Development of a computerized database for evaluation of nurse practitioner student clinical experiences in primary health care. Report of three pilot studies.

A computerized database for the collection of patient encounter information by nurse practitioner students provides insight into the number and diversity of cases seen. Menu-driven data entry and controlled vocabulary in the form of diagnostic clusters provide a mechanism to categorize and analyze the data. Faculty are able to review student clinical experience by quantitative measures such as number of patient encounters, diagnostic cluster of the encounter, and patient demographic data. Qualitative measures such as student's level of responsibility and student prior experience with stated encounter also are included in the database. Data analysis of two interdisciplinary pilots provided comparisons across disciplines of nursing, medicine, and physical therapy. A subsequent nurse practitioner student pilot provided further refinement and a broadened database terminology more inclusive of a nursing perspective. Educational and clinical issues involved in development, maintenance, and future use of the database are discussed.

Estimated prevalence of paratuberculosis in Missouri, USA cattle.

An absorbed ELISA for detection of antibodies against Mycobacterium paratuberculosis was performed on serum samples obtained from the Missouri Animal Health Laboratory. Samples from 1954 Missouri cattle representing 89 herds were randomly selected from samples submitted for brucellosis testing. The apparent seroprevalence of paratuberculosis in dairy cattle (8 +/- 3%) was similar to that in beef cattle (5 +/- 2%). When herds were classified as dairy or beef, 74% (14 of 19) of dairy herds and 40% (27 of 68) of beef herds were positive.

Comparison of milk with serum ELISA for the detection of paratuberculosis in dairy cows.

OBJECTIVE: To compare milk with serum ELISA for detection of antibodies to Mycobacterium paratuberculosis. DESIGN: Epidemiologic survey. ANIMALS: 821 Missouri dairy cattle of 12 herds that were brucellosis certified and Dairy Herd Improvement Association members. PROCEDURE: Milk and serum samples obtained concurrently from Missouri dairy herds were tested by use of a standard ELISA procedure. Concurrent collection of milk and serum samples controlled for interactions such as colostral antibodies and the effect of time. On the basis of milk and serum ELISA values, disease prevalence and correlation between milk and serum test results were determined. RESULTS: Correlation measures on individual animals indicated low correlation of milk and serum ELISA values. McNemar's chi 2 of 7.6 was significant (P = 0.05). Analysis correlation was low (kappa = 0.08), as was regression analysis (R2 = 0.02). CLINICAL IMPLICATIONS: Milk ELISA for the detection of exposure to M paratuberculosis lacked correlation with serum ELISA. Further evaluation to determine sensitivity and specificity of milk ELISA will augment the usefulness of milk ELISA as a herd screening test.

Using concept maps on the World-Wide Web to access a curriculum database for problem-based learning.

Development of medical school curriculum databases continues to be challenging. Representation of the instructional unit is becoming increasingly difficult due to characteristics of the problem-based learning (PBL) curricula. Curriculum databases may be used to store materials for the PBL curricula, and also to provide a delivery mechanism for those materials. However, in order to take advantage of the curriculum database as a tool for PBL, methods for accessing the curriculum database that are better suited to the information needs of students, faculty, and administrators must be developed. Concept maps are directed graph representations of conceptual relationships, and may be used to represent the content of a curriculum database. In this paper, we describe a Web application that uses Java-based concept maps was the user interface to a curriculum database.