"Survivor" torches "Who Wants to Be a Physician?" in the educational games ratings war

We recently developed an educational game for reviewing respiratory physiology in a large classroom. The "Who Wants to be a Physician?" game encouraged medical students to be active participants in the learning process. An evaluation of the game documented that students enjoyed the active format, and the students reported that the game enhanced their ability to understand and retain information. However, the evaluation also revealed that the game had limitations. Specifically, the students recommended the use of multiple-choice questions to match the Medical Board Examination format and to speed up the game (i.e., cover more topics). The students also wanted to increase their level of participation and interaction. Finally, we wanted to emphasize the benefits of peer instruction as a collaborative learning tool. To address these limitations, we designed a new game, "Survivor." Survivor incorporated multiple-choice questions and emphasized peer instruction and a capacity to gather information and solve novel problems. In addition, participation was increased by including the student audience in the game. Finally, an evaluation instrument was utilized to assess the effectiveness of this instructional tool in an academic setting. As a result of these improvements, the evaluation documents that the newly developed tool is a more effective educational game that couples fun and creative excitement with proven and effective educational concepts.     

Who wants to be a physician? An educational tool for reviewing pulmonary physiology

Traditional review sessions are typically focused on instructor-based learning. However, experts in the field of higher education have long recommended teaching modalities that incorporate student-based active-learning strategies. Given this, we developed an educational game in pulmonary physiology for first-year medical students based loosely on the popular television game show Who Wants To Be A Millionaire. The purpose of our game, Who Wants To Be A Physician, was to provide students with an educational tool by which to review material previously presented in class. Our goal in designing this game was to encourage students to be active participants in their own learning process. The Who Wants To Be A Physician game was constructed in the form of a manual consisting of a bank of questions in various areas of pulmonary physiology: basic concepts, pulmonary mechanics, ventilation, pulmonary blood flow, pulmonary gas exchange, gas transport, and control of ventilation. Detailed answers are included in the manual to assist the instructor or player in comprehension of the material. In addition, an evaluation instrument was used to assess the effectiveness of this instructional tool in an academic setting. Specifically, the evaluation instrument addressed five major components, including goals and objectives, participation, content, components and organization, and summary and recommendations. Students responded positively to our game and the concept of active learning. Moreover, we are confident that this educational tool has enhanced the students' learning process and their ability to understand and retain information.     

The Landscape Game: A learning tool demonstrating landscape design principles

Summary A board game was developed for use in workshops to demonstrate some theoretical principles underpinning conservation planning at the landscape scale. The game is based on neutral landscape models and demonstrates the effects of habitat removal and arrangement on landscape connectivity for organisms with different mobility characteristics. This paper briefly describes the ecological principles underpinning the game, the equipment required to run a game session, and the rules of the game. The game was piloted in three workshops where it was played by a total of 75 people, primarily extension personnel. It proved to be an effective learning tool that was adopted by a number of the participants for their own communication activities.     

Small group teaching: clinical correlation with a human patient simulator

The popularity of the problem-based learning paradigm has stimulated new interest in small group, interactive teaching techniques. Medical educators of physiology have long recognized the value of such methods, using animal-based laboratories to demonstrate difficult physiological principles. Due to ethical and other concerns, a replacement of this teaching tool has been sought. Here, the author describes the use of a full-scale human patient simulator for such a workshop. The simulator is a life-size mannequin with physical findings (palpable pulses, breath/heart sounds, blinking eyes, etc.) and sophisticated mechanical and software models of the cardiovascular and pulmonary systems. It can be connected to standard physiological monitors to reproduce a realistic clinical environment. In groups of 10, first-year medical students explore Starling's law of the heart, the physiology of the Valsalva maneuver, and the function of the baroreceptor in a clinically realistic context using the simulator. With the use of a novel pre-/postworkshop assessment instrument that included student confidence in their answers, student confidence improved for all questions and survey items following the simulator session (P < 0.0001). The students give these laboratory exercises uniformly superior evaluations with > 85% of the students rating the workshop "very good" or "excellent".     

Formative assessment can be fun as well as educational

An understanding of the hormonal basis of normal growth and development, including the changes occurring at puberty, is important foundation knowledge for contemporary medical practice in most fields of medicine. A quiz, testing the important physiological concepts of growth and puberty, was designed using the format of the well-known television game "Who Wants to Be a Millionaire." An evaluation of this formative assessment activity revealed that a cohort of first-year undergraduate medical students valued learning with peers in an enjoyable, interactive environment, where they were able to admit to uncertainties and clarify answers. It also showed that making an educational activity fun need not detract from the focus of giving feedback on learning. Formative assessment, known to produce learning gains in a range of educational settings, is an important activity in contemporary medical education. With a greater emphasis on self-directed learning and less well-defined curriculum boundaries, feedback helps students to understand and apply the important physiological concepts that underpin the practice of medicine.     

