Effect of anatomical studies prior to medical school on medical school anatomy study success and residency choice.

INTRODUCTION: There is little research on how medical school matriculants' experiences prior to medical school effects their choice of specialty or performance in medical school. This research attempts to fill that gap in research in regards to surgical and radiological fields. METHODS: An anonymous survey was sent to fourth year medical students asking them their background in anatomy studies prior to medical school and their anatomy grades in medical school and interest in surgical and radiological fields. Students were also asked whether they identified with under-represented demographic groups in those specialties. RESULTS: Prior anatomy experience did not significantly affect performance in anatomy courses or Step 1 and Step 2 scores. However, students who applied to surgical specialties had higher performance in anatomical courses and higher Step 1 scores compared to those who did not apply to surgical specialties. There was interestingly no difference in under-represented and not under-represented student application to these fields. DISCUSSION: For shareholders interested in increasing medical student performance, or interest in specific specialties, more information needs to be gathered.

YouTube-based course orientation videos delivered prior to matriculation fail to alleviate medical student anxiety about anatomy.

Gross anatomy is a source of anxiety for matriculating medical students due to the large volume of information presented in a truncated timeline, and because it may be their first exposure to human cadavers. This study aimed to assess if video-based resources would affect matriculating medical students' anatomy state anxiety levels. Videos were designed to be short, YouTube-based units that served to provide orientation information about the anatomy course, dissection facilities, and available study resources to dispel anxiety around beginning their anatomy studies. To evaluate the impact of the videos, students in two consecutive matriculating years (2018 and 2019) completed the validated State-Trait Anxiety Inventory and a demographic questionnaire. The 2019 cohort (n = 118) served as the experimental group with access to the videos; while the 2018 cohort (n = 120) without video access served as a historical control. Analyses revealed that the groups were equivalent in terms of trait anxiety (P = 0.854) and anatomy state anxiety even when student video exposure was controlled (P = 0.495). Anatomy state anxiety was only significantly lower in students with prior formal anatomy exposure (P = 0.006). Further inquiry into students' prior anatomy experience identified that individuals with post-secondary dissection experience were significantly less anxious than those without formal anatomical experience (P = 0.023). These results may serve as a cautionary tale to educators; while preference for video-based instructional materials is prevalent in the literature, videos delivered on public social media platforms fail to prepare students for the psychological impact of studying human anatomy.

Hyaluronan and the Fascial Frontier.

The buzz about hyaluronan (HA) is real. Whether found in face cream to increase water volume loss and viscoelasticity or injected into the knee to restore the properties of synovial fluid, the impact of HA can be recognized in many disciplines from dermatology to orthopedics. HA is the most abundant polysaccharide of the extracellular matrix of connective tissues. HA can impact cell behavior in specific ways by binding cellular HA receptors, which can influence signals that facilitate cell survival, proliferation, adhesion, as well as migration. Characteristics of HA, such as its abundance in a variety of tissues and its responsiveness to chemical, mechanical and hormonal modifications, has made HA an attractive molecule for a wide range of applications. Despite being discovered over 80 years ago, its properties within the world of fascia have only recently received attention. Our fascial system penetrates and envelopes all organs, muscles, bones and nerve fibers, providing the body with a functional structure and an environment that enables all bodily systems to operate in an integrated manner. Recognized interactions between cells and their HA-rich extracellular microenvironment support the importance of studying the relationship between HA and the body's fascial system. From fasciacytes to chronic pain, this review aims to highlight the connections between HA and fascial health.

Adapting Strategically to Changing Times in Health Professions Education: A Generational Workshop for Educators.

Introduction: Health professions classrooms are filled with a new generation of students: iGen/generation Z. Much is known about millennials' educational needs, but they no longer comprise the majority of student populations. Research indicates that curricular strategies once useful for millennials may be ineffective for iGen. Due to multiple and surprising generational differences including ubiquitous technology, verbal/social/reading skills, and attention spans, educators might struggle to reach iGen members and are encouraged to re-examine instructional methods with iGen in mind. Methods: We designed this 90-minute workshop to give educators an informed understanding of iGen and discuss curricular adaptations intended to maintain educational quality through a literature-based presentation, self-assessment activities, and case discussions. We delivered the session to multiple diverse groups of health professions educators and staff. The attendees evaluated the workshop's quality and its longitudinal impact using 5-point Likert-style agreement surveys. Results: Respondents deemed the topic crucial to professional development and rated the content highly relevant (100% agreement/strong agreement). Longitudinal respondents could recognize iGen and personal characteristics (79% agreement or strong agreement) and the majority (58%) agreed/strongly agreed they were able to implement new instructional strategies. Discussion: Although educators are aware of typical generational differences, many are surprised to learn the unique attributes of their iGen student population. Workshop participation allowed educators to better understand both iGen students as well as how their own generational characteristics might relate to iGen members. Gaining this perspective allows educators to more adeptly create and deliver content to current health professions students.

