A web-based tool for teaching pharmacy practice competency

Aims to implement and assess the effectiveness of the Strathclyde Computerized Randomized Interactive Prescription Tutor (SCRIPT) in teaching a competency-based undergraduate pharmacy course. Data on students' access to SCRIPT, collected by quantitative electronic data capture, were analyzed to determine student usage patterns and correlations between usage and grades in class assessments. Data on students' perceptions were collected by electronic questionnaire and semistructured interviews. Teaching staff members also were interviewed. Two hundred forty-three students accessed SCRIPT a median of 23 times each. Students accessed SCRIPT predominantly at times outside normal teaching hours and tended to access the tool more often in the 48 hours preceding class assessments. Feedback from students indicated overall satisfaction with the tool to compliment the timetabled teaching sessions but highlighted that more specific feedback on the examples was required. All staff comments were positive. Students and teaching staff members valued SCRIPT as a tool to compliment teaching of the competency-based pharmacy practice classes in the MPharm degree

A web-based simulation of a longitudinal clinic used in a 4-week ambulatory rotation: a cohort study

<p>Abstract</p> <p>Background</p> <p>Residency training takes place primarily on inpatient wards. In the absence of a resident continuity clinic, internal medicine residents rely on block rotations to learn about continuity of care. Alternate methods to introduce continuity of care are needed.</p> <p>Methods</p> <p>A web-based tool, Continuity of Care Online Simulations (COCOS), was designed for use in a one-month, postgraduate clinical rotation in endocrinology. It is an interactive tool that simulates the continuing care of any patient with a chronic endocrine disease. Twenty-three residents in internal medicine participated in a study to investigate the effects of using COCOS during a clinical rotation in endocrinology on pre-post knowledge test scores and self-assessment of confidence.</p> <p>Results</p> <p>Compared to residents who did the rotation alone, residents who used COCOS during the rotation had significantly higher improvements in test scores (% increase in pre-post test scores +21.6 [standard deviation, SD, 8.0] vs. +5.9 [SD 6.8]; p < .001). Test score improvements were most pronounced for less commonly seen conditions. There were no significant differences in changes in confidence. Residents rated COCOS very highly, recommending its use as a standard part of the rotation and throughout residency.</p> <p>Conclusion</p> <p>A stand-alone web-based tool can be incorporated into an existing clinical rotation to help residents learn about continuity of care. It has the most potential to teach residents about topics that are less commonly seen during a clinical rotation. The adaptable, web-based format allows the creation of cases for most chronic medical conditions.</p

Virtual patients design and its effect on clinical reasoning and student experience : a protocol for a randomised factorial multi-centre study

Background Virtual Patients (VPs) are web-based representations of realistic clinical cases. They are proposed as being an optimal method for teaching clinical reasoning skills. International standards exist which define precisely what constitutes a VP. There are multiple design possibilities for VPs, however there is little formal evidence to support individual design features. The purpose of this trial is to explore the effect of two different potentially important design features on clinical reasoning skills and the student experience. These are the branching case pathways (present or absent) and structured clinical reasoning feedback (present or absent). Methods/Design This is a multi-centre randomised 2x2 factorial design study evaluating two independent variables of VP design, branching (present or absent), and structured clinical reasoning feedback (present or absent).The study will be carried out in medical student volunteers in one year group from three university medical schools in the United Kingdom, Warwick, Keele and Birmingham. There are four core musculoskeletal topics. Each case can be designed in four different ways, equating to 16 VPs required for the research. Students will be randomised to four groups, completing the four VP topics in the same order, but with each group exposed to a different VP design sequentially. All students will be exposed to the four designs. Primary outcomes are performance for each case design in a standardized fifteen item clinical reasoning assessment, integrated into each VP, which is identical for each topic. Additionally a 15-item self-reported evaluation is completed for each VP, based on a widely used EViP tool. Student patterns of use of the VPs will be recorded. In one centre, formative clinical and examination performance will be recorded, along with a self reported pre and post-intervention reasoning score, the DTI. Our power calculations indicate a sample size of 112 is required for both primary outcomes

Multimedia Bootcamp: a health sciences library provides basic training to promote faculty technology integration

