test probability of aortic dissection included back pain, stroke, paraplegia, unilateral absence of pulses, interarm differences in blood pressure, hypertension, shock, bicuspid aortic valve, aortic coarctation, Turner's syndrome, and high D-dimer levels, respectively. In the absence of the murmur of aortic regurgitation timely diagnosis of aortic dissection could be expedited by increased attention to parameters which enhance pretest probability of aortic dissection. That logic would apply even if the only murmurs which were elicited were systolic murmurs.
•Associate degree nurses must understand and apply knowledge regarding the care of patients with eating disorders.•Flipped classroom method is an effective and student-approved teaching method for ...increasing knowledge and clinical reasoning skills related to the management of patients with eating disorders.•Associate degree nurse educators should be prepared and encouraged to implement flipped classroom method.
Evidence demonstrating that new nurses lack clinical judgment skills prompted a teaching-learning project in an associate degree of nursing (ADN) program. A needs assessment revealed the necessity of increased knowledge related to caring for patients with eating disorders. Constructivism guided the project, which aimed to provide students with an understanding of the three most common eating disorders, including patient care considerations. Teaching-learning occurred through flipped classroom method (FCM) involving textbook readings, a prerecorded lecture, and an unfolding case study. The author utilized standardized test results, pre- post-test results, and anonymous student evaluations to appraise learner understanding and approval. The project demonstrated that FCM increases student knowledge and satisfaction and is an effective teaching strategy for ADN programs. Recommendations include routine FCM training for nurse educators, regular use of FCM in undergraduate nurse education courses, and further research to determine the best strategies to break down barriers to FCM utilization.
This article describes the definition and proposed utilization of negative likelihood ratios (NLRs) as statistical parameters in breast imaging. Examples with calculations are provided using BI-RADS ...category 4 subcategories.
By auditing individual performance early and often against American College of Radiology benchmark positive predictive value ranges for the BI-RADS category 4 subcategories, and by fully understanding NLRs and their application in breast imaging, radiologists can minimize false-positive findings and unnecessary biopsies.
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