Category: Nevin Manimala

FASEB J. 2022 May;36 Suppl 1. doi: 10.1096/fasebj.2022.36.S1.R4751.

ABSTRACT

At the onset of the COVID-19 pandemic, many traditional in-person courses were converted to synchronous, asynchronous, or hybrid online formats. Instructors of a large undergraduate Basic Human Anatomy course at Indiana University – Bloomington leveraged these changes to convert the lecture portion of the course to a flipped-classroom model with two components: asynchronous online course content delivery, and live in-person interactive learning sessions. The in-person interactive learning sessions introduced students to active learning strategies and techniques (drawing, memory matrices, flow charts, diagrams, etc.), and the students actively participated in these sessions through the use of an online interactive learning platform – TopHat. Here we sought to assess the efficacy and outcomes of the active learning sessions on student performance in the course. Basic Human Anatomy (ANAT-A215) is a 5 credit hour undergraduate (baccalaureate) course that has an enrollment of 480 students with 1 large lecture section and 12 smaller lab sections. In Fall 2021, the instructors modified the lecture component of the course into a flipped classroom format. Lecture content was delivered via asynchronous online lectures, and the F2F class time was listed as optional (but strongly encouraged) for attendance. To facilitate greater student-instructor interaction, one half of the class attended on Mondays and the other half attended on Fridays, and participated in similar interactive sessions. Wednesday F2F interactive lecture sessions were open to the entire class. To encourage attendance and participation in the optional F2F interactive lecture sessions, extra credit points could be earned through participation in TopHat anatomy questions. Points were earned for participation only (.5 points per question). TopHat questions were created by the instructors and consisted of both lower order and higher order questions that tested lecture and lab anatomical content. At the end of each lecture exam block of material, the instructors selected multiple TopHat questions at random for extra credit, with a range of 2-4 extra credit points that could be earned per exam block. We found a statistically significant positive correlation between the number of points accumulated for participating in the F2F active learning lecture session questions and lecture exam scores. Using the number of points accumulated via the TopHat questions as a proxy for lecture attendance, we found that more TopHat points accumulated by students resulted in higher mean lecture exam scores – the greatest benefits occurring if students participated in multiple (>3) F2F lecture sessions per block. Students who regularly attended F2F interactive sessions saw the greatest gains in their lecture exam scores. These findings indicate that active learning strategies could be efficacious in supplementing an asynchronous lecture content delivery format. We shared our findings with the class to encourage them to attend the active learning sessions, but encouraging some student populations to attend these sessions remains a challenge. Future research should be conducted on methods to encourage student involvement and participation in the course.

PMID:35557326 | DOI:10.1096/fasebj.2022.36.S1.R4751

FASEB J. 2022 May;36 Suppl 1. doi: 10.1096/fasebj.2022.36.S1.R4775.

ABSTRACT

One key issue in medical education is medical student fear of learning and applying neuroanatomy called neurophobia. In a previous study, we found a negative correlation between neurophobia and neuroanatomy self-efficacy (one’s confidence in their ability to complete neuroanatomy tasks). Our findings suggest increasing neuroanatomy self-efficacy may reduce one’s neurophobia. Additionally, the literature shows self-efficacy improves academic achievement and clinical performance in medical school. It is unknown whether experiences before medical school may later influence medical student neuroanatomy self-efficacy. This study aims to fill this literature gap by isolating which premedical experiences most significantly influence neuroanatomy self-efficacy. We hypothesize medical students with premedical neuroanatomy-specific experience will exhibit greater neuroanatomy self-efficacy than students without this experience. Instrumentation to measure neuroanatomy self-efficacy and categorize premedical experiences was developed and administered to medical students (n=233). Premedical experiences were categorized as: neuroscience (NSC), neuroanatomy (NAC), neuroscience and neuroanatomy (NSAC), cadaveric gross anatomy (GR), or anatomy and physiology (AP). An analysis of variance with a Tukey’s post-hoc test was performed to isolate which premedical experience(s) showed significant differences in neuroanatomy self-efficacy compared to students with no previous experience. All statistical tests were performed at the p=0.05 level. IRB approval was obtained. Data analysis showed indirect premedical neuroanatomy exposure as part of a premedical gross anatomy course (GR) resulted in greater neuroanatomy self-efficacy (p=0.01, Cohen’s d= 0.50) compared to students with no previous experience. Interestingly, enrollment in a premedical molecular neuroscience (NSC) or neuroanatomy (NAC) course individually did not show an increase in neuroanatomy self-efficacy. Only medical students with both premedical NSC and NAC experiences (NSAC) demonstrated higher neuroanatomy self-efficacy than students with no premedical experience (p= 0.001, Cohen’s d= 0.52). Premedical exposure to neuroanatomy as part of a gross anatomy course (GR) or enrollment in both premedical neuroanatomy andneuroscience courses (NSAC) appears to be associated with higher neuroanatomy self-efficacy in medical students. Considering the decline in neurologists, and fewer medical students choosing neurology, these findings support youth STEM initiatives to provide increased access to both neuroscience and neuroanatomy experiences along with cadaveric gross anatomy.

