UMMS Student Perspectives on Lecturing

Provides lecturing faculty at the University of Massachusetts Medical School with clear, vibrant, concrete student perspectives on effective practices for conducting lectures, as developed in a student-run focus group. Students have seen countless permutations of the PowerPoint lecture, and this document describes some techniques used by UMMS faculty that students have found particularly effective. It provides concrete examples pulled from among our more successful lectures, offering explanations as to how and why these methods help promote sound basic science learning. Includes an executive summary

UMMS Student Perspectives on Course Structure

Provides course directors at the University of Massachusetts Medical School with clear, vibrant, concrete student perspectives on effective practices for conducting courses, as developed in a student-run focus group. Includes an executive summary

Are Our Students Teachers?

Background: Though the practical and philosophical importance of teaching educational skills to students of medicine has been widely acknowledged, the principle accrediting bodies of resident and medical student training in the U.S. do not require medical schools to offer formal training in how to teach. Both recognize resident teaching in their competencies: the Accreditation Council for Graduate Medical Education (ACGME) requires all residencies to have a formal program in teaching; the Liaison Committee on Medical Education (LCME) mandates that all residents and faculty charged with teaching medical students “be prepared for their roles in teaching and assessment.” But many medical students begin to teach their peers and junior students during medical school. In a 2008 poll of 130 accredited, M.D.-granting US medical schools, all 99 responding institutions reported using their students as teachers, though less than half offered formal curriculum in teaching, and among them, the majority of curricula reached only a fraction of graduating students, usually toward the end of their final year. In addition, students teach patients from early in their training, and formal teaching skills may support this activity and thus enhance patient care. Despite favorable argument for the value and efficacy of such programs in the literature of the past three decades, U.S. medical education has largely deferred the formal instruction of educational skills to the postgraduate level. UMMS offers its students a patchwork of peer and patient educational opportunities without presently offering formal background in evidence-based teaching skills. While this type of scattered elective experience can be immensely valuable to students, further formalization may better prepare UMMS students to satisfy the institutional competency of “assuming the role of teacher when appropriate.” The introduction and refinement of teaching skills may in turn benefit the quality of the educational program, the wider institutional and interprofessional learning environment, and patient care and health education across the Commonwealth. Many UMMS students stay on to become teaching residents and faculty, and remain – or later return – to the state to practice and teach. In a demanding era of expanding biomedical complexity, reduced resident duty hours, collaborative health care delivery, and patient-centered decision-making, offering or requiring relevant educational training to our clinicians early in their development may provide substantial benefit to our health care system and patients. Objectives: The objectives of this project were: 1) Quantify the existence of peer and patient teaching opportunities within and outside the formal UMMS educational program at all levels of the curriculum; 2) Describe the receptiveness of faculty and students toward institution of a formal program preparing all UMMS students to teach both peers and patients in a variety of settings common to residency and clinical practice in any field; 3) Report arguments for and against such a program from the vantage of faculty and students, including barriers specific to UMMS; and 4) Propose a blueprint for such a program based on the opportunities already offered, new ideas from faculty and students, and models culled both from the educational literature and from other institutions. Methods: Short online surveys were sent to course-directing faculty and to all currently enrolled UMMS students in years 1-4 of the curriculum using a combination of Likert-scale and open response items. Per the IRB, the survey did not require a formal approval or exemption process. Results: FACULTY: 58% of all course and clerkship faculty responded; 48% stated that their courses already offer some opportunity in peer and patient teaching, though only in select cases do students receive formal training in educational methodology and thorough feedback on their performance as educators. Often, these programs do not apply to all students. 50% of faculty were most (4-5 on a 5-point scale) “interested in incorporating a formal student teaching component into [their] course,” and when asked whether they had particular “ideas for how students might practice their peer education or patient teaching skills within [their] course?” 67% answered “yes,” posing a variety of possibilities for peer and patient education, both familiar and innovative. Students: 143 responses (28%) were received from currently enrolled students, constituting 17.6% of MS1, 25.4% of MS2, 26.9% of MS3, and 39.6% of MS4 and extending students. Self-reported comfort as a peer and patient educator increased modestly over class years, when expressed as an average of responses on a 1-5 Likert scale (Peer: MS1 3.00, MS2 3.13, MS3 3.13, MS4 3.47, MS4 extended 3.57; Patient: MS1 3.32, MS2 3.75, MS3 3.88, MS4 3.95, MS4 extended 4.21). 30.8% of students identified some opportunity to teach within the formal curriculum; outside the formal curriculum, 28.7% of students listed no opportunity, while the rest listed different amounts and frequencies ranging from daily to once a year, depending on how they defined teaching. 75.6% of responding students emphasized the value of “learn[ing] formal teaching skills - small group, lecture, bedside - in medical school” and 77.7% emphasized the value of opportunities to “practice formal teaching skills” (4-5 on a 5-point scale). 41.3% indicated that they would “actively create time to learn, practice, and refine these skills prior to residency if it were not included in the formal academic program.” Conclusion: Though teaching opportunities exist at UMMS, most are not formalized, and those offered reach less than a third of students. While comfort with peer and patient teaching increases across the educational continuum from first to fourth year, the increase remains modest. 84% of graduates report that they felt prepared to teach as interns based on their 2011 AAMC graduation questionnaire responses, but given the importance of teaching in many aspects of medicine, we see room for improvement. Overall, there is a strong call both from both faculty and students at UMMS for formally incorporating educational training into the curriculum, with a particular focus on teaching practice. Free-response items emphasized dramatic differences in student and faculty understanding and recognition of teaching as a professional role among both peers and patients. These discrepancies highlight a need for increased awareness of the teaching responsibilities of medical students, and of the possibilities that are open to them during medical school. A structured approach to medical student teaching skills across the continuum of undergraduate medical education is the first step in this process

