Post-COVID-19 approach to teaching an undergraduate laboratory class focused on experimental design and data interpretation.

To best prepare students for the real-world research environment, key skills, including experimental design, data analysis, communication of results, and critical thinking, should be key components of undergraduate science courses. Furthermore, the impact of the COVID-19 pandemic on in-person teaching has resulted in a need to develop courses that enable flexible learning. This paper details the laboratory component of a senior-level toxicology class that was developed to emphasize all these skills and allow for flexible learning. The aim of the laboratory class was for students to determine how curcumin protected against acetaminophen-induced hepatoxicity. To stimulate critical thinking, students were required to choose a maximum of four experiments from the six on offer. Before conducting an experiment, students stated a hypothesis and selected the appropriate treatment groups. Once an experiment was completed, students were given access to a complete dataset, on which they performed statistical analysis and drew conclusions. Students who were unable to attend the laboratory session in person were able to complete the required pre-lab work and access the dataset. Following each experiment, students could write a lab summary, and receive thorough feedback. The final assessment was a written manuscript of their findings as well as a chance to respond to reviewer comments. This teaching approach prioritized the critical thinking, analysis, and experimental design aspects of scientific research. Overall, this structure was well received by students and it could easily be adapted for use on other life science courses.

Learning effectiveness of a flexible learning study programme in a blended learning design: why are some courses more effective than others?

Flexible learning addresses students' needs for more flexibility and autonomy in shaping their learning process, and is often realised through online technologies in a blended learning design. While higher education institutions are increasingly considering replacing classroom time and offering more blended learning, current research is limited regarding its effectiveness and modifying design factors. This study analysed a flexible study programme with 133 courses in a blended learning design in different disciplines over more than 4 years with a mixed-methods approach. In the analysed flexible study programme, classroom instruction time was reduced by 51% and replaced with an online learning environment in a blended learning format (N students = 278). Student achievement was compared to the conventional study format (N students = 1068). The estimated summary effect size for the 133 blended learning courses analysed was close to, but not significantly different from, zero (d = - 0.0562, p = 0.3684). Although overall effectiveness was equivalent to the conventional study format, considerable variance in the effect sizes between the courses was observed. Based on the relative effect sizes of the courses and data from detailed analyses and surveys, heterogeneity can be explained by differences in the implementation quality of the educational design factors. Our results indicate that when implementing flexible study programmes in a blended learning design, particular attention should be paid to the following educational design principles: adequate course structure and guidance for students, activating learning tasks, stimulating interaction and social presence of teachers, and timely feedback on learning process and outcomes.

Extended reality (XR) virtual practical and educational eGaming to provide effective immersive environments for learning and teaching in forensic science.

Online virtual learning resources have been available for learning and teaching in forensic science for some years now, but the recent global COVID-19 related periods of irregular lockdown have necessitated the rapid development of these for teaching, learning and CPD activities. However, these resources do need to be carefully constructed and grounded in pedagogic theory to be effective. This article details eXtended Reality (XR) learning and teaching environments to facilitate effective online teaching and learning for forensic geoscientists. The first two case studies discussed in this article make use of Thinglink software to produce virtual learning and teaching XR resources through an internet system, which was delivered to undergraduate students in 2021. Case one details a range of XR virtual laboratory-based equipment resources, providing a consistent, reliable and asynchronous learning and teaching experience, whilst the second case study presents an XR virtual learning applied geophysics resource developed for a 12-week CPD training programme. This programme involves recorded equipment video resources, accompanying datasets and worksheets for users to work through. Both case studies were positively received by learners, but there were issues encountered by learners with poor internet connections or computer skills, or who do not engage well with online learning. A third case study showcases an XR educational forensic geoscience eGame that was developed to take the user through a cold case search investigation, from desktop study through to field reconnaissance and multi-staged site investigations. Pedagogic research was undertaken with user questionnaires and interviews, providing evidence that the eGame was an effective learning and teaching tool. eGame users highly rated the eGame and reported that they raised awareness and understanding of the use of geophysics equipment and best practice of forensic geoscience search phased investigations. These types of XR virtual learning digital resources, whilst costly to produce in terms of development time and staff resource, provide a complementary virtual learning experience to in-situ practical sessions, and allow learners to asynchronously familiarise themselves with equipment, environments and techniques resulting in more efficient use of in situ time. The XR resources also allow learners to reinforce learning post in-situ sessions. Finally, XR resources can provide a more inclusive and authentic experience for learners who cannot attend or complete work synchronously.

