Evolutionary science has consequences for individuals and society, ranging from the way we interpret human behavior to our notions of spirituality and the purpose of our existence. Popular portrayals of evolution depict a paradoxical theory, a source of knowledge and human connections, but also a threat to our humanity and freedom. Using quantitative and qualitative methodology, we examined how college‐educated adults (n = 135) from diverse ethnic and religious backgrounds perceive the impact of evolutionary theory on individuals and society. We identified a continuum of perspectives, ranging from strong creationist to strong evolutionist. Using the model of “knowledge as an ecology” (Demastes, Good, & Peebles, Science Education, 79, 637–666, 1995; Nardi & O'Day, Information ecologies: Using technology with heart, MIT Press, Cambridge, MA, 1999), we examined the relationships among participants' beliefs, their perceptions regarding the social and personal impact of evolutionary theory, their prior exposure to and knowledge of evolutionary theory, and their opinions regarding the teaching of evolution. Evolutionists and creationists differed in their prior exposure to evolutionary theory, and their opinions about some aspects of teaching, but showed striking similarities regarding perceived impact. All groups viewed the consequences of accepting evolutionary principles in a way that might be considered undesirable: increased selfishness and racism, decreased spirituality, and a decreased sense of purpose and self‐determination. From a science education perspective, this one‐sided interpretation is troublesome because it runs counter to the available evidence and theories in evolutionary science, and we consider ways of fostering more balanced presentation and appraisal of evolutionary theory. © 2003 Wiley Periodicals, Inc. Sci Ed 87:181–206, 2003; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/sce.10045

BackgroundDespite evidence that decision and communication aids are effective for enhancing the quality of preference-sensitive decisions, their adoption in the field of orthopaedic surgery has been limited. The purpose of this mixed-methods study was to evaluate the perceived value of decision and communication aids among different healthcare stakeholders.MethodsPatients with hip or knee arthritis, orthopaedic surgeons who perform hip and knee replacement procedures, and a group of large, self-insured employers (healthcare purchasers) were surveyed regarding their views on the value of decision and communication aids in orthopaedics. Patients with hip or knee arthritis who participated in a randomized controlled trial involving decision and communication aids were asked to complete an online survey about what was most and least beneficial about each of the tools they used, the ideal mode of administration of these tools and services, and their interest in receiving comparable materials and services in the future. A subset of these patients were invited to participate in a telephone interview, where there were asked to rank and attribute a monetary value to the interventions. These interviews were analyzed using a qualitative and mixed methods analysis software. Members of the American Hip and Knee Surgeons (AAHKS) were surveyed on their perceptions and usage of decision and communication aids in orthopaedic practice. Healthcare purchasers were interviewed about their perspectives on patient-oriented decision support.ResultsAll stakeholders saw value in decision and communication aids, with the major barrier to implementation being cost. Both patients and surgeons would be willing to bear at least part of the cost of implementing these tools, while employers felt health plans should be responsible for shouldering the costs.ConclusionsDecision and communication aids can be effective tools for incorporating patients preferences and values into preference-sensitive decisions in orthopaedics. Future efforts should be aimed at assessing strategies for efficient implementation of these tools into widespread orthopaedic practice.Electronic supplementary materialThe online version of this article (doi:10.1186/1472-6963-14-366) contains supplementary material, which is available to authorized users.