Learning Styles, Critical Thinking Aptitudes, and Immersion Learning in Physician Assistant Students

The changes in healthcare delivery systems and the global burden of disease along with the overwhelming corpus of new knowledge call for a re-evaluation of the educational process of health profession programs. The focus on how best to optimize the learning process necessitates an acknowledgement of the roles of learning styles and critical thinking aptitudes. It also requires attention to the learning experiences and how these, in turn, affect development of both the styles and aptitudes. A sample of 137 Physician Assistant students was recruited to complete a learning style inventory, the Gregorc Style Delineator, and a critical thinking aptitude test, the Health Science Reasoning Test. Participants were then divided into two subgroups, identified as ‘preclinical PA students’ and ‘clinical PA students’ and the results obtained from both instruments were compared to explore for possible associations between immersion clinical experiences and learning style preferences and critical thinking aptitudes. The PA students were preferentially concrete sequential learners with moderate to strong critical thinking aptitudes. There were no significant differences between preclinical and clinical PA students with respect to learning styles or overall critical thinking aptitudes. Significant differences (P=.002) with improvement in scores, was noted for only one parameter of critical thinking, identified by the Health Science Reasoning Test as “inference”. While immersion learning did not appear to impact learning style preferences or overall critical thinking aptitudes, it is important to note the improvement in ‘inference; a skill critical for the medical decision making process required of PA students in their preparation for future practice

Learning Styles, Critical Thinking Aptitudes, and Immersion Learning in Physician Assistant Students

The changes in healthcare delivery systems and the global burden of disease along with the overwhelming corpus of new knowledge call for a re-evaluation of the educational process of health profession programs. The focus on how best to optimize the learning process necessitates an acknowledgement of the roles of learning styles and critical thinking aptitudes. It also requires attention to the learning experiences and how these, in turn, affect development of both the styles and aptitudes. A sample of 137 Physician Assistant students was recruited to complete a learning style inventory, the Gregorc Style Delineator, and a critical thinking aptitude test, the Health Science Reasoning Test. Participants were then divided into two subgroups, identified as ‘preclinical PA students’ and ‘clinical PA students’ and the results obtained from both instruments were compared to explore for possible associations between immersion clinical experiences and learning style preferences and critical thinking aptitudes. The PA students were preferentially concrete sequential learners with moderate to strong critical thinking aptitudes. There were no significant differences between preclinical and clinical PA students with respect to learning styles or overall critical thinking aptitudes. Significant differences (P=.002) with improvement in scores, was noted for only one parameter of critical thinking, identified by the Health Science Reasoning Test as “inference”. While immersion learning did not appear to impact learning style preferences or overall critical thinking aptitudes, it is important to note the improvement in ‘inference; a skill critical for the medical decision making process required of PA students in their preparation for future practice

Combined preconditioning and in vivo chemoselection with 6-thioguanine alone achieves highly efficient reconstitution of normal hematopoiesis with HPRT-deficient bone marrow

Purine analogs such as 6-thioguanine (6TG) cause myelotoxicity upon conversion into nucleotides by hypoxanthine-guanine phosphoribosyltransferase (HPRT). Here we have developed a novel and highly efficient strategy employing 6TG as a single agent for both conditioning and in vivo chemoselection of HPRT-deficient HSC. The dose-response and time course of 6TG myelotoxicity were first compared in HPRT-wild type mice and HPRT-deficient transgenic mice. Dosage and schedule parameters were optimized to employ 6TG for myelo-suppressive conditioning, immediately followed by in vivo chemoselection of HPRT-deficient transgenic donor bone marrow (BM) transplanted into syngeneic HPRT-wild type recipients. At appropriate doses, 6TG induced selective myelotoxicity without any adverse effects on extra-hematopoietic tissues in HPRT-wild type mice, while HSC deficient in HPRT activity were highly resistant to its cytotoxic effects. Combined 6TG conditioning and post transplant chemoselection consistently achieved ~95% engraftment of HPRT-deficient donor BM, with low overall toxicity. Long-term reconstitution of immunophenotypically normal BM was achieved in both primary and secondary recipients. Our results provide proof-of-concept that single-agent 6TG can be used both for myelo-suppressive conditioning without requiring irradiation, and for in vivo chemoselection of HPRT-deficient donor cells. Our results show that by applying the myelosuppressive effects of 6TG both before (as conditioning) and after transplantation (as chemoselection), highly efficient engraftment of HPRT-deficient hematopoietic stem cells can be achieved