Computer-supported collaborative learning in the medical workplace: Students' experiences on formative peer feedback of a critical appraisal of a topic paper

BACKGROUND

Medical workplace learning consists largely of individual activities, since workplace settings do not lend themselves readily to group learning. An electronic Learning Management with System Computer-Supported Collaborative Learning (CSCL) could enable learners at different workplace locations to discuss personal clinical experiences at a distance to enhance learning.

AIM

To explore whether CSCL-enabled structured asynchronous discussions on an authentic task has additional value for learning in the medical workplace.

METHODS

Between January 2008 and June 2010, we conducted an exploratory evaluation study among senior medical students that were engaged in clinical electives. Students wrote a Critical Appraisal of a Topic paper about a clinical problem they had encountered and discussed it in discipline homogeneous subgroups on an asynchronous forum in a CSCL environment. A mixed method design was used to explore students' perceptions of the CSCL arrangement with respect to their preparation and participation, the design and knowledge gains. We analysed the messages recorded during the discussions to investigate which types of interactions occurred.

RESULTS

Students perceived knowledge improvement of their papers. The discussions were mostly task-focused. The students considered an instruction session and a manual necessary to prepare for CSCL. A high amount of sent messages and a high activity in discussion seem to influence scores on perceptions: 'participation' and 'knowledge gain' positively.

CONCLUSION

CSCL appears to offer a suitable environment for peers to provide formative feedback on a Critical Appraisal of a Topic paper during workplace learning. The CSCL environment enabled students to collaborate in asynchronous discussions, which positively influenced their learning.

Anoxia-induced changes in ventricular diastolic compliance in two models of hypertension in rats

OBJECTIVE

The effects of a brief period of anoxia upon myocardial distensibility and coronary vascular resistance (CVR) were evaluated in two models of pressure overload in the rat.

METHODS

A similar degree of left ventricular hypertrophy was obtained by using deoxycorticosterone acetate (DOCA)-salt treatment and abdominal aortic stenosis (AS). The study was performed using an isolated, isovolumic cardiac preparation perfused at a constant coronary flow of approximately 20 ml/min per g left ventricular weight.

RESULTS

In response to a 10-min period of anoxia, hypertrophied hearts manifested an exaggerated decrease in left ventricular diastolic chamber distensibility. Left ventricular diastolic blood pressure (DBP) rose in control, AS and DOCA-salt hearts, with no significant difference between the two hypertrophied groups. The anoxia-induced increase in left ventricular DBP correlated with the left ventricular weight: body weight ratio in all animals, but was higher in the two hypertrophied groups compared with controls when expressed per unit tissue mass. In response to anoxia, CVR increased in both groups of hypertrophied hearts and was correlated with enhanced left ventricular DBP. In addition, CVR increased in proportion to the degree of hypertrophy. Partial correlation analysis showed that this relationship depends upon the level of left ventricular DBP and disappears when this pressure is constant.

CONCLUSION

The anoxia-induced increase in myocardial stiffness is exaggerated in two different models of cardiac hypertrophy. This exaggeration is primarily related to the degree of hypertrophy and results in a more pronounced limitation of the coronary flow in hypertrophied hearts.

Antihypertensive activity of erythro-1-(1-[2-(1,4-benzodioxan-2-yl)-2-OH-ET]-4-piperidyl)-2-benzimidazolinone (R 28935)

Erythro-1-(1-[2-(1,4-benzodioxan-2-yl)-2-OH-ET]-4-piperidyl)-2-benzimidazolinone (R 28935), provokes marked antihypertensive effects lasting several hours in conscious SHR (0.63 to 40 mg/kg i.p.) and beagles with renal hypertension (1.25 mg/kg p.o.). In SHR, this compound induces much less bradycardia, compared to equiactive hypotensive doses of clonidine, guanethidine and propranolol. Significant postural hypotension during tilting, is induced by guanethidine and mecamylamine but not by R 28935. In anaesthetized beagles with renal hypertension, the lowering of the blood pressure by R 28935, (0.02-0.64 mg/kg i.v.) is associated with a considerable decrease in the total peripheral vascular resistance, whereas the myocardial function is not affected. R 28935 is considered a potent antihypertensive drug, with attractive haemodynamic characteristics.