Effects of a Serious Smartphone Game on Nursing Students' Theoretical Knowledge and Practical Skills in Adult Basic Life Support: Randomized Wait List-Controlled Trial

BACKGROUND

Retention of adult basic life support (BLS) knowledge and skills after professional training declines over time. To combat this, the European Resuscitation Council and the American Heart Association recommend shorter, more frequent BLS sessions. Emphasizing technology-enhanced learning, such as mobile learning, aims to increase out-of-hospital cardiac arrest (OHCA) survival and is becoming more integral in nursing education.

OBJECTIVE

The aim of this study was to investigate whether playing a serious smartphone game called MOBICPR at home can improve and retain nursing students' theoretical knowledge of and practical skills in adult BLS.

METHODS

This study used a randomized wait list-controlled design. Nursing students were randomly assigned in a 1:1 ratio to either a MOBICPR intervention group (MOBICPR-IG) or a wait-list control group (WL-CG), where the latter received the MOBICPR game 2 weeks after the MOBICPR-IG. The aim of the MOBICPR game is to engage participants in using smartphone gestures (eg, tapping) and actions (eg, talking) to perform evidence-based adult BLS on a virtual patient with OHCA. The participants' theoretical knowledge of adult BLS was assessed using a questionnaire, while their practical skills were evaluated on cardiopulmonary resuscitation quality parameters using a manikin and a checklist.

RESULTS

In total, 43 nursing students participated in the study, 22 (51%) in MOBICPR-IG and 21 (49%) in WL-CG. There were differences between the MOBICPR-IG and the WL-CG in theoretical knowledge (P=.04) but not in practical skills (P=.45) after MOBICPR game playing at home. No difference was noted in the retention of participants' theoretical knowledge and practical skills of adult BLS after a 2-week break from playing the MOBICPR game (P=.13). Key observations included challenges in response checks with a face-down manikin and a general neglect of safety protocols when using an automated external defibrillator.

CONCLUSIONS

Playing the MOBICPR game at home has the greatest impact on improving the theoretical knowledge of adult BLS in nursing students but not their practical skills. Our findings underscore the importance of integrating diverse scenarios into adult BLS training.

TRIAL REGISTRATION

ClinicalTrials.gov (NCT05784675); https://clinicaltrials.gov/study/NCT05784675.

Technology-Supported Guidance Models to Stimulate Nursing Students' Self-Efficacy in Clinical Practice: Scoping Review

BACKGROUND

In nursing education, bridging the gap between theoretical knowledge and practical skills is crucial for developing competence in clinical practice. Nursing students encounter challenges in acquiring these essential skills, making self-efficacy a critical component in their professional development. Self-efficacy pertains to individual's belief in their ability to perform tasks and overcome challenges, with significant implications for clinical skills acquisition and academic success. Previous research has underscored the strong link between nursing students' self-efficacy and their clinical competence. Technology has emerged as a promising tool to enhance self-efficacy by enabling personalized learning experiences and in-depth discussions. However, there is a need for a comprehensive literature review to assess the existing body of knowledge and identify research gaps.

OBJECTIVE

The aim of this study is to systematically map and identify gaps in published studies on the use of technology-supported guidance models to stimulate nursing students' self-efficacy in clinical practice.

METHODS

This scoping review followed the framework of Arksey and O'Malley and was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR). A systematic, comprehensive literature search was conducted in ERIC, CINAHL, MEDLINE, Embase, PsycINFO, and Web of Science for studies published between January 2011 and April 2023. The reference lists of the included papers were manually searched to identify additional studies. Pairs of authors screened the papers, assessed eligibility, and extracted the data. The data were thematically organized.

RESULTS

A total of 8 studies were included and four thematic groups were identified: (1) technological solutions for learning support, (2) learning focus in clinical practice, (3) teaching strategies and theoretical approaches for self-efficacy, and (4) assessment of self-efficacy and complementary outcomes.

CONCLUSIONS

Various technological solutions were adopted in the guidance models to stimulate the self-efficacy of nursing students in clinical practice, leading to positive findings. A total of 7 out of 8 studies presented results that were not statistically significant, highlighting the need for further refinement of the applied interventions. Nurse educators play a pivotal role in applying learning strategies and theoretical approaches to enhance nursing students' self-efficacy, but the contributions of nurse preceptors and peers should not be overlooked. Future studies should consider involving users in the intervention process and using validated instruments tailored to the studies' intervention objectives, ensuring relevance and enabling comparisons across studies.

