Peer evaluations of group work in different years of medical school and academic achievement: how are they related?

Abstract Background To develop the skills needed in health care teams, training communication and teamwork skills are important in medical education. Small group collaborative learning is one of the methods utilized in such trainings, and peer evaluation is suggested to be useful in reinforcing the effectiveness of group learning activities. In Mie University Faculty of Medicine, group work consisting of book review sessions of liberal arts education in the first grade and problem-based learning (PBL) sessions in preclinical years were conducted using the same peer evaluation system that included three domains: degree of prior learning, contribution to group discussion, and cooperative attitude. This study was conducted to determine the relationships among behaviors during group work and the academic achievement of medical students. Methods With the data from a cohort of medical students in three consecutive academic years (n = 340), peer evaluation scores in groupworks of book review sessions, those in PBL sessions and paper test scores of preclinical years were analyzed. The correlations were analyzed with Spearman’s correlation coefficient, and the respective scores were compared by using the Wilcoxon signed-ranked test. Results Significant correlations were observed among the evaluation scores of respective domains in group work and paper test scores. The degree of prior learning had the strongest relationship among the three domains (rs = 0.355, p &lt; 0.001 between book review sessions and PBL; rs = 0.338, p &lt; 0.001 between book review sessions and paper test score; rs = 0.551, p &lt; 0.001 between PBL and paper test score). Peer evaluation scores of respective domains were found to be significantly higher in PBL. Conclusion Medical students maintained their groupwork behaviors to some extent from early school to preclinical years. Those behaviors were positively related to their academic achievement in the later years of the medical education curriculum. Our study highlighted the importance of the early introduction of group work. The results will be useful to motivate medical students to put more effort into group work. </jats:sec

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Association of Continuous Vertebral Bone Bridges and Bone Mineral Density with the Fracture Risk in Patients with Diffuse Idiopathic Skeletal Hyperostosis

Study Design: Cross-sectional study.Purpose: To examine whether the number of continuous vertebral bone bridges and bone mineral density (BMD) influence the fracture risk in diffuse idiopathic skeletal hyperostosis (DISH) patients.Overview of Literature: Bone bridges connecting through the intervertebral body in DISH create long lever arms that can increase the risk of fractures from minor trauma. DISH patients have a BMD that is higher than or comparable to those of age-matched healthy subjects.Methods: We examined the computed tomography scans from the thoracic vertebra to the sacrum used to diagnose DISH in 140 patients (98 men and 42 women; average age, 78.6 years). We compared patients who did (n=52) and did not have (n=88) fractures at the continuous vertebral bodies fused by bone bridges. The relationship between the vertebral fractures and the maximum number of vertebrae that are bony cross-linked with contiguous adjacent vertebrae (max VB) from the thoracic vertebra to the sacrum or from the lumbar vertebra to the sacrum and proximal femur BMD were analyzed using a logistic regression model.Results: We found that after adjusting for the confounding factors, higher max VB, both from the thoracic vertebrae to the sacrum and the lumbar vertebrae to the sacrum, was associated with a higher risk of vertebral fractures. This difference was statistically significant. The risk was higher when only the lumbar vertebrae to the sacrum was considered (thoracic vertebrae to the sacrum: odds ratio, 1.21; p&lt;0.05; lumbar vertebrae to the sacrum: odds ratio, 2.78; p&lt;0.01). Moreover, low proximal femur BMD in DISH patients raises the fracture risk (odds ratio, 0.47; p&lt;0.01).Conclusions: Many continuous vertebral bone bridges, especially those that extend to the lumbar spine and low proximal femur BMD, are risk factors for fracture in DISH patients.</jats:p