A Pilot Study Investigating the Effect of the Supervision-Questioning-Feedback Model of Supervision on Stimulating Critical Thinking in Speech-Language Pathology Graduate Students

Purpose The purpose of this study was to investigate the effect of the supervision-questioning-feedback (SQF) model of supervision on critical thinking in graduate students studying speech-language pathology. The researchers hypothesized that students who were provided with the SQF model of supervision would score higher than students who received the non-SQF (NSQF) style of supervision on the selected critical thinking measures. Method Seventeen out of 24 first semester graduate students in speech-language pathology completing their on-site university-based clinical practicum experience consented to participate in the study. Of the 17 participating first semester students, 9 were randomly assigned to 1 of 3 SQF trained supervisors, and the other 8 were randomly assigned to 1 of 2 NSQF trained supervisors for the duration of 1 semester. Additionally, 3 out of 24 fourth semester graduate students completing their off-site externship experience and their supervisors consented to participate in the study. Four additional study participants served as independent SQF-trained raters charged with the task of analyzing video recorded student-supervisor conferences to determine whether the SQF model of supervision was being implemented. Prior to and at the conclusion of the clinical experience, all participating students completed two measures of critical thinking: (1) California Critical Thinking Skills Test (CCTST) and (2) two Simucase® clinical simulations. At the conclusion of the clinical experience, seventeen out of 20 participating students (11/12 SQF students and 6/8 NSQF students) completed a post-survey rating their supervisory experience . Results For participating first semester students, there were no overall statistically significant differences between SQF and NSQF groups as measured by pre to post completion of (1) CCTST (p=.544) and (2) two Simucase® clinical simulations (p=.781). The 3 participating fourth semester students who received the SQF model of supervision also showed no statistically significant differences on pre to post completion of the (1) CCTST (p=.827) and (2) two Simucase® virtual cases (p=.879). Results from SQF ratings revealed variability in the implementation of the SQF model across supervisors with a moderate level of inter-rater agreement. Results from post surveys completed by students showed that students preferred the SQF model of supervision over the NSQF model (p=.044). Conclusion Results from this preliminary study indicated that the SQF model did not influence the overall outcomes on the selected critical thinking measures. Student preference for the SQF model may support existing evidence that learning clinicians want to be actively engaged in the supervisory process. There were several limitations to this study including the small sample size, variability in the implementation of the SQF model across supervisors, sensitivity of the selected critical thinking measures, and timing of post-intervention procedures. Further investigation of the effects of SQF on students’ critical thinking is warranted

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Human predecidual stromal cells have distinctive characteristics of pericytes: Cell contractility, chemotactic activity, and expression of pericyte markers and angiogenic factors

Introduction: Human decidual stromal cells (DSCs) play a key role in maternalefetal interactions. Precursors of DSCs (preDSCs) localize around vessels in both the endometrium and decidua. Previous studies suggested a relationship between preDSCs and pericytes because these cells share a perivascular location, alpha smooth muscle actin (a-SM actin) expression and the ability to contract under the effects of cytokines. Methods: To further study this relationship, we established 15 human preDSC lines and 3 preDSC clones. The preDSC lines and clones were tested by flow cytometry with a panel of 29 monoclonal antibodies, 14 of which are pericyte markers. The expression of angiogenic factors was determined by RT-PCR, chemotactic activity was studied with the migration assay, and cell contractility was evaluated with the collagen cell contraction assay. Confocal microscopy was used to study decidual sections. Results: Under the effect of progesterone and cAMP, these lines decidualized in vitro: the cells became rounder and secreted prolactin, a marker of physiological DSC differentiation (decidualization). The antigen phenotype of these preDSC lines and clones was fully compatible with that reported for pericytes. PreDSC lines displayed pericyte characteristics: they expressed angiogenic factors and showed chemotactic and cytokine-induced contractile activity. Confocal microscopic examination of decidual sections revealed the expression of antigens detected in preDSC lines: a-SM actin colocalized with CD146, CD140b, MFG-E8, nestin, and STRO-1 (all of which are pericyte markers) in cells located around the vessels, a distinctive location of preDSCs and pericytes. Discussion: Taken together, our results show that preDSCs are pericyte-like cells.This work was supported by the Plan Estatal de Investigación Científica y Técnica y de Innovación 2013-2016, ISCIII-Subdirección General de Evaluación y Fomento de la Investigación, Ministerio de Economía y Competitividad, Spain (Grant PI16/01642), by ERDF/FEDER funding, European Community, by the basic sciences program of the Fondo Nacional para el financiamiento de la Ciencia, la Tecnología y la Innovación Francisco José de Caldas (COLCIENCIAS), and by Cal 658-2014, Basic Sciences Program, Colombia