Promoting the process of determining brain death through standardized training

Objective

This study aims to explore the training mode for brain death determination to ensure the quality of subsequent brain death determination.

Methods

A four-skill and four-step (FFT) training model was adopted, which included a clinical neurological examination, an electroencephalogram (EEG) examination, a short-latency somatosensory evoked potential (SLSEP) examination, and a transcranial Doppler (TCD) examination. Each skill is divided into four steps: multimedia theory teaching, bedside demonstration, one-on-one real or dummy simulation training, and assessment. The authors analyzed the training results of 1,577 professional and technical personnel who participated in the FFT training model from 2013 to 2020 (25 sessions), including error rate analysis of the written examination, knowledge gap analysis, and influencing factors analysis.

Results

The total error rates for all four written examination topics were < 5%, at 4.13% for SLSEP, 4.11% for EEG, 3.71% for TCD, and 3.65% for clinical evaluation. The knowledge gap analysis of the four-skill test papers suggested that the trainees had different knowledge gaps. Based on the univariate analysis and the multiple linear regression analysis, among the six factors, specialty categories, professional and technical titles, and hospital level were the independent influencing factors of answer errors (p < 0.01).

Conclusion

The FFT model is suitable for brain death (BD) determination training in China; however, the authors should pay attention to the professional characteristics of participants, strengthen the knowledge gap training, and strive to narrow the difference in training quality.

Extended Reality-New Opportunity for People With Disability? Practical and Ethical Considerations

Since the introduction of virtual environments in the 70s, technologies have moved through virtual reality, mixed reality, and augmented reality into extended reality (XR). This development is promising for various groups. Previous research has shown people with disability benefiting from using technology in social and professional settings. Technology has offered people with disability the opportunity to communicate, interact, participate, and build new relationships. However, we do not know what impact XR has or will have and whether it will offer new opportunities for people with disability. This paper aims to indicate potential opportunities and challenges afforded by XR to people with disability. We offer reflections on the opportunities as well as the ethical considerations needed when introducing immersive technologies to a marginalized group.

Transforming undergraduate laboratory courses with interlinked real-world challenges

Undergraduate laboratory course components often provide training in various techniques without connections to an interlinked real-world scenario. This article emphasizes the benefits of longitudinal integration of research techniques to enhance learning and emphasize societal relevance. An example of a biomedical engineering challenge involving a new pandemic is described.

A research-led flexible cell biology practical for biological sciences undergraduate and postgraduate degree courses

A challenge in the pandemic era is to implement effective but flexible practical teaching for biological sciences courses. Such teaching needs to deliver conceptual, analytical and practical skills training while having the option to rapidly respond to health and safety issues, local regulations, staff and student concerns. In this paper, we describe a set of cell biology practicals (mini-project) that meets many of these requirements and provides flexibility in providing skills training both through online and in practical laboratory environments. We have used a human adenocarcinoma cell line A431 stably transfected with a fluorescent cell cycle reporter as a biological model to deliver training through discrete work packages encompassing cell culture, fluorescence microscopy, biochemistry and statistics. How such work packages can be modified to, an online format either partially or completely is also described. Furthermore, the activities can be adapted for teaching both undergraduate and postgraduate level courses to ensure effective skills training which is applicable to a wide range of biological degree programs and levels of study.

An introduction to insulin use in type 2 diabetes mellitus

The benefits of the newer antidiabetic agents available for managing type 2 diabetes mellitus (T2DM) remain indisputable, but many patients will require insulin therapy in the disease course. Given the limited access to newer antidiabetic agents, insulin remains a standard treatment modality in T2DM in South Africa. Early, multifactorial intervention remains ideal, but glucose, blood pressure and cholesterol values remain above target in many countries. Barriers to achieving glucose control in South Africa include the healthcare provider's being unfamiliar with the practicalities of insulin administration, initiation and titration. This article highlights these gaps and offers pragmatic solutions to overcome them.

A Literature Review of Barriers and Opportunities Presented by Digitally Enhanced Practical Skill Teaching and Learning in Health Science Education

INTRODUCTION

An evidence gap exists identifying the challenges and opportunities presented by digitally enhanced practical skill teaching and learning in health science education. A literature review was carried out to address this gap and to provide recommendations for overcoming identified challenges.

