[Discrepancies in medical textbooks and their impact on medical school students]. / Discordances entre les référentiels des collèges d'enseignants en médecine et leur impact sur les étudiants en médecine.

BACKGROUND: Textbooks endorsed by national medical specialty societies and colleges are used as official references for faculty and national examinations. Oncology is transdisciplinary, practiced and taught by oncologists but also by other specialists. We aimed at identifying discrepancies between chapters on cancers in different official specialty textbooks and evaluating their impact on students. MATERIAL AND METHODS: Volunteer 6th-year medical students of the Sorbonne University faculty were paired and asked to list the discrepancies between all official specialty textbooks addressing a given cancer and then individually asked to evaluate the impact of discrepancies on their learning experience. RESULTS: In March 2018, the 17 cancers listed in the French medical school education program were addressed in 14 official specialty textbooks (2 to 4 textbooks/cancer). Out of a class of 390 students, 78 volunteered and were paired; each cancer was analyzed by 3 pairs of students (1 or 2 cancers/pair); 154 discrepancies were reported (range: 4-18 per cancer). Discrepancies induced doubt and anxiety in students; 85% considered that harmonization should be achieved for all topics of the national medical school program. CONCLUSIONS: Discrepancies between official textbook are frequent, generate anxiety in students and impact learning experience.

A comprehensive validation of the novel 8th edition of American Joint Committee on Cancer staging manual for the long-term survivals of patients with non-functional pancreatic neuroendocrine neoplasms.

Histologically, the World Health Organization has classified pancreatic neuroendocrine neoplasms (p-NENs) into well-differentiated pancreatic neuroendocrine tumors (G1/G2 p-NETs) and poorly-differentiated pancreatic neuroendocrine carcinoma (G3 p-NECs) based on tumor mitotic counts and Ki-67 index. Recently, the 8th edition of American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging manual has incorporated some major changes in 2017 that the TNM staging system for p-NENs should only be applied to well-differentiated G1/G2 p-NETs, while poorly-differentiated G3 p-NECs be classified according to the new system for pancreatic exocrine adenocarcinomas. However, this new manual for p-NENs has seldom been evaluated.Data of patients with both G1/G2 and G3 non-functional p-NENs (NF-p-NENs) from our institution was retrospectively collected and analyzed using 2 new AJCC 8th staging systems. We also made survival comparisons between the 8th and 7th edition system separately for different subgroups.For G1/G2 NF-p-NETs, there were 52 patients classified in AJCC 8th edition stage I, 40 in stage II, 41 in stage III and 19 in stage IV. As for G3 NF-p-NECs, 17, 19, 24, and 18 patients were respectively defined from AJCC 8th edition stage I to stage IV. In terms of the AJCC 7th staging system, the 230 patients with NF-p-NENs were totally distributed from stage I to stage IV (94, 63, 36, 37, respectively). For the survival analysis of both G1/G2 NF-p-NETs and G3 NF-p-NECs, the AJCC 7th edition system failed to discriminate the survival differences when compared stage III with stage II or stage IV (P > .05), while the 8th edition ones could perfectly allocate patients into 4 statistically different groups (P < .05). The HCIs of AJCC 8th stage for G1/G2 NF-p-NETs [HCI=0.658, 95% confidence interval (CI)=0.602-0.741] and stage for G3 NF-p-NECs (HCI=0.704, 95% CI=0.595-0.813) was both statistically larger than those of AJCC 7th stage for different grading NF-p-NENs [(HCI=0.578, 95% CI=0.557-0.649; P=.031), (HCI=0.546, 95% CI=0.531-0.636; P = .019); respectively], indicating a more accurate predictive ability for the survivals of NF-p-NENs.Our data suggested the 2 new AJCC 8th staging systems were superior to its 7th edition for patients with both G1/G2 NF-p-NETs and G3 NF-p-NECs.

[Ivory-Coast: Textbooks Misinform on HIV]. / Côte d'Ivoire : la désinformation des manuels scolaires sur l'infection à VIH.