Development of executive function-relevant skills is related to both neural structure and function in infants.

The development of skills related to executive function (EF) in infancy, including their emergence, underlying neural mechanisms, and interconnections to other cognitive skills, is an area of increasing research interest. Here, we report on findings from a multidimensional dataset demonstrating that infants' behavioral performance on a flexible learning task improved across development and that the task performance is highly correlated with both neural structure and neural function. The flexible learning task probed infants' ability to learn two different associations, concurrently, over 16 trials, requiring multiple skills relevant to EF. We examined infants' neural structure by measuring myelin density in the brain, using a novel macromolecular proton fraction (MPF) mapping method. We further examined an important neural function of speech processing by characterizing the mismatch response (MMR) to speech contrasts using magnetoencephalography (MEG). All measurements were performed longitudinally in monolingual English-learning infants at 7- and 11-months of age. At the group level, 11-month-olds, but not 7-month-olds, demonstrated evidence of learning both associations in the behavioral task. Myelin density in the prefrontal region at 7 months of age was found to be highly predictive of behavioral task performance at 11 months of age, suggesting that myelination may support the development of these skills. Furthermore, a machine-learning regression analysis revealed that individual differences in the behavioral task are predicted by concurrent neural speech processing at both ages, suggesting that these skills do not develop in isolation. Together, these cross-modality results revealed novel insights into EF-related skills. HIGHLIGHT: Monolingual infants demonstrated flexible learning on a task requiring executive function skills at 11 months, but not at 7 months. Infants' myelin density at 7 months is highly predictive of their behavioral performance in the flexible learning task at 11 months of age. Individual differences in the flexible learning task performance are also correlated with concurrent neural processing of speech at both ages.

The Rise and Fall of the HyFlex Approach in Mexico.

During the Covid-19 pandemic, the world turned to online tools as a means of ensuring continued access to education, highlighting possibilities for innovation, particularly in contexts like Mexico, where the use of edtech was not previously prevalent. When educational institutions reopened their physical campuses, many schools and universities considered a hybrid, flexible (HyFlex) approach as a way of catering for different needs. While research findings on students' perspectives tend to be positive, the implementation of HyFlex courses has shown some challenges. Issues reported by teachers relate to poor technical infrastructure, work overload and lack of guidance. The initial excitement for the HyFlex approach has subdued. However, an openness to innovation is still there, ready to be exploited.

Connection, connectivity and choice: Learning during COVID-19 restrictions across mainstream schools and Flexible Learning Programmes in Australia.

The COVID-19 pandemic and associated school closures may have constrained educational participation particularly for students in disadvantaged circumstances. We explore how 30 disadvantaged students in secondary school (14 mainstream/16 Flexible Learning Programme) from Queensland, New South Wales and Tasmania experienced home learning during the first wave of COVID-19, teasing out nuances across two educational models. Drawing on semi-structured interviews with these students, our analysis revealed three interconnected themes inflecting their learning: connection, connectivity and choice. Connection captures the desire for belonging and practices that facilitated meeting this desire during system-wide disruptions to school routines and face-to-face learning. Connectivity captures the impact of digitally facilitated learning at home on students' ability to engage with curriculum content and with their learning community. Choice captures the availability of viable options to overcome barriers students encountered in their learning and possibilities to flexibly accommodate student preferences and learning needs. Students from Flexible Learning Programmes appeared generally better supported to exercise agency within the scope of their lived experience of home-based learning. Findings indicate a need for strengthening student-centred policy and practices aimed at leveraging the affordances of information technology, balancing self-directed and structured learning and providing holistic support to enable meaningful student choice.

