Feasibility of a Cinematic-Virtual Reality Training Program for Health Professional Students: A Single-Arm Pre-Post Study.

BACKGROUND: Cinematic-virtual reality (cine-VR) has demonstrated improvements in cultural self-efficacy, diabetes attitudes, and empathy among healthcare providers, but its impact on health professional students is unknown. The purpose of the single-arm pre-post study was to examine the feasibility of this cine-VR diabetes training program as well as to assess changes in cultural self-efficacy, diabetes attitudes, and empathy among health professional students. METHOD: Participants viewed 12 cine-VR 12 simulations about a 72-year-old patient with type 2 diabetes. Pre-training and post-training, they completed the Transcultural Self-Efficacy Tool, Diabetes Attitude Scale-3, and Jefferson Scale of Empathy. RESULTS: All 92 participants completed the full training. No participants reported technological difficulties or adverse events. For the assessment, 66 participants completed the pre-post measures for a response rate of 71.7% (mean age = 21.1 ± 1.9 years, 82.6% [n = 57] women; 84.1% [n = 58] white). We observed positive improvements in all three cultural self-efficacy subscales: "Cognitive" (t value = -4.705, P < .001), "Practical" (mean change = -.99, t value = -4.240, P < .001), and "Affective" (t value = -2.763, P = .008). Similarly, we observed positive improvements in four of the five diabetes attitude subscales: "Need for special training" (Z = -4.281, P < .001), "Seriousness of type 2 diabetes" (Z = -3.951, P < .001), "Value of tight glucose control" (Z = -1.676, P = .094), "Psychosocial impact of diabetes" (Z = -5.892, P < .001), and "Attitude toward patient autonomy" (Z = -2.889, P = .005). Finally, we observed a positive improvement in empathy (t value = -5.151, P < .001). CONCLUSIONS: Findings suggest that the cine-VR diabetes training program has the potential to improve cultural self-efficacy, diabetes attitudes, and empathy among health professional students. A randomized controlled trial is needed to confirm its effectiveness.

Measuring grit, self-efficacy, curiosity, and intolerance of uncertainty in first-generation college and first-generation osteopathic medical students.

BACKGROUND: Medical school is a challenging time, with many medical students reporting symptoms of burnout, depression, anxiety, suicidal ideation, and psychological distress during pre-clinical and clinical years. First-generation college and first-generation medical students may be two groups of students at increased risk for the negative psychosocial effects of medical school. Importantly, grit, self-efficacy, and curiosity are protective factors against the negative psychosocial effects of medical school, whereas intolerance of uncertainty is a risk factor. Thus, research examining the associations among grit, self-efficacy, curiosity, and intolerance of uncertainty in first-generation college and first-generation medical students is needed. METHODS: We conducted a cross-sectional, descriptive study to assess medical students' grit, self-efficacy, curiosity, and intolerance of uncertainty. We conducted independent samples t-tests and regression analyses using SPSS statistical software version 28.0. RESULTS: A total of 420 students participated in the study for a response rate of 51.5%. One-fifth of participants (21.2%, n = 89) identified as first-generation students, 38.6% (n = 162) participants reporting having a physician relative, and 16.2% (n = 68) reported having a physician parent. Grit, self-efficacy, and curiosity and exploration scores did not differ by first-generation college status, physician relative(s), or physician parent(s). However, total intolerance of uncertainty scores differed by physician relative(s) (t= -2.830, p = 0.005), but not by first-generation status, or physician parent(s). Further, subscale scores for prospective intolerance of uncertainty differed by physician relative(s) (t= -3.379, p = 0.001) and physician parent(s) (t= -2.077, p = 0.038), but not by first-generation college student status. In the hierarchical regression models, first-generation college student status and first-generation medical student status were not predictive of grit, self-efficacy, curiosity and exploration, or intolerance of uncertainty, although statistical trends were observed with students with physician relative(s) predicting lower intolerance of uncertainty scores (B= -2.171, t= -2138, p = 0.033) and lower prospective intolerance of uncertainty (B= -1.666, t= -2.689, p = 0.007). CONCLUSIONS: These findings suggest that first-generation college students did not differ by grit, self-efficacy, curiosity, or intolerance of uncertainty. Similarly, first-generation medical students did not differ by grit, self-efficacy, or curiosity; however, first-generation medical students showed statistical trends in higher total intolerance of uncertainty and higher prospective intolerance of uncertainty. Additional research needs to confirm these findings in first-generation medical students.