Schools are considered as one of the most effective vectors for education on sexually transmitted diseases among young people. We report here the results of a study of HIV infection as presented in school textbooks in Ivory Coast, conducted in June 2018 as part of the development of a communication strategy to increase demand for HIV infection testing, especially among young people. Surprisingly, even though the textbooks studied were published between 2007 and 2017, almost all of them stated that HIV infection leads to death, with no mention of the existence of treatments that make it possible to live in good health. Some textbooks even stated that no treatment is available. These findings highlight one cause - perhaps major - for the reluctance of young people to get tested. The misrepresentation of HIV infection, reinforced by education, hampers incentive campaigns for HIV testing, for which the best argument is that awareness of a positive HIV status makes it possible to benefit from treatment. The present study included textbooks from the French educational program, used throughout French-speaking Africa, and from the Ivory Coast program. It would be interesting to conduct a similar study in other French-speaking and English-speaking African countries. Adapting the presentation of HIV in school textbooks to reflect the current situation in the fight against HIV infection should be a priority.

L'éducation scolaire est connue comme l'un des vecteurs les plus efficaces d'éducation sur les maladies sexuellement transmissibles chez les jeunes. Nous rapportons ici les résultats d'une étude de la présentation de l'infection à VIH dans les manuels scolaires en Côte d'Ivoire. De façon surprenante, bien qu'ils aient été imprimés entre 2007 et 2017, ces manuels affirment dans leur quasi-totalité que le VIH conduit à la mort, sans mentionner l'existence de traitements qui permettent de vivre en bonne santé, voire pour certains en affirmant qu'il n'existe pas de traitement. Ceci met en lumière une cause, peut-être majeure, de la réticence des jeunes à se faire dépister. La représentation erronée de l'infection à VIH renforcée par l'enseignement entrave les campagnes d'incitation au passage du test de dépistage, le meilleur argument pour celui-ci étant que connaître son statut positif permet de bénéficier des traitements. Certains des livres étudiés sont utilisés dans toute l'Afrique francophone. Il serait intéressant de mener une étude similaire dans d'autres pays d'Afrique francophone et anglophone. Vérifier le contenu scientifique et adapter le discours des manuels scolaires sur le VIH à la situation actuelle de la lutte contre l'infection devraient être une urgence.

Palliative and end of life care content within common pharmacy textbooks.

INTRODUCTION: This study compared the end-of-life care (EOLC) content in pharmacy-related textbooks to textbooks evaluated in a comparable 2003 study. METHODS: Six common pharmacy-related textbooks were reviewed for content relating to EOLC. Five of the textbooks were the newest editions of the same texts reviewed in a similar 2003 study, and one focused primarily on clinical ethics, a topic that was underrepresented in the previous study. The six texts were searched for a list of 33 keywords or phrases pertaining to EOLC. Entries containing any of these 33 keywords were assigned a domain and scored using a simple scoring system of one if minimally helpful content was present or two if helpful content was present. The total number of entries and their average scores were compared to the results of the previous study. RESULTS: The average number of entries per textbook was 154, which represents an increase from the 110.1 average number of entries in the 2003 study. However, one of the textbooks had a total of 470 entries alone. Of a total number of 78 possible domains, 40 had either zero or one entries. The average ratings for each book ranged from 0.5 to 1.6, whereas they ranged from 0.9 to 1.6 in 2003. Four of six books in this study had average rating of less than 0.9. CONCLUSION: Although certain texts have made strides to include more EOLC content, overall, EOLC content in pharmacy textbooks may still be improved.

Textbook coverage of a common topic: fluid management of patients after surgery.

CONTEXT: Maintenance fluid therapy is a protean topic but is clinically often mismanaged. Our teaching of medical students led us to suspect that textbooks provide limited information about the topic, so we set out to verify this possibility by reviewing the content of books written in English that covered perioperative care. METHODS: We reviewed publishers' lists of textbooks and found 22 suitable books. After compiling a standard list of questions on intravenous therapy, we read each book to find out to what extent it delivered the answers, and listed the information obtained. RESULTS: Only 13 books answered more than half of the questions. The information varied considerably. Suggested quantities of daily fluid, sodium and potassium requirements varied hugely. CONCLUSIONS: Information provided in standard textbooks to guide fluid prescription is scant and variable. This could be a cogent reason why junior doctors prescribe postoperative fluids badly: the information in textbooks is inadequate and varies from book to book. The reasons for the poor coverage are not clear. Perhaps other common topics that are often poorly managed are also badly addressed by standard books.