Increasing student involvement in lectures: (very) low tech innovations in a biochemistry lecture class

The inherent passivity of the traditional lecture format makes this a poor mode for learning. In this paper I outline a simple but effective approach for eliciting student participation in the intermediate size lecture course (50–100 students). Two types of question are employed to increase student involvement. Each lecture ends with a set of questions directly related to concepts that will be covered in the next session. At the following lecture, specific students, chosen at random from the class list, are called on to answer these questions. Classroom participation is also elicited by calling on students to answer questions which focus on the major points during each lecture. Finally, students are invited to submit questions for inclusion on each exam. These devices make the lecture a more active and participatory experience.     

"Virtual" experiment for understanding the electrocardiogram and the mean electrical axis

Educators have placed an emphasis on the development of laboratory materials that supplement the traditional lecture format. The laboratory materials should encourage active learning, small group discussion, and problem-solving skills. To this end, we developed a virtual experiment designed to introduce students to the theory and application of the electrocardiogram (ECG) and the mean electrical axis (MEA). After reviewing background material, the students will analyze ECG recordings from two individuals who underwent a series of experimental procedures. The students are challenged to reduce and analyze the data, calculate and plot the MEA, and answer questions related to the theory and application of the ECG. In conducting the virtual experiment, students are introduced to inquiry-based learning through experimentation.     

Revision bingo

Bingo can be a versatile and engaging tool for spicing up end-of-module revision and other contexts in which course content is being reviewed. Instead of numbers being called out, students are given a verbal clue that fits with one of the answers on their playing grid. Get five correct answers in any straight line (including either of the major diagonals) and they win the game. The interactive and light-hearted medium of a bingo game can provide motivation for study and enhance learning by the students. Protein revision bingo is included as an example.     

Computers in health-sciences education. An application to electrocardiography

Aspects of a computer-based education (CBE) are described. Recent developments in the use of computer in health-sciences education are highlighted. An interactive computer system ( CALE ) has been developed to provide individualised instruction and testing for biomedical and medical sciences students. CALE is a system for computer assisted learning of electrocardiography which consists of an organizer program and few subprograms . The system has a self-instruction mode which is equivalent to lecturing . Moreover, review questions are supplied either in multiple choice questions ( MCQ ) and/or matched questions and answers ( MQA ) forms. Furthermore, the system can stimulate normal as well as abnormal electrocardiograms. A statistical program is included to evaluate the performance of the students while using the CALE -system. A comment file is created so that the users can register their comments about the CALE and the difficulties they have faced in using the system. CALE is easy to use and requires no knowledge of programming. The feedback obtained from the students currently using the system is encouraging. CALE is written in Data General FORTRAN 5.     

Current Practice in Software Development for Computational Neuroscience and How to Improve It

Almost all research work in computational neuroscience involves software. As researchers try to understand ever more complex systems, there is a continual need for software with new capabilities. Because of the wide range of questions being investigated, new software is often developed rapidly by individuals or small groups. In these cases, it can be hard to demonstrate that the software gives the right results. Software developers are often open about the code they produce and willing to share it, but there is little appreciation among potential users of the great diversity of software development practices and end results, and how this affects the suitability of software tools for use in research projects. To help clarify these issues, we have reviewed a range of software tools and asked how the culture and practice of software development affects their validity and trustworthiness.We identified four key questions that can be used to categorize software projects and correlate them with the type of product that results. The first question addresses what is being produced. The other three concern why, how, and by whom the work is done. The answers to these questions show strong correlations with the nature of the software being produced, and its suitability for particular purposes. Based on our findings, we suggest ways in which current software development practice in computational neuroscience can be improved and propose checklists to help developers, reviewers, and scientists to assess the quality of software and whether particular pieces of software are ready for use in research.     

Development of a Learning-Oriented Computer Assisted Instruction Designed to Improve Skills in the Clinical Assessment of the Nutritional Status: A Pilot Evaluation

Computer assisted instruction (CAI) is an effective tool for evaluating and training students and professionals. In this article we will present a learning-oriented CAI, which has been developed for students and health professionals to acquire and retain new knowledge through the practice. A two-phase pilot evaluation was conducted, involving 8 nutrition experts and 30 postgraduate students, respectively. In each training session, the software developed guides users in the integral evaluation of a patient’s nutritional status and helps them to implement actions. The program includes into the format clinical tools, which can be used to recognize possible patient’s needs, to improve the clinical reasoning and to develop professional skills. Among them are assessment questionnaires and evaluation criteria, cardiovascular risk charts, clinical guidelines and photographs of various diseases. This CAI is a complete software package easy to use and versatile, aimed at clinical specialists, medical staff, scientists, educators and clinical students, which can be used as a learning tool. This application constitutes an advanced method for students and health professionals to accomplish nutritional assessments combining theoretical and empirical issues, which can be implemented in their academic curriculum.     

