The relationship between professional behaviour grades and tutor performance ratings in problem-based learning

PURPOSE: We investigated the influence of harsh grading by tutors on tutor performance rating by students. METHODS: A total of 187 tutors assessed students' professional behaviour in tutorial groups. Students rated tutor performance after receiving their grades for professional behaviour. In addition, students were asked to indicate whether they perceived their professional behaviour grades as too positive, adequate or too negative. This was considered to reflect tutors' harshness of grading. Students also rated the quality of the feedback they received from tutors with respect to their grades. RESULTS: Professional behaviour grades that students perceived as too negative, adequate or too positive were associated with tutor performance ratings of 7.4 (SD = 0.9, scale 1-10, n = 33), 7.7 (SD = 0.9, scale 1-10, n = 95) and 7.5 (SD = 0.8, scale 1-10, n = 59), respectively. Harshness of grading did not influence tutor performance ratings significantly. Tutor ratings were predicted more effectively by the quality of the feedback tutors provided on grades than by the harshness of grading. CONCLUSIONS: Tutor performance ratings were not related significantly to harshness of grading. Two explanations can be given: (1) tutor performance ratings were based on rating by groups of students and (2) the percentage of tutors who rated students' professional behaviour as unsatisfactory was low. The strong relationship between tutor performance ratings and the adequacy of the feedback given by tutors suggests that the tutor performance ratings collected in this study are a valid measure of the quality of their teaching, although, for a full picture of teaching quality, more measures will be needed.     

Analysis of verbal interactions in tutorial groups: a process study

INTRODUCTION: Collaborative learning, including problem-based learning (PBL), is a powerful learning method. Group interaction plays a crucial role in stimulating student learning. However, few studies on learning processes in medical education have examined group interactions. Most studies on collaboration within PBL used self-reported data rather than observational data. We investigated the following types of interactions in PBL tutorial groups: learning-oriented interactions (exploratory questioning, cumulative reasoning and handling conflicts about knowledge); procedural interactions, and irrelevant/off-task interactions. AIM: The central question concerned how much time is spent on the different types of interaction during group sessions and how the types of interaction are distributed over the meeting. METHOD: Four tutorial group sessions in Year 2 of the PBL undergraduate curriculum of Maastricht Medical School were videotaped and analysed. The sessions concerned the reporting phase of the PBL process. We analysed the interactions using a coding scheme distinguishing several verbal interaction types, such as questions, arguments and evaluations. RESULTS: Learning-orientated interactions accounted for 80% of the interactions, with cumulative reasoning, exploratory questioning and handling conflicts about knowledge accounting for about 63%, 10% and 7% of the interactions, respectively. Exploratory questioning often preceded cumulative reasoning. Both types occurred throughout the meeting. Handling conflicts mainly occurred after the first 20 minutes. CONCLUSIONS: Task involvement in the tutorial groups was high. All types of learning-orientated interactions were observed. Relatively little time was spent on exploratory questions and handling conflicts about knowledge. Problem-based learning training should pay special attention to stimulating discussion about contradictory information.     

Students' perceptions of time spent during clinical rotations

Some rotations during clinical education are characterized by a high number of hours spent per week in the hospital because students panicipate in a hospital on-call system, i.e. hours beyond usual working hours, e.g. at night. However, students complain about spending too many hours in the hospital on non-instructive activities. This study was undertaken to investigate differences among rotations in time spent in hospital, in on-call hours, in self-study and in non-instructive activities and to investigate the relationship between time spent on the various activities and the overall effectiveness as perceived by students. A questionnaire was administered to students at the end of various clinical rotations. Rotations differ considerably in time spent in hospital, on call (i.e. beyond usual working hours), on self-study and on non-instructive activities. In some rotations students report spending on average 18-20% of their time in the hospital on non-instructive activities. Furthermore, the numbers of hours spent in hospital do not correlate with the overall effectiveness as perceived by students, unless the numbers of hours spent in non-instructive activities are taken into account. The effectiveness of a rotation does not automatically improve if students spend more hours in hospital. The number of hours spent on non-instructive activities should be reduced in some rotations and should be kept as low as possible. Further research is needed to find out which activities are perceived as non-instructive.     

Autosomal dominant cerulean cataract is associated with a chain termination mutation in the human beta-crystallin gene CRYBB2

Congenital cataracts are a common major abnormality of the eye that frequently cause blindness in infants. At least a third of all cases are familial; autosomal dominant congenital cataract (ADCC) appears to be the most common familial form in the Western world. Cerulean cataracts have peripheral bluish and white opacifications in concentric layers with occasional central lesions arranged radially. Although the opacities may be observed during fetal development and childhood, usually visual acuity is only mildly reduced until adulthood, when lens extraction is generally necessary. We have been studying a family (ADCC- 1) with cerulean blue ADCC, in which the affected daughter of a first cousin mating was presumed to be homozygous for the cataract gene. Recently, we mapped an ADCC gene in this family to a region of chromosome 22 containing three beta-crystallin genes. Here we report that a chain-termination mutation in CRYBB2 is associated with ADCC in this family.      