METHOD

A systematic search strategy was carried out using PRISMA guidelines. The research databases PubMed, ERIC, Medline and CINHL, were searched using MeSH terms. Barriers and opportunities were identified through deductive thematic analysis of the included articles.

RESULTS

Of the 602 articles identified through the database screening, 29 were included in the current review. Potential challenges posed by technologically supported practical skill teaching identified were i) Inaccessibility and Inequity of Online Learning (ii) Digital illiteracy Among Staff (iii) Technological Challenges (iv) Lack of Engagement with Preparatory Material Hinders Practical Learning (v) Lack of Staff-Student Interaction (vi) Negative Attitudes Towards Online Learning and (vii) Skill Suitability. The opportunities presented by digital technologies identified were (i) Facilitates Higher Order Learning (ii) Ability to Practice in a Safe Environment (iii) Efficacious Use of Class Time (iv) Access to Education (v) Learning Brought to Life (vi) Diverse Range of Learning Materials (vii) Promotes Autonomous Learning.

DISCUSSION

This literature review demonstrates the acceptability and usability of digitally enhanced practical teaching in health science education among students and educators.

CONCLUSION

To consolidate the positive disturbances in higher education from the Covid-19 pandemic, potential barriers to online delivery and student engagement must be acknowledged and addressed by relevant stakeholders. Recommendations detailed as part of this paper suggest means of overcoming barriers and leveraging opportunities.

The Use of Simulators for Teaching Practical Clinical Skills to Veterinary Students - A Review

In the context of veterinary education, simulators are devices or sets of conditions aiming to imitate real patients and enable students to practice skills without the need for live animal use. Simulator use in veterinary education has increased significantly in recent years, allowing consistent practical teaching without reliance on clinical cases. This review examines the available literature regarding the use of simulation and simulators for teaching practical day one competences to veterinary students. Scientific databases were searched and 73 relevant articles were reviewed. The reviewed articles revealed that there are a number of simulators currently available to veterinary educators, that simulators can enhance student skills and provide an alternative learning environment without the need for live animal and/or cadaver use, and that they usually receive positive feedback from the students who use them. There appears to be a bias towards small animal simulators - however, some skills that are developed through the use of small animal or table-top models will be transferrable to other species. The majority of large animal simulators focus on bovine rectal palpation and/or pregnancy diagnosis. Further research is required to increase the repertoire of available simulators for use in veterinary education, in order to improve the practical skills of veterinary students and reduce the use of live animals and cadaver material for teaching purposes.

Rat skeletal muscle-nerve preparation to teach skeletal muscle physiology

This sourcebook update describes a variation of a previous sourcebook experiment that used isolated extensor digitorum longus muscle from mouse to teach skeletal muscle properties (Head SI, Arber MS. Adv Physiol Educ 37: 405-414, 2013). Gastrocnemius-sciatic nerve preparation in an anaesthetized rat was developed and muscle contractions were recorded in a computerized data acquisition system using an isometric force transducer. Teachers and students in physiology or biology can use this preparation to demonstrate skeletal muscle properties like simple muscle twitch, quantal summation, wave summation, superposition, incomplete tetanus, complete tetanus, treppe, fatigue, and length-tension relationship.

Development and Validation of the Nursing Students' Rights Awareness Scale in Clinical Practice: A Scale Development Study

Nursing students perform clinical training in a variety of clinical practice fields, so their rights are important. Efforts are needed to accurately identify and measure the awareness of nursing students' rights. This study aimed to develop and evaluate the psychometric properties of nursing students' rights awareness scale. The study procedure was carried out in four stages: the concept analysis, item development, scale development, and scale evaluation stage. First, in the concept analysis stage, the attributes of the concept were derived. Second, in the item development stage, preliminary items were derived, and the content validity was verified. Third, in the scale development stage, a preliminary and main survey were conducted, and item reduction was implemented. Fourth, in the scale evaluation stage, construct validity and reliability were verified. The collected data were analyzed using the SPSS 24.0, and item analysis was conducted using skewness, kurtosis, and item-total correlation scores. The construct validity was assessed by exploratory factor analysis, convergent validity, and divergent validity. The reliability was analyzed using Cronbach's alpha coefficient and composite reliability. The final version of the scale was tested on 240 nursing students from three cities in South Korea. From the construct validity, three factors and 14 items were selected. The factors included "the rights to be protected, cared for, supported, and respected" (eight items), "the rights to be recognized as a member of a nursing team" (three items), and "the rights to learn" (three questions). The reliability of the scale was also verified. Through this study, the scale was developed to identify the rights of nursing students in clinical practice. The implication of this study is that it has laid the foundation for measuring the rights of nursing students applicable in clinical settings for the first time. The limitation of this study is that data were collected in some regions. Therefore, it is necessary to verify the validity and reliability of the scale in various cultures.

