Guided self-study in preclinical physiotherapy students - A feasibility study.

Background: Literature describing the impact of guided self-study (G-SS) in knowledge changes and skills improvements in undergraduate students is scarce. Objectives: The aims of our study were to evaluate the feasibility of a G-SS programme in a full-time undergraduate physiotherapy degree course and to assess the effectiveness of the G-SS on changes in knowledge and development of skills (hands-on). Method: Fifty-three first-semester undergraduate physiotherapy students were randomly divided into a G-SS group and a control group (CG). The G-SS group received six clinical cases and prepared each case during an 8-day cycle. The control group received self-study learning units of the original curriculum content. Primary outcome parameters were (1) time of task, (2) responsiveness of students and (3) programme differentiation. Knowledge changes and skills changes were tested using a multiple-choice questionnaire and the objective structured clinical examination (OSCE). Results: Students' responsiveness was 32%. This was below the a priori set 83%. No differences in programme differentiation were found. The OSCE grade was significantly higher in the G-SS compared to CG (p = 0.003). Conclusion: The G-SS programme in its current form was not feasible regarding students' responsiveness. Therefore, a slight modification of our study protocol (e.g., better time planning in the academic calendar) is needed to improve students' willingness to participate in the G-SS programme. Clinical implications: Adaptation of the school timetable should allow undergraduate physiotherapy students to prepare clinical cases under conditions of lower workload. Guided self-study as compared to CG is superior in knowledge change and (hands-on) skills improvement.

The impact of guided self-study on knowledge and skills in Swiss pre-clinical physiotherapy students - a feasibility study protocol.

Physiotherapy education in Europe must incorporate self-study units in the curriculum due to the bologna reform. Studies investigating the impact of guided self-study (G-SS) on knowledge and skills in pre-clinical Swiss physiotherapy students are scarce. This study protocol describes a prospective randomized feasibility education study that will primarily examine the feasibility of establishing G-SS using retired physiotherapists as tutors in undergraduate physiotherapy students at the Bern University of Applied Sciences, School of Health Professions. Secondary objective will be to evaluate the effectiveness of six G-SS cycles with retired physiotherapists as tutors on knowledge and skills of pre-clinical undergraduate physiotherapy students. Students of the physiotherapy degree course will be allocated into a G-SS group or control group (CG). G-SS consists of an 8-day cycle. Feasibility outcome are the fidelity of implementation that include exposure dosage and students' responsiveness, and the degree of acceptability. Success criteria of feasibility are (1) exposure dosage calculated as the number of 90-min presentations that are conducted, and the content of cases and competences and (2) students' responsiveness, with at least a 83% willingness to participate. Acceptability of intervention from the undergraduate students' perspective will be evaluated by a questionnaire with open, semi-structured questions (post intervention). This study will provide new information regarding the feasibility of embedding G-SS in the curriculum and about the students' responsiveness and their acceptability for G-SS. Study protocol version 1 Trial registration: German Register of Clinical Studies (DKRS: DRKS00015518).

Genome Sequencing and Transcriptome Profiling in Twins Discordant for Mayer-Rokitansky-Küster-Hauser Syndrome.

To identify potential genetic causes for Mayer-Rokitansky-Küster-Hauser syndrome (MRKH), we analyzed blood and rudimentary uterine tissue of 5 MRKH discordant monozygotic twin pairs. Assuming that a variant solely identified in the affected twin or affected tissue could cause the phenotype, we identified a mosaic variant in ACTR3B with high allele frequency in the affected tissue, low allele frequency in the blood of the affected twin, and almost absent in blood of the unaffected twin. Focusing on MRKH candidate genes, we detected a pathogenic variant in GREB1L in one twin pair and their unaffected mother showing a reduced phenotypic penetrance. Furthermore, two variants of unknown clinical significance in PAX8 and WNT9B were identified. In addition, we conducted transcriptome analysis of affected tissue and observed perturbations largely similar to those in sporadic cases. These shared transcriptional changes were enriched for terms associated with estrogen and its receptors pointing at a role of estrogen in MRKH pathology. Our genome sequencing approach of blood and uterine tissue of discordant twins is the most extensive study performed on twins discordant for MRKH so far. As no clear pathogenic differences were detected, research to evaluate other regulatory layers are required to better understand the complex etiology of MRKH.