Carcinofibroma--a rare variant of mixed müllerian tumor

We report a case of an endometrial neoplasm of Müllerian origin, consisting of a malignant epithelial component and a benign stromal component. Only 3 similar cases have been described previously. By comparative study of other, more common mixed Müllerian tumors, we have tried to determine the behavior and management of this neoplasm.     

The Relation Between Time Spent on Individual Study and Academic Achievement in a Problem-Based Curriculum

Logically a relation is expected between time spent on individual study and achievement. The purpose of this study is to examine whether a positive relation exists between the amount of time spent on individual study and academic achievement and whether this differs when using a test measuring short-term knowledge or one measuring long-term knowledge. Data were collected in a problem-based medical curriculum. The results suggest that time spent on individual study correlates poorly with scores on the test measuring short-term knowledge but also with those on the test measuring long-term knowledge. This study reaffirms the complexity of the relationship and it demonstrates the importance to search for qualitative factors about the way students learn. This revised version was published online in June 2006 with corrections to the Cover Date.     

Evaluation of predominant risk factors for type 2 diabetes mellitus among out-patients in two Nigerian secondary health facilities

BackgroundPrevention of type 2 diabetes is enabled by identification and effective management of risk factors.ObjectivesTo evaluate the predominant risks for type 2 diabetes and identify persons at highest risk in a population; to facilitate the understanding of implications for practice.MethodsCross-sectional survey using Canadian diabetes risk assessment questionnaire was conducted among non-diabetic persons who visited two secondary hospitals. SPSS version 18 was used for data analysis.ResultsA total of 300 respondents participated in the study, with 25.7% having family history of type 2 diabetes, while 160 (53.3%) were at high risk of developing the disease. Males (62.5%), overweight (65.1%) and obese (82.6%) participants, were at higher risk. Others found to be at high risk were respondents with high waist circumference (55.6%), respondents who did not exercise (77.0%), those who did not eat fruits/vegetable daily (54.4%), those with high blood pressure (67.5%) and those who have had raised blood sugar in the past (71.0%).ConclusionMajority of the study participants was at high risk for type 2 diabetes, male participants had higher risks and lifestyles/habits were the major risks for developing the disease..     

Hyaluronan Enhances Bone Marrow Cell Therapy for Myocardial Repair After Infarction

Hyaluronan (HA) has been shown to play an important role during early heart development and promote angiogenesis under various physiological and pathological conditions. In recent years, stem cell therapy, which may reduce cardiomyocyte apoptosis, increase neovascularization, and prevent cardiac fibrosis, has emerged as a promising approach to treat myocardial infarction (MI). However, effective delivery of stem cells for cardiac therapy remains a major challenge. In this study, we tested whether transplanting a combination of HA and allogeneic bone marrow mononuclear cells (MNCs) promotes cell therapy efficacy and thus improves cardiac performance after MI in rats. We showed that HA provided a favorable microenvironment for cell adhesion, proliferation, and vascular differentiation in MNC culture. Following MI in rats, compared with the injection of HA alone or MNC alone, injection of both HA and MNCs significantly reduced inflammatory cell infiltration, cardiomyocyte apoptosis, and infarct size and also improved cell retention, angiogenesis, and arteriogenesis, and thus the overall cardiac performance. Ultimately, HA/MNC treatment improved vasculature engraftment of transplanted cells in the infarcted region. Together, our results indicate that combining the biocompatible material HA with bone marrow stem cells exerts a therapeutic effect on heart repair and may further provide potential treatment for ischemic diseases.     

The effect of EDTA, cations, and various buffers on the morphology of erythrocyte membranes: an electron-microscopic study

Membranes of human erythrocytes were prepared by stepwise osmotic hemolysis in Ca2+-free solutions. Examination with the electron microscope after negative staining showed some short, conelike protuberances on the surface of about 20 percent of the ghosts, while 80 percent were round, intact spheres. After Ca2+ treatment, all membranes were round and intact. After exposure to ethylenediaminetetraacetic acid (EDTA) (1.0 mM, pH 7.4), the entire ghost surface was covered with long, thin extrusions called stromalytic forms (about 460 per cell). Their sizes, shapes, and fine structure are described. Exposure to ionic calcium (1.4 times 10-minus 4M) abolished the EDTA-induced stromalytic forms. A second exposure to EDTA reversed this Ca2+ effect. ATP, like EDTA, produced stromalytic forms. EDTA- induced stromalytic forms were also abolished by Zn2+, La3+, and Nd3+ at concentrations of 1-5 times 10-minus 4 M. Mg2+ at 10-minus 2 M was ineffective. Ghosts were prepared by graded lysis in various buffers. Those prepared in phosphate were the most stable and provided consistent EDTA effects and Ca2+ reversal. Ghosts in Tris-HCl showed breakdown unless salt was added. Moderately satisfactory ghosts were also obtained in Hepes-NaOH buffer and salt.