Neural correlates of transitive inference: An SDM meta-analysis on 32 fMRI studies.

Transitive inference (TI) is a critical capacity involving the integration of relevant information into prior knowledge structure for drawing novel inferences on unobserved relationships. To date, the neural correlates of TI remain unclear due to the small sample size and heterogeneity of various experimental tasks from individual studies. Here, the meta-analysis on 32 fMRI studies was performed to detect brain activation patterns of TI and its three paradigms (spatial inference, hierarchical inference, and associative inference). We found the hippocampus, prefrontal cortex (PFC), putamen, posterior parietal cortex (PPC), retrosplenial cortex (RSC), supplementary motor area (SMA), precentral gyrus (PreCG), and median cingulate cortex (MCC) were engaged in TI. Specifically, the RSC was implicated in the associative inference, whereas PPC, SMA, PreCG, and MCC were implicated in the hierarchical inference. In addition, the hierarchical inference and associative inference both evoked activation in the hippocampus, medial PFC, and PCC. Although the meta-analysis on spatial inference did not generate a reliable result due to insufficient amount of investigations, the present work still offers a new insight for better understanding the neural basis underlying TI.

An exploration of instructors' and students' perspectives on remote delivery of courses during the COVID-19 pandemic.

The world-wide pivot to remote learning due to the exogenous shocks of COVID-19 across educational institutions has presented unique challenges and opportunities. This study documents the lived experiences of instructors and students and recommends emerging pathways for teaching and learning strategies post-pandemic. Seventy-one instructors and 122 students completed online surveys containing closed and open-ended questions. Quantitative and qualitative analyses were conducted, including frequencies, chi-square tests, Welch Two-Samples t-tests, and thematic analyses. The results demonstrated that with effective online tools, remote learning could replicate key components of content delivery, activities, assessments, and virtual proctored exams. However, instructors and students did not want in-person learning to disappear and recommended flexibility by combining learning opportunities in in-person, online, and asynchronous course deliveries according to personal preferences. The paper concludes with future directions and how the findings influenced our planning for Fall 2021 delivery. The video abstract for this article is available at https://www.youtube.com/watch?v=F48KBg_d8AE.

A blended learning exercise physiology theory module that supports student autonomy and improves academic performance.

A limited number of studies have explored the impact of blended exercise physiology theory curricula on student learning and experience. This study aimed to investigate the impact of an exercise physiology blended learning theory module on student performance, engagement, and perceptions. The module, which comprised a range of elements (student guide, lecturer-recorded videos, supplementary videos, formative quizzes, workshops, and discussion forum), was implemented in a third-year subject taken by students in nonspecialist undergraduate science, technology, engineering, and mathematics (STEM) degrees. Students chose which elements to engage with to support their learning. Exam performance was assessed by comparing exam marks from fully face-to-face delivery to the blended delivery with an independent t test. Student perceptions were determined via an end-of-module questionnaire comprised of Likert-scale questions and open-ended questions. Descriptive statistical analysis was conducted on the Likert-scale responses, and qualitative content analysis was conducted on the open-ended responses. Student engagement with online resources was determined through analysis of access statistics from the learning management system. Student exam marks in the blended learning student group were significantly higher (P < 0.0001) than in the face-to-face group, even though the questions were of a higher Bloom's level in the blended learning group. Students preferred blended delivery over fully face-to-face delivery. Most students accessed the student guide, lecturer-recorded videos, and quizzes, with supplementary videos, workshops, and discussion forums accessed by fewer students. In conclusion, a blended exercise physiology theory module improved student exam performance and was positively perceived by students, and engagement with the elements of the module was varied.NEW & NOTEWORTHY Few studies have explored the impact of blended delivery of exercise physiology theory curricula on student learning and experience. This study investigated the impact of a novel blended model on student learning and experience. The module comprised a range of elements (student guide, lecturer-recorded videos, supplementary videos, formative quizzes, workshops, and discussion forum), where students were able to choose which elements to engage with to support their learning.

