bluuebunny/crossref_metadata_2025_split huggingface dataset:
High Fidelity Patient Simulations (HFPS) in Medical Physiology Improve Non‐Cognitive Skills in First Year Medical Students
Authors: Harris David , Bellew Christine , Asmar Abdo , Cendan Juan , Johnson Teresa 
Published: June 2021

Non‐cognitive skills (NCS) play a vital role in academic performance, yet they are often undervalued due to large content loads in medical education. Targeting time in a curriculum for students to learn NCS is crucial. Our hypothesis was that HFPS could be used to learn physiology and improve NCS.METHODS120 1st yr med students participated in 3 HFPS. Students were rated by two faculty (1 live, 1 video) using a validated Likert like eval tool (1‐9 from unsatisfactory to outstanding)with 8 categories focusing on TeamSTEPPS principles about patient safety. After each HFPS, all students received a 10 min faculty debrief on physio content. Then 1/2 of the students had student led (SL) debriefs and 1/2 had faculty led (FL) debriefs about NCS. Feedback regarding simulation was also obtained following the module.RESULTSThere was a significant increase in rating scores on 6 of 7 categories on the eval tool, with 1 category eliminated due to missing scores. There was no significant difference between SL and FL debriefs in 6 of 7 categories.

TeamSTEPPS principle
Student Led Debrief Sim 1
Student Led Debrief Sim 3
Faculty Led Debrief Sim 1
Faculty Led Debrief Sim 3

Team is assembled and established
4.0±0.6
5.3±0.3*
4.5±0.8
6.2±0.5*

Delegation of Roles and Responsibilities
3.7±0.5
5.5±0.3*
4.0±0.8
6.3±0.3*

Aware of Environment
4.2±0.4
5.5±0.3*
4.8±0.6
6.3±0.3*

Re‐evaluation and Summarizing
4.5±0.4
5.4±0.3
5.4±0.3
6.6±0.1* &amp;

Shared Mental Model of Patient
4.4±0.4
5.9±0.3*
5.3±0.2
6.4±0.3*

Clear Messages were Provided by Leader
4.0±0.4
5.4±0.2*
5.1±0.6
5.5±0.3

Teams used Closed Loop Communication
3.4±0.5
5.6±0.3*
3.4±0.4
5.3±0.4*

* =P &lt;.05 Sim1 vs Sim 3
&amp; = P&lt;.05 student led vs faculty led

Anonymous student feedback and qualitative interviews indicated that students perceived improved team skills and better integration of physio.ConclusionsThese data suggest that HFPS can facilitate NCS development in med students in the context of learning physio. Additionally, these data suggest that SL and FL debriefs are equally effective at promoting NCS development which may allow limited faculty resources to be utilized more efficiently. Overall, these data suggest that HFPS may be an alternative for NCS development similar to PBL and TBL curricula. Ultimately, improved NCS could help students learn better and increase patient safety.
Optimizing Nutrition Education in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
Authors: Greenblatt Yael , Gomez Sofia , Alleman Gayle , Rico Karen , McDonald Daniel , Hingle Melanie 
Published: June 2021

Research has demonstrated that nutrition education leads to healthier food choices in low‐income populations. WIC provides compulsory nutrition education to clients; however, the most effective way to deliver education remains unclear. The study objective was to explore staff and clients' perceptions of WIC nutrition education. Participants were recruited to focus group discussions from community‐based locations in Tucson, Arizona. Guided by a semi‐structured script, trained interviewers led discussions that were audio‐recorded and transcribed verbatim. Transcripts were coded and analyzed using deductive thematic analysis. Ten focus groups were conducted: 4 with current WIC clients (n=21 participants), 2 with previous clients (n=8), and 4 with staff members (n=25). Results suggested WIC staff struggled to discern clients' nutritional interests within limited time. Both clients and staff thought emotion‐based educational tools and handouts were time‐consuming and lengthy. Clients desired brief lists of toddler‐friendly foods; staff and clients suggested updated nutrition education formats (e.g., videos) with proposed topics including food preparation and child eating practices. Implementing the suggested strategies might enhance effectiveness of WIC nutrition education. These findings will be shared with WIC partners to inform changes to nutrition education.This work was supported by a UA Canyon Ranch Center for Prevention & Health Promotion Faculty Seed Grant awarded to Dr. Hingle in 2013.
Use of a Learning Management System and Related Technology to Improve Physiology Classroom Teaching
Authors: Mulroney Susan , Whitney Jennifer , Myers Adam 
Published: June 2021

