The Role of Students' Beliefs When Critically Reasoning From Multiple Contradictory Sources of Information in Performance Assessments.

Critical reasoning (CR) when confronted with contradictory information from multiple sources is a crucial ability in a knowledge-based society and digital world. Using information without critically reflecting on the content and its quality may lead to the acceptance of information based on unwarranted claims. Previous personal beliefs are assumed to play a decisive role when it comes to critically differentiating between assertions and claims and warranted knowledge and facts. The role of generic epistemic beliefs on critical stance and attitude in reflectively dealing with information is well researched. Relatively few studies however, have been conducted on the influence of domain-specific beliefs, i.e., beliefs in relation to specific content encountered in a piece of information or task, on the reasoning process, and on how these beliefs may affect decision-making processes. This study focuses on students' task- and topic-related beliefs that may influence their reasoning when dealing with multiple and partly contradictory sources of information. To validly assess CR among university students, we used a newly developed computer-based performance assessment in which the students were confronted with an authentic task which contains theoretically defined psychological stimuli for measuring CR. To investigate the particular role of task- and topic-related beliefs on CR, a purposeful sample of 30 university students took part in a performance assessment and then were interviewed immediately afterward. In the semi-structured cognitive interviews, the participants' task-related beliefs were assessed. Based on qualitative analyses of the interview transcripts, three distinct profiles of decision-making among students have been identified. More specifically, the different types of students' beliefs and attitudes derived from the cognitive interview data suggest their influence on information processing, reasoning approaches and decision-making. The results indicated that the students' beliefs had an influence on their selection, critical evaluation and use of information as well as on their reasoning processes and final decisions.

On the complementarity of holistic and analytic approaches to performance assessment scoring.

BACKGROUND: A holistic approach to performance assessment recognizes the theoretical complexity of multifaceted critical thinking (CT), a key objective of higher education. However, issues related to reliability, interpretation, and use arise with this approach. AIMS AND METHOD: Therefore, we take an analytic approach to scoring students' written responses on a performance assessment. We focus on the complementarity of holistic and analytic approaches and on whether theoretically developed analytical scoring rubrics can produce sub-scores that may measure the 'whole' performance in a holistic assessment. SAMPLE: We use data from the Wind Turbines performance assessment, developed in the iPAL project this study where 55 students at a German university participated. RESULTS: The (sub)scores generated from the scoring scheme empirically reproduced the theoretically assumed structure of CT, with valid and reliable scores in a three-dimensional model. The proposed interpretation of CT as assessed with a performance assessment and measured by the rating scheme was supported preliminarily. CONCLUSION: Our results support the complementarity of holistic and analytic approaches to assessing CT. When combined, they provide interpretable scores for a complex, multifaceted construct useful in diagnostic contexts.

The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a multinational, randomized, double-blind, placebo-controlled trial in patients receiving high-dose cisplatin--the Aprepitant Protocol 052 Study Group.

PURPOSE: In early clinical trials with patients receiving highly emetogenic chemotherapy, the neurokinin antagonist aprepitant significantly enhanced the efficacy of a standard antiemetic regimen consisting of a type-three 5-hydroxytryptamine antagonist and a corticosteroid. This multicenter, randomized, double-blind, placebo-controlled phase III study was performed to establish definitively the superiority of the aprepitant regimen versus standard therapy in the prevention of chemotherapy-induced nausea and vomiting (CINV). PATIENTS AND METHODS: Patients receiving cisplatin > or = 70 mg/m2 for the first time were given either standard therapy (ondansetron and dexamethasone on day 1; dexamethasone on days 2 to 4) or an aprepitant regimen (aprepitant plus ondansetron and dexamethasone on day 1; aprepitant and dexamethasone on days 2 to 3; dexamethasone on day 4). Patients recorded nausea and vomiting episodes in a diary. The primary end point was complete response (no emesis and no rescue therapy) on days 1 to 5 postcisplatin, analyzed by a modified intent-to-treat approach. Treatment comparisons were made using logistic regression models. Tolerability was assessed by reported adverse events and physical and laboratory assessments. RESULTS: The percentage of patients with complete response on days 1 to 5 was significantly higher in the aprepitant group (72.7% [n = 260] v 52.3% in the standard therapy group [n = 260]), as were the percentages on day 1, and especially on days 2 to 5 (P <.001 for all three comparisons). CONCLUSION: Compared with standard dual therapy, addition of aprepitant was generally well tolerated and provided consistently superior protection against CINV in patients receiving highly emetogenic cisplatin-based chemotherapy.

Clinical or epidemiologic diagnosis of nosocomial pneumonia: is there any difference?

OBJECTIVE: To evaluate the draft Centers for Disease Control and Prevention definitions of nosocomial pneumonia in comparison with current CDC definitions to increase acceptance by intensive care specialists. SETTING: A 12-bed medical intensive care unit in a German teaching hospital. METHOD: Clinicians were asked to retrospectively assess all patients of the year 1999 according to 3 different definitions of pneumonia: the current CDC definitions, the draft CDC definitions, and their own clinical criteria for diagnosing and treating. To test the agreement observed between the different sets of criteria, the kappa method described by Fleiss was used; for evaluating the strength of agreement between various categories, the recommendations of Landis and Koch were applied. RESULTS: One thousand eight hundred forty-two patients were assessed. According to the clinical criteria, 31 patients developed nosocomial pneumonia during their stay in the intensive care unit. The number of pneumonia cases according to the current CDC definitions was 30 and according to the draft definitions, 32. However, agreement with the clinical definitions was intermediate for the current definitions kappa = 0.62 (95% CI, 0.47-0.76) but excellent for the draft definitions kappa = 0.98 (95% CI, 0.95-1.02). CONCLUSION: Even though the current definitions are useful, agreement with the clinical assessment was greater for the draft definitions and might lead to improved acceptance of surveillance data by intensive care specialists.