Research on biofilms is predominantly made in in vitro contexts. However, in vivo observation of biofilms in human chronic infections shows distinct differences compared to in vitro biofilm growth. This could imply the use of an inadequate mental model both in research and healthcare practices. Drawing on knowledge from the cognitive sciences, we hypothesise that the predominance of in vitro research on biofilms is skewed towards a mental model promoting wrong inferences for researchers and healthcare professionals (HCPs) in the in vivo context. To explore the prevalence of such a mental model, we carried out a qualitative image analysis in which biofilm illustrations from a Google image search were coded for typical in vitro or in vivo characteristics. Further, to investigate potential misinformed and unhelpful clinical interventions related to biofilms, we conducted a quantitative questionnaire among HCPs. The questions were designed to test whether knowledge about in vitro biofilms was used in an in vivo context. This questionnaire was analysed through a chi-squared test. Most biofilm illustrations were consistent with the in vitro model. A statistical analysis of survey responses revealed that HCPs have adequate knowledge about biofilm but often respond incorrectly when asked to apply their knowledge to in vivo contexts. The outcome of this research points to a prevalent and consolidated mental model derived from in vitro observations. This model has likely been made dominant by HCPs’ frequent exposure to visual depictions in articles and presentations. The prevalence of the in vitro model sets up the possibility of erroneous claims when the in vitro model is inadequately applied to in vivo contexts. This has potential implications for HCPs working in fields involving biofilm, such as wound care treatment.

中文翻译：

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心智模型对生物膜慢性感染治疗和研究的影响

对生物膜的研究主要是 在体外 环境中进行的。然而， 与体外 生物膜生长相比，人类慢性感染中生物膜的体内观察显示出明显的差异 。这可能意味着在研究和医疗保健实践中使用了不适当的心理模型。利用认知科学的知识，我们假设生物膜体外研究的主导地位偏向于促进研究人员和医疗保健专业人员 (HCP)在体内进行错误推断的心理模型语境。为了探索这种心理模型的普遍性，我们进行了定性图像分析，其中对来自 Google 图像搜索的生物膜插图进行了编码，以获得典型的体外或体内特征。此外，为了调查与生物膜相关的潜在误导和无益的临床干预措施，我们在 HCP 中进行了定量问卷调查。这些问题旨在测试有关体外生物膜的知识是否用于体内环境。该问卷通过卡方检验进行分析。大多数生物膜插图与体外实验一致模型。对调查响应的统计分析表明，HCP 对生物膜有足够的了解，但当被要求将他们的知识应用于体内环境时，往往会做出错误的反应。这项研究的结果指出了一种源自体外观察的普遍而统一的心理模型。由于 HCP 经常接触文章和演示文稿中的视觉描述，这种模式很可能占据主导地位。的患病率在体外模型集合起来的时候错误权利要求的可能性的体外模型没有被充分施加到体内的上下文。这对在涉及生物膜的领域（例如伤口护理治疗）工作的 HCP 具有潜在影响。