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The complexity of the material being taught in clinical neuroscience within the medical school curriculum requires creative pedagogies to teach medical students effectively. Many clinical teaching strategies have been developed and are well described to address these challenges. However, only a few have been evaluated to determine their impact on the performance of students studying clinical neuroscience. Interactive, 2-hour, self-directed small-group interactive clinical case-based learning sessions were conducted weekly for 4 weeks to integrate concepts learned in the corresponding didactic lectures. Students in the small groups analyzed cases of patients suffering from neurological disease that were based on eight learning objectives that allowed them to evaluate neuroanatomical data and clinical findings before presenting their case analysis to the larger group. Students' performances on the formative quizzes and summative tests were compared to those of first-year medical students in the previous year for whom the self-directed, small-group interactive clinical sessions were not available. There was a significant improvement in the summative performance of first-year medical students with self-directed clinical case learning in the second year (Y2) of teaching clinical neuroscience (P < 0.05) when compared with first-year students in the first year (Y1) for whom the self-directed learning approach was not available. Student performance in the formative assessments between Y1 and Y2 was not significantly different (P = 0.803). A target of ≥70% student scoring above 80% in the final summative examination was met. The current study revealed evidence for the impact and educational outcomes of a self-directed, clinical teaching strategy in a clinical neuroscience curriculum for first-year medical students. Anat Sci Educ 11: 478-487. © 2017 American Association of Anatomists.

Men and women differ in their clinical risk factors with respect to various predictors of severity in acute ischemic stroke (AIS). High cholesterol is a risk factor for AIS and the mechanism by which high cholesterol levels lead to an AIS is well established. However, the specific relationship between demographic, clinical risk factors, total cholesterol, and the resulting gender difference in AIS patients is yet to be investigated. This study recruited AIS patients between January 2000 and June 2016 classified into normal, borderline or high total cholesterol (TC). Normal was defined as ≤200 mg/dl, borderline 200 to 239 mg/dl and high ≥240 mg/dl based on Adult Treatment Panel III (ATP III) Guidelines for the classification of TC levels. The logistic regression model was used to predict clinical risk factors associated within men and women AIS patients with different levels of TC. A total of 3532 AIS patients presented with normal TC, 760 patients with borderline TC and 427 patients with high TC. The high total cholesterol group was more likely to be women with increasing age (OR = 1.028, 95% CI, 1.006–1.052, P = .014), body mass index (BMI) (OR = 1.052, 95% CI, 1.004–1.102, P = .033), and high-density lipoprotein cholesterol (HDL-C) (OR = 1.039, 95% CI, 1.019–1.060, P < .001), while those with coronary artery disease (OR = 0.435, 95% CI, 0.234–0.809, P = .003), history of drug or alcohol abuse (OR = 0.261, 95% CI, 0.079–0.867, P = .028), increasing INR (OR = 0.187, 95% CI, 0.047–0.748, P = .018), and elevated diastolic blood pressure (OR = 0.982, 95% CI, 0.970–0.995, P = .006) were associated with being a male AIS patient. There were disparities in demographic and clinical risk factors associated with high TC levels in men when compared to women and more clinical risk factors were associated with high TC levels in men when compared to women with AIS. It is important to take into account specific clinical risk factors associated with gender-related differences in total cholesterol in AIS population to facilitate personalizing their therapeutic actions.

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The goal of the stroke intervention programs was to increase knowledge in stroke awareness and healthy habits. Most of the existing school-based didactic stroke education intervention programs have not been very effective in improving learned information. We developed a student-centered or active learning educational pedagogy to improve the retention of learned knowledge on stroke issues and healthy habits. Middle school students, ages of 11 to 14 years attending a public school in the stroke belt were recruited to participate in an intervention program to raise stroke awareness and promote healthy habit. The impact of the intervention program on students' knowledge post-test and three weeks following the intervention was evaluated. Middle school students at all grade levels were aware of the cardinal symptoms of stroke, demonstrated basic knowledge of the salty foods in the post-test, and knowledge of learned information increased significantly after three weeks post intervention. The three weeks follow-up test revealed a significant increase in stroke knowledge among the 6th, 7th, and 8th grades [F (2,109) = 134.65, P = 0.001]. Post-hoc pair-wise comparisons analysis revealed a significant difference (P < 0.05) between the 6th, 7th, and 8th grades. In an active learning or a student-centered stroke and healthy life style educational program, middle school students perceived the intervention program as fun, instead of primarily educational and this allowed the learned information to be retained even three weeks after the intervention.