Absence makes the mind grow stronger - Educating in a pandemic and beyond.

With more than one academic year into the pandemic, it is timely to consider the lessons we learnt, and how they could shape education in the future. Papers from around the globe, reflecting on the directions we took and could take, were published in the FEMS Microbiology Letters virtual Thematic Issue 'Educating in a pandemic and beyond' in October 2021. Its content is reviewed here to facilitate discussions within the professional community. Online platforms and tools, that allowed a rapid emergency response, are covered, as well as enhancing student engagement, complementing and blending in-person activities with online elements for more flexible and accessible learning opportunities, the need for educator training, and improving science literacy overall and microbiology literacy specifically. As we go forward, in order to benefit from blended and flexible learning, we need to select our approaches based on evidence, and mindful of the potential impact on learners and educators. Education did not only continue during the pandemic, but it evolved, leading us into the future.

Short-term research projects in cognitive neuroscience for undergraduate students: a contingency plan to maintain quality teaching during COVID-19 pandemic.

The Corona Virus Disease 19 (COVID-19) pandemic has imposed serious restrictions for academic institutions to maintain their research and teaching practical subjects. Universities have implemented adaptive measures to maintain educational activities and achieve the learning objectives for undergraduate and postgraduate students by shifting to online teaching and learning. Although such approaches have enabled delivering the theoretical content of courses during the pandemic, universities have faced serious difficulties in running practicals with actual research experiments and teaching hand-on skills because such activities potentially override the required safety guidelines. Here, we report an adaptive measure, implemented at Monash University, to run home-based studies in cognitive neuroscience and achieve learning objectives, which are normally delivered in face-to-face practicals. We introduce two specifically designed short-term research projects and describe how different aspects of these projects, such as tutorials, experiments, and assessments, were modified to meet the required social distancing. The results of cognitive tests were closely comparable between the laboratory-based and home-based experiments indicating that students followed the guidelines and the required procedures for a reliable data collection. Our assessments of students' performance and feedback indicate that the majority of our educational goals were achieved, while all safety guidelines and distancing requirements were also met.

Sentiment Analysis of Student Engagement with Lecture Recording.

Lecture recordings are useful learning resources that can support flexible, remote and distance learning, especially during the Covid-19 pandemic. This study explored students' experiences of engaging with recorded lectures and the extent to which such engagement contributes to enhanced learning. The research involved the deployment of a questionnaire to undergraduate and postgraduate students (n = 660) who had access to lecture recordings at a research intensive public university in New Zealand. Key findings revealed that students who accessed lecture recordings reported an enhanced learning experience. They stated that the availability of lecture recordings created an inclusive learning environment for students with learning disabilities and fostered flexible learning for those who would otherwise be unable to attend lectures either due to sickness or work commitments. Data also suggest that students utilised lecture recordings as supplementary learning resources rather than a substitute for regular lecture attendance. Our findings substantiated previous research studies and additionally demonstrated the various ways in which students engage with lecture recordings. Moreover, the use of sentiment analysis shows how multiple data can be triangulated to confirm or contest research findings. Finally, we believe this study adds to the voice that lecture recordings are vital resources that support students' learning.

Blended learning in undergraduate nursing education - A scoping review.