[Misleading information on smoking in German medical textbooks]. / Fehlinformation zum Tabakrauchen in deutschen Medizin-Lehrbüchern.

BACKGROUND AND OBJECTIVE: Smoking is a major risk factor for coronary heart disease and lung cancer. While nicotine causes addiction, heart and lung diseases are caused by other substances contained in tobacco smoke. This study assessed whether these facts are adequately portrayed in German medical textbooks. METHODS: The sections on cardiovascular and lung cancer risk factors in 28 German textbooks of internal medicine, available in two bookstores as well as the library of Göttingen University (Germany), were scanned for the words "smoking" and "nicotine" as risk factors for coronary artery disease and lung cancer. RESULTS: In 12 of the 25 textbooks covering cardiovascular disease, smoking was mentioned as a risk factor for coronary artery disease; another 12 textbooks listed nicotine or nicotine addiction. In one textbook both terms were used. While smoking was referred to in all 21 textbooks that also discussed risk factors for lung cancer, nicotine was not mentioned in this context. CONCLUSION: Many German textbooks of internal medicine contain misleading terms for the health effects of smoking, which may influence the thoughts and possibly also the behaviour of their readers. The use of the words "smoking" and "nicotine" as synonymous within the context of cardiovascular risk factors, suggesting a causal relationship between nicotine and coronary heart disease, is incorrect and should be removed from the specialist medical literature.

[Effect of school education on students' perception of radiation].

There is a strong tendency in Japan to perceive even the smallest amount of radiation or radioactivity as dangerous or detrimental. An investigation was done to identify the age at which this perception is formed. It was found that the perception was initially formed during elementary school, especially when the description of an atomic bomb was given during the history course, which is part of the sociology curriculum. The description in the sociology textbook emphasizes the damage produced by radiation. In contrast, the textbook has few descriptions of the positive uses of radiation. The perception, formed in elementary school, of radiation as something dangerous and detrimental remains vivid until adolescence. The only textbook to correctly describe the benefits of radiation was a high school physics textbook. However, only 30% of high school students take physics. The system of selecting science subjects in high school is preventing students from obtaining a correct understanding of radiation. Little improvement can be found in the latest textbook published following the 2002 governmental guidelines for education.

The effectiveness of an interactive multimedia learning tool on nursing students' math knowledge and self-efficacy.

The use of online learning tutorials to provide instruction in schools of nursing is growing in popularity; however, the outcomes associated with this method of instruction are not well documented. The focus of this experimental study, conducted at 2 universities in northern California, was to determine the effectiveness of an online interactive multimedia-learning tool versus text only, text and images, and multimedia learning explanations on math achievement, math self-efficacy, and student satisfaction. Compared to students in the control groups, students in the interactive multimedia group demonstrated equal posttest and retest knowledge of math; their math self-efficacy scores were also the same. Interactive multimedia group students were more satisfied with the method of learning, reported the technique to be enjoyable and more interesting, and provided sufficient feedback. An online interactive multimedia-learning tool is a realistic and creative method of teaching medication dosage calculations.

Surgical textbooks: past, present, and future.

The Sabiston Textbook of Surgery and other classic textbooks have been invaluable resources for generations of surgeons. Although they play an important role in medical education, printed textbooks often cannot meet the daily information needs of practicing surgeons because they are inaccessible, incomplete, unstructured, and out of date. Advances in communication technology have radically changed the creation and distribution of medical information. Many clinicians now seek evidence to support clinical decisions on the Internet and handheld devices. This article describes the evolution of surgical textbooks from printed volumes to versatile collections of knowledge that serve as both comprehensive resources and question-answering tools.

Strengthening end-of-life care through specialty nursing certification.

