A 50% Reduction of Excitability but Not of Intercellular Coupling Affects Conduction Velocity Restitution and Activation Delay in the Mouse Heart

Computer simulations suggest that intercellular coupling is more robust than membrane excitability with regard to changes in and safety of conduction. Clinical studies indicate that SCN5A (excitability) and/or Connexin43 (Cx43, intercellular coupling) expression in heart disease is reduced by approximately 50%. In this retrospective study we assessed the effect of reduced membrane excitability or intercellular coupling on conduction in mouse models of reduced excitability or intercellular coupling. Epicardial activation mapping of LV and RV was performed on Langendorff-perfused mouse hearts having the following: 1) Reduced excitability: Scn5a haploinsufficient mice; and 2) reduced intercellular coupling: Cx43(CreER(T)/fl) mice, uninduced (50% Cx43) or induced (10% Cx43) with Tamoxifen. Wild type (WT) littermates were used as control. Conduction velocity (CV) restitution and activation delay were determined longitudinal and transversal to fiber direction during S(1)S(1) pacing and S(1)S(2) premature stimulation until the effective refractory period. In both animal models, CV restitution and activation delay in LV were not changed compared to WT. In contrast, CV restitution decreased and activation delay increased in RV during conduction longitudinal but not transverse to fiber direction in Scn5a heterozygous animals compared to WT. In contrast, a 50% reduction of intercellular coupling did not affect either CV restitution or activation delay. A decrease of 90% Cx43, however, resulted in decreased CV restitution and increased activation delay in RV, but not LV. Reducing excitability but not intercellular coupling by 50% affects CV restitution and activation delay in RV, indicating a higher safety factor for intercellular coupling than excitability in R

Peer-instructed seminar attendance is associated with improved preparation, deeper learning and higher exam scores: a survey study

Background: Active engagement in education improves learning outcomes. To enhance active participation in seminars, a student-centered course design was implemented and evaluated in terms of self-reported preparation, student motivation and exam scores. We hypothesized that small group learning with intensive peer interaction, using buzz-groups followed by plenary discussion, would motivate students to prepare seminar assignments at home and to actively engage in the seminars. Active engagement involved discussion of the preparatory assignments until consensus was reached. Methods: In total seven seminars were scheduled in a 10-week physiology course of an undergraduate Biomedical Sciences program. After each seminar, students were asked to fill out their perceptions of preparation and quality of the seminar (deepening of knowledge and confidence in answers) on a five-point scale using electronic questionnaires. Student motives were first collected using open questions. In the final questionnaire students were asked to indicate on a five-point scale how each motive was perceived. Students overall explanations why they had learned from seminars were collected via open questions in the final questionnaire. One hundred and twenty-four students of the cohort from November 2012 to February 2013 (82.6 %) voluntarily participated. Students’ motives to prepare and attend seminars were analyzed by inspection of descriptive statistics. Linear regression analysis was conducted to relate student preparation to the quality of seminars, seminar attendance to exam scores, and exam scores to the quality of seminars. Answers to open questions were deductively clustered. Results: Studying the material, training for exams and comparing answers with peers motivated students to prepare the seminars. Students were motivated to participate actively because they wanted to keep track of correct answers themselves, to better understand the content and to be able to present their findings in plenary discussions. Perceived preparation of peers was positively associated with the perceived quality of seminars. Also, seminar attendance was positively associated with exam scores. Students’ overall explanations suggest that discussing with peers and applying knowledge in pathophysiology cases underlies this association. Conclusion: Discussion with well-prepared peers during seminars improves student perceptions of deeper learning and peer-instructed seminar attendance was associated with higher exam scores

Peer-instructed seminar attendance is associated with improved preparation, deeper learning and higher exam scores: a survey study

Background: Active engagement in education improves learning outcomes. To enhance active participation in seminars, a student-centered course design was implemented and evaluated in terms of self-reported preparation, student motivation and exam scores. We hypothesized that small group learning with intensive peer interaction, using buzz-groups followed by plenary discussion, would motivate students to prepare seminar assignments at home and to actively engage in the seminars. Active engagement involved discussion of the preparatory assignments until consensus was reached. Methods: In total seven seminars were scheduled in a 10-week physiology course of an undergraduate Biomedical Sciences program. After each seminar, students were asked to fill out their perceptions of preparation and quality of the seminar (deepening of knowledge and confidence in answers) on a five-point scale using electronic questionnaires. Student motives were first collected using open questions. In the final questionnaire students were asked to indicate on a five-point scale how each motive was perceived. Students overall explanations why they had learned from seminars were collected via open questions in the final questionnaire. One hundred and twenty-four students of the cohort from November 2012 to February 2013 (82.6 %) voluntarily participated. Students’ motives to prepare and attend seminars were analyzed by inspection of descriptive statistics. Linear regression analysis was conducted to relate student preparation to the quality of seminars, seminar attendance to exam scores, and exam scores to the quality of seminars. Answers to open questions were deductively clustered. Results: Studying the material, training for exams and comparing answers with peers motivated students to prepare the seminars. Students were motivated to participate actively because they wanted to keep track of correct answers themselves, to better understand the content and to be able to present their findings in plenary discussions. Perceived preparation of peers was positively associated with the perceived quality of seminars. Also, seminar attendance was positively associated with exam scores. Students’ overall explanations suggest that discussing with peers and applying knowledge in pathophysiology cases underlies this association. Conclusion: Discussion with well-prepared peers during seminars improves student perceptions of deeper learning and peer-instructed seminar attendance was associated with higher exam scores

How do medical students prepare for flipped classrooms?

