Intervention Descriptions in Medical Education: What Can Be Improved? A Systematic Review and Checklist

PURPOSE: Many medical education studies focus on the effectiveness of educational interventions. However, these studies often lack clear, thorough descriptions of interventions that would make the interventions replicable. This systematic review aimed to identify gaps and limitations in the descriptions of educational interventions, using a comprehensive checklist. METHOD: Based on the literature, the authors developed a checklist of 17 criteria for thorough descriptions of educational interventions in medical education. They searched the Ovid MEDLINE, Embase, and ERIC databases for eligible English-language studies published January 2014-March 2016 that evaluated the effects of educational interventions during classroom teaching in postgraduate medical education. Subsequently, they used this checklist to systematically review the included studies. Descriptions were scored 0 (no information), 1 (unclear/partial information), or 2 (detailed description) for each of the 16 scorable criteria (possible range 0-32). RESULTS: Among the 105 included studies, the criteria most frequently reported in detail were learning needs (78.1%), content/subject (77.1%), and educational strategies (79.0%). The criteria least frequently reported in detail were incentives (9.5%), environment (5.7%), and planned and unplanned changes (12.4%). No article described all criteria. The mean score was 15.9 (SD 4.1), with a range from 8 (5 studies) to 25 (1 study). The majority (76.2%) of articles scored 11-20. CONCLUSIONS: Descriptions were frequently missing key information and lacked uniformity. The results suggest a need for a common standard. The authors encourage others to validate, complement, and use their checklist, which could lead to more complete, comparable, and replicable descriptions of educational interventions

The effects of high fat diet on the basal activity of the hypothalamus-pituitary-adrenal axis in mice.

Item does not contain fulltextAlterations in hypothalamus-pituitary-adrenal (HPA) axis activity have been linked to the development of the metabolic syndrome (MetS). Common features of the MetS, like insulin resistance and obesity, are reproducibly induced by high fat diet (HFD) in animal models of diet-induced obesity. These models, hampered by methodological differences, reveal conflicting results with respect to HPA axis activation. This study was aimed to evaluate in detail nonstressed diurnal HPA axis activity in mice during obesity development. Male C57Bl/6J mice were fed high or low fat diet for 12 weeks. HPA axis activity was evaluated by plasma corticosterone concentrations (at 0700, 1200, and 1800 h), corticotropin-releasing hormone (CRH), and glucocorticoid receptor (GR) mRNA expression in the hippocampus, amygdala, and hypothalamus, and 11beta-hydroxysteroid dehydrogenase type-1 and -2 (11beta-HSD-1 and -2) expression in adipose tissue and liver. Within 1 week, the HFD induced obesity and decreased corticosterone levels at 1200 and 1800 h, which persisted throughout the experiment. Twelve weeks of HFD decreased CRH mRNA in the paraventricular nucleus (PVN) and amygdala and GR mRNA in the PVN at 0900 h. At 1800 h, CRH mRNA expression increased in the PVN and amygdala, and GR mRNA increased in the CA1 region. 11beta-HSD-1 expressions decreased in gonadal, visceral, and subcutaneous adipose tissues at 0900 and 1800 h, whereas hepatic 11beta-HSD-1 expression increased at 1800 h, whereas 11beta-HSD-2 expression was unaffected. The HFD induces complex changes in the diurnal regulation of the different components of the HPA axis. These changes are not unequivocally characterized by increased, but rather by decreased HPA axis activity.1 augustus 201