Problem-based learning in dental education: what's the evidence for and against... and is it worth the effort?

The document attached has been archived with permission from the Australian Dental Association. An external link to the publisher’s copy is included.All Australian dental schools have introduced problem-based learning (PBL) approaches to their programmes over the past decade, although the nature of the innovations has varied from school to school. Before one can ask whether PBL is better than the conventional style of education, one needs to consider three key issues. Firstly, we need to agree on what is meant by the term PBL; secondly, we need to decide what “better” means when comparing educational approaches; and thirdly, we must look carefully at how PBL is implemented in given situations. It is argued that PBL fulfils, at least in theory, some important principles relating to the development of new knowledge. It also represents a change in focus from teachers and teaching in conventional programmes to learners and learning. Generally, students enjoy PBL programmes more than conventional programmes and feel they are more nurturing. There is also some evidence of an improvement in clinical and diagnostic reasoning ability associated with PBL curricula. The main negative points raised about PBL are the costs involved and mixed reports of insufficient grounding of students in the basic sciences. Financial restraints will probably preclude the introduction of pure or fully integrated PBL programmes in Australian dental schools. However, our research and experience, as well as other published literature, indicate that well-planned hybrid PBL programmes, with matching methods of assessment, can foster development of the types of knowledge, skills and attributes that oral health professionals will need in the future.T Winning and G Townsen

Identifying the core concepts of pharmacology education : a global initiative

Background and Purpose: In recent decades, a focus on the most critical and fundamental concepts has proven highly advantageous to students and educators in many science disciplines. Pharmacology, unlike microbiology, biochemistry or physiology, lacks a consensus list of such core concepts . Experimental approach: We sought to develop a research-based, globally relevant list of core concepts that all students completing a foundational pharmacology course should master. This two-part project consisted of exploratory and refinement phases. The exploratory phase involved empirical data mining of the introductory sections of five key textbooks, in parallel with an online survey of over 200 pharmacology educators from 17 countries across six continents. The refinement phase involved three Delphi rounds involving 24 experts from 15 countries across six continents. Key Results: The exploratory phase resulted in a consolidated list of 74 candidate core concepts. In the refinement phase, the expert group produced a consensus list of 25 core concepts of pharmacology. Conclusion and Implications: This list will allow pharmacology educators everywhere to focus their efforts on the conceptual knowledge perceived to matter most by experts within the discipline. Next steps for this project include defining and unpacking each core concept and developing resources to help pharmacology educators globally teach and assess these concepts within their educational contexts

Six-Pack Balancing Act: A Conceptual Model for the Intestinal Lining

The cells chat form the lining of the intestine belong to a class of cells termed 'polarized' or 'asymmetric.' The membranes surrounding these cells show functional differences at the luminal and contraluminal surfaces. The cells line up to form sheets and it is across these sheers that movement of fluids and solutes occurs. Such movement occurs in both directions across the lining and the occurrence of diarrhea or constipation depends to a considerable extent upon the net result of the absorptive and secretory mechanisms and their modulation by a host of factors such as neurotransmitters, bacterial products, drugs, etc. This review provides a simple framework for understanding the dynamics of the gut lining. Diamond's six-pack model of epithelia is modified to include the dynamic tension between absorptive and secretory mechanisms

Prostanoids Stimulate K Secretion and Cl Secretion in Guinea Pig Distal Colon via Distinct Pathways

Short-circuit current (I sc) and transepithelial conductance (G t) were measured in guinea pig distal colonic mucosa isolated from submucosa and underlying muscle layers. Indomethacin (2 μM) and NS-398 (2 μM) were added to suppress endogenous production of prostanoids. Serosal addition of PGE2 (10 nM) stimulated negative I scconsistent with K secretion, and concentrations \u3e30 nM stimulated positive I sc consistent with Cl secretion. PGE2 also stimulated G t at low and high concentrations. Dose responses to prostanoids specific for EP prostanoid receptors were consistent with stimulating K secretion through EP2receptors, based on a rank order potency (from EC50 values) of PGE2 (1.9 nM) \u3e 11-deoxy-PGE1 (8.3 nM) \u3e 19(R)-hydroxy-PGE2 (13.9 nM) \u3e butaprost (67 nM) \u3e 17-phenyl-trinor-PGE2 (307 nM) ≫ sulprostone (\u3e10 μM). An isoprostane, 8-iso-PGE2, stimulated K secretion with an EC50 of 33 nM. Cl secretory response was stimulated by PGD2 and BW-245C, a DP prostanoid receptor-specific agonist: BW-245C (15 nM) \u3e PGD2 (30 nM) \u3e PGE2 (203 nM). Agonists specific for FP, IP, and TP prostanoid receptors were ineffective in stimulating I sc and G t at concentrations \u3c1 \u3eμM. These results indicate that PGE2stimulated electrogenic K secretion through activation of EP2 receptors and electrogenic KCl secretion through activation of DP receptors. Thus stimulation of Cl secretion in vivo would occur either via physiological concentrations of PGD2(\u3c100 \u3enM) or pathophysiological concentrations of PGE2(\u3e100 nM) that could occur during inflammatory conditions