BACKGROUND: Recent research has shown a backlash against the enthusiastic promotion of technological solutions as replacements for traditional educational content delivery. Many institutions, including the University of Virginia, have committed staff and resources to supporting state-of-the-art, showpiece educational technology projects. However, the Claude Moore Health Sciences Library has taken the approach of helping Health Sciences faculty be more comfortable using technology in incremental ways for instruction and research presentations. In July 2004, to raise awareness of self-service multimedia resources for instructional and professional development needs, the Library conducted a "Multimedia Bootcamp" for nine Health Sciences faculty and fellows. METHODS: Case study. RESULTS: Program stewardship by a single Library faculty member contributed to the delivery of an integrated learning experience. The amount of time required to attend the sessions and complete homework was the maximum fellows had to devote to such pursuits. The benefit of introducing technology unfamiliar to most fellows allowed program instructors to start everyone at the same baseline while not appearing to pass judgment on the technology literacy skills of faculty. The combination of wrapping the program in the trappings of a fellowship and selecting fellows who could commit to a majority of scheduled sessions yielded strong commitment from participants as evidenced by high attendance and a 100% rate of assignment completion. Response rates to follow-up evaluation requests, as well as continued use of Media Studio resources and Library expertise for projects begun or conceived during Bootcamp, bode well for the long-term success of this program. CONCLUSION: An incremental approach to integrating technology with current practices in instruction and presentation provided a supportive yet energizing environment for Health Sciences faculty. Keys to this program were its faculty focus, traditional hands-on instruction, unrestricted access to technology tools and support, and inclusion of criteria for evaluating when multimedia can augment pedagogical aims

Does individual learning styles influence the choice to use a web-based ECG learning programme in a blended learning setting?

<p>Abstract</p> <p>Background</p> <p>The compressed curriculum in modern knowledge-intensive medicine demands useful tools to achieve approved learning aims in a limited space of time. Web-based learning can be used in different ways to enhance learning. Little is however known regarding its optimal utilisation. Our aim was to investigate if the individual learning styles of medical students influence the choice to use a web-based ECG learning programme in a blended learning setting.</p> <p>Methods</p> <p>The programme, with three types of modules (learning content, self-assessment questions and interactive ECG interpretation training), was offered on a voluntary basis during a face to face ECG learning course for undergraduate medical students. The Index of Learning Styles (ILS) and a general questionnaire including questions about computer and Internet usage, preferred future speciality and prior experience of E-learning were used to explore different factors related to the choice of using the programme or not.</p> <p>Results</p> <p>93 (76%) out of 123 students answered the ILS instrument and 91 the general questionnaire. 55 students (59%) were defined as users of the web-based ECG-interpretation programme. Cronbach's alpha was analysed with coefficients above 0.7 in all of the four dimensions of ILS. There were no significant differences with regard to learning styles, as assessed by ILS, between the user and non-user groups; Active/Reflective; Visual/Verbal; Sensing/Intuitive; and Sequential/Global (p = 0.56-0.96). Neither did gender, prior experience of E-learning or preference for future speciality differ between groups.</p> <p>Conclusion</p> <p>Among medical students, neither learning styles according to ILS, nor a number of other characteristics seem to influence the choice to use a web-based ECG programme. This finding was consistent also when the usage of the different modules in the programme were considered. Thus, the findings suggest that web-based learning may attract a broad variety of medical students.</p

Stochastic Cahn-Hilliard equation with singular nonlinearity and reflection

We consider a stochastic partial differential equation with logarithmic (or negative power) nonlinearity, with one reflection at 0 and with a constraint of conservation of the space average. The equation, driven by the derivative in space of a space-time white noise, contains a bi-Laplacian in the drift. The lack of the maximum principle for the bi-Laplacian generates difficulties for the classical penalization method, which uses a crucial monotonicity property. Being inspired by the works of Debussche and Zambotti, we use a method based on infinite dimensional equations, approximation by regular equations and convergence of the approximated semi-group. We obtain existence and uniqueness of solution for nonnegative intial conditions, results on the invariant measures, and on the reflection measures

Common Genetic Variant Association with Altered HLA Expression, Synergy with Pyrethroid Exposure, and Risk for Parkinson's Disease: An Observational and Case-Control Study.

Background/objectivesThe common non-coding single nucleotide polymorphism (SNP) rs3129882 in HLA-DRA is associated with risk for idiopathic Parkinson's disease (PD). The location of the SNP in the major histocompatibility complex class II (MHC-II) locus implicates regulation of antigen presentation as a potential mechanism by which immune responses link genetic susceptibility to environmental factors in conferring lifetime risk for PD.MethodsFor immunophenotyping, blood cells from 81 subjects were analyzed by qRT-PCR and flow cytometry. A case-control study was performed on a separate cohort of 962 subjects to determine association of pesticide exposure and the SNP with risk of PD.ResultsHomozygosity for G at this SNP was associated with heightened baseline expression and inducibility of MHC class II molecules in B cells and monocytes from peripheral blood of healthy controls and PD patients. In addition, exposure to a commonly used class of insecticide, pyrethroids, synergized with the risk conferred by this SNP (OR = 2.48, p = 0.007), thereby identifying a novel gene-environment interaction that promotes risk for PD via alterations in immune responses.ConclusionsIn sum, these novel findings suggest that the MHC-II locus may increase susceptibility to PD through presentation of pathogenic, immunodominant antigens and/or a shift toward a more pro-inflammatory CD4+ T cell response in response to specific environmental exposures, such as pyrethroid exposure through genetic or epigenetic mechanisms that modulate MHC-II gene expression