El diseño e implementación del aprendizaje basado en problemas: ¿por qué es tan complicado?

Problem-based learning cannot easily be implemented in a curriculum without making structural changes. The most relevant of them are cultural and organizational changes. The culture change requires dealing with traditional teacher beliefs and with the consequences of professionalism in universities. A better understanding of student learning is needed to make the necessary changes. Faculty development is essential in making the shift. Organizational changes are also needed to make PBL a success. Without a clear external need to change and good leadership implementation of change is hard to achieve.El Aprendizaje basado en problemas no puede ser implementado fácilmente en el currículo sin hacer cambios estructurales. Entre ellos, los más relevantes son cambios culturales y de organización. El cambio cultural tiene que ver con las creencias tradicionales del profesorado y con las consecuencias del profesionalismo en las universidades. Se necesita una mejor comprensión del aprendizaje del estudiante para poder realizar los cambios necesarios. El desarrollo del profesorado es esencial para conseguir este cambio. También son necesarios cambios organizativos para conseguir que el ABP sea exitoso. Sin una clara y externa necesidad de cambio y un buen liderazo, la implentación del cambio es difícil de alcanzar

Co-display of diverse spike proteins on nanoparticles broadens sarbecovirus neutralizing antibody responses

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants poses continuous challenges in combating the virus. Here, we describe vaccination strategies to broaden SARS-CoV-2 and sarbecovirus immunity by combining spike proteins based on different viruses or viral strains displayed on two-component protein nanoparticles. First, we combined spike proteins based on ancestral and Beta SARS-CoV-2 strains to broaden SARS-CoV-2 immune responses. Inclusion of Beta spike improved neutralizing antibody responses against SARS-CoV-2 Beta, Gamma, and Omicron BA.1 and BA.4/5. A third vaccination with ancestral SARS-CoV-2 spike also improved cross-neutralizing antibody responses against SARS-CoV-2 variants, in particular against the Omicron sublineages. Second, we combined SARS-CoV and SARS-CoV-2 spike proteins to broaden sarbecovirus immune responses. Adding SARS-CoV spike to a SARS-CoV-2 spike vaccine improved neutralizing responses against SARS-CoV and SARS-like bat sarbecoviruses SHC014 and WIV1. These results should inform the development of broadly active SARS-CoV-2 and pan-sarbecovirus vaccines and highlight the versatility of two-component nanoparticles for displaying diverse antigens

The Rijksuniversiteit Limburg, Maastricht, Netherlands:Development of medical education

The Netherlands is highly developed, densely populated, and possesses a generally well-functioning health delivery system. Geographic maldistribution of professional health personnel is not a problem, but even through medical care is provided through a system of general practice, the Netherlands' medical schools offer a specialty-oriented curriculum. The high cost of health care is a major concern. A new Faculty of Medicine was authorized in 1974 to be the first faculty of a new university in the Limburg region. The Faculty of Medicine's purpose is to develop a system of medical education particularly oriented towards primary care practice in relation to Maastricht and the Limburg region. The University participates in a recently founded Regional Medical Centre, which is the mechanism established by the Government to contain costs and improve the health care delivery system. The medical curriculum at Maastrict offers basic science instruction in an integrated way with the focus on medical or health problems. Students are expected to assume considerable responsibility for their own learning in order to acquire the important skills of self-assessment and self-education. The curriculum emphasizes an awareness of social needs and problems, and students are introduced to the practice of health care in their first year. The evaluation programme and process are a dominant feature. The evaluation plan takes into account student performance assessment, instructional programme evaluation, and institutional factors in immediate, intermediate and ultimate goals. The implementation of this carefully designed educational programme was helped considerably by the absence of two often-found constraints: the University's organizational structure was developed to be consistent with, and supportive of, the educational concepts, and, because the Netherlands has no national accrediting or licensing bodies, the school has a great degree of freedom to define its own graduation standards.</p

The Rijksuniversiteit Limburg, Maastricht, Netherlands: Development of medical education

The Netherlands is highly developed, densely populated, and possesses a generally well-functioning health delivery system. Geographic maldistribution of professional health personnel is not a problem, but even through medical care is provided through a system of general practice, the Netherlands' medical schools offer a specialty-oriented curriculum. The high cost of health care is a major concern. A new Faculty of Medicine was authorized in 1974 to be the first faculty of a new university in the Limburg region. The Faculty of Medicine's purpose is to develop a system of medical education particularly oriented towards primary care practice in relation to Maastricht and the Limburg region. The University participates in a recently founded Regional Medical Centre, which is the mechanism established by the Government to contain costs and improve the health care delivery system. The medical curriculum at Maastrict offers basic science instruction in an integrated way with the focus on medical or health problems. Students are expected to assume considerable responsibility for their own learning in order to acquire the important skills of self-assessment and self-education. The curriculum emphasizes an awareness of social needs and problems, and students are introduced to the practice of health care in their first year. The evaluation programme and process are a dominant feature. The evaluation plan takes into account student performance assessment, instructional programme evaluation, and institutional factors in immediate, intermediate and ultimate goals. The implementation of this carefully designed educational programme was helped considerably by the absence of two often-found constraints: the University's organizational structure was developed to be consistent with, and supportive of, the educational concepts, and, because the Netherlands has no national accrediting or licensing bodies, the school has a great degree of freedom to define its own graduation standards

A Comparison between Patient-and Physician-Reported Late Radiation Toxicity in Long-Term Prostate Cancer Survivors

Patient-reported outcome measures (PROMs) are advocated for the monitoring of toxicity after radiotherapy. However, studies comparing physician-and patient-reported toxicity show low concordance. In this study, we compared physician-and patient-reported toxicity in long-term prostate cancer survivors after radiotherapy, and we determined the correlation with a presumable risk factor for late toxicity: γ-H2AX foci decay ratio (FDR). Patients formerly included in a prospective study were invited to participate in this new study, comprising one questionnaire and one call with a trial physician assistant. Concordance was calculated for seven symptoms. Gamma-H2AX FDRs were determined in ex vivo irradiated lymphocytes in a previous analysis. Associations between FDR and long-term prevalence of toxicity were assessed using univariable logistic regression analyses. The 101 participants had a median follow-up period of 9 years. Outcomes were discordant in 71% of symptomatic patients; in 21%, the physician-assessed toxicity (using CTCAE) was higher, and, in 50%, the patients reported higher toxicity. We did not find a correlation between presence of toxicity at long-term follow-up and FDR. In conclusion, patients assigned greater severity to symptoms than the trial physician assistant did. Consideration of both perspectives may be warranted to provide the best care