Team-based learning at ten medical schools: two years later.

PURPOSE: In 2003, we described initial use of team-based learning (TBL) at 10 medical schools. The purpose of the present study was to review progress and understand factors affecting the use of TBL at these schools during the subsequent 2 years. METHODS: Representatives from 10 schools evaluated in 2003 were again evaluated in 2005. They were interviewed by members of the Team Based Learning Collaborative using a semistructured interview process. Data were analysed by 2 researchers using the constant comparative method and were triangulated through sharing results with other interviewers at regular intervals to verify conclusions and form consensus. RESULTS: TBL continued to be used in all but 1 school. At the 9 remaining schools, TBL was added to 18 courses, continued to be used in 19 and was discontinued in 13 courses. At some schools, it was discontinued in single courses in lieu of new, longitudinal integration courses in which TBL was a main instructional strategy. Faculty, student, course and institutional factors were associated with changes in TBL use. CONCLUSION: Faculty, administration/curriculum, students and characteristics of specific courses influence ongoing utilisation of TBL. Those who desire to implement TBL would do well to take these factors into account as they plan implementation efforts at their schools.

Effect of arginine deficiency on arginine-dependent post-translational protein modifications in mice.

Transgenic mice that overexpress arginase-I in their small-intestinal enterocytes suffer from a pronounced, but selective decrease in circulating arginine levels during the suckling period, resulting in impaired growth and development of hair, muscle and immune system. In the present study, we tested the hypothesis that the arginine-deficiency phenotype is caused by arginine-specific post-translational modifications, namely, an increase in the degree of mono-ADP-ribosylation of proteins because of reduced competition by free arginine residues and/or an increase in protein-tyrosine nitration because of an increased O2- production by NO synthases in the presence of limiting amounts of arginine. Arginine ADP-ribosylation and tyrosine nitration of proteins in the affected organs were assayed by Western blot analysis, using specific anti-ADP-ribosylarginine and protein-nitrotyrosine antisera. The composition of the group of proteins that were preferentially arginine ADP-ribosylated or tyrosine-nitrated in the respective organs was strikingly similar. Arginine-deficient mice differed from their controls in a reduced ADP-ribosylation of a 130 kDa and a 65 kDa protein in skin and an increased protein nitration of an 83 kDa protein in bone marrow and a 250 kDa protein in spleen. Since only 20 % of the visualised proteins were differentially modified in a subset of the affected organs, our findings appear to rule out these prominent arginine-dependent post-translational protein modifications as mediators of the characteristic phenotype of severely arginine-deficient mice.