Assessing Student Opinion on Autopsy as a Supplement to Medical Education

Purpose: Medical schools in the United States have decreased use of autopsy as a teaching tool in undergraduate medical education (UME). However, there are no recent data to understand how undergraduate medical students (UMS) value autopsies in their education, thus limiting suggestions for improving UME. This study aims to assess UMS opinion regarding autopsies as a supplement to their medical curriculum: is autopsy important and how? Methods: This was a questionnaire study targeted to UMS at Sidney Kimmel Medical College. The questionnaire contained 51 closed- and open-ended questions (e.g. multiple choice, Likert scale, free response), and was distributed electronically. Data were collected and analyzed using RedCap. Results and Conclusions: 103 respondents completed the survey: 84.5% (n=87) were preclinical medical students; 63.1% (n=65) identified as female, 34% (n=35) as male, and 2.9% (n=3) as gender non-conforming or preferred not to answer. 85.4% (n=88) respondents were interested in witnessing an autopsy. On Likert scale (1=Strongly Disagree; 5=Strongly Agree) questions, respondents were neutral in its importance in pathology thread (x̅=3.66) and overall medical (x̅=3.63) education. They agreed that witnessing an autopsy can improve anatomical knowledge (x̅=4.27), observational skills (x̅=4.1), and clinico-pathological correlations (x̅=4.28). Respondents agreed that it can also increase understanding of the role of pathologists (x̅=4.33) and autopsy (x̅=4.25) in patient care. However, 39.8% (n=41) reported “I don’t know” for UMS eligibility and 42.7% (n=44) reported “I don’t know” who to request permission. Overall, the data suggest that UMS are interested in witnessing autopsies, believe it can improve specific knowledge and skill sets, but lack information on access. This implies that UME will benefit from expanding access to the autopsy witness program

Case-Based Asynchronous Interactive Modules in Undergraduate Medical Education.

Undergraduate medical education traditionally consists of 2 years of lecture-based courses followed by 2 years of clinical clerkships. However, over the past couple decades, undergraduate medical education has been evolving toward non-lecture-based integrated curriculums, requiring a collaborative curriculum. Additionally, e-learning platforms have become efficacious and essential to delivering education asynchronously to students. At Thomas Jefferson University, the Pathology and Obstetrics and Gynecology departments collaborated to create a pilot series of case-based asynchronous interactive modules to teach gynecologic pathology in a clinical context, while interweaving other educational components, such as evidence-based medicine, clinical skills, and basic sciences. The case-based asynchronous interactive modules were given to third-year medical students during their obstetrics and gynecology clerkship. Students interpreted histologic and clinical images while being evaluated on clinical management skills, gynecologic diagnoses, general principles of population health and pathology. Sixty-eight students from 3 blocks completed a pre and posttest. All participants showed improvement in interpreting gynecologic pathology in routine clinical scenarios as well as improved case-based decision-making, with an average score increase by 5.7%. Learner feedback was positive, with suggestions to apply this method to other medical specialties, particularly radiology. Asynchronous interactive modules are an efficacious and popular method of pathology education

The relationship between breast cancer molecular subtypes and mast cell populations in tumor microenvironment

Mast cells (MCs) are a part of the innate immune system. The MC functions toward cancer are partially based on the release of chymase and tryptase. However, the MC effect on breast cancer is controversial. The aim of our study was to investigate the presence of MCs in breast cancer tumors of different molecular subtypes and their relationships with other pathological prognostic factors. Tryptase- and chymase-positive mast cell densities were evaluated by immunohistochemistry in 108 primary invasive breast cancer tissue samples. Positive cells were counted within the tumor bed and at the invasive margin. For all analyzed MC subpopulations, we observed statistically significant differences between individual molecular subtypes of breast cancer. The significantly higher numbers of intratumoral chymase- and tryptase-positive mast cells were observed in luminal A and luminal B tumors compared to triple-negative and HER2+ non-luminal lesions. A denser MC infiltration was associated with lower tumor grade, higher ER and PR expression, lower proliferation rate as well as the lack of HER2 overexpression. The results obtained in our study indicate a possible association of chymase- and tryptase-positive MCs with more favorable cancer immunophenotype and with beneficial prognostic indicators in breast cancer

