Effects of review on medical students' recall of different types of neuroanatomical content.

BACKGROUND: Review of previously learned content is central to formal medical education and continuing lifelong learning; however, little is known about the review process itself. This study examined ways in which structured review impacted students' recall and use of different types of neuroanatomical information, categorized as general constructs, fundamental content, and advanced content. METHOD: Seven months after completing first-year neuroscience, medical students were given equivalent short-answer tests requiring description of pathways and localization of lesions both before and after a review of clinically related neuroanatomy. Scores that reflected the three different types of information were compared. RESULTS: Prereview, students recalled General Constructs of neuroanatomy, with little additional Fundamental or Advanced Content. Postreview, Fundamental Content and Advanced Content scores both increased significantly. CONCLUSIONS: Reviews appear to enhance recall of related content, not only isolated facts. The review process may thus have unrealized potential as an educational strategy in medical training.

Embryonic stem cell rescue of tremor and ataxia in myelin-deficient shiverer mice.

Transplantation of neural precursor cells has been proposed as a possible approach for replacing missing or damaged central nervous system myelin. Neonatal and adult myelin-deficient shiverer (shi) mice, bearing a mutation of the myelin basic protein (MBP) gene, have been used extensively as hosts for testing cell engraftment, migration, and myelination, but relatively little progress has been made in reversing shi motor deficits. Here we describe a prenatal cell replacement strategy, showing that embryonic stem cells injected into shi blastocyst embryos can generate chimeric mice with strong and widespread immunoreactive MBP expression throughout the brain and a behavioral (motor) phenotype that appears essentially rescued.

Student decisions about lecture attendance: do electronic course materials matter?

BACKGROUND: This study explored whether first-year medical students make deliberate decisions about attending nonrequired lectures. If so, it sought to identify factors that influence these decisions, specifically addressing the potential impact of electronic materials. METHOD: Medical students who completed first-year studies between 2004 and 2006 responded to an open-ended survey question about their own lecture-attendance decisions. Responses were coded to capture major themes. Students' ratings of the electronic materials were also examined. RESULTS: Most respondents made deliberate attendance decisions. Decisions were influenced by previous experiences with the lecturer, predictions of what would occur during the session itself, personal learning preferences, and learning needs at that particular time, with the overriding goal of maximizing learning. Access to electronic materials did not influence students' choices. CONCLUSIONS: Fears that the increasing availability of technology-enhanced educational materials has a negative impact on lecture attendance seem unfounded.

Myelination and long diffusion times alter diffusion-tensor-imaging contrast in myelin-deficient shiverer mice.

Diffusion tensor imaging (DTI) using variable diffusion times (t(diff)) was performed to investigate wild-type (wt) mice, myelin-deficient shiverer (shi) mutant mice and shi mice transplanted with wt neural precursor cells that differentiate and function as oligodendrocytes. At t(diff) = 30 ms, the diffusion anisotropy "volume ratio" (VR), diffusion perpendicular to the fibers (lambda( perpendicular)), and mean apparent diffusion coefficient () of the corpus callosum of shi mice were significantly higher than those of wt mice by 12 +/- 2%, 13 +/- 2%, and 10 +/- 1%, respectively; fractional anisotropy (FA) and relative anisotropy (RA) were lower by 10 +/- 1% and 11 +/- 3%, respectively. Diffusion parallel to the fibers (lambda(//)) was not statistically different between shi and wt mice. Normalized T(2)-weighted signal intensities showed obvious differences (27 +/- 4%) between wt and shi mice in the corpus callosum but surprisingly did not detect transplant-derived myelination. In contrast, diffusion anisotropy maps detected transplant-derived myelination in the corpus callosum and its spatial distribution was consistent with the donor-derived myelination determined by immunohistochemical staining. Anisotropy indices (except lambda(//)) in the corpus callosum showed strong t(diff) dependence (30-280 ms), and the differences in lambda( perpendicular) and VR between wt and shi mice became significantly larger at longer t(diff), indicative of improved DTI sensitivity at long t(diff). In contrast, anisotropy indices in the hippocampus showed very weak t(diff) dependence and were not significantly different between wt and shi mice across different t(diff). This study provides insights into the biological signal sources and measurement parameters influencing DTI contrast, which could lead to developing more sensitive techniques for detection of demyelinating diseases.

