PBL 2.0: enhancing problem-based learning through increased student participation.

PURPOSE: The purpose of this study was to test a new problem-based learning (PBL) method to see if it reinvigorated the learning experience. METHOD: A new PBL format called PBL 2.0, which met for 90 min two times per week, was introduced in 2009 into an 11-week integrated neuroscience course. One hundred second-year medical students, divided into 10 groups of 10, who had completed their first year of medical school using a traditional PBL format, participated in PBL 2.0. Students were prohibited from using computers during the first session. Learning objectives were distributed at the end of the first day to the small groups, and students were assigned to pairs/trios responsible for leading an interactive discussion on specific learning objectives the following day. Student-led 'lectures' were prohibited. All students were responsible for learning all of the learning objectives so that they could participate in their discussions. RESULTS: One hundred and six students were surveyed and 98 submitted answers (92% response). The majority of groups adhered to the new PBL method. Students invested more time preparing the learning objectives. Students indicated that the level of interaction among students increased. The majority of students preferred the new PBL format. CONCLUSIONS: PBL 2.0 was effective in increasing student interaction and promoting increased learning.

Standardized patient outcomes trial (SPOT) in neurology.

BACKGROUND: The neurologic examination is a challenging component of the physical examination for medical students. In response, primarily based on expert consensus, medical schools have supplemented their curricula with standardized patient (SP) sessions that are focused on the neurologic examination. Hypothesis-driven quantitative data are needed to justify the further use of this resource-intensive educational modality, specifically regarding whether using SPs to teach the neurological examination effects a long-term benefit on the application of neurological examination skills. METHODS: This study is a cross-sectional analysis of prospectively collected data from medical students at Weill Cornell Medical College. The control group (n=129) received the standard curriculum. The intervention group (n=58) received the standard curriculum and an additional SP session focused on the neurologic examination during the second year of medical school. Student performance on the neurologic examination was assessed in the control and intervention groups via an OSCE administered during the fourth year of medical school. A Neurologic Physical Exam (NPE) score of 0.0 to 6.0 was calculated for each student based on a neurologic examination checklist completed by the SPs during the OSCE. Composite NPE scores in the control and intervention groups were compared with the unpaired t-test. RESULTS: In the fourth year OSCE, composite NPE scores in the intervention group (3.5±1.1) were statistically significantly greater than those in the control group (2.2±1.1) (p<0.0001). CONCLUSIONS: SP sessions are an effective tool for teaching the neurologic examination. We determined that a single, structured SP session conducted as an adjunct to our traditional lectures and small groups is associated with a statistically significant improvement in student performance measured 2 years after the session.

Subverting the hegemony of the synapse: complicity of neurons, astrocytes, and vasculature in spreading depression and pathology of the cerebral cortex.

Contrary to Golgi's "reticular" theory of nervous structure, it is clear that the synapse rules over communication among nerve cells. Spreading depression, however, does not follow synaptic pathways. It sweeps across gray matter like a political revolution, ignoring structural boundaries and carefully established regulatory mechanisms. Neurons form alliances with their usually subordinate partners, the astrocytes, to cause a perturbation of function that strains resources necessary for recovery. Innocent bystanders, the blood vessels, are obliged to try to ameliorate the disturbance but may not be able to respond optimally in the chaotic environment. Under extreme circumstances, a purge of some of the instigators may ensue. This anarchic picture of interactions among the elements of nervous tissue does little to rescue the reticular theory that was one of Golgi's most important intellectual offerings. Nevertheless, it reminds us that the behavior of populations of nerve cells need not necessarily be limited by the pathways dictated by synaptic junctions. Spreading depression is a multifactorial phenomenon, in which intense depolarization of neurons and/or astrocytes leads to perturbations that include release of K(+), release of glutamate, increase in intracellular Ca(++), release of ATP and local anoxia, as well as vascular changes. This process plays a role in migraine and contributes to the damage produced by brain anoxia, trauma, stroke, and subarachnoid hemorrhage. It may provide clues to new treatments for the damaged brain.

Terminology for neuroscience data discovery: multi-tree syntax and investigator-derived semantics.

The Neuroscience Information Framework (NIF), developed for the NIH Blueprint for Neuroscience Research and available at http://nif.nih.gov and http://neurogateway.org , is built upon a set of coordinated terminology components enabling data and web-resource description and selection. Core NIF terminologies use a straightforward syntax designed for ease of use and for navigation by familiar web interfaces, and readily exportable to aid development of relational-model databases for neuroscience data sharing. Datasets, data analysis tools, web resources, and other entities are characterized by multiple descriptors, each addressing core concepts, including data type, acquisition technique, neuroanatomy, and cell class. Terms for each concept are organized in a tree structure, providing is-a and has-a relations. Broad general terms near each root span the category or concept and spawn more detailed entries for specificity. Related but distinct concepts (e.g., brain area and depth) are specified by separate trees, for easier navigation than would be required by graph representation. Semantics enabling NIF data discovery were selected at one or more workshops by investigators expert in particular systems (vision, olfaction, behavioral neuroscience, neurodevelopment), brain areas (cerebellum, thalamus, hippocampus), preparations (molluscs, fly), diseases (neurodegenerative disease), or techniques (microscopy, computation and modeling, neurogenetics). Workshop-derived integrated term lists are available Open Source at http://brainml.org ; a complete list of participants is at http://brainml.org/workshops.

The neuroscience information framework: a data and knowledge environment for neuroscience.

With support from the Institutes and Centers forming the NIH Blueprint for Neuroscience Research, we have designed and implemented a new initiative for integrating access to and use of Web-based neuroscience resources: the Neuroscience Information Framework. The Framework arises from the expressed need of the neuroscience community for neuroinformatic tools and resources to aid scientific inquiry, builds upon prior development of neuroinformatics by the Human Brain Project and others, and directly derives from the Society for Neuroscience's Neuroscience Database Gateway. Partnered with the Society, its Neuroinformatics Committee, and volunteer consultant-collaborators, our multi-site consortium has developed: (1) a comprehensive, dynamic, inventory of Web-accessible neuroscience resources, (2) an extended and integrated terminology describing resources and contents, and (3) a framework accepting and aiding concept-based queries. Evolving instantiations of the Framework may be viewed at http://nif.nih.gov , http://neurogateway.org , and other sites as they come on line.

Roger Sperry: pioneer of neuronal specificity.

This essay looks at the historical significance of two APS classic papers that are freely available online: Sperry RW. Optic nerve regeneration with return of vision in anurans. J Neurophysiol 7: 57-69, 1944 (http://jn.physiology.org/cgi/reprint/7/1/57). Sperry RW. Restoration of vision after crossing of optic nerves and after contralateral transplantation of eye. J Neurophysiol 8: 15-28, 1945 (http://jn.physiology.org/cgi/reprint/8/1/15).