The Data Life Aquatic

   This paper assesses data consumers’ perspectives on the interoperable and re-usable aspects of the FAIR Data Principles. Taking a domain-specific informatics approach, ten oceanographers were asked to think of a recent search for data and describe their process of discovery, evaluation, and use. The interview schedule, derived from the FAIR Data Principles, included questions about the interoperability and re-usability of data. Through this critical incident technique, findings on data interoperability and re-usability give data curators valuable insights into how real-world users access, evaluate, and use data. Results from this study show that oceanographers utilize tools that make re-use simple, with interoperability seamless within the systems used. The processes employed by oceanographers present a good baseline for other domains adopting the FAIR Data Principles.&nbsp

Correlation of CAG repeat length between the maternal and paternal allele of the Huntingtin gene: evidence for assortative mating

Triplet repeats contribute to normal variation in behavioral traits and when expanded, cause brain disorders. While Huntington's Disease is known to be caused by a CAG triplet repeat in the gene Huntingtin, the effect of CAG repeats on brain function below disease threshold has not been studied. The current study shows a significant correlation between the CAG repeat length of the maternal and paternal allele in the Huntingtin gene among healthy subjects, suggesting assortative mating

RFI Risk Reduction Activities Using New Goddard Digital Radiometry Capabilities

The Goddard Radio-Frequency Explorer (GREX) is the latest fast-sampling radiometer digital back-end processor that will be used for radiometry and radio-frequency interference (RFI) surveying at Goddard Space Flight Center. The system is compact and deployable, with a mass of about 40 kilograms. It is intended to be flown on aircraft. GREX is compatible with almost any aircraft, including P-3, twin otter, C-23, C-130, G3, and G5 types. At a minimum, the system can function as a clone of the Soil Moisture Active Passive (SMAP) ground-based development unit [1], or can be a completely independent system that is interfaced to any radiometer, provided that frequency shifting to GREX's intermediate frequency is performed prior to sampling. If the radiometer RF is less than 200MHz, then the band can be sampled and acquired directly by the system. A key feature of GREX is its ability to simultaneously sample two polarization channels simultaneously at up to 400MSPS, 14-bit resolution each. The sampled signals can be recorded continuously to a 23 TB solid-state RAID storage array. Data captures can be analyzed offline using the supercomputing facilities at Goddard Space Flight Center. In addition, various Field Programmable Gate Array (FPGA) - amenable radiometer signal processing and RFI detection algorithms can be implemented directly on the GREX system because it includes a high-capacity Xilinx Virtex-5 FPGA prototyping system that is user customizable

Healing Through History: a qualitative evaluation of a social medicine consultation curriculum for internal medicine residents

Background: Social context guides care; stories sustain meaning; neither is routinely prioritized in residency training. Healing Through History (HTH) is a social medicine consultation curriculum integrating social determinants of health narrative into clinical care for medically and socially complex patients. The curriculum is part of an internal medicine (IM) residency outpatient clinical rotation at a Veterans Health Administration hospital. Our aim was to explore how in-depth social medicine consultations may impact resident clinical practice and foster meaning in work. Methods: From 2017 to 2019, 49 categorical and preliminary residents in their first year of IM training were given two half-day sessions to identify and interview a patient; develop a co-produced social medicine narrative; review it with patient and faculty; and share it in the electronic health record (EHR). Medical anthropologists conducted separate 90-min focus groups of first- and second-year IM residents in 2019, 1–15 months from the experience. Results: 46 (94%) completed HTH consultations, of which 40 (87%) were approved by patients and published in the EHR. 12 (46%) categorical IM residents participated in focus groups; 6 PGY1, and 6 PGY2. Qualitative analysis yielded 3 themes: patient connection, insight, and clinical impact; clinical skill development; and structural barriers to the practice of social medicine. Conclusions: HTH offers a model for teaching co-production through social and narrative medicine consultation in complex clinical care, while fostering meaning in work. Integration throughout training may further enhance impact

Transport of ER Vesicles on Actin Filaments in Neurons by Myosin V

Axoplasmic organelles in the giant axon of the squid have been shown to move on both actin filaments and microtubules and to switch between actin filaments and microtubules during fast axonal transport. The objectives of this investigation were to identify the specific classes of axoplasmic organelles that move on actin filaments and the myosin motors involved. We developed a procedure to isolate endoplasmic reticulum (ER) from extruded axoplasm and to reconstitute its movement in vitro. The isolated ER vesicles moved on exogenous actin filaments adsorbed to coverslips in an ATP-dependent manner without the addition of soluble factors. Therefore myosin was tightly bound and not extracted during isolation. These vesicles were identified as smooth ER by use of an antibody to an ER-resident protein, ERcalcistorin/protein disulfide isomerase (EcaSt/PDI). Furthermore, an antibody to squid myosin V was used in immunogold EM studies to show that myosin V localized to these vesicles. The antibody was generated to a squid brain myosin (p196) that was classified as myosin V based on comparisons of amino acid sequences of tryptic peptides of this myosin with those of other known members of the myosin V family. Dual labeling with the squid myosin V antibody and a kinesin heavy chain antibody showed that the two motors colocalized on the same vesicles. Finally, antibody inhibition experiments were performed with two myosin V-specific antibodies to show that myosin V motor activity is required for transport of vesicles on actin filaments in axoplasm. One antibody was made to a peptide in the globular tail domain and the other to the globular head fragment of myosin V. Both antibodies inhibited vesicle transport on actin filaments by greater than 90% compared to controls. These studies provide the first direct evidence that ER vesicles are transported on actin filaments by myosin V. These data confirm the role of actin filaments in fast axonal transport and provide support for the dual filament model of vesicle transport