OBJECTIVES: To provide a comprehensive scoping review of the existing literature regarding the use of blended learning in undergraduate nursing education. To align the varied educational terms and definitions with the broad definition of blended learning. DESIGN: Scoping review following established methodology. DATA SOURCES: In consultation with library services, the academic literature was searched. Electronic databases searched included ERIC (OVID), Medline (OVID), PubMed, Nursing and Allied Health, and CINAHL Plus. REVIEW METHODS: A total of 189 potentially relevant nursing research articles published between the years of 2009 and 2019. Three reviewers independently reviewed the articles, leaving 37 relevant primary articles in the nursing field to be included in the scoping review. RESULTS: Nursing content delivered using blended learning approaches were organized into 8 themes. Themes include Professional Nursing Skills; Mental Health Nursing; Bioscience; Pharmacology, Specialty Populations; Nursing Assessment; Acute Care Nursing; and the Art of Nursing. A variety of blended learning approaches are being utilized in Undergraduate nursing education, the majority of which are happening in the classroom. CONCLUSION: This scoping review presents explicit the degrees to which blended learning is referred to in the nursing education literature and expanded the definition of blended learning to encompass the terminology associated with distributed, decentralized, hybrid, and flexible learning. There is a wide, varied, and expanding number of blended learning approaches currently being utilized in nursing education to teach a wide range of nursing content and skills. An expanded scoping review focused on blended learning in psychiatric nursing, licenced practical nursing, nurse practitioners, and all graduate level nursing education programs is recommended as is additional research into the use of blended learning in the lab or clinical setting.

The oral language and reading comprehension skills of adolescents in flexible learning programmes.

Purpose: Access to flexible learning programmes (FLPs) for students who have been excluded or diverted from mainstream school settings is increasing internationally. While still technically "engaged with education" such students face long-term vulnerability with respect to acquiring marketable employment skills post-school. Language and literacy skills are central to such training; hence, this study describes the oral language and reading comprehension profiles of a sample of flexible learning programmes (FLP) students.Method: Fifty young people (mean age 16 years) enrolled in three FLPs in Victoria, Australia were assessed by a speech-language pathologist in order to profile their oral language and reading comprehension skills.Result: Seventy-two percent of participants had oral language skills that placed them in an at-risk range on standardised measures, and 47.5% had reading comprehension ages of ≤12 years. A moderate significant association existed between oral language and reading comprehension skills.Conclusion: Language and reading comprehension difficulties are prevalent in this population and may be missed in the context of the mental health and adjustment difficulties experienced by this group, but are likely to be key to academic engagement and success. Speech-language pathology scope of practice needs to include FLP settings.

Design-based research for the development of a flexible learning environment.

BACKGROUND: Students enrolled for the Bachelor of Radiography degree at the Central University of Technology Free State in Bloemfontein, South Africa, spent many weeks off campus at hospitals during workplace learning. A design-based research approach was applied to analyse an educational problem, namely that students apparently fail to apply the theory of radiation safety regulations to protect themselves and patients. AIMS: The purpose of the study was to develop authentic activities and assessment for radiation safety requirements, to provide flexible learning in a blended environment to students off campus. SETTING: The second-year radiography students of 2016 and 2017 responded off campus to the QuestionPro survey. METHOD: Authentic learning and assessment opportunities were contextualised and compiled to align with learning outcomes of the safety regulations as confirmed during a Delphi process. Flexible learning opportunities were delivered via electronic mail (email) and WhatsApp. Assessment responses from the students were received via mobile phones with a Web-based software tool, QuestionPro. RESULTS: Of the 117 students, 92.3% responded to the QuestionPro survey. From the incorrect responses, learning areas that needed revision were identified, as well as the areas in the X-ray departments of the hospitals showing non-compliance with the requirements for radiation safety. CONCLUSION: The three outcomes of this design-based research included the formulation of design principles, a designed product in the form of a Website and professional development of the researcher. The design-based research principles that were tested involved the use of knowledge in real life and measuring if students were effective performers with acquired knowledge.