A student practical to conceptualize the importance of Poiseuille's law and flow control in the cardiovascular system

The laboratory practical reported here is based in Poiseuille's law and utilizes low-cost laboratory consumable items, thereby making it easy to deploy in any teaching laboratory. In the practical, students take an experimental approach of individually changing physical variables and measuring fluid flow rates. Plotting these results allows them to discuss the effect each variable has on flow. Furthermore, students enhance their appreciation of experimental errors and variability by making repeat measurements. In the follow-up teaching session, the students are encouraged to apply their experimental findings to the cardiovascular system and the control of blood flow both at rest and under conditions of altered cardiac output, such as during exercise. By tackling the topic of flow control as a core concept, it allows the students to then apply their understanding in wider physiological contexts, such as airflow in the respiratory system.

Optimizing SSVEP-Based BCI System towards Practical High-Speed Spelling

The brain–computer interface (BCI) spellers based on steady-state visual evoked potentials (SSVEPs) have recently been widely investigated for their high information transfer rates (ITRs). This paper aims to improve the practicability of the SSVEP-BCIs for high-speed spelling. The system acquired the electroencephalogram (EEG) data from a self-developed dedicated EEG device and the stimulation was arranged as a keyboard. The task-related component analysis (TRCA) spatial filter was modified (mTRCA) for target classification and showed significantly higher performance compared with the original TRCA in the offline analysis. In the online system, the dynamic stopping (DS) strategy based on Bayesian posterior probability was utilized to realize alterable stimulating time. In addition, the temporal filtering process and the programs were optimized to facilitate the online DS operation. Notably, the online ITR reached 330.4 ± 45.4 bits/min on average, which is significantly higher than that of fixed stopping (FS) strategy, and the peak value of 420.2 bits/min is the highest online spelling ITR with a SSVEP-BCI up to now. The proposed system with portable EEG acquisition, friendly interaction, and alterable time of command output provides more flexibility for SSVEP-based BCIs and is promising for practical high-speed spelling.

Chronic diarrhoea in children: A practical algorithm-based approach

Diarrhoea is a leading cause of morbidity and mortality world-wide. Most diarrhoeal episodes are acute and infectious in origin. Diarrhoea lasting for longer than 4 weeks with no discernible infectious aetiology warrants thorough evaluation. The aim of this review is to elucidate an approach to evaluation of diarrhoea based on its pathophysiologic mechanisms with focus on aetiology, investigation and management of chronic diarrhoea. It includes a brief description of normal fluid homeostasis in the gut and pathophysiology of diarrhoea. Further, diarrhoea is classified as 'watery', 'fatty' and 'bloody' based on stool characteristics. Relevant history, physical examination findings, first and second-line investigations which help in differentiating the different types of diarrhoea are listed and an algorithmic approach to individual types of diarrhoea has been devised. Principles of management and recent advances in diagnostics and therapeutics of diarrhoea are briefly discussed.

Spreading the message of antimicrobial resistance: a detailed account of a successful public engagement event

The increase in Antimicrobial resistance (AMR) microorganisms has been exacerbated by exposure to antimicrobial drugs (e.g. antibiotics). A solution to AMR may require academic researchers to not only contribute to the drug discovery pipeline through laboratory research, but also to engage and inform non-specialist audiences using a variety of interventions in order to change behaviour towards our use of antibiotics. In this paper, the authors describe a hands-on public engagement event focusing on AMR. 'A Spoonful of Soil', was created by drawing on the past experiences of the delivering team (also described), with planning focusing on clear concise messages, selection of an appropriate audience and ensuring the event would be of significant interest to the audience. The event had a significant footfall of over 300 visitors. Key messages which aimed to raise awareness of AMR and educate visitors on the actions and behaviours that can help address the global issue of AMR were delivered by appropriate experts successfully, however success in reaching audience cannot be concluded from the feedback and evaluation gathered.