PMID:35557316 | DOI:10.1096/fasebj.2022.36.S1.R4775

FASEB J. 2022 May;36 Suppl 1. doi: 10.1096/fasebj.2022.36.S1.R6090.

ABSTRACT

Roleplay is a technique that allows students to explore realistic situations by interacting with others in a managed way, in order to develop experiences, skills, and test different strategies in a learning environment. In the teaching of clinical anatomy, the use of this teaching methodology as a tool is scarce. Thus, we implemented the use of this technique as a strategy in the teaching and learning process. The objective of this paper was to report our experience based on the use of the roleplay technique in the teaching and learning process of clinical anatomy. An exploratory, cross-sectional study with a quantitative approach was carried out with 61 students from the anatomy discipline. To carry out the proposed activity, the students were divided into four groups, in which each one planned a clinical anatomy situation. To meet these objectives, Roleplay was structured in three parts: planning the implementation of the roleplay technique, application of roleplay, and debriefing. The results showed that roleplay can be used adequately in the teaching of clinical anatomy. It was observed that 98.1% of students approved the use of the technique in teaching anatomy. It was found that 95.1% of respondents reported that the roleplay achieved the learning goals, while 4.9% reported that the learning goals were not achieved. There was no statistically significant difference between the participants’ ages (p>0.05). It was found that 86.9% of respondents would recommend the use of roleplay as a teaching methodology for the next semester. It was found that roleplay is a playful, versatile, and totally viable and feasible teaching methodology as a tool in the teaching and learning process of clinical anatomy. In addition, this training contributes to discussions and reflections in the teaching-learning process, especially regarding the use of active teaching and learning strategies.

PMID:35557322 | DOI:10.1096/fasebj.2022.36.S1.R6090

FASEB J. 2022 May;36 Suppl 1. doi: 10.1096/fasebj.2022.36.S1.0R412.

ABSTRACT

The Fishbowl is an active teaching methodology whose group discussion format promotes dialogue and exchange of experience among session students and allows everyone to have an equal chance to express their opinions and views during class. So, we use this method to teach endocrine system anatomy to undergraduate students. However, there is little evidence of the use of this methodology to guide teachers on the best way to implement the Fishbowl in teaching anatomy. Based on these premises, the objective of this work was to report our experience based on the use of the Fishbowl technique in the teaching and learning process of the anatomy of the endocrine system. A quasi-experimental study with a quantitative approach was carried out with students from the discipline of anatomy of the endocrine system. The technique used was the open fishbowl in online mode. For data analysis, we used the relative frequency and the Mann Whitney test with the aid of the Graph Pad Prism version 7.0 program, with the data with a value of p<0.05 being considered significant. It was observed that there was no statistically significant difference between the participants’ ages (p>0.05). In our studies, we found that Fishbowl was more effective for teaching undergraduate anatomy than traditional teaching (p<0.05). The Fishbowl proved to be a satisfactory teaching technique for students when compared to the traditional class. We found that students who participated in the Fishbowl got statistically significantly more questions on the test when compared to students in traditional education (p<0.05). It was found that the Fishbowl allowed the educational process to be carried out with greater interaction in a more playful way. In addition, students became protagonists in the teaching and learning process, participating more effectively in classes. Thus, the Fishbowl becomes another active tool in the process of teaching and learning anatomy.

PMID:35557314 | DOI:10.1096/fasebj.2022.36.S1.0R412

FASEB J. 2022 May;36 Suppl 1. doi: 10.1096/fasebj.2022.36.S1.R4007.