The old but new IgM Fc receptor (FcµR).

IgM is the first Ig isotype to appear during phylogeny, ontogeny and the immune response. The importance of both pre-immune "natural" and antigen-induced "immune" IgM antibodies in immune responses to pathogens and self-antigens has been established by studies of mutant mice deficient in IgM secretion. Effector proteins interacting with the Fc portion of IgM, such as complement and complement receptors, have thus far been proposed, but fail to fully account for the IgM-mediated immune protection and regulation of immune responses. Particularly, the role of the Fc receptor for IgM (FcµR) in such effector functions has not been explored until recently. We have identified an authentic FcµR in humans using a functional cloning strategy and subsequently in mice by RT-PCR and describe here its salient features and the immunological consequences of FcµR deficiency in mice. Since the FcµR we cloned was identical to Toso or Fas inhibitory molecule 3 (FAIM3), there have been spirited debates regarding the real function of FcµR/Toso/FAIM3 and we will also comment on this topic.

The long elusive IgM Fc receptor, FcµR.

IgM exists as both a monomer on the surface of B cells and a pentamer secreted by plasma cells. Both pre-immune "natural" and antigen-induced "immune" IgM antibodies are important for protective immunity and for immune regulation of autoimmune processes by recognizing pathogens and self-antigens. Effector proteins interacting with the Fc portion of IgM, such as complement and complement receptors, have thus far been proposed but fail to fully account for the IgM-mediated protection and regulation. A major reason for this deficit in our understanding of IgM function seems to be lack of data on a long elusive Fc receptor for IgM (FcµR). We have recently identified a bona fide FcµR in both humans and mice. In this article we briefly review what we have learned so far about FcµR.

Genetic sorting of subordinate species in grassland modulated by intraspecific variation in dominant species.

Genetic variation in a single species can have predictable and heritable effects on associated communities and ecosystem processes, however little is known about how genetic variation of a dominant species affects plant community assembly. We characterized the genetic structure of a dominant grass (Sorghastrum nutans) and two subordinate species (Chamaecrista fasciculata, Silphium integrifolium), during the third growing season in grassland communities established with genetically distinct (cultivated varieties or local ecotypes) seed sources of the dominant grasses. There were genetic differences between subordinate species growing in the cultivar versus local ecotype communities, indicating that intraspecific genetic variation in the dominant grasses affected the genetic composition of subordinate species during community assembly. A positive association between genetic diversity of S. nutans, C. fasciculata, and S. integrifolium and species diversity established the role of an intraspecific biotic filter during community assembly. Our results show that intraspecific variation in dominant species can significantly modulate the genetic composition of subordinate species.

Altered Ig levels and antibody responses in mice deficient for the Fc receptor for IgM (FcµR).

Cell surface Fc receptor for IgM antibody (FcµR) is the most recently identified member among FcRs. We determined the cellular distribution of mouse FcµR and the functional consequences of Fcmr disruption. Surface FcµR expression was restricted to B-lineage cells, from immature B to plasma cells, except for a transient down-modulation during germinal center reactions. Fcmr ablation had no significant effect on overall B- and T-cell development, but led to a reduction of marginal zone B cells and an increase in splenic B1 B cells. Preimmune serum IgM in mutant mice was significantly elevated as were natural autoantibodies. When immunized with live attenuated pneumococci, mutant mice mounted robust antibody responses against phosphorylcholine, but not protein, determinants compared with wild-type mice. By contrast, upon immunization with a hapten-carrier conjugate, nitrophenyl-coupled chicken γ-globulin (NP-CGG), the mutant mice had a diminished primary IgG1 response to both NP and CGG. These findings suggest that FcµR has an important role in IgM homeostasis and regulation of humoral immune responses.