Intelligent and adaptive tutoring for active learning and training environments

Active learning facilitated through interactive and adaptive learning environments differs substantially from traditional instructor-oriented, classroom-based teaching. We present a Web-based e-learning environment that integrates knowledge learning and skills training. How these tools are used most effectively is still an open question. We propose knowledge-level interaction and adaptive feedback and guidance as central features. We discuss these features and evaluate the effectiveness of this Web-based environment, focusing on different aspects of learning behaviour and tool usage. Motivation, acceptance of the approach, learning organisation and actual tool usage are aspects of behaviour that require different evaluation techniques to be used

Elevated apoptosis impairs epithelial cell turnover and shortens villi in TNF-driven intestinal inflammation

The intestinal epithelial monolayer, at the boundary between microbes and the host immune system, plays an important role in the development of inflammatory bowel disease (IBD), particularly as a target and producer of pro-inflammatory TNF. Chronic overexpression of TNF leads to IBD-like pathology over time, but the mechanisms driving early pathogenesis events are not clear. We studied the epithelial response to inflammation by combining mathematical models with in vivo experimental models resembling acute and chronic TNF-mediated injury. We found significant villus atrophy with increased epithelial cell death along the crypt-villus axis, most dramatically at the villus tips, in both acute and chronic inflammation. In the acute model, we observed overexpression of TNF receptor I in the villus tip rapidly after TNF injection and concurrent with elevated levels of intracellular TNF and rapid shedding at the tip. In the chronic model, sustained villus atrophy was accompanied by a reduction in absolute epithelial cell turnover. Mathematical modelling demonstrated that increased cell apoptosis on the villus body explains the reduction in epithelial cell turnover along the crypt-villus axis observed in chronic inflammation. Cell destruction in the villus was not accompanied by changes in proliferative cell number or division rate within the crypt. Epithelial morphology and immunological changes in the chronic setting suggest a repair response to cell damage although the villus length is not recovered. A better understanding of how this state is further destabilised and results in clinical pathology resembling IBD will help identify suitable pathways for therapeutic intervention

Studying health information from a distance: refining an e-learning case study in the crucible of student evaluation

Purpose: To present a formative evaluation of the impact of a multimedia case study as a component of a masters course in health informatics delivered by distance learning. Setting/Participants/Resources: First and second year health informatics students undertaking four core modules of a masters programme at the University of Sheffield. Methodology: Individual qualitative user surveys and interviews. Results/Outcomes: Formative evaluation has played a significant role in refining the case study through its text-based, intermediate and CD-ROM based stages. Feedback from students has resulted in clarification of case study tasks, clearer definition of teaching roles and a revised approach to assessment. At the same time it has highlighted the importance of ongoing revision and maintenance in keeping the scenarios realistic and current. Discussion/Conclusion: The multimedia case study has met many of its original aims in providing greater cohesion for core modules and encouraging greater levels of interaction and multidisciplinary collaboration