Attitudes of medical staff towards the psychiatric label "schizophrenic patient" tested by an anti-stigma questionnaire

The aim of this research was to investigate the opinions and attitudes of medical staff towards schizophrenic patients. The research included three groups of examinees, 200 physicians of various specialties, 200 nurses and technicians working in Zagreb city hospitals, and 200 3rd and 4th year students of the School of Medicine in Zagreb. Previously validated anti-stigma questionnaire was used, consisting of 25 questions divided into three thematic groups, structured and adapted to the specific requirements of this study. The results were mutually compared and statistically analyzed by applying the chi 2-test. Significant difference (p < 0.01) between the answers of physicians and those of medical students was found in questions 2, 4, 5, 6, 11, 13, 15, 16, 18, 22, 23, 25, and between physicians and nurses/technicians in answers to questions 4, 15, 22, 23. Significant difference (p < 0.01) between the answers given by nurses/technicians and medical students was found in questions 10, 13, 22, 23. The results point to the existence of prejudices and stigmatizing attitudes in all three investigated groups. The most frequent reasons for stigmatizing attitude of students are based on fear and insufficient knowledge about mental patients and schizophrenia as a disease, while there are a high percentage of positive answers to the questions on rehabilitation and resocialization. The nurses/technicians also show a high degree of mistrust towards schizophrenic patients and mostly answer with "I don't know", thus presenting insufficiently formed attitudes about the mentioned problems. The physicians in their answers confirm fear, mistrust and stigmatizing attitudes towards schizophrenic patients found in general population in Croatia. The consequences of such attitudes are the low quality of life of schizophrenic patients, and slow, often incomplete, resocialization.     

Epilepsy patient-participants and genetic research results as "answers"

Better understanding of how research participants with a known condition ascribe meaning to individual genetic results is important to help researchers and institutional review boards evaluate the potential benefits and harms of disclosing results in the context of genotype-driven research recruitment. Based on 29 in-depth interviews with epilepsy patients participating in a genetic study, we found that this population of research subjects anticipated that genetic research results would provide answers to a range of questions about the research process and their condition. Their multi-layered interpretations underscore the need for clear communication about the nature and limitations of results if individual or aggregate genetic results are returned in the process of recruitment for additional research.     

Model format for a vaccine stability report and software solutions

A session of the International Association for Biologicals Workshop on Stability Evaluation of Vaccine, a Life Cycle Approach was devoted to a model format for a vaccine stability report, and software solutions. Presentations highlighted the utility of a model format that will conform to regulatory requirements and the ICH common technical document. However, there need be flexibility to accommodate individual company practices. Adoption of a model format is premised upon agreement regarding content between industry and regulators, and ease of use. Software requirements will include ease of use and protections against inadvertent misspecification of stability design or misinterpretation of program output.     

Questioning behaviour in general practice: a pragmatic study.

OBJECTIVE: To study the extent to which general practitioners'' questioning behaviour in routine practice is likely to encourage the adoption of evidence based medicine. DESIGN: Self recording of questions by doctors during consultations immediately followed by semistructured interview. SETTING: Urban Australian general practice. SUBJECTS: Random sample of 27 general practitioners followed over a half day of consultations. MAIN OUTCOME MEASURES: Rate of recording of clinical questions about patients'' care which doctors would like answered; frequency with which doctors found answers to their questions. RESULTS: Doctors asked a total of 85 clinical questions, at a rate of 2.4 for every 10 patients seen. They found satisfactory answers to 67 (79%) of these questions. Doctors who worked in small practices (of one or two doctors) had a significantly lower rate of questioning than did those in larger practices (1.6 questions per 10 patients v 3.0 patients, P = 0.049). No other factors were significantly related to rate of questioning. CONCLUSIONS: These results do not support the view that doctors routinely generate a large number of unanswered clinical questions. It may be necessary to promote questioning behaviour in routine practice if evidence based medicine and other forms of self directed learning are to be successfully introduced.     

