Practical examinations in anatomy are usually conducted on specimens in the anatomy laboratory (referred to here as the "traditional" method). Recently, we have started to administer similar examinations online using the quiz facility in Moodle™. In this study, we compare student scores between two assessment environments viz. online and traditional environments. We hypothesized that regardless of the examination medium (traditional or online) overall student performance would not be significantly different. For the online medium, radiological images, prosected specimens, and short video clips demonstrating muscle action were first acquired from resources used for teaching during anatomy practical classes. These were optimized for online viewing and then uploaded onto Moodle learning management software. With regards to the traditional format, actual specimens were usually laid out in a circular stream. Identification tags were then attached to specific spots on the specimens and questions asked regarding those identified spots. A cohort of students taking practical examinations in six courses was studied. The courses were divided into three pairs with each pair credit-weight matched. Each pair consisted of a course where the practical examination was conducted online and the other in the traditional format. There was no significant difference in the mean scores within each course pair. In addition, a significant positive correlation between score in traditional and online formats was found. We conclude that mean grades in anatomy practical examination conducted either online or in the traditional format were comparable. These findings should reassure teachers intending to use either format for their practical examinations.
Objectives: Although team-based learning (TBL) is widely used in medical education, its evaluation from the perspectives of the students exposed to it has been limited. This paper reports on a quantitative and qualitative evaluation of perceptions of first year medical students towards TBL. Methods: Lectures in an anatomy course were transformed into a series of TBL sessions for two cohorts of first-year medical students. Each session consisted of pre-class reading, in-class readiness assurance tests, and problem-solving of clinical cases by student teams. At the end of each course, students were surveyed using qualitative and quantitative instruments to assess their perceptions of the strategy. Internal consistency of questionnaire items was determined by a reliability analysis (Cronbach's alpha). Principal component factor analysis and correspondence analysis were conducted on the quantitative data. Open-ended questions were explored by thematic analysis. Results: Students' evaluations indicated that TBL is a welcome alternative to lecture-based teaching; as implemented in this study, it encouraged clinical problem solving and fruitful in-class discussion. Principal component factor analysis identified five factors (Cronbach's alpha 0.602-0.875). However, the majority of students disapproved of mixed gender TBL teams. Most students agreed that the strategy facilitated consistency in their study, generated an increased awareness about selfdirected learning, and had a positive impact on their learning attitudes. Conclusion: TBL is a welcome instructional strategy as reported by our first-year medical students. It was perceived to be a better approach compared to content-based lectures. The effect on actual student performance is currently being investigated. O ne of the global trends in teaching in medical schools has been a move towards more student-centered, integrated, clinical application models. [1][2][3] In addition, teaching strategies that promote active learning and problem-solving are increasingly being advocated. [4][5][6][7] An example of such a strategy that combines features of student-centeredness and problem-solving attributes is team-based learning (TBL). 8 In its classical format, TBL employs a structured three-phase sequence during which learners study an advanced assignment defined by faculty, demonstrate knowledge through individual and group readiness assurance tests (IRATs, GRATs), and apply course concepts to problemsolving exercises designed by faculty and analysed by teams. 9 The method employs strategies that incorporate the effectiveness of small group learning methods like problem-based learning (PBL) into large-group, lecture-oriented sessions. 10,11 Adequate knowledge of basic sciences such as anatomy, with a strong emphasis on 'clinical application' , logical learning, and developing effective problem solving skills is considered crucial for effective and safe clinical practice. 12,13 Although numerous strategies have been employed to develop these skills, implementing t...