Reinforcing complex physiologic concepts is a daunting task as medical and graduate courses increase content while decreasing class lecture time. Our objective is to incorporate technology (lecture capture, short podcasts, Adobe Captivate workshops and tutorials, progressive disclosure cases) into the BlackBoard (Bb) learning management system to decompress lectures while providing formative feedback through online exercises, allowing flipped learning sessions during class. We used four strategies: Bb based podcasts of difficult cardiovascular concepts; Adobe Captivate on Bb for a workshop on bile; a Bb based workshop on acid‐base physiology; and a progressive disclosure case through Bb that allows interactive clinical session in class. Each session includes on‐line questions with answers, to provide immediate formative feedback to the students, as well as in class iClicker questions to assess retention of material and provide more formative feedback. We have developed Bb templates that provide objectives for each session, as well as syllabus, slides, and interactive workshops/podcasts. Evaluation of these on‐line resources and the flipped class sessions has been extremely positive, with >85% of GUMC medical and graduate students reporting that they feel the resources improved the learning environment. Tracking of student utilization of online resources revealed that student use of required exercises approached 100%; student use of non‐required resouces (podcasts and Echo 360 lecture captures) was variable but in most cases these resources were used by the majority of students and feedback in student evaluations was positive. We are currently working on incorporating more of these resources into other physiologic systems.Funded by GU ITEL
Do Spatial Skills Affect Performance in Health Professional Schools?
Authors: Peterson Dana , Holliday Janet 
Published: June 2021

Spatial skills have been shown to be correlated with performance in scientific fields. These skills may be particularly important for high achievement in medical school, where the extrapolation of 2‐dimensional images to 3‐dimensional patients is increasingly important for diagnosis, prognosis and treatment monitoring. Subsets of students, like females, have been shown to score lower on specific tests for spatial skills. In our student sample, females scored significantly lower than males in both spatial skills and anatomy practical exam scores.Our experimental questions included 1) are baseline spatial skills correlated with performance in first year medical/pharmacy school classes, 2) can students who score low in spatial skills improve these skills and class performance with a short, directed schedule of spatial training not related to anatomical study and 3) are improvements in spatial skills correlated with improved performance on assessments in classes in subsequent years.220 participants took a pre‐test of rotational skills (Peters, et al., 1995) at the beginning of their first year of medical and pharmacy training. Participants who were identified as low scoring spatial rotators were compared with participants who were adept spatial rotators throughout their first year of professional school assessments. No significant correlations were found between spatial skills and the first anatomy exam. A participant sub‐group of the low scorers undertook a well‐defined training program to improve spatial skills. This subgroup scored significantly better on their first anatomy practical than students with similar starting spatial scores but no spatial skills training.
Is There A Perfect Assessment For Undergraduate Medical Student Including Anatomy Examination?
Authors: Mustafa Ahmad 
Published: June 2021

ObjectivesThe purpose is to produce a systematic review on the examination methods for medical students. Conclusions will be drawn regarding the bestassessment method, and make recommendations based on the analysis results in order to produce a proposal of the perfect test reliability formula.MethodsThe first search made for the literature review, based on a computerised search of the following electronic databases: MIDLINE, PsycINFO, Pubmed and Google scholar from 1989 to 2014. 131 published studies were analysed. The second search focused on assessments in anatomical science education, which conducted using the “Anatomical Science Education” at the Wiley online database. There are 25 suitable articles. Then, Two studies were focused fully on assessments in anatomy; both included the average reliability coefficient.ResultsThe first search, MCQ dominated, with 45 published articles out of the 131 articles, which represents 30%of the relevant literature. This was followed by 25 on OSCE, 21 on Spotter, 9 on EMQ, 8 on Essay, 8 on True/False, 7 on SBA, 5 on Viva and two SAQ. The average reliability tests were 0.8, 0.65, CI‐95% (0.85 – 0.75), (0.7 – 0.6), MCQ and OSCE, respectively. P‐value is 0.023, which shows a significant difference between the average of the reliability test for MCQ versus OSCE.The second search showed, 33 relevant articles which included anatomy assessment, thirteen (38%) of those articles focused on practical examinations.ConclusionsMCQ and OSCE were found to be dominant in the medical assessment literature, and showed high values for the reliability alpha Cronbach's coefficient. Unlike anatomical assessments, which were dominated by the spotter in the literature, but reliability for this was low.
The Effect of Image Quality on Anatomy Learning
Authors: Mackinnon Chelsea , Fenesi Barbara , Cheng Lucia , Lucibello Kristen , Kim Joseph , Wainman Bruce 
Published: June 2021

