Illness perceptions predict reassurance following a negative exercise stress testing result

Many patients are not reassured after receiving normal results following cardiac investigations. While previous studies have shown anxiety to be a contributing factor, little research has investigated the influence of patients’ illness perceptions on reassurance. In this study we investigated whether illness perceptions predicted patients’ reassurance following normal exercise stress test results. Sixty-two chest pain patients without prior diagnosed cardiac pathology completed questionnaires assessing anxiety and illness perceptions prior to exercise stress testing. Patients completed a reassurance questionnaire immediately following their appointment and again one month later. Illness perceptions (consequences, timeline, identity, illness concern, and emotional effect) but not anxiety, significantly predicted reassurance immediately following testing. We found both state anxiety and illness perceptions to predict reassurance one month later. After controlling for anxiety, longer timeline and lower treatment control beliefs predicted lower reassurance. The results suggest that an intervention targeting patients who have high anxiety and negative illness perceptions prior to testing may improve reassurance and decrease disability and the subsequent use of medical care.

Can computer-based testing achieve quality and efficiency in assessment?

This paper reports findings of a two year study concerning the development and implementation of a general-purpose computer-based assessment (CBA) system at a UK University. Data gathering took place over a period of nineteen months, involving a number of formative and summative assessments. Approximately 1,000 students, drawn from undergraduate courses, were involved in the exercise. The techniques used in gathering data included questionnaires, observation, interviews and an analysis of student scores in both conventional examinations and computer-based assessments. Comparisons with conventional assessment methods suggest that the use of CBA techniques may improve the overall performance of students. However it is clear that the technique must not be seen as a "quick fix" for problems such as rising student numbers. If one accepts that current systems test only a relatively narrow range of skills, then the hasty implementation of CBA systems will result in a distorted and inaccurate view of student performance. In turn, this may serve to reduce the overall quality of courses and - ultimately - detract from the student learning experience. On the other hand, if one adopts a considered and methodical approach to computer-based assessment, positive benefits might include increased efficiency and quality, leading to improved student learning.