Teaching pre-clinical medical students remotely in Nigeria post Covid-19 pandemic: can past experiences shape future directions?

PURPOSE: Online teaching has gained popularity in recent years, but changes have been slower to implement in Lower or Medium Income Countries (LMIC). The aim of this research was to build upon educators' experiences of remote teaching during Covid-19 to inform the development of a blended learning approach for teaching pre-clinical subjects at the Faculty of Biomedical Sciences at Obafemi Awolowo University, Ile-Ife, Nigeria (OAU). METHODS: The Critical Incident Technique (CIT) was used in this exploratory study. Participants were invited to either complete an online qualitative questionnaire or take part in an online structured interview, which were hosted on Microsoft platforms. Data were obtained from eighteen educators and were analyzed using thematic analysis. RESULTS: Findings suggest that most educators (72%) continued to engage with remote teaching post-pandemic. All lab-based practical topics returned to being in-person, and teachers' experiences highlighted that a new blended learning approach should focus on asynchronized online teaching of didactic subjects. Five main themes captured educators' experiences and lessons learned regarding online teaching including: skills and training, teachers' motivation and attitudes, internet and connectivity, learners' behaviors, and socio-economic constraints. CONCLUSION: Findings provided additional evidence on the way in which educators in LMIC would like to build upon the positive aspects of online teaching and move towards a blended learning model. However, the implementation of such an approach should consider students' and faculty's needs and socio-economic constraints.

Learners' Perception of the Applicability of Pre-clinical Subjects to Clinical Training and Experience in Obafemi Awolowo University, Ile-Ife.

This article was migrated. The article was marked as recommended. Introduction: This study investigated how Final Year Students and Newly qualified Doctors of Obafemi Awolowo University (OAU) Medical School perceive the applicability of the three pre-clinical subjects (Anatomy, Biochemistry and Physiology) to clinical studies and medical practice with the aim of ascertaining whether or not the students are able to establish a real connect between knowledge acquired in the pre-clinical years and their experience during clinical exposure. Methods: A cross sectional study involving 106 final year medical students and 81 interns was conducted using convenience sampling method. Data was collected using a structured self-administered questionnaire consisting of demographic characteristics and 10 items regarding perception of the relevance of basic medical courses to clinical training experience. Responses were rated using a 5 point Likert scale, which ranged from "strongly disagree" to "strongly agree". Data analysis was carried out using descriptive and inferential statistics and values expressed as mean of scores. Results: Overall mean scores for anatomy, biochemistry and physiology were 26.4 ± 0.32, 25.7 ± 0.29 and 28.1 ± 0.31 respectively. Thus, physiology was rated as having the highest applicability with the highest score in 4 out of 10 items. Biochemistry had the lowest score for the item "I remember most of the content of the course even now". Newly qualified Doctors were found to have a more positive perception of anatomy and biochemistry than final year medical students. All Subjects were scored high (average of 3-0/4.0) on items having to do with introduction of curriculum integration and clinical studies to teaching. Conclusion: Findings from the study suggest that the responses of the subjects were based more on their ability to understand and recall content, rather than how relevant the subjects are to their clinical experience. The study concludes that there is an urgent need to embrace integration of the curriculum and introduce more learner-centered teaching methods.

Perspectives of Final Year Students and Newly Qualified Doctors of the Teaching of Preclinical Courses at the College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.

BACKGROUND: It is established that there is a strong relationship between perception and outcome of learners' satisfaction, achievement, and success and that a positive learning environment well received by learners is necessary for positive learning outcomes. This study is a first step in providing an answer to the question "how do learners perceive preclinical medical education in Ife" with the aim of obtaining information which can serve as basis for the review of teaching methods and improvement of learning environment. METHODOLOGY: A questionnaire adopted from two validated questionnaires (Dundee Ready Education Environment Measure questionnaire from Dundee and another from a study carried out in Bangladesh) was administered to 187 respondents comprising 106 final year students and 81 newly qualified doctors to obtain the information about their perception of teaching and learning of the three major preclinical participants. Items were rated using the 5-point Likert scale, and each item was scored 4-0. Data were analyzed using the descriptive and inferential statistics. Values were expressed as the mean of scores. RESULTS: The mean gross scores for the 19 items rated for anatomy, biochemistry, and physiology were 28.92, 35.76, and 45.06 (out of 76), respectively. Physiology had the highest score in all the subdomains examined, with 62% of the respondents rating their overall quality of learning experience in the subject "very good." Scores for perception of learning environment were generally low (7.54 ± 0.43, 10.44 ± 0.42, and 12.51 ± 0.47, out of a total of 28 for anatomy, biochemistry, and physiology, respectively). CONCLUSION: The opinion of learners in this study emphasizes the need for the improvement of teaching methods and learning environment.