ABSTRACT

BACKGROUND: Since the seventeenth century, the primary approach to teaching anatomy has involved hands-on learning using cadaveric specimens. However, the ability to use this long-standing tradition was curtailed in the 2020-2021 school year due to the COVID-19 pandemic. Many institutions closed physical classrooms entirely, launching experiential courses, such as anatomy, into the online space.

HYPOTHESIS: We hypothesized that Q-methodology could be used to uncover student perceptions of an introductory anatomy and physiology course that was offered online for the very first time.

METHODS: Q-methodology, considered the study of subjectivity, is an approach that statistically uncovers groups of individuals with shared perceptions within a larger cohort. Instructors can use Q-methodology to identify groups of students with shared needs, allowing for more specific and productive course reform. In the current study, Q-methodology was used as a means of course evaluation in the fall 2020 and winter 2021 semesters. Students were asked to sort 44 opinion-based statements in a quasi-normal table based on their level of agreement. By-person factor analysis of 166 responses revealed three statistically distinct groups of students.

RESULTS: The three groups were assigned the following monikers: Connected and Contented (CC), Disconnected and Disgruntled (DD), and Interconnected and Collaborative (IC). CC students (n=66) felt generally ambivalent toward course components and were comfortable with the technology skills required to participate in the online course space. DD students (n=50) were deeply unhappy with several elements of the course, including lectures, assignments, and evaluations. These students also felt as if they were teaching themselves. Finally, IC students (n=29) looked favourably upon the tutorial space and the role of teaching assistants. Analysis also revealed that some sentiments were shared across all three groups, including the preference for physical rather than virtual specimens, and the desire for more practice questions from faculty in order to prepare for bellringer exams. Interestingly, cohort opinions did not remain static across both semesters. There was a positive attitude shift as more students felt “Disconnected and Disgruntled” in the fall, and “Connected and Contented” in the winter.

CONCLUSIONS: These findings are useful for anatomy instructors interested in transitioning courses to an online or blended space, particularly in the face of ever evolving public health restrictions. The current study also models the wealth of information that can be uncovered using Q-methodology – useful for anyone interested in the previously amorphous study of subjectivity.

PMID:35557298 | DOI:10.1096/fasebj.2022.36.S1.R4007

FASEB J. 2022 May;36 Suppl 1. doi: 10.1096/fasebj.2022.36.S1.R4522.

ABSTRACT

Reciprocal peer teaching is a prominent pedagogical approach utilized across medical education to counteract reduction in gross anatomy contact hours. Traditionally, the roles of peer teacher and peer learner are alternated among students within a dissection group. This instance of reciprocal peer teaching was examined during Covid protocol, which prompted a third role, non-participants. Non-participants were students not present during peer teaching sessions due to enforced limitations on the number of students present at a table at a given time for social distancing. The purpose of this study was to examine the impact of student role (teacher, learner, or non-participant) during reciprocal peer teaching on performance of 1^st year medical students (n=34). The context of the study was a 10 week Human Gross Anatomy course taken first in the 1^st year medical student curriculum. Twenty-two peer teaching sessions were video recorded across the 4 blocks of anatomical content which resulted in (n=131) instances of reciprocal peer teaching. Peer teaching videos were cross-referenced to track student role during a given session and whether or not an anatomical structure was taught or not by cross-referencing the associated dissection structure list. Medical students throughout the course took 4 block laboratory practical exams which were collected and coded for student role, whether a question was answered correct or not, and if it was taught or not during the recorded peer teaching session. A GEE (generalized estimating equation) was used to determine if student role during reciprocal peer teaching sessions had a statistically significant effect on their likelihood to correctly answer lab practical questions, i.e., their performance. The factor role in the model was statistically significant (Wald χ² = 34.95 (2), p<0.0001) and indicated that those in the role of peer teacher had 4.14 times more likelihood to correctly answer lab practical questions. In practicality, this equated to an average increase in mean lab practical answers correct of 13% for peer teachers compared to peer learners, whereas peer learners only had a 3% increase in mean lab practical answers correct compared to non-participants. Given that peer teachers had to be involved in the hands-on dissection of the anatomical content for their given peer teaching session, the boost to their performance is not surprising. What is surprising is the marginal difference between peer learners and non-participants. These results may indicate that even though reciprocal peer teaching is premised as an active learning pedagogy, just because it is implemented doesn’t mean the peer learners are participating actively during teaching sessions and were largely passively being taught structures. A suggestion to increase peer learner benefit would be to allocate time for them to have an opportunity to identify and teach structures back to the peer teacher to increase their own retrieval practice. Future directions may incorporate the role of peer teacher as a facilitator rather than a passive lecturer, allowing the peer learners opportunities to become more actively involved in their own learning during reciprocal peer teaching sessions.