Illustrations are critical learning tools in anatomy education. However, evaluation of anatomy image quality is entirely subjective and images display an immense variance in complexity and clarity.The objective of the current study is to determine whether image quality impacts learnability of human anatomy. Undergraduate students with no previous anatomy and physiology background undergo a learning phase where they review two paper‐based instructional modules on independent anatomical material (human hand and eye). There are two versions of each module that vary in image quality, but contain identical text. One version contains low‐quality images the other high‐quality images. The high‐quality images had enhanced visual contrast, label clarity, colour‐coding and consistency in style and anatomical view across images. Immediately following the learning phase, participants are tested on their comprehension of the modules using either 2‐dimensional illustrations or anatomical specimens. Two delayed comprehension assessments are completed 24 and 48 hours later to determine long‐term learning outcomes. We predict higher comprehension scores when material is presented using high‐quality images on both immediate and delayed tests, and on both illustration‐based and specimen tests. Higher quality images will reduce any cognitive demands geared towards identifying and processing critical visual features and structures. As a result, more cognitive resources can be dedicated to consolidating presented information and integrating this new knowledge with pre‐existing information for stable, long‐term learning. This study will help guide medical illustrators to create educational material that maximizes learning.
Simulation‐based training improves non‐technical skills of general surgery residents: a pilot study
Authors: Nguyen Ngan , Elliott John , Watson William , Dominguez Edward 
Published: June 2021

BackgroundFailures in non‐technical skills (NTS) rather than technical expertise are frequently at the root of medical errors in the operating room (OR). NTS are the cognitive (decision making and situation awareness) and interpersonal (communication and teamwork) skills that are recognized, but not formally addressed in surgical training.PurposeTo examine the effect of simulation‐based training (SBT) on NTS performance of surgical residents during laparoscopic cholecystectomy (LC).SettingThe study was carried out in a simulated OR that was arranged with standard equipment for LC, a high‐fidelity patient simulator and a real OR team.Design11 surgery residents completed 2 identical SBT Sessions. For each Session, the resident was briefed on the LC case, completed the case in the simulated OR and debriefed his/her videotaped performance with a content expert.Assessment4 raters, blinded to the residents' PGY level and the order of the videotaped Sessions, reviewed the recordings and scored the residents' NTS using a perioperative Time Out checklist and Intraoperative LC checklist.ResultsScores on both checklists improved from Session 1 to Session 2, p<0.05, suggesting that SBT is effective for improving the NTS that underpin surgical proficiency.ConclusionIt could be reasonably argued that improved NTS of surgeons would reduce medical errors and improve patient safety in the OR.
Exposing the Gaps: A Review of Anatomy Education Literature
Authors: Traser Courtney , Hoffman Leslie , Brokaw James , Wilson Adam 
Published: June 2021

Background & PurposeThis review investigated the thematic nature of articles most commonly published in Anatomical Sciences Education (ASE) so as to propose a research agenda that identifies underrepresented anatomy education research topics.MethodsThe PubMed database was searched for all ASE published articles between January 2008 and October 2014. Articles listed as either “Research Reports” or “Descriptive Articles” were included in the analysis. Frequencies of article prevalence were tallied after categorizing articles according to their title and study aims.ResultsOf the 301 articles analyzed, 75% had a focus in gross anatomy and more than half (57%) were from institutions outside of the U.S. The three principal areas of research focus included ‘development and/or evaluation of anatomy education resources' (28% of articles), ‘teaching methods and approaches' (25% of articles), and ‘body donation/dissection’ (14% of articles). Technology‐oriented studies were also common and a number of research topics, such as virtual microscopy, recurred more than five times.ConclusionThe preliminary findings of this study suggest a greater need for systematic reviews and focused meta‐analyses. This review assimilated 6+ years of research and proposes topics for future study in anatomy education.
Inbred Background Effects On Craniofacial Shape Dysmorphology In Mice With Spry Deletions
Authors: Percival Christopher , Mushegyan Vagan , Tran Dong‐Kha , Klein Ophir , Hallgrímsson Benedikt 
Published: June 2021