Ultra-Narrow Faraday Rotation Filter at the Rb D1 Line

We present a theoretical and experimental study of the ultra-narrow bandwidth Faraday anomalous dispersion optical filter (FADOF) operating at the rubidium D1 line (795 nm). This atomic line gives better performance than other lines for the main FADOF figures of merit, e.g. simultaneously 71% transmission, 445 MHz bandwidth and 1.2 GHz equivalent noise bandwidth.Comment: 3 pages, 2 figures. Manuscript same as v1. FADOF calculator (ancillary file) now allows for extension to the D2 lin

How Well Do Executives Trust Their Intuition

In this age of Big Data and analytics, knowledge gained through experiential learning and intuition may be taking a back seat to analytics. However, the use of intuition should not be underestimated and should play an important role in the decision process. How Well Do Executives Trust Their Intuition covers the Fulbright research study conducted by this international team of editors. The main question of their investigation is: How well do executives trust their intuition? In other words, do they typically prefer intuition over analysis and analytics. And equally importantly, what types of intuition may be most favorable looking at different variables? The research utilizes survey and biometrics approaches with C-level executives from Canada, U.S., Poland, and Italy. In addition, the book contains chapters from leading executives in industry, academia, and government. Their insights provide examples of how their intuition enabled key decisions that they made. This book covers such topics as: Using intuition How gender, experience, role, industry, and country affect intuition Trust and intuition in management Trusting intuition It’s a matter of heart Leadership intuition and the future of work Creating an intuitive awareness for executives Improvisation and instinct. The book explores how executives can use intuition to guide decision making. It also explains how to trust intuition-based decisions. How Well Do Executives Trust Their Intuition is a timely and prescient reminder in this age of data-driven analytics that human insight, instinct, and intuition should also play key roles

Inhibition of yes-associated protein suppresses brain metastasis of human lung adenocarcinoma in a murine model.

Yes-associated protein (YAP) is a main mediator of the Hippo pathway and promotes cancer development and progression in human lung cancer. We sought to determine whether inhibition of YAP suppresses metastasis of human lung adenocarcinoma in a murine model. We found that metastatic NSCLC cell lines H2030-BrM3(K-rasG12C mutation) and PC9-BrM3 (EGFRΔexon19 mutation) had a significantly decreased p-YAP(S127)/YAP ratio compared to parental H2030 (K-rasG12C mutation) and PC9 (EGFRΔexon19 mutation) cells (P < .05). H2030-BrM3 cells had significantly increased YAP mRNA and expression of Hippo downstream genes CTGF and CYR61 compared to parental H2030 cells (P < .05). Inhibition of YAP by short hairpin RNA (shRNA) and small interfering RNA (siRNA) significantly decreased mRNA expression in downstream genes CTGF and CYR61 in H2030-BrM3 cells (P < .05). In addition, inhibiting YAP by YAP shRNA significantly decreased migration and invasion abilities of H2030-BrM3 cells (P < .05). We are first to show that mice inoculated with YAP shRNA-transfected H2030-BrM3 cells had significantly decreased metastatic tumour burden and survived longer than control mice (P < .05). Collectively, our results suggest that YAP plays an important role in promoting lung adenocarcinoma brain metastasis and that direct inhibition of YAP by shRNA suppresses H2030-BrM3 cell brain metastasis in a murine model

Undergraduate Medical Student Perspectives on the Role of Autopsy in Medical Education

Medical autopsy has historically been considered a valued experience in undergraduate medical education; however, student participation has declined in recent years. Medical education literature from the educator point of view supports autopsy as an educational tool, but more data are needed on undergraduate medical students\u27 (UMS) perspectives on autopsy. This study aims to assess UMS opinions on the role of autopsy in undergraduate medical education. A 5-point Likert scale survey concerning autopsy and medical education was offered to all UMS at Sidney Kimmel Medical College. In addition, 28 senior students were assigned a 500 word essay on hospital autopsy and its role in medical education. Senior students were given the opportunity to view an autopsy prior to completing their essays. UMS (n = 87) reported that witnessing an autopsy can improve anatomic knowledge (μ = 4.3), observational skills (μ = 4.1), and clinicopathologic correlation (μ = 4.3) but were neutral in their perceived importance of viewing an autopsy in their pathology education (μ = 3.7). Senior students (n = 27) responding to the essay prompt reported that autopsy is essential in medical education (85.2%) and increases clinical and anatomical understanding (63.0%). This study suggests that many UMS acknowledge the importance and applicability of autopsy in their education. This concurrence of UMS opinion with the medical education literature supports making autopsy participation a widely available component of undergraduate medical education