A Guide to Competencies, Educational Goals, and Learning Objectives for Teaching Medical Histology in an Undergraduate Medical Education Setting.

Horizontal and vertical integration within medical school curricula, truncated contact hours available to teach basic biomedical sciences, and diverse assessment methods have left histology educators searching for an answer to a fundamental question-what ensures competency for medical students in histology upon completion of medical school? The Liaison Committee for Medical Education (LCME) and the Commission on Osteopathic College Accreditation (COCA) advocate faculty to provide medical students with a list of learning objectives prior to any educational activities, regardless of pedagogy. It is encouraged that the learning objectives are constructed using higher-order and measurable action verbs to ensure student-centered learning and assessment. A survey of the literature indicates that there is paucity of knowledge about competencies, goals, and learning objectives appropriate for histology education in preclinical years. To address this challenge, an interactive online taskforce, comprising faculty from across the United States, was assembled. The outcome of this project was a desired set of competencies for medical students in histology with educational goals and learning objectives to achieve them.

Immunohistochemical localisation of renal cyclooxygenase-1 expression in non-steroidal anti-inflammatory drug-treated mice.

The utility of cyclooxygenase-inhibiting non-steroidal anti-inflammatory drugs is limited by unwanted side effects that include disturbances in renal function. In order to further understand the mechanisms that underlie these renal side effects, the expression of the prostaglandin-synthesizing enzyme cyclooxygenase (COX) was examined by immunohistochemical methods in murine kidneys after treatment with indomethacin, a non-selective inhibitor or nimesulide, an inhibitor that preferentially and selectively blocks the COX-2 isoform of the enzyme. In untreated control kidneys, COX-1 protein was expressed in the glomeruli and parietal cells of the glomerular capsule, epithelial cells of the proximal and distal convoluted tubules including the juxtaglomerular region, and the collecting ducts. At therapeutic doses, indomethacin (10mg/kg) did not alter renal COX-1 expression relative to immunoreactivity in untreated control kidney. By contrast, an equipotent therapeutic dose of nimesulide reduced renal COX-1 expression within the first 24h of treatment. Taken together with the reports of reduced COX-1 expression prior to renal tissue damage following high-dose indomethacin treatment, our findings suggest that effects of NSAIDs on renal COX expression are dependent on dose and may be related to isoform specificity.

NSAIDs and Cell Proliferation in Colorectal Cancer.

Colon cancer is common worldwide and accounts for significant morbidity and mortality in patients. Fortunately, epidemiological studies have demonstrated that continuous therapy with NSAIDs offers real promise of chemoprevention and adjunct therapy for colon cancer patients. Tumour growth is the result of complex regulation that determines the balance between cell proliferation and cell death. How NSAIDs affect this balance is important for understanding and improving treatment strategies and drug effectiveness. NSAIDs inhibit proliferation and impair the growth of colon cancer cell lines when tested in culture in vitro and many NSAIDs also prevent tumorigenesis and reduce tumour growth in animal models and in patients, but the relationship to inhibition of tumour cell proliferation is less convincing, principally due to gaps in the available data. High concentrations of NSAIDs are required in vitro to achieve cancer cell inhibition and growth retardation at varying time-points following treatment. However, the results from studies with colon cancer cell xenografts are promising and, together with better comparative data on anti-proliferative NSAID concentrations and doses (for in vitro and in vivo administration), could provide more information to improve our understanding of the relationships between these agents, dose and dosing regimen, and cellular environment.

Age modulates attitudes to whole body donation among medical students.

Managing a whole body donor program is necessary for facilitating a traditional dissection-based anatomy curriculum in medicine and health sciences. Factors which influence body donations to medical science can therefore affect dissection-based anatomy teaching. In order to determine whether age influences the attitudes of medical students to donations, this study surveyed, by Likert-type questionnaires, first-year graduate-entry medical students attending a dissection-based anatomy course. In contrast to attitudes among younger traditional-entry medical students, initial support for whole body donation by an unrelated stranger (83.8%), a family member (43.2%) or by the respondent (40.5%) did not decrease among graduate-entry medical students after exposure to dissection although there was a significant shift in strength of support for donation by stranger. This suggests that older medical students do not readily modify their pre-established attitudes to the idea of whole body donation after exposure and experience with dissection. Initial ambivalence among respondents to the idea of donation by family member was followed by opposition to this type of donation. These findings demonstrate that age modulates the influences on a priori attitudes to whole body donation that exposure to dissection causes in younger medical students.

Attitudes to anatomy dissection in an Irish medical school.

Many studies around the world have looked at the stresses placed on medical students by cadaveric dissection. Although these studies have linked the use of cadavers in medical teaching to stress, some investigations have suggested an association with severe psychological stress and even post-traumatic stress disorder. This study assessed the attitudes of medical and biomedical sciences students in an Irish medical school towards cadaveric dissection by recording, through a questionnaire, their perceptions and experience before initial exposure to dissection and subsequently examining their attitudes after the first dissection and after 9 weeks. Student attitudes towards the dissecting room remained consistently positive for the duration of the study with only a minority of respondents reporting negative symptoms. Pre-existing attitudes to the idea of dissection were unaffected by exposure and subsequent continuous experience of dissection. The majority of students in this study did not find the dissecting room experience stressful, and considered time spent in the dissecting room valuable. However, the proportion of students with negative experiences in the dissecting room was higher than has been reported in previous studies. Many respondents felt they could be better prepared for the dissecting room experience, indicating an increasing requirement for effective preparatory programmes.

Student attitudes to whole body donation are influenced by dissection.

Given the important role that anatomical dissection plays in the shaping of medical student attitudes to life and death, these attitudes have not been evaluated in the context of whole body donation for medical science. First year students of anatomy in an Irish university medical school were surveyed by questionnaire before and after the initial dissection and again after 9 weeks of anatomical dissection. Analysis of student responses to the idea of whole body donation by an unrelated stranger, a family member, or by the respondent showed that a priori attitudes to donation by a stranger did not change with exposure to dissection. However, student opposition to donation by a family member was evident immediately after the initial dissection and was sustained throughout the duration of this study. Support for the idea of donating their bodies to medical science decreased significantly among respondents after exposure to dissection (31.5% before dissection, 19.6% after dissecting for 9 weeks) but not to levels reported in the general population in other studies. This study demonstrates that where dissection forms a part of anatomy teaching, students expect to learn anatomy by dissecting donors whom they do not know. As a potential donor population, students are reluctant to become emotionally involved in the donation process and are unwilling to become donors themselves.