A mutation's effect on craniofacial phenotype is modulated by genetic background, but associated developmental interactions are not well understood. Our objective was to quantify the influence of three inbred backgrounds (FVB, 129, BL6) on the expression of craniofacial dysmorphology associated with Sprouty (Spry) 1, 2, and 4 deletions in mice. We quantified adult morphology with landmarks placed on micro‐computed tomography derived surfaces of heterozygote and homozygote knockouts, and unaffected littermates of each background. Within a background strain, mice with two deletions differ strongly from controls, including a visually identifiable rounded cranium and shortened face in Spry 2 homozygotes. Although not as extreme, heterozygotes significantly differ in shape from controls in many cases. Deletion effects are significantly different between background strains after correcting for shape differences in background controls, including a larger reduction of the nasal aperture associated with Spry1 deletion on 129 background versus FVB. Spry 4 deletion on FVB results in a more projected upper face associated with diastema teeth, while the effect of it on C57 is minimal. There are significant background effects on expression of craniofacial dysmorphology associated with Spry deletions, patterns of which can help illuminate how modifier genes can influence the effects of major genetic perturbations.Grant Funding Source: NIH (1R01‐DE021708, DP2‐OD007191, RO1‐DE021420, F30‐DE022482); NSERC (238992‐12); CIHR fellowship through ACHRI to CJP
Tooth Replacement in an Anatomical Context: Studies in the Zebrafish
Authors: Huysseune Ann , Crucke Jeroen 
Published: June 2021

Most non‐mammalians that possess teeth display lifelong tooth renewal. So far, studies aiming to dissect the mechanisms underlying continuous tooth replacement have focused mostly on the molecular cues that may regulate replacement. However, if we wish to fully understand this process, we also need to consider the cellular environment in which teeth develop.We have embarked on studies investigating the vasculature and innervation of the zebrafish pharyngeal dentition (there are no oral teeth), and their respective roles in tooth replacement, using light microscopy, 3D reconstructions and immunohistochemistry. First, we have demonstrated that, while the first‐generation teeth develop before the vasculature has reached the last pharyngeal arch on which these teeth develop, functional teeth become surrounded by an elaborate sinusoidal cavity. Capillaries branching off from this sinusoidal vessel supply replacement teeth at an advanced stage in their development, as they enter the pulp cavity only at late cytodifferentiation. Blocking VEGF, a major angiogenic factor, slows down replacement tooth development but does not prevent initiation of new teeth, suggesting that formation of new blood vessels does not trigger the replacement process. Like the more anterior, gill‐bearing arches, the dentigerous pharyngeal arch is innervated by posttrematic rami of the vagal nerve (NX). Sensory fibers enter the pulp cavity at a late stage of cytodifferentiation, shortly before attachment of the tooth. Autonomous fibers have not been identified so far.Whether nerves follow the vasculature in entering the pulp, as in mammalian teeth, and what the role is of the neurovascular supply in teeth that are renewed anyway, needs further studies.This study was supported by a grant of the IWT‐Vlaanderen to JC.
Combination of Sub‐effective Doses of NMDA and D1 Dopamine Receptor Antagonists Impairs Executive Function in Rats
Authors: Desai Sagar , Allman Brian , Rajakumar Raj 
Published: June 2021