PMID:35557289 | DOI:10.1096/fasebj.2022.36.S1.R4522

FASEB J. 2022 May;36 Suppl 1. doi: 10.1096/fasebj.2022.36.S1.R4298.

ABSTRACT

SAMP1/YitFC (SAMP) mice exhibit spontaneous ileitis as they age with morphological and functional epithelial abnormalities mimicking human Crohn’s disease, a chronic disease characterized by ileal inflammation. Indole-3-carbinole (I3C), found in broccoli and Brussel sprouts, plays a crucial role in the anti-inflammatory processes by activating the aryl hydrocarbon receptor (AhR), a transcription factor vital for epithelial and immune cell functions. The impact of I3C diet on disease progression and epithelial integrity in SAMP model of ileitis is not known. METHODS: 6-week-old male and female (n=8 per group) SAMP and control AKR/J mice (Jackson) were fed for 14 weeks either a standard chow diet or a purified diet supplemented with 200 ppm with indole-3-carbinole (+I3C diet), or purified diet depleted of AhR ligands (-I3C diet). Ileum samples were collected for qPCR and histological analyses. Statistical analysis was performed by Tukey’s multiple comparison test for all three diets. To detect changes between +I3C vs. -I3C, delta values (Δ +/-I3C = SAMP-AKR) were analyzed by unpaired T-test. RESULTS: As expected, H&E staining for the ileum of SAMP mice fed chow diet, showed thickening of the muscle layer, neutrophil infiltration, and epithelial tufting vs. AKR mice. Severity of inflammation in SAMP mice, as assessed by fecal calprotectin ELISA, mRNA expression of cytokines, and histological analysis was not significantly impacted by dietary depletion or supplementation of I3C. With respect to epithelial abnormalities, Periodic Acid Schiff staining showed increased number of goblet cells per villi (~47-75%) in SAMP mice on all three diets. While mRNA levels of the major goblet cell secretory proteins, mucin2 (Muc2) and intestinal trefoil factor (ITF), were dramatically decreased in SAMP mice vs. AKR, supplementation of I3C attenuated this decrease in Muc2 and ITF by ~35% and 51% (p<.001), respectively, indicating defective synthesis or secretion. Similarly, I3C diet significantly (p<.01) attenuated the decrease in Paneth cell markers lysozyme C-1 (LYZ1) alpha defensin 5 (Def5α) and regenerating islet-derived protein 3 alpha (Reg3α) in SAMP mice by ~65%, 60%, and 24%, respectively. A decrease in fibroblast growth factor 15 (FGF15) and the epithelial ion transporters serotonin transporter (SERT) and organic solute transporter (OST) were observed in ileal mucosa of SAMP mice vs. AKR, and the supplementation of I3C mitigated these decreases by 30-58% (p<.01). There were no significant changes in the expression of tryptophan hydroxylase 1 (tph-1), C-X-C motif chemokine ligand 2 (CXCL2), or AhR by I3C diet in SAMP mice. In summary, I3C supplementation significantly attenuated the goblet cell, Paneth cell, and epithelial-specific abnormalities seen in SAMP mice. These data imply that dietary supplementation of AhR ligands may be a viable therapeutic strategy for Crohn’s patients to restore epithelial integrity.

PMID:35557290 | DOI:10.1096/fasebj.2022.36.S1.R4298

FASEB J. 2022 May;36 Suppl 1. doi: 10.1096/fasebj.2022.36.S1.R2685.

ABSTRACT

INTRODUCTION: Retrieval practice through testing can strengthen long-term memory. Experimentally, this concept known as the “testing effect” has often been demonstrated using word pairs. As many health science students quiz with flashcards to enhance recall, can the testing effect be detected within the more complex study of anatomy? It was hypothesized that participants utilizing flashcards for review would score higher on tests than those restudying a handout.

