title: Revisiting the concept of knowledge: how much is learned by students participating in suicide prevention gatekeeper training?
abstract: BACKGROUND
  Although gatekeeper training is effective at increasing knowledge, some question the effectiveness of these programs due to high pretraining knowledge levels. However, knowledge scores may be artificially inflated when students guess answer options correctly but lack information needed to assist suicidal peers.
  
  
  OBJECTIVE
  To use free-recall questions to evaluate suicide prevention knowledge and compare levels of knowledge using this methodology with established assessment methods in the literature.
  
  
  METHODS
  Free-recall knowledge questions were examined before and after participation in a student gatekeeper training program. Focus groups with students enriched interpretation of quantitative results.
  
  
  RESULTS
  Unlike in studies using forced-choice assessment, students' baseline knowledge was markedly low using free-recall questions and, despite making significant improvement from pretraining levels, posttraining knowledge barely approached passable levels. Focus group findings suggest that training sessions may need to be more engaging and interactive in order to improve knowledge transfer.
  
  
  CONCLUSIONS
  Free-recall questions may provide a less inflated measure of accessible knowledge learned from school-based suicide prevention curricula. Evaluators and programmatic partners should be cognizant of this methodological issue and consider using a mix of assessment methodologies to determine students' actual levels of knowledge after participation in gatekeeper training.
authors.affiliation: 1 Division of Child and Adolescent Psychiatry, The New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA.
authors.forename: Christa D
authors.initials: CD
authors.lastname: Labouliere
authors.affiliation: 2 Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Tarquini
authors.affiliation: 3 Auburn University, Auburn, AL, USA.
authors.forename: Christine M W
authors.initials: CM
authors.lastname: Totura
authors.affiliation: 4 Louis De La Parte Florida Mental Health Institute at the University of South Florida, Tampa, FL, USA.
authors.forename: Krista
authors.initials: K
authors.lastname: Kutash
authors.affiliation: 5 Department of Psychology at the University of South Florida, Tampa, FL, USA.
authors.forename: Marc S
authors.initials: MS
authors.lastname: Karver
mesh_terms: D000293:Adolescent; D005260:Female; D017144:Focus Groups; D020793:Gatekeeping; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011939:Mental Recall; D010379:Peer Group; D012572:School Health Services; D013334:Students; D059020:Suicidal Ideation; D014495:Universities; D000092864:Suicide Prevention
keywords: adolescents; gatekeeper training; open-ended assessment; school; suicide prevention