Contemporary research in the pathophysiology of cognitive deficits in schizophrenia has provided a multifactorial view, in which the neurotransmitters dopamine, gamma aminobutyric acid (GABA) and glutamate are disturbed in the prefrontal cortex (PFC) of schizophrenic brains. This view is supported by the fact that current antipsychotic drugs, which are primarily dopamine receptor blockers, are not effective in treating the cognitive symptoms of schizophrenia. We hypothesized that abnormality in dopamine, GABA and glutamate neurotransmissions act synergistically to cause certain cognitive symptoms of schizophrenia. We tested the effect of blockade of all three neurotransmitter systems on executive function using an operant conditioning‐based attentional set‐shifting task to assess behavioral flexibility. In a series of dose‐response studies, we determined the effective doses of the specific antagonists for dopamine D1 receptors (SH‐23390), GABA‐A receptors (bicuculline methiodide) and NMDA receptors (MK‐801). Next, sub‐effective doses were administered subcutaneously 25 min before the set‐shifting task. Our results indicate that while the single antagonist treatments did not impair set‐shifting, combination of sub‐effective doses of SH‐23390 and MK‐801 severely affected performance. Present findings will help to elucidate mechanisms underlying cognitive deficits in schizophrenia.Acknowledgement: Supported by NSERC and the Dept. of Psychiatry, University of Western Ontario.
Nucleosome Dynamics Around a DNA Double Stranded Break During Repair by Gene Conversion.
Authors: Tsabar Michael , Hicks Wade , Haber James 
Published: June 2021

In eukaryotes, double‐stranded break repair (DSB) takes place in the context of chromatin. Saccharomyces cerevisiae mating type (MAT) switching provides an opportunity to investigate nucleosome dynamics around a well‐characterized DSB. MAT switching is initiated by synchronous induction of a DSB by HO endonuclease at the MAT locus following which the DSB ends are resected and the Rad51 recombinase is loaded on the 3‐ended single strand. Rad51 facilitates strand invasion with a homologous donor sequence, which is required for initiation of new DNA synthesis and the resulting repair.A hurdle in studying nucleosome positioning around the MAT locus has been the weak nucleosome positioning around the MAT locus relative to the heterochromatic donors HML and HMR. To address this hurdle we designed a novel system in which we inserted the Xenopus laevis 5S nucleosome positioning sequence adjacent to the MAT locus. Using this system we have, for the first time, monitored the loss of chromatin protection following resection of the DSB end and the re‐establishment of chromatin structure following repair. We show that nucleosome protection is lost around a DSB in a resection‐dependent manner. Further, we show that nucleosome protection is reestablished following repair of a DSB but not to the level of protection seen prior to induction of a DSB. This reestablishment depends on repair of the DSB and not on passage through the cell cycle. We show that complete protection is reestablished after several cell cycles, suggesting that there is a mechanistic difference between repair‐dependent and replication‐dependent nucleosome positioning.
Lack of Glucocorticoid Receptor Hypersensitivity‐Related Polymorphisms in an Undergraduate Population
Authors: Leibovitz Evan , Cohen Brian 
Published: June 2021

Many phenotypic similarities exist between Cushing's Syndrome (CS) and Metabolic Syndrome (MetS). As the main diagnostic criterion for CS is elevation of the steroid hormone cortisol, a glucocorticoid, we hypothesize that MetS, in some cases, represents a CS like state in the absence of elevated cortisol. One potential mechanism by which this could occur is elevated sensitivity to glucocorticoids as a result of mutation of the glucocorticoid receptor (GR).Two particular polymorphisms of the GR that correlate with hypersensitivity to cortisol are the asparagine to serine mutation at the 363rd codon of the receptor gene (N363S) as well as a mutation at the BclI site on the second intron of the receptor gene. The objective of this study was to investigate the presence of these two polymorphisms of the human glucocorticoid receptor that are associated with hypersensitivity to cortisol in a population of college students.Student DNA was isolated using a chelex isolation method from buccal (cheek) cells. A novel set of allele specific primers were designed to detect the two hypersensitivity‐causing polymorphisms. Using polymerase chain reaction (PCR), in a population of white, non‐obese, college aged students neither heterozygotes nor mutant homozygotes of the two GR alleles were detectable.Our finding of a prevalence of zero is not surprising as our population of non‐obese students is unlikely to have cortisol hypersensitivity. This is evident by their normal range BMIs and lack of MetS and CS like symptoms. However, the population did allow us to test the specificity of the PCR method we developed. Future research will investigate the prevalence of the polymorphisms in morbidly obese adults seeking bariatric surgery and it is expected that the mutant alleles will be detected in this population.