BACKGROUND: Effective interventions during the coronavirus disease 2019 (COVID-19) pandemic require an understanding of patients' knowledge and perceptions that influence their behaviour. Our study assessed knowledge of COVID-19 among kidney transplant recipients and donors, hitherto unevaluated. METHODS: We conducted a cross-sectional survey among 325 kidney transplant recipients and 172 donors between 1 May 2020 and 30 June 2020. The survey questionnaire assessed knowledge levels of COVID-19, sociodemographic data, health status, psychosocial impact of COVID-19 and precautionary behaviours during the pandemic. RESULTS: The mean COVID-19 knowledge score of the study population was 7.5 (standard deviation: 2.2) out of 10. The mean score was significantly higher among kidney recipients compared to kidney donors (7.9 [1.9] vs. 6.7 [2.6]; P <0.001). Younger age (21-49 vs. ≥50 years) and higher education (diploma and higher vs. secondary and lower) were associated with significantly higher knowledge scores in donors, but not among recipients ( P -interactions ≤0.01). In both kidney recipients and donors, financial concerns and/or social isolation were associated with lower knowledge levels. CONCLUSIONS Concerted efforts are needed to improve COVID-19 knowledge in kidney transplant recipients and donors, particularly older donors, donors with lower education and patients with financial concerns or feelings of social isolation. Intensive patient education may mitigate the impact of education levels on COVID-19 knowledge levels.
Humans ; COVID-19/epidemiology* ; Kidney Transplantation ; Middle Aged ; Singapore/epidemiology* ; Male ; Female ; Adult ; Cross-Sectional Studies ; Health Knowledge, Attitudes, Practice ; Transplant Recipients/psychology* ; Surveys and Questionnaires ; Tissue Donors/psychology* ; SARS-CoV-2 ; Young Adult ; Aged ; Pandemics

Good assessment is crucial for feedback on curriculum and to motivate students to learn. This study was conducted to perform item analysis on the Medical Education Assessment Consortium clinical knowledge mock examination (MEAC CKME) (2011–2016) and to evaluate several effects to improve item quality using both classical test theory and item response theory. The estimated difficulty index (P) and discrimination index (D) were calculated according to each course, item type, A (single best answer)/R (extended matching) type, and grading of item quality. The cut-off values used to evaluate P were: >0.8 (easy); 0.6–0.8 (moderate); and <0.6 (difficult). The cut-off value for D was 0.3. The proportion of appropriate items was defined as those with P between 0.25–0.75 and D ≥0.25. Cronbach α was used to assess the reliability and was compared with those of the Korean Medical Licensing Examination (KMLE). The results showed the recent mean difficulty and decimation index was 0.62 and 0.20 for the first MEAC CKME and 0.71 and 0.19 for the second MEAC CKME, respectively. Higher grade items evaluated by a self-checklist system had better D values than lower grade items and higher grade items gradually increased. The preview and editing process by experts revealed maintained P, decreased recall items, increased appropriate items with better D values, and higher reliability. In conclusion, the MEAC CKME (2011–2016) is deemed appropriate as an assessment to evaluate students' competence and prepare year four medical students for the KMLE. In addition, the self-checklist system for writing good items was useful in improving item quality.
Curriculum ; Discrimination (Psychology) ; Education, Medical ; Humans ; Licensure ; Mental Competency ; Students, Medical ; Writing