METHODS: Students were recruited from Pacific Northwest University of Health Sciences (PNWU). On day 1 of the study, subjects were given 3 memory tests (assessing memory of printed words, pictures, and spoken words), the scores of which were combined and used to assign participants to groups with approximately equal “memory.” Participants studied a handout on ruminant digestive anatomy, a topic novel to most students. After the initial study session, subjects were divided into a “flashcard group” (FG) or a “handout group” (HG) and reviewed the learned material via their assigned method. Participants then took a 15-question test, indicating whether they were confident or not for each answer, and took a similar test 1 and 3 weeks later. Participants completed surveys on demographics, existing knowledge of ruminants and anatomical terms, wellness, and study behaviors on day 1 of the study. Data were analyzed using Mann Whitney U test, Fischer’s exact test, Pearson Correlation Coefficient, and repeated measures ANOVA using SPSSv25.0 software with p<0.05 considered statistically significant. This study was deemed exempt by PNWU IRB (#2021-015).

RESULTS: Though not statistically so, mean scores were higher in the FG than in the HG for each of the ruminant digestive anatomy assessments. For day 1 test score means (FG 10.67 ± 1.50 vs HG 9.00 ± 2.68), a large effect size (η_p² =0.16) was detected. While the FG started with more experience with anatomical terms (p=0.046), this experience was not significantly correlated with day 1 test scores (n=17). Though the FG tended to perform better on day 1 tests, the HG was more confident in their answer choices (mean confidence scores HG 10.00 ± 1.10 vs FG 7.78 ± 1.72), with a large effect size present (η_p² =0.38). Memory scores were not significantly different between the FG and the HG. Though not significant, most memory scores were negatively correlated with age. Sleep was negatively correlated with memory scores, which was significant for memory of printed words (r=-0.56; p=0.019). Female memory scores consistently ranked higher than male scores.

CONCLUSIONS: Participants who restudied with flashcards tended to outperform those restudying handouts on tests covering a novel anatomy topic, suggesting that the testing effect may have occurred. Interestingly, the opposite pattern was seen in confidence, with those studying handouts seemingly more confident in their test answers. Utilizing memory test scores resulted in evenly distributed groups with respect to memory, and some intriguing potential differences were seen related to sleep on the night before day 1 of the study, age, and gender. This study was limited by a small sample size and should be expanded to further investigate the effect of various restudy techniques, such as using flashcards or handouts while learning anatomy.

PMID:35557288 | DOI:10.1096/fasebj.2022.36.S1.R2685

Reprod Health. 2022 May 12;19(1):117. doi: 10.1186/s12978-022-01422-w.

ABSTRACT

BACKGROUND: Lifestyle modification (diet, exercise, and behavioral interventions) is the first-line treatment for polycystic ovary syndrome (PCOS). The benefits of face-to-face lifestyle modification intervention in a short time have been demonstrated. However, few studies have investigated the mobile technology effects on lifestyle modification in PCOS. Therefore, we examined the effect of transtheoretical model-based mobile health application intervention program for PCOS.

METHODS: A randomised controlled, single-blind trial, was carried out from October 2018 to March 2019, which included 122 participants recruited from gynecology outpatient clinics of affiliated Hospital of Zunyi Medical University in Guizhou. The study participants were randomised into intervention (n = 61) and control groups (n = 61). Participants in the intervention group undertook a TTM-based mobile health application program in addition to routine care, and participants in the control group received only routine care.

RESULTS: Fifty-one participants in the intervention group and 49 in the control group completed the study. Compared to the control group, participants in the intervention group showed statistically significant decrease for BMI (P < 0.05), WC (P < 0.05), SAS (P < 0.05), and SDS (P < 0.05) scores at 6-month and 12-month, respectively. Behavior stage change of exercise and diet among paticipants with PCOS was significant at 6 months (c² = 43.032, P < 0.05) and 12th months (c² = 49.574, P < 0.05) between the intervention and control groups.

CONCLUSIONS: This study showed that the TTM-based mobile health application program can decrease BMI, WC, anxiety, and depression, and improve exercise and diet adherence in patients with PCOS in the long term. The TTM-based mobile health application program can be applied for lifestyle modification in women with PCOS. Trial registration This study was approved by the ethics committee NO.[2019]1-028 in March 2018 and was registered at the Chinese Clinical Trial Registry (website: www.chictr.org.cn , registry number: ChiCTR2000034572).

PMID:35549736 | DOI:10.1186/s12978-022-01422-w