ChIP-seq performed on lymphoblastoid cell lines (LCLs), expressing epitope-tagged EBNA3A, EBNA3B or EBNA3C from EBV-recombinants, revealed important principles of EBNA3 binding to chromatin. When combined with global chromatin looping data, EBNA3-bound loci were found to have a singular character, each directly associating with either EBNA3-repressed or EBNA3-activated genes, but not with both. EBNA3A and EBNA3C showed significant association with repressed and activated genes. Significant direct association for EBNA3B loci could only be shown with EBNA3B-repressed genes. A comparison of EBNA3 binding sites with known transcription factor binding sites in LCL GM12878 revealed substantial co-localization of EBNA3s with RUNX3—a protein induced by EBV during B cell transformation. The beta-subunit of core binding factor (CBFβ), that heterodimerizes with RUNX3, could co-immunoprecipitate robustly EBNA3B and EBNA3C, but only weakly EBNA3A. Depletion of either RUNX3 or CBFβ with lentivirus-delivered shRNA impaired epitope-tagged EBNA3B and EBNA3C binding at multiple regulated gene loci, indicating a requirement for CBF heterodimers in EBNA3 recruitment during target-gene regulation. ShRNA-mediated depletion of CBFβ in an EBNA3C-conditional LCL confirmed the role of CBF in the regulation of EBNA3C-induced and -repressed genes. These results reveal an important role for RUNX3/CBF during B cell transformation and EBV latency that was hitherto unexplored.
ObjectiveThis study surveyed all UK medical schools regarding their Bachelor of Medicine (MB), Doctor of Philosophy (PhD) (MB/PhD) training policy in order to map the current training landscape and to provide evidence for further research and policy development.SettingDeans of all UK medical schools registered with the Medical Schools Council were invited to participate in this survey electronically.PrimaryThe number of medical schools that operate institutional MB/PhD programmes or permit self-directed student PhD intercalation.SecondaryMedical school recruitment procedures and attitudes to policy guidance.Findings27 of 33 (81%) registered UK medical schools responded. Four (14%) offer an institutional MB/PhD programme. However, of those without institutional programmes, 17 (73%) permit study interruption and PhD intercalation: two do not (one of whom had discontinued their programme in 2013), three were unsure and one failed to answer the question. Regarding student eligibility, respondents cited high academic achievement in medical studies and a bachelor's or master's degree. Of the Medical schools without institutional MB/PhD programmes, 5 (21%) have intentions to establish a programme, 8 (34%) do not and 3 were unsure, seven did not answer. 19 medical schools (70%) considered national guidelines are needed for future MB/PhD programme development.ConclusionsWe report the first national survey of MB/PhD training in the UK. Four medical schools have operational institutional MB/PhD programmes, with a further five intending to establish one. Most medical schools permit study interruption and PhD intercalation. The total number MB/PhD students yet to graduate from medical school could exceed 150, with 30 graduating per year. A majority of medical school respondents to this survey believe national guidelines are required for MB/PhD programme development and implementation. Further research should focus on the MB/PhD student experience. Discussion regarding local and national MB/PhD policies between medical schools and academic stakeholders are needed.
PurposeTeaching competencies such as empathy and communication skills is difficult. Our institution has instituted a curriculum to teach these competencies in an interactive workshop setting. The challenge is connecting what the resident learns with their clinical practice. We set out to design and evaluate an educational model using sequential peer and self-assessment to bridge the gap between learning and practice.MethodsThree case scenarios were designed to test communication skills and the ability to provide empathic, patient-centered care. All second year residents participated. Residents were divided into groups of three and role-played the scenarios. This session was videotaped. After this session they completed peer and self-assessment surveys. The surveys consisted of 20 items measuring their confidence, overall performance, and use of specific behaviors related to the competencies being taught. The residents then received interactive workshops on empathy, communication skills, and other related topics. They then viewed their role-play session and were asked again to complete peer and self-assessments. At a final wrap-up session they were given feedback. Evaluation of the teaching model was based on comparing the change in ratings between the two assessments and surveying of the participants' impression of the training model. Residents rated the experience on a 10-point scale (eg. 1 = not useful, 10 = very useful) and in open-ended responses.Results20 residents participated. The residents rated themselves and their peers highly on both the initial and final assessment of the role-play session. The differences between ratings on all items between the two sessions were small and not statistically significant. They rated the overall experience as useful (mean 8.79, range 7-10). They agreed that the role-play and sequential assessments provided a connection between what they learned and clinical practice (mean 8.33, range 5-10). They stated they learned something new from the sequential assessments (mean 8.53, range 6-10) and that the educational sessions changed their peer and self-assessments (mean 8.29, range 5-10). Comments regarding the sequential assessments were positive. One resident stated, “As far as affecting how I practice it was the most useful thing.”ConclusionsObjectively measuring the impact of this training model on peer and self-assessment was not successful with the survey used and will require the use of different tools in future iterations. Initial subjective data suggest that this model may provide a way to bridge the gap between learning and practice when teaching the competencies of empathy and communication skills.
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