Dietary marine-derived long-chain monounsaturated fatty acids and cardiovascular disease risk: a mini review.

Regular fish/fish oil consumption is widely recommended for protection against cardiovascular diseases (CVD). Fish and other marine life are rich sources of the cardioprotective long-chain n-3 polyunsaturated fatty acids (n-3 PUFA) eicosapentaenoic acid (C20:5 n-3; EPA) and docosahexaenoic acid (C22:6 n-3; DHA). The lipid content and fatty acid profile of fish, however, vary greatly among different fish species. In addition to n-3 PUFA, certain fish, such as saury, pollock, and herring, also contain high levels of long-chain monounsaturated fatty acids (LCMUFA), with aliphatic tails longer than 18 C atoms (i.e., C20:1 and C22:1 isomers). Compared with well-studied n-3 PUFA, limited information, however, is available on the health benefits of marine-derived LCMUFA, particularly in regard to CVD. Our objective in this review is to summarize the current knowledge and provide perspective on the potential therapeutic value of dietary LCMUFA-rich marine oil for improving CVD risk factors. We will also review the possible mechanisms of LCMUFA action on target tissues. Finally, we describe the epidemiologic data and small-scaled clinical studies that have been done on marine oils enriched in LCMUFA. Although there are still many unanswered questions about LCMUFA, this appears to be promising new area of research that may lead to new insights into the health benefits of a different component of fish oils besides n-3 PUFA.

Long-chain monounsaturated fatty acid-rich fish oil attenuates the development of atherosclerosis in mouse models.

SCOPE: Fish oil-derived long-chain monounsaturated fatty acids (LCMUFA) containing chain lengths longer than 18 were previously shown to improve cardiovascular disease risk factors in mice. However, it is not known if LCMUFA also exerts anti-atherogenic effects. The main objective of the present study was to investigate the effect of LCMUFA on the development of atherosclerosis in mouse models. METHODS AND RESULTS: LDLR-KO mice were fed Western diet supplemented with 2% (w/w) of either LCMUFA concentrate, olive oil, or not (control) for 12 wk. LCMUFA, but not olive oil, significantly suppressed the development of atherosclerotic lesions and several plasma inflammatory cytokine levels, although there were no major differences in plasma lipids between the three groups. At higher doses 5% (w/w) LCMUFA supplementation was observed to reduce pro-atherogenic plasma lipoproteins and to also reduce atherosclerosis in ApoE-KO mice fed a Western diet. RNA sequencing and subsequent qPCR analyses revealed that LCMUFA upregulated PPAR signaling pathways in liver. In cell culture studies, apoB-depleted plasma from LDLR-K mice fed LCMUFA showed greater cholesterol efflux from macrophage-like THP-1 cells and ABCA1-overexpressing BHK cells. CONCLUSION: Our research showed for the first time that LCMUFA consumption protects against diet-induced atherosclerosis, possibly by upregulating the PPAR signaling pathway.

Iron status in HIV-1 infection: implications in disease pathology.

BACKGROUND: There had been conflicting reports with levels of markers of iron metabolism in HIV infection. This study was therefore aimed at investigating iron status and its possible mediation of severity of HIV- 1 infection and pathogenesis. METHOD: Eighty (80) anti-retroviral naive HIV-1 positive and 50 sero-negative controls were recruited for the study. Concentrations of serum total iron, transferrin, total iron binding capacity (TIBC), CD4+ T -lymphocytes, vitamin C, zinc, selenium and transferrin saturation were estimated. RESULTS: The mean CD4+ T-lymphocyte cell counts, serum iron, TIBC, transferrin saturation for the tests and controls were 319 ± 22, 952 ± 57 cells/µl (P < 0.001), 35 ± 0.8, 11.8 ± 0.9 µmol/l (P < 0.001), 58.5 ± 2.2, 45.2 ± 2.4 µmol/l (P < 0.005) and 68.8 ± 3.3, 27.7 ± 2.2%, (P <0.001), respectively, while mean concentrations of vitamin C, zinc and selenium were 0.03 ± 0.01, 0.3 ± 0.04 (P < 0.001), 0.6 ± 0.05, 11.9 ± 0.26 µmol/l (P < 0.001) and 0.1 ± 0.01, 1.2 ± 0.12 µmol/l (P < 0.001) respectively. Furthermore, CD4+ T-lymphocyte cell count had a positive correlation with levels of vitamin C (r = 0.497, P < 0.001), zinc (r = 0.737, P < 0.001), selenium (r = 0.639, P < 0.001) and a negative correlation with serum iron levels (r = -0.572, P < 0.001). CONCLUSION: It could be inferred that derangement in iron metabolism, in addition to oxidative stress, might have contributed to the depletion of CD4+ T cell population in our subjects and this may result in poor prognosis of the disease.