Are First Answers Right?
An instructor at a medical school
gave his new students some advice
before they began an examination:
“Once vou’ve marked an answer as
correct, don't change it. The odds are
vou w ill lower your score.”
It was the kind of advice that has
been given students for more than
half a century. But was the instructor
right?
A brief study of examination data
at the Eastern V'irginia Medical
School seems to show conclusivelv
that the instructor was wrong.
Indeed, the advice he gave is a myth:
answer changes go more frequently
from correct-to-wrong than from
wrong-to-correct.
Dr. Richard E. Davis, psychiatry
professor at the school, recently
found that of the total answer
changes made by students,
incorrect-to-correct changes
occurred al^)ut 2.8 times as often as
did correct-to-incorrect changes.
Davis points out that other
investigators have come to a similar
conclusion: no matter how persistent
the belief that first impression
answers on objective examinations
are so dependable that subseciuent
changes more often result in a loss
than in a gain of credits, there is little,
if any. objective data to support it.
Moreover, the scientific literature
almost always identifies the mvth as
verbal in origin.
Whv is it that students can lietter
their scores by changing their
answers?
"Speculation as to why answer
changes are more frequently
beneficial than not," Davis writes,
“seems to include the possibility of
subliminal stimulation of stored
information.”
BEGINNINGS OF A SHOE—Felton Elliott has broken the mold from around the cast
of a patient's foot. From this cast and the one for the other fopt, he will make special
shoes to fit the patient's misshapen feet. The Limb and Brace Shop, one of a number
in the country, has helped numerous amputees resume almost normal lives.
Limb and Brace 'Carpenters' Reshape Lives
By David Williamson
On a wintery morning in Rome,
Ga., a year and a half ago, a rural
road lay covered by a thin film of ice
and snow.
When two young Georgia men on a
quail hunting trip rounded a curve in
a pickup truck, their vehicle lost
traction and skidded head-on into a
large flatbed trailer rig hauling 43
tons of granite slabs.
Johnny Wilson, 25, was thrown
from the pickup as it spun across the
roadway, and he slid beneath the
heavy-duty tires of the larger truck.
The cruel wheels cut away a
quarter of him just below the waist.
Although emergency medical aid
saved his life, by August of 1974,
Wilson had almost given up the idea
of ever walking again. One of his legs
was gone along with part of his pelvis,
and experts in Atlanta and
Chattanooga told him he couldn’t be
fitted with an artificial limb since he
had no stump on which to attach any
such device.
Following the suggestion of a
friend, he contacted the medical
center’s Department of Prosthetics
and Orlhotics; otherwise known here
as “the limb and brace shop.”
Director Bert Titus suggested that
Wilson make the 350-mile journey to
Durham, and they’d see what could
be done.
Less than two months later, Wilson
was walking once again. Now, in spite
of “phantom pains” — discomfort
which seems to originate in his
severed leg — the young man hunts,
fishes and hikes as he used to before
the accident.
“I feel I’ve been slowed down
some,” he said, “but I haven’t been
stopped by a long shot.”
A History of Helping
ntcucom
is published weekly for Duke
University Medical Center employees,
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Medical Center's Office of Public Relations.
Joe Sigler, director: William Erwin, medical
writer; Miss Annie Kittrell. secretary.
Editor
David Williamson
Associate Editor
Margaret Howell
Public Relations Advisory Committee; Sam
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ArxJerson Jr.. surgery; James L. Bennett Jr..
vice president's office; Wayne Gooch,
personnel; Dr. Athos Ottolenghi. physiology
and pharmacology: Michael Schwartz,
hospital administration; Miss Isabelle Webb.
RN. nursing service: Dr Tom C. Vanaman.
microbiology and immu nology.
SUPPORT FOR A CHILD—Bert Titus, right, examines a Milwaukee braice being built
by Bill Harris. The brace is for a child, a victim of scoliosis, or curvature of the spine.
(Photos by Thad Sparks)
A History of Helping
Helping people to have the use of
limbs after their own have been
removed as a result of disease or
accident and helping children with
congenital birth defects grow to
productive adulthood has been the
goal of the limb and brace shop since
its founding in the early ’30’s.
Director Titus explained that
orthotics is the science of making and
fitting orthopaedic braces for the
support of weakened body parts and
the correction of bodily defects.
Prosthetics, he said, is the science of
making and fitting artificial limbs.
The use of man-made limbs and
braces is probably as old as accidents,
warfare and birth defects, he
suggested.
“In prehistoric times, ancient man
undoubtedly made splints for broken
arms and legs and constructed
wooden legs for those who had lost
the ones they were f)orn with,” Titus
said.
And the care of the congenitally
deformetl has often reflected the
political and cultural ideas of the
times. Under a line of pharoahs in
ancient Egypt, a powerful military
state simply exterminated imperfect
babies. The same was true in Nazi
Germany under Adolf Hitler.
Titus said that before artillery
made armor obsolete, armorers were
the chief artificial limb makers. Later,
locksmiths, physicians, watchmakers
and carpenters all made
tontributions to the science.
Although most of their incisions
are unintentional today, barbers
frequently doubled as surgeons
during the Middle Ages in Western
Europe. Since the creation of an
artificial limb is dependent on the
skillful surgical creation of a useful
stump, most of the early prostheses
were unsatisfactory.
The stumps of amputees weren’t
closed surgically, Titus said. Rather,
they were immersed in boiling oil or
simply crushed to stop bleeding. It’s
not surprising then, that before the
advent of sterile techniques, at least
75 per cent of all surgical procedures
resulted in death at that time.
Professional Requirements
Today, prosthetists and orthotists
are highly-specialized professionals
and the requirements for becoming
certified are becoming more
demanding each year.
“Currently,” Titus said, “a
candidate must have either an
associate of arts or a bachelor’s
degree. Four years of on-the-job
training preceed certification by the
American Orthotic and Prosthetic
Association, and 15 hours of
continuing education are required
yearly to maintain the rating.”
Duke’s limb and brace shop
currently employs 19 people,
including four certified prosthetists,
four certified orthotists, several who
are about to take their examinations,
clerical personnel and a corseteer.
Titus, who serves as professor in the
School of Medicine, is certified in
both specialties.
The people who go into either of
these closely related fields come from
(Continued on page 4)
Personnel Invites Employees
To Phone-In Change Requests
Since its recent reorganization and
accompanying changes of IcKation,
the Personnel Department is urging
employees to save steps whenever
possible by calling in changes for
their personnel records.
According to Richard Bindewald,
personnel director of benefits and
records, “we want to give assistance
with a minimum of inconvenience to
our personnel. We are encouraging
employees to use the telephone
whenever possible to make any
necessary changes in their personnel
records.”
The Benefits and Records Office of
the department, which serves
employees both on campus and at the
medical center, was centralized
recently by a move to room 160 in the
Bell Building.
Bindewald stated that the move
was made primarily to provide more
space to house records previously
kept at several locations throughout
the university. Now, he said, the
department wants to encourage all
employees to use the telephone for
records changes so that “we may
render service with a minimum effort
on the part of the employees.”
Employee changes of address can
be called in to the department,
Bindewald said, as well as some other
changes which an employee might
wish to make in his records.
“Information about any of the
fringe benefit programs can and will
be provided by phone from this
office,” he said. “However, if a person
desires a more confidential discusaon
dealing with fringe benefits or
payroll, we will be pleased to have
them make an appointment or drop
by.”
The Benefits and Records Office
has three extensions which may be
used for questions from employees:
684-6086,684-3033 and 684-6723.