E o Passado é uma Roupa que Não nos Serve Mais: uma Reflexão sobre Integração Ensino-Saúde-Comunidade em Curso Médico do Nordeste / And the Past is a Garment that no Longer Suits us: Reflecting on Teaching-Health-Community Integration in a Medical Course in Northeast Brazil

RESUMO A formação médica, assim como a sociedade brasileira, tem passado por importantes transformações. Tais mudanças buscam atender as demandas sociais e sanitárias contemporâneas, sobretudo no que diz respeito a uma formação voltada à realidade sociossanitária local. Em razão disso, a formação deve buscar desenvolver competências, habilidades e atitudes em um cenário de integração do ensino com a saúde e a comunidade. O curso de Medicina da Universidade Federal de Alagoas, campus Arapiraca, iniciado no ano de 2015, resulta do processo de expansão das escolas médicas do País e do processo de interiorização das ações dessa universidade. O curso está estruturado em três eixos (tutoria, habilidades médicas e integração ensino-saúde-comunidade). Neste texto, pretende-se apresentar o processo de trabalho do eixo de Integração Ensino-Saúde-Comunidade (Iesc), seus principais avanços e os desafios envolvidos no processo de formação. O Iesc tem como missão promover a aproximação entre o acadêmico e a realidade sociossanitária local a fim de garantir uma formação médica capaz de oferecer uma assistência integral, respeitosa, ética, crítica e humanística, considerando o sujeito e o contexto em que está inserido, sua cultura, crença, hábitos e costumes. Em 2017, para cumprir sua missão, o eixo reestruturou o currículo do curso de modo que a formação ocorra no ciclo básico (primeiro e segundo anos), passando pelo ciclo intermediário (terceiro e quarto anos) e alcançando o internato (quinto e sexto anos). Nossa experiência tem mostrado que o aprendizado significativo deve nascer da prática, isto é, do processo de experimentações com a realidade. É nítido o maior envolvimento dos nossos estudantes quando incluímos atividades com finalidades práticas bem definidas. Nossa sistemática de trabalho envolve reuniões mensais, quando são discutidos os principais problemas e elaboradas estratégias de condução do eixo, padronização de cadernos de curso e estratégias avaliativas, processo de formação continuada dos docentes, como parte do plano bianual de qualificação e inclusão de avaliação por parte dos acadêmicos, com o semestre em curso. A variedade de estratégias pedagógicas, todas ancoradas nas metodologias ativas de ensino-aprendizagem, contribui para o maior envolvimento dos nossos estudantes nas aulas. Os principais desafios são consolidar a inserção na rede de saúde local e qualificar o corpo docente no uso de metodologias ativas em todos os processos de aprendizagem.

ABSTRACT Both medical education and Brazilian society as a whole have undergone significant transformations in recent years. These changes seek to meet contemporary social and sanitary demands, especially with regard to a training focused on the local socio-sanitary reality. Medical training should therefore seek to develop skills, abilities and attitudes in a setting where teaching is integrated with health care and the community. The medical course of the Federal University of Alagoas, Arapiraca campus, was founded in 2015, resulting from the expansion of medical schools in Brazil and the internalization of the University's actions. The course is structured on three axes (tutoring, medical skills and teaching-health-community integration). This text intends to present the work process of the Teaching-Health-Community Integration (LESC) axis, its main advances and the challenges involved in the training process. The mission of LESC is to place the academic into closer contact with the local socio-sanitary reality in order to ensure a medical training that offers comprehensive, respectful, ethical, critical and humanistic care, considering the subject and his or her context, culture, beliefs, habits and customs. To fulfill this mission, in 2017 the course curriculum was restructured so as to split the training into the basic cycle (1 st and 2 nd years), the intermediate cycle (3 rd and 4 th years) and, finally, medical internship (5 th and 6 th years). Our experience has shown that meaningful learning must come from practice, that is, from the process of experimentation with reality. Our students are distinctly more involved and interested when we include activities with well-defined practical purposes. Our work system involves monthly meetings, where major issues are discussed and strategies developed for conducting LESC, the standardization of course books and evaluation strategies, a continuing education program for teachers, as part of the biannual qualification plan and the inclusion of student-led evaluation during the semester. The variety of teaching strategies, all anchored in active learning methodologies, encourages greater involvement of our students in class. The main challenges can be summarised as consolidating student insertion into the local health care network and qualifying the teachers in their use of active methodologies in all learning processes.

