Using Self-Reflection Activities to Aid Student Progression Through First-Year University

Each university student experiences different challenges during their education, whether it’s with course material or with issues outside the classroom. One method that can allow instructors to track and assess their students’ progression through a course or learning program is self-reflection. Through self-reflection activities, students are encouraged to reflect upon their overall learning experience and provide an opportunity to describe any challenges they might be facing. By monitoring reflection responses, instructors can quickly identify aspects of their course material or learning environment that students are struggling with. For the last two years, weekly reflection activities have been offered to students in the Science One Program at the University of British Columbia. This homework assignment is offered through our learning management system, with responses monitored by faculty, graded for completion, and feedback provided where necessary. A thematic analysis of responses have found strong themes around ideas of (1) Relationships, health and wellness, (2) Academic progress, skills and study habits and (3) Science, how it’s done, and its role in society. We have used these results to develop specific program elements that help our students address these issues. In this presentation, we will describe the nature of the reflection activity and its implementation, and discuss common themes identified in the reflection responses and their implications for student learning at university. Self-reflection activities are applicable to nearly any discipline or class structure, and can be an effective method for instructors to gain insight into the issues that students encounter during the school term

Severe falciparum malaria with dengue coinfection complicated by rhabdomyolysis and acute kidney injury: an unusual case with myoglobinemia, myoglobinuria but normal serum creatine kinase

<p>Abstract</p> <p>Background</p> <p>Acute kidney injury (AKI) is a complication of severe malaria, and rhabdomyolysis with myoglobinuria is an uncommon cause. We report an unusual case of severe falciparum malaria with dengue coinfection complicated by AKI due to myoglobinemia and myoglobinuria while maintaining a normal creatine kinase (CK).</p> <p>Case presentation</p> <p>A 49-year old Indonesian man presented with fever, chills, and rigors with generalized myalgia and was diagnosed with falciparum malaria based on a positive blood smear. This was complicated by rhabdomyolysis with raised serum and urine myoglobin but normal CK. Despite rapid clearance of the parasitemia with intravenous artesunate and aggressive hydration maintaining good urine output, his myoglobinuria and acidosis worsened, progressing to uremia requiring renal replacement therapy. High-flux hemodiafiltration effectively cleared his serum and urine myoglobin with recovery of renal function. Further evaluation revealed evidence of dengue coinfection and past infection with murine typhus.</p> <p>Conclusion</p> <p>In patients with severe falciparum malaria, the absence of raised CK alone does not exclude a diagnosis of rhabdomyolysis. Raised serum and urine myoglobin levels could lead to AKI and should be monitored. In the event of myoglobin-induced AKI requiring dialysis, clinicians may consider using high-flux hemodiafiltration instead of conventional hemodialysis for more effective myoglobin removal. In Southeast Asia, potential endemic coinfections that can also cause or worsen rhabdomyolysis, such as dengue, rickettsiosis and leptospirosis, should be considered.</p