The Perceived Tightness Scale Does Not Provide Reliable Estimates of Blood Flow Restriction Pressure

CONTEXT

The perceived tightness scale is suggested to be an effective method for setting subocclusive pressures with practical blood flow restriction. However, the reliability of this scale is unknown and is important as the reliability will ultimately dictate the usefulness of this method.

OBJECTIVE

To determine the reliability of the perceived tightness scale and investigate if the reliability differs by sex.

DESIGN

Within-participant, repeated-measures.

SETTING

University laboratory.

PARTICIPANTS

Twenty-four participants (12 men and 12 women) were tested over 3 days.

MAIN OUTCOME MEASURES

Arterial occlusion pressure (AOP) and the pressure at which the participants rated a 7 out of 10 on the perceived tightness scale in the upper arm and upper leg.

RESULTS

The percentage coefficient of variation for the measurement was approximately 12%, with no effect of sex in the upper (median δ [95% credible interval]: 0.016 [-0.741, 0.752]) or lower body (median δ [95% credible interval]: 0.266 [-0.396, 0.999]). This would produce an overestimation/underestimation of ∼25% from the mean perceived pressure in the upper body and ∼20% in the lower body. Participants rated pressures above their AOP for the upper body and below for the lower body. At the group level, there were differences in participants' ratings for their relative AOP (7 out of 10) between day 1 and days 2 and 3 for the lower body, but no differences between sexes for the upper or lower body.

CONCLUSIONS

The use of the perceived tightness scale does not provide reliable estimates of relative pressures over multiple visits. This method resulted in a wide range of relative AOPs within the same individual across days. This may preclude the use of this scale to set the pressure for those implementing practical blood flow restriction in the laboratory, gym, or clinic.

Robust Self-Adaptation Fall-Detection System Based on Camera Height

Vision-based fall-detection methods have been previously studied but many have limitations in terms of practicality. Due to differences in rooms, users do not set the camera or sensors at the same height. However, few studies have taken this into consideration. Moreover, some fall-detection methods are lacking in terms of practicality because only standing, sitting and falling are taken into account. Hence, this study constructs a data set consisting of various daily activities and fall events and studies the effect of camera/sensor height on fall-detection accuracy. Each activity in the data set is carried out by eight participants in eight directions and taken with the depth camera at five different heights. Many related studies heavily depended on human segmentation by using Kinect SDK but this is not reliable enough. To address this issue, this study proposes Enhanced Tracking and Denoising Alex-Net (ETDA-Net) to improve tracking and denoising performance and classify fall and non-fall events. Experimental results indicate that fall-detection accuracy is affected by camera height, against which ETDA-Net is robust, outperforming traditional deep learning based fall-detection methods.

Implementation of a Standardized Data-Collection System for Comprehensive Appraisal of Cleft Care

OBJECTIVE

Our objective is to describe the process of adapting a conceptual framework into a practical toolkit for one cleft team.

DESIGN

This is a single-arm implementation study in a single institution.

SETTING

Implementation took place at a mid-sized multidisciplinary clinic for patients with cleft lip and/or palate (CL/P) from urban/suburban and rural areas across North Carolina and neighboring states.

PARTICIPANTS

Eligible participants were patients with CL/P from English-speaking families. Sixty patients entered and finished the study.

INTERVENTIONS

The implementation of a prospective data collection system based on the International Consortium for Health Outcomes Measurement (ICHOM) standard set of outcome measures for CL/P was accomplished in multiple stages. Patient- and clinician-reported forms and protocols for gathering data were created. Team members were trained and the system was tested; finally, the system was deployed.

MAIN OUTCOME MEASURES

Success was appraised using the RE-AIM framework to assess reach, effectiveness, adoption, implementation, and maintenance.

RESULTS

Ninety-eight percent of patients and all team members agreed to participate. Ninety-four percent of required data were captured. Adaptations to friction points were made; specifically, visible reminders were affixed to charts, primary clinicians were required to assume data entry responsibility, and e-mail reminders were instituted. Development cost was US$7707; average time cost per clinician was 21 min/wk.