A flipped classroom, an approach abandoning traditional lectures and having students come together to apply acquired knowledge, requires students to come to class well prepared. The nature of this preparation is currently being debated. Watching web lectures as a preparation has typically been recommended, but more recently, a variety of study materials has been considered to serve students personal learning preferences. The aim of this study was to explore in two flipped courses which online study materials stimulate students most to prepare for in-class activities, to find out whether students differ in their use of study materials, and to explore how students use of online study materials relates to their learning strategies. In a basic science and a clinical course, medical students were provided with web lectures, text selections, scientific papers, books, and formative test questions or case studies. Use of these online materials was determined with questionnaires. All students watched web lectures and read text selections to prepare for in-class activities, but students differed in the extent to which they used more challenging materials. Additionally, the use of online study materials was related to students’ learning strategies that involved regulation and monitoring of study effort. Our findings suggest that students have similar learning preferences as they all use the same “basic materials” to prepare for in-class activities. We interpret the preferential use of web lectures and text selections as being regarded as sufficient for active in-class participation. The less intensive use of other study materials may reflect students’ perception of limited study time

How do medical students prepare for flipped classrooms?

A flipped classroom, an approach abandoning traditional lectures and having students come together to apply acquired knowledge, requires students to come to class well prepared. The nature of this preparation is currently being debated. Watching web lectures as a preparation has typically been recommended, but more recently, a variety of study materials has been considered to serve students personal learning preferences. The aim of this study was to explore in two flipped courses which online study materials stimulate students most to prepare for in-class activities, to find out whether students differ in their use of study materials, and to explore how students use of online study materials relates to their learning strategies. In a basic science and a clinical course, medical students were provided with web lectures, text selections, scientific papers, books, and formative test questions or case studies. Use of these online materials was determined with questionnaires. All students watched web lectures and read text selections to prepare for in-class activities, but students differed in the extent to which they used more challenging materials. Additionally, the use of online study materials was related to students’ learning strategies that involved regulation and monitoring of study effort. Our findings suggest that students have similar learning preferences as they all use the same “basic materials” to prepare for in-class activities. We interpret the preferential use of web lectures and text selections as being regarded as sufficient for active in-class participation. The less intensive use of other study materials may reflect students’ perception of limited study time

Audio peer feedback to promote deep learning in online education

We investigated the relation between providing and receiving audio peer feedback with a deep approach to learning within online education. Online students were asked to complete peer feedback assignments. Data through a questionnaire with 108 respondents and 14 interviews were used to measure to what extent deep learning was perceived and why. Results support the view that both providing and receiving audio peer feedback indeed promote deep learning. As a consequence of the peer feedback method, the following student mechanisms were triggered: “feeling personally committed,” “probing back and forth,” and “understanding one's own learning process.” Particularly important for both providing and receiving feedback is feeling personally committed. Results also show that mechanisms were a stronger predictor for deep learning when providing than when receiving. Given the context in which instructors face an increasing number of students and a high workload, students may be supported by online audio peer feedback as a method to choose a deep approach to learning

Audio peer feedback to promote deep learning in online education

We investigated the relation between providing and receiving audio peer feedback with a deep approach to learning within online education. Online students were asked to complete peer feedback assignments. Data through a questionnaire with 108 respondents and 14 interviews were used to measure to what extent deep learning was perceived and why. Results support the view that both providing and receiving audio peer feedback indeed promote deep learning. As a consequence of the peer feedback method, the following student mechanisms were triggered: “feeling personally committed,” “probing back and forth,” and “understanding one's own learning process.” Particularly important for both providing and receiving feedback is feeling personally committed. Results also show that mechanisms were a stronger predictor for deep learning when providing than when receiving. Given the context in which instructors face an increasing number of students and a high workload, students may be supported by online audio peer feedback as a method to choose a deep approach to learning

Promoting Deep Learning through Online Feedback in SPOCs

Higher education aims for deep learning and increasingly uses a specific form of online education: Small Private Online Courses (SPOCs). To overcome challenges that instructors face in order to promote deep learning through that format, the use of feedback may have significant potential. We interviewed eleven instructors and four students and organized a focus group to formulate scalable design propositions for instructors in SPOCs to promote deep learning. Propositions have been formulated according to the CIMO-logic. This study resulted in identification of four mechanisms by which the desired outcome (deep learning) can be achieved, which we describe here along with proposed interventions. Results show that the “online learning interaction model” can be deepened with these mechanisms: 1) Feeling personally committed, 2) Asking and providing relevant feedback, 3) Probing back and forth, and 4) Understanding one’s own learning process. To activate these mechanisms, scalable feedback interventions are described in three categories. Results at this relatively young field of SPOCs also show that feedback as a dialogical process may contribute to solving the current challenges of instructors in SPOCs to achieve deep learning with their students