The purpose of this study was to determine the adequacy of content related to end-of-life (EOL) care in materials used in the nursing certification process across clinical nursing specialties. Thirty-eight certification examination blueprints, 18 specialty nursing scope and standards of practice documents, and 28 specialty nursing core curriculum text books were analyzed by using descriptive statistics to determine the quantity and quality of content related to nine critical areas of EOL content contained in them. Fifteen (38 per cent) of the certification examination blueprints contained at least one of the critical EOL content areas. Eight (44 per cent) of the scope and standards of practice documents contained at least one sentence on EOL care. Seven (25 per cent) of the 28 textbooks contained at least one chapter dedicated to EOL care content, and 129.5 (0.8 per cent) of the 15,706 textbook pages reviewed were dedicated to EOL care content. Expert ratings regarding the overall accuracy, currency, and comprehensiveness of EOL content found in the textbooks were poor to good. An increased focus on EOL care in the nursing specialty certification process is warranted. The content of nursing specialty certification examinations has a direct influence on nursing education as well as a significant impact on nursing practice in clinical specialty areas.

[Trauma and resuscitation course (TRC): evaluation of the first 2 years]. / Travma ve resüsitasyon kursu (TRK): ilk 2 yilin degerlendirmesi.

Eight Trauma and resuscitation Courses (TRC): two instructor and 6 student courses have been organized in Turkey between December 1998 and November 2000. Questionnaire results of 121 students and 63 instructors were reviewed. We strongly believe that these results will be supportive for the courses in the future. Fifty-five of the instructors were from university, and 8 were from teaching hospitals. 121 doctors attended six student courses, the average age of whom was 34. Average time period following university graduation was 10 years (3 months 43 years) for the participants. Among these, 94% found the course content sufficient. The course book was determined as insufficient in terms of drawings and pictures by 15%. The main target population of the course was selected as emergency service doctors and practitioners. As a result we determined that the main criticisms were insufficient practical and video sessions and the lack of drawings in the course book our main goal is to accomplish the required changes, and make new courses more yielding and profitable, thus introduce standardization in terms of trauma care nationwide.

Development of the Texas Textbook Evaluation Tool (T-TET).

Nurse educators face many challenges in evaluating textbooks to meet the needs of their students and preparing professional nurses who will practice in the next millennium. Using four phases of development, the Texas Textbook Evaluation Tool (T-TET) was created to develop a reliable and valid textbook evaluation instrument. The T-TET may be used to evaluate all levels of textbooks, including specialty textbooks in nursing.

The quality of medical textbooks: bladder cancer diagnosis as a case study.

PURPOSE: This study was conducted to determine whether there is an inherent bias in medical texts that influences physicians to favor certain signs and symptoms over others when evaluating patients with bladder cancer. MATERIALS AND METHODS: Numerous sources, primarily textbooks from various medical specialties, were reviewed (italics are added for emphasis). Attention was paid to the criteria the authors suggested for use in the diagnosis of bladder cancer. RESULTS: Although most authors agree on a core of presenting signs and symptoms, some concentrate strongly on hematuria with the result of down playing the importance of other findings such as irritative voiding symptoms. The concern is that this approach may lead to delay in the diagnosis of tumors, some of which may be highly aggressive, which present with dysuria and pyuria but no hematuria. CONCLUSIONS: Inconsistencies do exist in the literature regarding which diagnostic criteria to use in selecting those patients to be evaluated for bladder cancer. Recommendations are made for ways to improve standardization.

Accuracy of current educational literature on the staging of gastric carcinoma.

Staging of gastric adenocarcinoma is important for comparing aspects of the disease in Asia and in the Western countries, and it may be used to direct the treatment strategy. A survey of 13 popular current surgical textbooks and review journals found a high level of inaccuracy. Two texts (15%) did not mention any staging systems, and one (8%) described a nonstandard system. Three (23%) described staging systems that were out of date, and six descriptions (46%) were inaccurate. Only 40% of the cited staging systems was reliable. This level of inaccuracy leads to confusion for the reader and to difficulty interpreting other relevant literature.