CONCLUSIONS

Conceptual frameworks for outcomes studies must be tailored to their environments; otherwise, they cannot be practically implemented and sustained. We present this process for a cleft team using the ICHOM standard set. The process may help other teams implement the standard set or other conceptual frameworks.

Creation of Novel Toxic Gas Surrogates and the Development of Safe and Facile Catalytic Reactions

The use of toxic gas surrogates in organic reactions instead of the gas itself contributes to enhancing the safety, practicality, and efficiency of the reactions involved. Our efforts toward the creation of toxic gas surrogates and the development of a series of catalytic reactions using these surrogates are described. Improvements in substrate scope during the hydroesterification of alkenes using formates facilitated by the Ru-imidazole catalyst system provided the opportunity to discover that phenyl formate is a useful carbon monoxide (CO) surrogate for the generation of CO and phenol under weakly basic conditions. This discovery triggered the development of highly reactive but stable CO surrogates and a variety of Pd-catalyzed carbonylative transformations. N-Formylsaccharin facilitated the use of additional nucleophiles in carbonylation reactions that provided access to a variety of carbonyl compounds. Detailed experimental and theoretical mechanistic studies into the generation of CO from phenyl formate suggest that CO generation proceeds via a concerted E2 α-elimination. Furthermore, a known surrogate of sulfur dioxide was applied for the first time to the selective syntheses of cyclic sulfonamides and sulfinamides, confirming that the surrogate operates as an "S=O" source. Notably, the reactions described herein are scalable and can be performed without the use of external toxic gases and specialized reaction vessels; they are easy and simple to perform and demonstrate enormous potential for industrial application.

Impact of supplemental training programs on improving medical students' confidence in providing diabetes self-management education and support

BACKGROUND/PURPOSE

The purpose of this study was to evaluate the effectiveness of supplemental diabetes-related training modalities and volunteer activities in increasing first-year medical students' knowledge/comfort in providing diabetes self-management education and support (DSMES) to patients.

METHODS

A group of medical students developed supplemental diabetes-related training/volunteer programs. The training modalities included an optional 7-session interprofessionally taught Diabetes Enrichment Elective and a 3-hour endocrinologist-led training session intended to prepare students for involvement in an inpatient DSMES volunteer program. The volunteer program provided the students with the opportunity to provide DSMES to patients with diabetes admitted to an academic medical center. Those participating in any of the stated programs were compared to those with no such training regarding confidence in providing DSMES using an optional online survey. The results were analyzed by using Mann-Whitney U test and descriptive analyses.

RESULTS

A total of 18 first-year medical students responded to the optional survey with a response rate of ~30% (10 of 33) among participants in any training/volunteer program. First-year medical students who attended any of the offered optional programs had statistically significant higher comfort level in 4 of the 6 areas assessed regarding providing DSMES compared with those with no such training (p<0.05), with medium to large effect size (r=0.48-0.59).

CONCLUSION

This study suggests that the supplemental preclerkship diabetes-specific training modalities/volunteer programs can provide benefit in providing medical students with practical knowledge while improving their confidence in providing DSMES to patients with diabetes.

Demonstrating biosimilar and originator antidrug antibody binding comparability in antidrug antibody assays: a practical approach

Biosimilar drug development has brought new challenges to bioanalytical ligand-binding assays used to determine drug concentration, antidrug antibodies and neutralizing antibodies. One particular challenge is how to demonstrate that the antidrug antibody assay can adequately detect antibodies against both biosimilar and originator. In this paper, we review the current guidelines and literature for practical recommendations and present a gap analysis. Case examples of antibody binding comparability testing are presented, and the challenges and implications are discussed. Based on the lessons learned from our biosimilar assay applications, we recommend a bioanalytical comparability testing approach that is outlined and discussed.

Capillary microsampling in nonclinical safety assessment: practical sampling and bioanalysis from a CRO perspective

Microsampling has the 3R benefits of refining blood collection techniques while reducing the number of animals required for rodent safety assessment studies. There are significant scientific benefits of correlating study findings with systemic exposure and consequently, there is an industry drive to utilize microsampling in regulatory toxicology studies. This article will focus on capillary microsampling and will discuss the initial considerations before using capillary microsampling, study design and some practicalities of sample collection. From a bioanalytical perspective, the impact of different sample collection and storage workflows on the design of method validation experiments, the suitability of using microsampling for unstable analytes and aspects supporting analysis of peptides, large molecules and for biomarker applications will be discussed.