Inteligência artificial, o Futuro da Medicina e a Educação Médica / Artificial Intelligence, the Future of Medicine and Medical Education

RESUMO Inteligência artificial (IA) é um ramo da ciência da computação que usando algoritmos definidos por especialistas é capaz de reconhecer um problema, ou uma tarefa a ser realizada, analisar dados e tomar decisões, simulando a capacidade humana. Sistemas computadorizados de apoio à decisão já existem há décadas, mas o aumento da velocidade de processamento e de armazenamento de informação dos computadores, permitiu analisar um grande volume de dados em nanosegundos propondo soluções de problemas, orientando a proposta e tomada de decisões, realizando tarefas sem receber instruções diretas de humanos. Já utilizadas em um grande número de atividades em áreas como o comércio, bancos, transporte, atendimento a usuários e, mesmo, gestão de recursos materiais e do capital humano, IA tem ampliado significativamente a sua aplicação em saúde. Em saúde IA analisa dados disponíveis em bases de dados de nascimentos, mortalidade, hospitalizações, doenças de notificação compulsória e de dados de pacientes registrados em prontuários eletrônicos. Busca, seja indicar a prevalência e evolução de enfermidades, possibilitando antecipar surtos epidêmicos e propor medidas preventivas com oportunidade, seja analisar, por exemplo, a coerência entre uma hipótese diagnóstica de um paciente e exames solicitados e terapia prescrita. IA reconhece imagens, permite interações computadorizadas em linguagem aberta, escrita e falada, percebe relações e nexos, entende conceitos e não apenas processa dados, segue algoritmos e cria sua própria experiência ("machine learning"). A constatação de que 32% dos erros médicos no Estados Unidos decorrem de problemas na relação médico-paciente, de um exame clínico deficiente, ou falha na avaliação de dados e de resultados de exames complementares, tem ressaltado a necessidade de se redefinir a prática médica, visando reservar tempo numa consulta para garantir uma boa comunicação e orientação do paciente. O uso de linguagem natural no registro de dados em prontuários eletrônicos, melhoria do relacionamento através da internet, emprego de computadores na comunicação médico-paciente, emprego de dispositivos vestíveis e corporais na obtenção de dados ("wearable devices"), telemedicina, trabalho em equipes multiprofissionais, visam otimizar o desempenho do médico no atendimento de seu paciente. A redefinição da prática médica resultará, necessariamente, em mudanças na formação do médico. Essa preocupação se refletiu no estabelecimento de um consórcio de escolas, estabelecido pela Associação Americana de Medicina, para discutir mudanças curriculares, ajustando a formação profissional a uma época caracterizada pelo uso intensivo de tecnologias e inteligência artificial. O autor faz considerações sobre a formação médica, propondo um núcleo de conhecimento que deverá alicerçar uma maior flexibilidade do aprendizado, ajustando-o às motivações e orientações dos alunos.