In most medical schools, summative practical examination in Anatomy usually takes the format of a "steeplechase" ("spotters" or "bell ringers") conducted in the gross anatomy laboratory using cadaveric material and prosected specimens. Recently, we have started to administer similar examinations online using the quiz facility in WebCT™ and Moodle™. This article chronicles how we conceived and developed this method within the peculiar nature of our medical school setting. Over a five year period, practical summative examinations were organized as "steeplechase" online. The online examinations were administered using WebCT™ and later Moodle™ learning management software. Assessment "objects" were created from the materials available for anatomy teaching. These were digital images of cadaveric materials, radiological, and prosected specimens. In addition, short video clips of 30 seconds duration demonstrating muscle action were produced. These objects were optimized for online viewing and then uploaded onto the learning management software. A bank of questions (multiple choice or short answer type) was then created and linked to the assessment objects. These were used in place of the steeplechase in the computer laboratory. This method serves a crucial purpose in places like ours where continuous availability of human cadavers is impossible. Although time consuming initially, once questions are setup online, future retrieval, and administration becomes convenient especially where there are large batches of students. In addition, the online environment offers distinct advantages with regards to image quality, psychometric analysis of the examination and reduction of staff preparation time compared to traditional "steeplechase."
Background: Team-based learning (TBL) is an innovative form of collaborative learning. The aim of TBL is to create a motivational context in which students become accountable for their learning. Aim: Student attendance at didactic lecture sessions in our school is usually poor. A modified TBL approach in lieu of lectures was undertaken for the first time in a large class (150 students). This communication reports on the challenges of its implementation in our setting and preliminary data on its effects on student performance. Method: Using computer-based evaluation followed by an in-class activity, a modified TBL approach was implemented over two semesters during an introductory basic science course. Data on student performance, student motivation and faculty reflection were collected and analysed. Results: This strategy had significantly enhanced students' class attendance. They performed better on the built-in TBL assessment (IRAT) compared to standard in-course tests. Besides content mastery, TBL approach could also instill useful attitudinal outcomes such as self-directed learning. Conclusions: The TBL strategy is a viable and refreshing alternative to the usual didactic faculty engagement with the teaching process. Students appear to do better in tests built-in within TBL as compared to stand-alone in-course tests.
Background In recent years, several hundred autism spectrum disorder (ASD) implicated genes have been discovered impacting a wide range of molecular pathways. However, the molecular underpinning of ASD, particularly from the point of view of ‘brain to behaviour’ pathogenic mechanisms, remains largely unknown. Methods We undertook a study to investigate patterns of spatiotemporal and cell type expression of ASD-implicated genes by integrating large-scale brain single-cell transcriptomes (> million cells) and de novo loss-of-function (LOF) ASD variants (impacting 852 genes from 40,122 cases). Results We identified multiple single-cell clusters from three distinct developmental human brain regions (anterior cingulate cortex, middle temporal gyrus and primary visual cortex) that evidenced high evolutionary constraint through enrichment for brain critical exons and high pLI genes. These clusters also showed significant enrichment with ASD loss-of-function variant genes (p < 5.23 × 10–11) that are transcriptionally highly active in prenatal brain regions (visual cortex and dorsolateral prefrontal cortex). Mapping ASD de novo LOF variant genes into large-scale human and mouse brain single-cell transcriptome analysis demonstrate enrichment of such genes into neuronal subtypes and are also enriched for subtype of non-neuronal glial cell types (astrocyte, p < 6.40 × 10–11, oligodendrocyte, p < 1.31 × 10–09). Conclusion Among the ASD genes enriched with pathogenic de novo LOF variants (i.e. KANK1, PLXNB1), a subgroup has restricted transcriptional regulation in non-neuronal cell types that are evolutionarily conserved. This association strongly suggests the involvement of subtype of non-neuronal glial cells in the pathogenesis of ASD and the need to explore other biological pathways for this disorder.
Significant concern has been raised regarding the effect of COVID-19 on medical education. This study aimed to shed light on the distance learning experiences of medical students and their instructors at the Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU) in Dubai, United Arab Emirates. A convergent mixed methods approach was utilized. Qualitative and quantitative data was collected using a survey of closed-ended followed by open-ended questions. The percentage of the total average of satisfaction among stakeholders was 76.4%. The qualitative analysis led to developing the 4Ps Model of Transitioning to Distance Learning, which encapsulates four interrelated themes. It would be helpful to leverage the lessons learned to tailor blended medical programs with a reasonable mélange of experiences. The study also contributes to the mixed methods research by showcasing a means of adapting it to evaluate critical situations reliably and rapidly.
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