Evaluating the effectiveness of a practical inquiry-based learning bioinformatics module on undergraduate student engagement and applied skills

A pedagogic intervention, in the form of an inquiry-based peer-assisted learning project (as a practical student-led bioinformatics module), was assessed for its ability to increase students' engagement, practical bioinformatic skills and process-specific knowledge. Elements assessed were process-specific knowledge following module completion, qualitative student-based module evaluation and the novelty, scientific validity and quality of written student reports. Bioinformatics is often the starting point for laboratory-based research projects, therefore high importance was placed on allowing students to individually develop and apply processes and methods of scientific research. Students led a bioinformatic inquiry-based project (within a framework of inquiry), discovering, justifying and exploring individually discovered research targets. Detailed assessable reports were produced, displaying data generated and the resources used. Mimicking research settings, undergraduates were divided into small collaborative groups, with distinctive central themes. The module was evaluated by assessing the quality and originality of the students' targets through reports, reflecting students' use and understanding of concepts and tools required to generate their data. Furthermore, evaluation of the bioinformatic module was assessed semi-quantitatively using pre- and post-module quizzes (a non-assessable activity, not contributing to their grade), which incorporated process- and content-specific questions (indicative of their use of the online tools). Qualitative assessment of the teaching intervention was performed using post-module surveys, exploring student satisfaction and other module specific elements. Overall, a positive experience was found, as was a post module increase in correct process-specific answers. In conclusion, an inquiry-based peer-assisted learning module increased students' engagement, practical bioinformatic skills and process-specific knowledge. © 2016 by The International Union of Biochemistry and Molecular Biology, 44:304-313 2016.

Supportive care needs among Indigenous cancer patients in Queensland, Australia: less comorbidity is associated with greater practical and cultural unmet need

Little is known about the supportive care needs (SCN) of Australian Indigenous cancer patients. This cross-sectional study investigated the association between comorbidity and SCN among newly diagnosed Indigenous cancer patients in Queensland. Comorbidity was ascertained from medical chart review using the Charlson Comorbidity Index (CCI) and SCN were measured using the Supportive Care Needs Assessment Tool for Indigenous Peoples (SCNAT-IP). Of 183 participants, 76 (42%) had no comorbidity (CCI = 0), 60 (33%) had had a CCI score of 1 and 47 (26%) had a CCI of two or more, with the most common condition being diabetes (30%). The most common moderate-high unmet need items varied between comorbidity groups, although all patients most frequently reported moderate-high unmet need in the Physical and Psychological and the Practical and Cultural needs domains. Patients with the greatest comorbidity (CCI ≥ 2) had significantly more reduced odds of practical and cultural needs than patients without comorbidity (OR 0.28, 95% CI 0.11-0.75). This appeared to be partially explained by time since diagnosis, age, whether they were receiving current treatment and residential remoteness. Patients' experience of chronic disease, hospitals and the healthcare system may better prepare them for the practical and cultural aspects of their cancer journey.

Evaluating dissection in the gross anatomy course: Correlation between quality of laboratory dissection and students outcomes

Anatomy learned by active exploration through dissection has many proven benefits including improvement of anatomic knowledge. Decreased laboratory time may affect the quality of dissection and ultimately lower student performance in anatomy translating to lower knowledge acquisition. The aim of this study was to determine whether the quality of students' dissection in teams correlates with their performance in the gross anatomy course. Quality of dissections for each team enrolled in a gross anatomy course at Mayo Medical School was evaluated biweekly using a five-point rubric based on course learning objectives. Assessment of anatomic knowledge was based on sequential laboratory practice practical examination scores, achievements on daily audience response system (ARS) quizzes, and final practical, written, and National Board of Medical Examiners(®) (NBME(®) ) Gross Anatomy and Embryology Subject Examinations. Twelve teams comprising 48 students were included in the study. There was a positive correlation between dissection quality and practice practical examination score (R = 0.83) and a negative correlation between dissection quality and ARS quizzes (R = -0.985). Dissection teams with a passing score on their dissection evaluations (>70%) performed better on their final examinations. Based on an end of course survey, students agreed that dissection evaluations should continue to be a part of the course. This study showed that better quality of dissection was associated with higher scores on practice practical examinations, final practical, written, and NBME examinations. The study demonstrated a positive correlation between dissection evaluations, accompanied by formative feedback during the course, and higher scores on final course assessments.