ABSTRACT Artificial Intelligence (AI) is a branch of computer science that using algorithms defined by specialists can recognize a problem, or a task to be performed, analyzing data and taking decisions simulating the human being. Decision support systems were developed decades ago but were reemphasized as a consequence of the incredible increase in computer storage and data processing, creating the concept of "big data". AI is already part of a large number of activities in sectors like commerce, banking, transportation, communication, and administration of human and material resources. The impact of AI in health allows the analysis of data banks such as birth, death, diseases of compulsory declaration, hospitalization of patients and data registered in electronic health records, indicating the prevalence and evolution of diseases, anticipating epidemic outbreaks and proposing preventive measures to be taking by the population. Picture analysis and pattern recognition of radiologic, dermatologic and ophthalmologic images is being now widely used. The processing of medical records is being also done to discuss cases and detect inconsistencies between diagnosis, complementary tests requested, and treatment prescribed. The indication that 32% of medical errors in the USA were due to inadequate time for patient assessment, resulting in less accurate diagnosis, not recognition of a problem, or the urgency of the case, has made urgent a reappraisal of the patient-physician relationship, trying to reserve time in the consultation for the physician hear, discuss the case and orient the patient. The use of natural language in the registration of patient data in electronic medical records, employment of computers and internet to communicate with patients, use of data collected in wearable devices, telemedicine, multi-professional team work in the delivery of health care, are proposals to optimize the medical attention to patients. The redefinition of medical practice will result, consequently, in the reform of the medical graduation. The American Medical Association established in 2013 a medical school consortium ("the work of the AMA accelerating change in medical education") to foster these curricular changes needed to graduate physicians able to cope with innovation and artificial intelligence. The author makes considerations on medical graduation, proposing a core curriculum that will provide the competencies of a general practitioner, which will be complemented by flexible courses to take into consideration students' orientations.

Toward a theoretical role for tonic norepinephrine in the orbitofrontal cortex in facilitating flexible learning.

To adaptively respond in a complex, changing world, animals need to flexibly update their understanding of the world when their expectations are violated. Though several brain regions in rodents and primates have been implicated in aspects of this updating, current models of orbitofrontal cortex (OFC) and norepinephrine neurons of the locus coeruleus (LC-NE) suggest that each plays a role in responding to environmental change, where the OFC allows updating of prior learning to occur without overwriting or unlearning one's previous understanding of the world that changed, while elevated tonic NE allows for increased flexibility in behavior that tracks an animal's uncertainty. In light of recent studies highlighting a specific LC-NE projection to the OFC, in this review we discuss current models of OFC and NE function, and their potential synergy in the updating of associations following environmental change.

Individualizing Student Instruction in Reading: Implications for Policy and Practice.

Despite three decades of scientific and public attention on efforts to improve literacy in America, little progress has been made in closing achievement gaps across racial, ethnic and socioeconomic lines. This article argues that one major reason is failure to take into account the mosaic of strengths and weaknesses individual children bring to school. With this comes the failure to develop personalized instruction for each child. We briefly review the research available, and then describe how research, ours and others, supports the efficacy of individualizing or personalizing student instructional (ISI) and illustrate how society might close achievement gaps. ISI, and other regimes, offer a systematic instructional program, incorporate child assessment, and personalized small-group instruction. In ISI, this is aided by computer-generated recommendations and planning tools, coupled with extensive, ongoing professional development. ISI has been shown to be highly effective from preschool through third grade in improving children's literacy skills. The practical and policy implications of implementing effective instruction are discussed.

Evaluating the Effects of Flexible Learning about Aseptic Compounding on First-year Students in a Pharmacy Skills Laboratory.

OBJECTIVE: To evaluate how flexible learning via online video review affects the ability and confidence of first-year (P1) pharmacy students to accurately compound aseptic preparations. DESIGN: Customary instructions and assignments for aseptic compounding were provided to students, who were given unlimited access to 5 short review videos in addition to customary instruction. Student self-confidence was assessed online, and faculty members evaluated students' aseptic technique at the conclusion of the semester. ASSESSMENT: No significant difference on final assessment scores was observed between those who viewed videos and those who did not. Student self-confidence scores increased significantly from baseline, but were not significantly higher for those who viewed videos than for those who did not. CONCLUSION: First-year students performed well on final aseptic compounding assessments, and those who viewed videos had a slight advantage. Student self-confidence improved over the semester regardless of whether or not students accessed review videos.