Improvements in teaching behavior at two German medical schools resulting from a modified Flanders interaction analysis feedback intervention process.

UNLABELLED: Abstract Background: Person-centered teachers who are more empathic and "indirect" (accept, encourage, praise and ask questions) tend to be more effective than those who are "direct" (lecture, give directions and criticize) (Amidon & Flanders 1991). The Flanders Interaction Analysis (FIA) is a tool for diagnosing these teaching aspects, though not yet used to improve lecturing in undergraduate medical education. AIMS: Does structured expert feedback to volunteer lecturers lead to improvement in person-centered teaching behavior as measured by a Modified Flanders Interaction Analysis (MFIA) and student questionnaires? METHODS: Twenty-one volunteer lecturers from two German medical faculties were stratified by past teaching experience and randomized into two groups. The intervention group received MFIA diagnoses of their lectures plus feedback by an expert observer after winter and summer semester lectures, respectively. The control group was only diagnosed with the MFIA. Teaching behavior changes for both groups were compared and teacher feedback about the intervention process was assessed. RESULTS: Faculty in the intervention group improved significantly in their summer lectures regarding person-centered teaching behavior while controls did not. CONCLUSIONS: A structured individual expert feedback intervention using a MFIA as a teaching diagnostic tool is a powerful, cost-effective faculty development process for improving teaching behavior of volunteer lecturers in undergraduate medical education.

Spinal cord atrophy in early Huntington's disease.

Despite evidence for spinal cord involvement, it remains unclear whether spinal cord atrophy exists in early Huntington's disease. We studied magnetic resonance images, covering both brain and upper cervical cord, in two cohorts of Huntington's patients and in one cohort of Alzheimer's patients. All cohorts included healthy controls comparable with regard to age and gender. We found significant spinal cord atrophy in both cohorts of Huntington's patients but not in the cohort of Alzheimer's patients. Furthermore, spinal cord atrophy correlated with motor symptoms indicating that spinal cord atrophy occurs in the clinical stages and does not result from abnormal development.

Variation within the Huntington's disease gene influences normal brain structure.

Genetics of the variability of normal and diseased brain structure largely remains to be elucidated. Expansions of certain trinucleotide repeats cause neurodegenerative disorders of which Huntington's disease constitutes the most common example. Here, we test the hypothesis that variation within the IT15 gene on chromosome 4, whose expansion causes Huntington's disease, influences normal human brain structure. In 278 normal subjects, we determined CAG repeat length within the IT15 gene on chromosome 4 and analyzed high-resolution T1-weighted magnetic resonance images by the use of voxel-based morphometry. We found an increase of GM with increasing long CAG repeat and its interaction with age within the pallidum, which is involved in Huntington's disease. Our study demonstrates that a certain trinucleotide repeat influences normal brain structure in humans. This result may have important implications for the understanding of both the healthy and diseased brain.