Twelve tips for interfacing with the new generation of medical students: iGen.

iGen, or Generation Z, is the newest generation of health professions students to enter the classroom. This generation represents the first cohort of students in which technology has been present in all aspects of their lives. Since birth, they have been influenced by the boom of social media and wide-spread internet availability, leading to decreased face-to-face interactions and a desire for immediate access to information. Health professions educators should recognize the unique attributes of iGen students in order to foster student success and create a more positive learning environment. The following twelve tips examine the research-based distinctive characteristics of iGen students and highlight important concepts to consider when modifying current pedagogy to better support their needs. Incorporating these tips as an educator can promote lifelong learning and skill development for iGen students and empower this generation to thrive.

Educational avenues for promoting dialog on fascia.

If your healthcare professional students have not heard about the importance of fascia they definitely should, and if your residents have not heard about the manifestations of fascia health they definitely will from their patients. While fascia may not be the sexiest of organ systems, it is one of the most influential. Fascia is gaining interest from researchers, physicians, and many subdivisions of manual medicine including massage therapists. The fascial system is now being recognized with roles in pathology, fluid movement, and proprioception. It is also important in skeletal muscle movement, perception of pain, protein regulation and expression, cell signaling, neoplastic growth, and hormone distribution in our body. It can be the reason why we feel chronic pain or why we feel tightness after physical activity. The primary responsibility of fascia is to connect systems so that the body works as a whole, which is what permits this topic to be easily embedded anywhere in our health curricula. Whether you teach students in schools of medical, veterinary, dental, physical therapy, physician assistant studies, or occupational therapy, fascia matters. Whether you teach in an integrated curriculum or a curriculum that is designed for problem-based learning or a classical discipline-based curriculum, connective tissue has a place in academia. So, in our cramped curriculum how do we make sure that our current undergraduate and graduate students understand the complexity of fascia without adding additional time to coursework? To answer this question, this article demonstrates how fascia can fit anywhere in the curriculum because it is found everywhere. Clin. Anat. 32:871-876, 2019. © 2019 Wiley Periodicals, Inc.

Are we throwing histology out with the microscope? A look at histology from the physician's perspective.

A trend in medical schools across the United States is the refurbishing of histology laboratories with digital microscopy systems. Although such systems may reduce curricular time, they do not teach basic microscope skills, and students who learn solely with these systems may be less prepared for their practices or specialties, particularly in rural areas that may not be equipped with digital microscope technology. At the West Virginia School of Osteopathic Medicine (WVSOM), students are trained to practice in a wide variety of environments, especially rural areas. A research survey was conducted to gather information for evidence-based decisions about histology education at WVSOM. The survey asked a range of questions concerning histology knowledge, tissue preparation, and microscopy. Responses did not differ significantly between physicians in urban versus rural practices. Ninety percent of physicians do not utilize digitized images, and only 50% have microscopes readily available. Regardless of the technology available, 90% feel that students must have microscope training and 88% of physicians feel that histology is important to the medical curriculum and use their histology knowledge often (weekly or daily) (66%). These results demonstrate that histology education should move toward a blending of traditional microscope and glass slides with computer-based instructional technologies.

Ligand binding up-regulates EphA2 messenger RNA through the mitogen-activated protein/extracellular signal-regulated kinase pathway.

The EphA2 receptor tyrosine kinase is overexpressed in aggressive cancer cells, where it critically influences many aspects of malignant character. Although high levels of EphA2 have been documented in many different cancers, relatively little is known of the mechanisms that govern EphA2 gene expression in normal or malignant cells. Our present studies demonstrate that EphA2 influences the regulation of its own gene expression. Specifically, ligand-mediated phosphorylation of EphA2 transmits signals to the nucleus via extracellular signal-regulated kinase kinases to up-regulate de novo EphA2 gene expression and synthesis. This mechanism governs EphA2 expression in normal and malignant cells. In normal cells, EphA2 protein expression is balanced by ligand-mediated induction of EphA2 gene expression countered by EphA2 protein turnover. These findings suggest that EphA2 expression and ligand binding are intimately linked in epithelial cells. Increased understanding of this mechanism could have important implications for understanding the causes of EphA2 overexpression and for developing new strategies for therapeutic intervention in the many cancers that overexpress EphA2.

Activation of the EphA2 tyrosine kinase stimulates the MAP/ERK kinase signaling cascade.

Intracellular signaling by receptor tyrosine kinases regulates many different aspects of cell behavior. Recent studies in our laboratory and others have demonstrated that the EphA2 receptor tyrosine kinase critically regulates tumor cell growth, migration and invasiveness. Although the cellular consequences of EphA2 signaling have been the focus of recent attention, the biochemical changes that are triggered by ligand-mediated activation of EphA2 remain largely unknown. Herein, we demonstrate that ligand stimulation of EphA2 promotes the nucleus translocation and phosphorylation of ERK kinases, followed by an increase in nuclear induction of the Elk-1 transcription factor. Ligand-mediated activation allows EphA2 to form a molecular complex with the SHC and GRB2 adaptor proteins. Specifically, we demonstrate that tyrosine phosphorylated EphA2 interacts with the PTB and SH2 domains of SHC. We also show that the interaction of EphA2 with GRB2 is indirect and mediated by SHC and that this complex is necessary for EphA2-mediated activation of ERK kinases. These studies provide a novel mechanism to demonstrate how EphA2 can convey information from the cell exterior to the nucleus.