Regulation of Calpain-2 in Neurons: Implications for Synaptic Plasticity

The family of calcium-dependent neutral proteases, calpains, was discovered more than 30 years ago, but their functional roles in the nervous system under physiological or pathological conditions still remain unclear. Although calpain was proposed to participate in synaptic plasticity and in learning and memory in the early 1980s, the precise mechanism regarding its activation, its target(s) and the functional consequences of its activation have remained controversial. A major issue has been the identification of roles of the two major calpain isoforms present in the brain, calpain-1 and calpain-2, and the calcium requirement for their activation, which exceeds levels that could be reached intracellularly under conditions leading to changes in synaptic efficacy. In this review, we discussed the features of calpains that make them ideally suited to link certain patterns of presynaptic activity to the structural modifications of dendritic spines that could underlie synaptic plasticity and learning and memory. We then summarize recent findings that provide critical answers to the various questions raised by the initial hypothesis, and that further support the idea that, in brain, calpain-2 plays critical roles in developmental and adult synaptic plasticity.     

Staff and student perceptions of computer-assisted assessment for physiology practical classes

Effective assessment of laboratory practicals is a challenge for large-size classes. To reduce the administrative burden of staff members without compromising the student learning experience, we utilized dedicated computer software for short-answer question assessment for nearly 300 students and compared it with the more traditional, paper-based method of assessment of the same student cohort. Students were generally favorably disposed toward computer-assisted assessment (CAA): 75% of the students responded that for future assignments, they either had no preference for the method of assessment or would prefer CAA. Advantages were perceived to be remote access to the questions and ease of submission. The most common disadvantage cited was lack of internet access. Various advantages of CAA were mentioned by staff members: notably, the reduction in marking time and reduction of paperwork as well as the potential for the software to detect plagiarism and to administer anonymous marking. Disadvantages to CAA were the need to tailor questions to the technology, having to adapt to reading answers and marking onscreen, and the quality of feedback to students. All of the disadvantages could be overcome by training and improved versions of CAA software, currently under development. The use of CAA has proved to be a welcome addition to the tools available to staff members for the assessment of practical classes, and future improved versions of the software will increase the utility of this assessment method.     

Replacing lectures by textbased flexible learning: students' performance and perceptions

This paper presents the results of an extended evaluation programme designed to test the effectiveness of text-based flexible learning as a replacement to 30 – 50% of the lectures in certain modules in conventional undergraduate courses within the School of Life Sciences at Napier University. For examinations in which students answered both types of question, marks for questions based on topics taught by flexible learning were equivalent to marks for questions based on topics taught by conventional teaching methods. Marks for examinations in which at least 50% of the answers were based on topics taught by flexible learning were equivalent to marks for examinations in which questions were based on topics taught by conventional teaching methods. Rates of achievement of a mark of 40% or more at first attempt for examinations in which at least 50% of the answers were based on topics taught by flexible learning were significantly better than rates of achievement of a mark of 40% or more at first attempt for questions based on topics taught by conventional teaching methods. Students gave positive feedback on flexible learning, both verbally and by questionnaire, and showed highly significant bias in favour of topics taught by flexible learning in their choice of questions in examinations. The flexible learning programme studied here has satisfied the various quality assurance criteria in place within the University throughout the time that it has been in operation. The evaluation has demonstrated that the textbased flexible learning programme studied here was an effective alternative to lectures.     

Re-defining the chromatin loop domain

It is commonly accepted that the loop domain represents the basic structural unit of eukaryotic chromatin associated with DNA replication, gene expression and higher order packaging. However, molecular-cytological information defining the loop domain is lacking. There are gaps in our knowledge of the loop structure and how it regulates gene expression. The combination of new data/reagents from the Human Genome Project plus the use of novel molecular cytological technology will provide answers. Here we briefly review the status of chromatin loop research and pose questions that need to be addressed. New experimental systems are also presented to target some long-standing issues regarding the structure and function of the chromatin loop domain and its relationship with the nuclear matrix. This new knowledge will have a profound impact for modern genetics and molecular medicine.     

Peer instruction enhanced student performance on qualitative problem-solving questions

We tested the hypothesis that peer instruction enhances student performance on qualitative problem-solving questions. To test this hypothesis, qualitative problems were included in a peer instruction format during our Physiology course. Each class of 90 min was divided into four to six short segments of 15 to 20 min each. Each short segment was followed by a qualitative problem-solving scenario that could be answered with a multiple-choice quiz. All students were allowed 1 min to think and to record their answers. Subsequently, students were allowed 1 min to discuss their answers with classmates. Students were then allowed to change their first answer if desired, and both answers were recorded. Finally, the instructor and students discussed the answer. Peer instruction significantly improved student performance on qualitative problem-solving questions (59.3 +/- 0.5% vs. 80.3 +/- 0.4%). Furthermore, after peer instruction, only 6.5% of the students changed their correct response to an incorrect response; however, 56.8% of students changed their incorrect response to a correct response. Therefore, students with incorrect responses changed their answers more often than students with correct responses. In conclusion, pausing four to six times during a 90-min class to allow peer instruction enhanced student performance on qualitative problem-solving questions.