Development and validation of the stroke action test.

BACKGROUND AND PURPOSE: Accurately assessing the public's readiness to respond to stroke is important. Most published measures are based on recall or recognition of stroke symptoms, or knowledge of the best action for stroke when the diagnosis is provided. The purpose of this study was to develop and evaluate a new written instrument whose items require the respondent to associate individual symptoms with the most appropriate action. METHODS: The Stroke Action Test (STAT) contains 21 items that name or describe stroke symptoms from all 5 groups of warning signs and 7 items that are nonstroke symptoms. For each item, the respondent selects 1 of 4 options: call 911, call doctor, wait 1 hour, or wait 1 day. The instrument validation sample included 249 subjects from community-based organizations. Score reliability and validity were analyzed using multiple data and information sources. RESULTS: The mean overall STAT score (all 28 items) for the lay people was 36.8%. On average, they chose call 911 for 34.1% of the stroke symptoms. They chose call doctor for 39.4% of the stroke symptoms, wait 1 hour for 20.1%, and wait 1 day for 6.0%. Score reliability is good (alpha=0.83). Evidence confirming score validity is presented based on analysis of item content and response patterns, and examination of the relationships between test scores and key variables related to stroke knowledge. CONCLUSIONS: STAT directly assesses a critical aspect of practical stroke knowledge that has been largely overlooked and provides scores with good reliability and validity.

Interpreting course evaluation results: insights from thinkaloud interviews with medical students.

PURPOSE: To determine whether some of the fundamental assumptions that frequently underlie interpretation of course evaluation results are justified by investigating what medical students are thinking as they complete a typical basic science course evaluation. METHODS: A total of 24 students participated in thinkaloud cognitive interviews, voicing their thoughts while completing a typical evaluation instrument that included items on overall course design, educational materials and methods, and faculty teaching. Students' responses were organised to consider how they interpreted questions, formed judgements and selected response options. Major themes relevant to the meaningful interpretation of course evaluation data were identified. RESULTS: Medical students understood educational terms such as 'independent learning' in different ways from both one another and common usage. When formulating responses, students' judgements were sometimes based on unique or unexpected criteria, and they described editing their judgements by considering factors such as effort or caring on the part of teaching faculty. Students tended to avoid using the lower end of the rating scale, used the highest rating option selectively, but chose the second highest category indiscriminately. CONCLUSIONS: These results call into question fundamental assumptions that frequently underlie interpretation of course evaluation results, such as whether students understand the intended meanings of terms used in items; whether faculty members who receive the same rating are perceived similarly; whether ratings actually reflect teaching effectiveness, and whether 'positive' ratings reflect positive opinions. This study also demonstrates how thinkaloud interviews can be used in validity studies, providing information to supplement statistical and psychometric analyses.

Does reading about stroke increase stroke knowledge? The impact of different print materials.

The purpose of this study was to determine whether print materials on stroke resulted in increased knowledge in a sample of lay people. One hundred and seventy-seven participants received (at random) one of five versions of a stroke information packet, or a control packet on colorectal cancer. Participants rated the materials on readability, understandability and usefulness immediately after reading. After a delay of 18 days on average, participants answered questions assessing stroke knowledge. Ratings of all packets were generally positive; however, stroke knowledge scores were significantly higher for the stroke information groups compared to the control group only for knowledge of causal mechanisms (stroke pathophysiology). While there was some indication that the fictionalized material on stroke was more effective than the expository materials, overall the impact of print materials on stroke knowledge, measured after a delay of at least 1 week, was minimal at best. Further research is needed to determine whether fictional contexts make some information more memorable.