I recently attended a meeting where a keynote speaker talked about "knowledge neglect." I was not sure what this meant as she started, but I became intrigued by the idea of neglecting knowledge and decided to read about it. Knowledge neglect was first studied as a phenomenon that occurs when we actually know what is correct but we are responding incorrectly because of a distraction caused by something in the statement or question we are reading or hearing. Researchers have used a variety of methods to examine knowledge neglect, including the classic question: How many animals of each kind did Moses take on the ark? The answer of course is none. Moses did not have an ark. However, typically many respondents skip over the part of the question that attributes to Moses the act of taking animals on the ark because we "know" the answer is two animals of each kind. We, in fact, neglect information we know because we are distracted by the first part of the question (Erickson & Mattson, 1981).

The classic example above seems to me to be mostly about skipping important information (Moses instead of Noah), something I am certain happens quite often. However, in my reading, I learned that neglecting knowledge has a lot to do with people being misled by misinformation. Our recent history with all manner and type of public media demonstrates that, for many, if it is written, or perhaps spoken, there is an assumption of truth (Fazio et al., 2015). As noted by researchers who study knowledge neglect, rarely do we examine our existing knowledge base to evaluate the truthfulness or adequacy of new information. Rather, we accept what we read or hear as true, and then we repeat that misinformation in our own writing and speaking; we neglect true knowledge in favor of misinformation. Clearly, this is a problem for all; it is a particular problem for scientists whose work is knowledge, both its development and its dissemination.

Much research has been conducted on knowledge neglect. Most recently, researchers have focused on misinformation spread on social media and in other public venues. Worries about misinformation increase when the misinformation is spread via social media such as through tweets and retweets and by unregulated "influencers" (Suarez-Lledo & Alvarez-Galvez, 2021). Unfortunately, misinformation is also spread in the scientific literature. Clearly the spread of misinformation is concerning on several levels. What is most worrisome from the knowledge neglect research is the consistent finding that exposure to false information increases the perception that the information is true (Brashier & Marsh, 2020) and thus to the further spread of false information (Fazio et al., 2019). That is, people tend to incorporate misinformation into their own thinking and then to promulgate it even when it goes against what they already know to be verifiably true.

As a nursing scientist, my concern is that there seem to be quite a few pronouncements about what is "true" related to human health and well-being that lack significant, substantiated, replicable data from rigorously conducted research. As a reader of thousands of research papers every year, I am often struck by the misleading tone of "truth" presented in papers, even though the support of many truth claims are weak and largely unverifiable. I worry that, once read, inaccurate or unconfirmed "findings" become incorporated into the "knowledge" of the discipline. I worry that, as scientists, we continue to accept what we read as true, basing our own work on misinformation and recommending the "truth" of that misinformation to practitioners and policy makers.

As scientists, one of our tasks is to protect against the adoption and dissemination of misinformation. This is easier said than done based on the extensive research conducted on knowledge neglect (Salovich et al., 2022). Apparently, passive evaluation of what we read, which is what often happens when we read research, does not prevent the adoption of misinformation as true. However, there is evidence that deliberate evaluation with thoughtful consideration of the accuracy of the information can reduce misinformation uptake. One strategy for deliberate evaluation is to "fact-check" what we read for accuracy. This requires that readers actually know the "facts" that have been generated from well-validated research findings. It also requires that readers are not reading for interests (i.e., political statements, etc.) or ideas (i.e., assumptions about people or conditions, etc.) that may personally resonate with beliefs but not necessarily with facts; self-interests and notional ideas will adversely affect deliberate evaluation. Furthermore, although reading for accuracy may reduce uptake and dissemination of misinformation, how this actually happens is not entirely clear. In a recent set of experiments, Salovich et al. (2022) demonstrated that participants were more likely to answer questions with incorrect information after prior exposure to that information, especially if the information was less familiar to them (i.e., novel, startling ideas), and, conversely, to answer correctly after exposure to true information, especially when the information was familiar (i.e., affirmation of well-established research facts). Thus, although false information influenced uptake and further spreading, deliberate evaluation of accuracy by comparing what was read to existing knowledge reduced the belief in and use of misinformation.

There are many lessons here. First, it is clear that knowledge accuracy-and thus knowledge use-is limited by what the reader already knows. Scientific knowledge comes from rigorously conducted research. Furthermore, to be known, knowledge must be widely disseminated, preferably under judgment-free conditions. We cannot wish for something to be true, or believe something to be true, or act as if something is true when it is not or when it is not verified. There must be strong evidence for truth, especially in nursing science, where the practice of nursing and the health and well-being of the public are ultimately affected. As scientists, we need to conduct rigorous research and disseminate it widely, perhaps especially to students who will need to use that knowledge for safe and efficacious practice and as the basis for evaluating exposure to other knowledge claims.

I am curious about the knowledge we, well-informed scientists, might be neglecting in the research we read? Do we suppose that we, or the readers of our work, understand the foundational knowledge necessary to judge research claims? How would we, or they, have attained that understanding? Surely, knowledge appraisal is more than evaluating "evidence," as it is currently taught in many of our undergraduate nursing programs. Accurate knowledge appraisal must also include having learned the vast depth and breadth of facts and other truths that have been discovered, learned, and transmitted over the years, forming the basis of our professional and disciplinary knowledge. This is not to say that today's facts and truths might not be discovered false tomorrow; scientific knowledge constantly evolves (Pickler, 2021). However, even as we understand the fallibility of scientific truth, we cannot accept all newly written statements, including those found in research reports, as true without first comparing those statements to what is already known and without evaluating the credibility of the science from which the statements emanate. We cannot simply, because of the popularity of an idea or even the seeming significance of an idea, accept that idea as truth without substantial research supporting the idea's veracity.

Knowledge neglect is an important topic that should perhaps be considered throughout all aspects of our professional (i.e., teaching, practice, and policy) and disciplinary (i.e., scientific research) work. We should certainly be teaching students theoretically derived "facts" about health and human well-being-what it is, how it is obtained and sustained, what affects it and how; this is the foundation of nursing. We should also be teaching students and perhaps ourselves how to deliberately evaluate new information from high-quality research reports, comparing new knowledge to existing knowledge. We should also carefully monitor what we write and how we write it, as well as what we read and how we use what we read in order to ensure that we have not neglected known knowledge in favor of "sexy," high-profile misinformation. In an age where so much information is so readily available, it is challenging to engage in thoughtful deliberation of that information. It takes time and care to be thoughtful and deliberate. I think, though, if we are not deliberately thoughtful, we will find ourselves lost in misinformation and thus of little use to those who depend on us for safe, accurate, meaningful, verifiable knowledge to help them stay well, prevent illness, or manage illness to the best possible outcome. We cannot afford to fall prey to knowledge neglect.

ORCID iDs

Rita H. Pickler https://orcid.org/0000-0001-9299-5583

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