Results of a double-blind placebo-controlled study using ciprofloxacin for prevention of travelers' diarrhea

To determine the efficacy, safety and effect on fecal flora of ciprofloxacin in the prevention of travelers' diarrhea, 54 volunteers traveling to Tunisia were randomized in a double-blind manner to receive either 500 mg ciprofloxacin or a placebo once daily for one week. Results of 53 volunteers were available for evaluation of efficacy. One of 25 subjects (4%) receiving ciprofloxacin versus 18 of 28 subjects (64%) in the placebo group experienced travelers' diarrhea (p<0.0001). The protection offered by ciprofloxacin was 94 %. In one volunteer taking ciprofloxacin, prophylaxis was terminated due to sunburn with blistering. Among 41 subjects reporting sunburn, no statistical difference was observed between the two treatment groups in the percentage of body surface area of sunburn. Quantitative feces cultures revealed a marked decrease in the number of gram-negative organisms in volunteers receiving ciprofloxacin and a significant increase in the number ofEscherichia coli in the placebo group. Five weeks after return, the aerobic bacterial flora of both treatment groups showed the pre-travel pattern.     

Testing a Causal Model for Learning in a Problem-based Curriculum

The aim of this study was to identify the relationship between elements that are important for the tutorial group process and the individual learning process in a problem-based curriculum. The variables under investigation were student-generated learning issues, individual learning process, reporting in the tutorial group, and achievement. A questionnaire containing 22 items was developed. Data were collected in the first year (N = 195) of the Medical School of the Maastricht University in the Netherlands during the academic year 1997–1998. The data were analysed using a structural modelling approach. The results indicate that the model fitted the data well. The path coefficients were moderately high, particular between the explanation-oriented approach and the depth of the reporting in the tutorial group. High path coefficients were also found between the depth of the reporting and achievement. In sum, the model gives insight into how important variables are related and it is recommended that data should be collected to test the model repeatedly. This revised version was published online in August 2006 with corrections to the Cover Date.     

Complex Interactions Between Tutor Performance,Tutorial Group Productivity and the Effectiveness of PBL Units as Perceived by Students

Aim: Tutor performance and tutorial group productivity interact with each other in a complex manner. The aim of this study was to investigate how tutor performance, tutorial group productivity and the effectiveness of a PBL unit interact with each other. Three hypotheses were tested: (1) Does the tutor performance score differ across different levels of group productivity? (2) Does the group productivity score differ across different levels of tutor performance? and (3) Is the learning effectiveness score of a PBL unit related to tutor performance and group productivity? Method: Students rated the tutor performance, the tutorial group productivity and the effectiveness of the PBL unit. In total 287 unique tutors were involved and were categorized as having a relatively low, average or relatively high score on tutor performance. This was also done for the group productivity score. For each combination, average effectiveness score were computed. Furthermore, partial correlation coefficients were computed. Results: The results demonstrated that the average tutor performance score was higher if the productivity score was higher (hypothesis 1). The results also demonstrated that the average productivity score was higher if the tutor performance score was higher (hypothesis 2). Furthermore it was found that the effectiveness score was higher if the productivity score was higher. The effectiveness score was also higher if the tutor score was higher. The results furthermore demonstrated that the correlation coefficient between tutor performance and effectiveness of the PBL unit is 0.01 (n.s.) if the correlation between the two variables was controlled for group productivity (was 0.36). In addition, the correlation coefficient between group productivity and effectiveness became 0.39 if the correlation between these two variables was controlled for tutor performance (was 0.51) (hypothesis 3). Conclusion: It is concluded that tutor performance differs across different levels of group productivity and that the group productivity score differs across different levels of tutor performance. In addition, it is concluded that both group productivity and the tutor’s performance have an impact on the effectiveness of a PBL unit, although the correlation between group productivity and effectiveness is higher than the correlation between tutor performance and effectiveness. This finding illustrates the importance of the group’s productivity in PBL and the tutor’s importance and implies that schools should put more efforts in improving tutorial group functioning as well as in improving a tutor’s performance.     

The impact of student-generated learning issues on individual study time and academic achievement

OBJECTIVES: The aim of this study was twofold. The first question concerns the way students make use of the learning issues they generate (as strict guidelines or as global guidelines) and whether this changes across years of training. The second question concerned the relationship between the way students make use of learning issues and the time spent on individual study and achievement on two tests of knowledge. DESIGN: A questionnaire was developed, containing seven items that measured to what extent students study strictly according to the student-generated learning issues and six items that measured to what extent students study beyond the student-generated learning issues. The questionnaire also contained one question in which students had to estimate the mean time spent on individual study. Achievement was measured by two forms of tests of knowledge, a block test assessing course content and a progress test assessing long-term functional knowledge. SETTING: Medical School of Maastricht University, the Netherlands. SUBJECTS: Medical students (response=69%) from the problem-based curriculum at the Maastricht University. RESULTS: During their first year students study strictly according to the content of the learning issues, whereas in later years students studied more according to their own learning needs and interests. In addition, students who tended to study beyond the generated learning issues spent more time on individual study and achieved better on both tests. CONCLUSIONS: Students in a problem-based curriculum seem to become better self-directed learners during the years of training.