Construction of an affordable and easy-to-build zebrafish facility

In vivo biomedical research is pivotal to translate in vitro findings into clinical advances. Small academic institutions with limited resources find it virtually impossible to build and maintain typical rodent facilities for research. Zebrafish research has been demonstrated to be a valuable alternative for in vivo research in pharmacology, physiology, development and genetic studies. This article demonstrates that a functional zebrafish facility can be built in an easy and affordable manner. We demonstrate that such a facility could be built in about one working day with minimal tools and expertise. The cost of the 27 1.8 L fish tank zebrafish facility constructed in this study was approximately $1,500. We estimate that the maintenance of an initial working 150 fish colony for 3 months is $1,000. This project involved students, who were introduced to aquaculturing of zebrafish for research proposes.

The impact of various assessment parameters on medical students' performance in first professional examination in physiology

Background:

This study was carried out to assess the relationship between thevarious assessment parameters, viz. continuous assessment (CA), multiple choice questions (MCQ), essay, practical, oral with the overall performance in the first professional examination in Physiology.

Materials and Methods:

The results of all 244 students that sat for the examination over 4 years were used. The CA, MCQ, essay, practical, oral and overall performance scores were obtained. All the scores were rounded up to 100% to give each parameter equal weighting.

Results:

Analysis showed that the average overall performance was 50.8 ± 5.3. The best average performance was in practical (55.5 ± 9.1), while the least was in MCQ (44.1 ± 7.8). In the study, 81.1% of students passed orals, 80.3% passed practical, 72.5% passed CA, 58.6% passed essay, 22.5% passed MCQ and 71.7% of students passed on the overall performance. All assessment parameters significantly correlated with overall performance. Continuous assessment had the best correlation (r = 0.801, P = 0.000), while oral had the least correlation (r = 0.277, P = 0.000) with overall performance. Essay was the best predictor of overall performance (β = 0.421, P = 000), followed by MCQ (β = 0.356, P = 000), while practical was the least predictor of performance (β = 0.162, P = 000).

Conclusion:

We suggest that the department should uphold the principle of continuous assessment and more effort be made in the design of MCQ so that performance can improve.

Statins: Practical Considerations - A Review

Statins are currently the most efficacious and widely prescribed lipid-lowering medications. The 2013 ACC/AHA cholesterol guidelines provide a dramatic shift in treatment approach with a focus on fixed-dose statins matched to individual risk scores. Statin intolerance is not uncommon and can be challenging to diagnose and manage; however, several therapeutic strategies have been successful in achieving statin tolerance. Statin use is also associated with liver enzyme elevations and increased risk of incident diabetes, but studies show these individuals benefit from statins. Several guidelines exist and statin use is expected to increase with the new cholesterol guidelines bringing along new challenges for prescribers. This review article will provide practical considerations for statin use and management of statin intolerance.

Learning physical examination skills outside timetabled training sessions: what happens and why?

Lack of published studies on students' practice behaviour of physical examination skills outside timetabled training sessions inspired this study into what activities medical students undertake to improve their skills and factors influencing this. Six focus groups of a total of 52 students from Years 1-3 using a pre-established interview guide. Interviews were recorded, transcribed and analyzed using qualitative methods. The interview guide was based on questionnaire results; overall response rate for Years 1-3 was 90% (n = 875). Students report a variety of activities to improve their physical examination skills. On average, students devote 20% of self-study time to skill training with Year 1 students practising significantly more than Year 3 students. Practice patterns shift from just-in-time learning to a longitudinal selfdirected approach. Factors influencing this change are assessment methods and simulated/real patients. Learning resources used include textbooks, examination guidelines, scientific articles, the Internet, videos/DVDs and scoring forms from previous OSCEs. Practising skills on fellow students happens at university rooms or at home. Also family and friends were mentioned to help. Simulated/real patients stimulated students to practise of physical examination skills, initially causing confusion and anxiety about skill performance but leading to increased feelings of competence. Difficult or enjoyable skills stimulate students to practise. The strategies students adopt to master physical examination skills outside timetabled training sessions are self-directed. OSCE assessment does have influence, but learning takes place also when there is no upcoming assessment. Simulated and real patients provide strong incentives to work on skills. Early patient contacts make students feel more prepared for clinical practice.