Curriculum mapping as a tool to facilitate curriculum development: a new School of Medicine experience.

BACKGROUND: Every curriculum needs to be reviewed, implemented and evaluated; it must also comply with the regulatory standards. This report demonstrates the value of curriculum mapping (CM), which shows the spatial relationships of a curriculum, in developing and managing an integrated medical curriculum. METHODS: A new medical school developed a clinical presentation driven integrated curriculum that incorporates the active-learning pedagogical practices of many educational institutions worldwide while adhering to the mandated requirements of the accreditation bodies. A centralized CM process was run in parallel as the curriculum was being developed. A searchable database, created after the CM data was uploaded into an electronic curriculum management system, was used to ensure placing, integrating, evaluating and revising the curricular content appropriately. RESULTS: CM facilitated in a) appraising the content integration, b) identifying gaps and redundancies, c) linking learning outcomes across all educational levels (i.e. session to course to program), c) organizing the teaching schedules, instruction methods, and assessment tools and d) documenting compliance with accreditation standards. CONCLUSIONS: CM is an essential tool to develop, review, improve and refine any integrated curriculum however complex. Our experience, with appropriate modifications, should help other medical schools efficiently manage their curricula and fulfill the accreditation requirements at the same time.

Possible protective role of silybin against polymyxin E-induced toxic effect in rat kidneys: A biochemical approach.

AIMS: Polymyxin E was used for treating gram-negative bacterial infections but not recently for fear of its nephrotoxicity. Silybin has potential to counteract nephrotoxicity; however, few studies have investigated its protective effect on the kidney in an animal model. The purpose of the present study was to assess whether silybin could decrease elevated urine and serum renal biochemical markers induced by polymyxin E in rat kidney. METHODS: Forty rats were divided randomly into four groups of 10 rats: control (I), vehicle (II), treatment (III, using polymyxin E), and protection (IV, using silybin and polymyxin E). Urine was collected daily for 7 days to test for N-acetyl-beta-D-glucosaminidase (NAG). Serum was collected after euthanizing the rats on day 7 to test kidney functions. RESULTS Group III had significant increases in NAG (all P < 0.001) compared with the other groups, but no differences were found between the other groups. Significant differences in kidney functions were found between Group III and Groups I and II, and between Group IV and Groups I and II (all P < 0.001). No differences were found between Groups III and IV. CONCLUSIONS: Group III results suggested an affection of the renal glomeruli and tubules, and Group IV results suggested a possible protective effect of silybin against polymyxin E-induced nephrotoxicity. Additional studies are recommended that use different doses of silybin for Groups III and IV to test for statistical differences for kidney functions and that test the protective effect of silybin against nephrotoxicity induced by polymyxin E in humans.

A practical hybrid model of application, integration, and competencies at interactive table conferences in histology (ITCH).

Significant changes have been implemented in the way undergraduate medical education is structured. One of the challenges for component courses such as histology in medical and dental curricula is to restructure and deliver training within new frameworks. This article describes the process of aligning the purpose and experience in histology laboratory to the goal of applying knowledge gained to team-based medical practice at Tulane University School of Medicine. Between 2011 and 2015, 711 medical students took either a traditional laboratory-based histology course (353 students) or a team-based hybrid histology course with active learning in laboratory (358 students). The key difference was in the laboratory component of the hybrid course - interactive table conferences in histology-during which students developed new competencies by working in teams, reviewing images, solving problems by applying histology concepts, and sharing learning. Content, faculty and online resources for microscopy were the same in both courses. More student-student and student-faculty interactions were evident during the hybrid course but student evaluation ratings and grades showed reductions following introduction of table conferences when compared to previous ratings. However, outcomes at National Board of Medical Examiners(®) (NBME(®) ) Subject Examination in Histology and Cell Biology showed significant improvement (72.4 ± 9.04 and 76.44 ± 9.36 for percent correct answers, traditional and hybrid courses, respectively, P < 0.0001). This model of table conferences to augment the traditional histology laboratory experience exemplifies the extent that restructuring enhancements can be used in currently taught courses in the undergraduate medical curriculum. Anat Sci Educ 9: 286-294. © 2016 American Association of Anatomists.

Curriculum integration = course disintegration: what does this mean for anatomy?

Many basic scientists including anatomists are currently involved in decisions related to revisions of the undergraduate medical curriculum. Integration is a common theme in many of these decisions. As described by Harden, integration can occur along a multistep continuum from independent, discipline-based courses to a completely interdisciplinary curriculum. For anatomy, each derivative of curricular integration can be shown to involve progressive disruptions of the temporal and topographical relationship between organ systems in a body region, of the temporal relationship with other courses in a harmonized curriculum, and of the relationships between components of organ systems when integration is implemented in thematic curricula. Drawing from our experience teaching in various types of integrated medical curricula, we encourage readers to proceed cautiously with their curricular decisions because each one can have gains and losses that may impact learning in the new format.

Attitudes to cadaveric organ donation in Irish preclinical medical students.

There is a worldwide shortage of organs for transplantation. It has been shown that the attitude of healthcare professionals can improve the rates of organ donation, and that educational programs aimed at improving both attitudes and knowledge base of professionals can have positive outcomes. Although there has been research carried out on this topic, there has been none in Ireland. Anatomy dissection can be a stressor to medical students-we investigate the attitudes of Irish students to organ donation and how they change with exposure to anatomy dissection. A questionnaire was administered to first year students in the School of Medicine in University College Dublin, Ireland, three times over a nine-week period at the commencement of classes in an academic year. The attitudes of the students were positive throughout regarding organ donation by a stranger, a family member, or themselves. There was, however, a significant decrease in support for the donation of a family member's organs in a minority of students. Irish students' attitudes to postmortem organ donation are positive and are not changed by exposure to the dissecting room. There is support for the donation of organs, and willingness among students to donate their own organs and support donation by family members.

Nimesulide inhibits crypt epithelial cell proliferation at 6 hours in the small intestine in CD-1 mice.

To determine whether the gut-sparing selectivity of cyclooxygenase-2 inhibitors is related to early crypt kinetic mechanisms, this study compared the primary effects on small intestinal mucosal epithelial cell proliferation and morphometry of a nonselective dual cyclooxygenase inhibitor, indomethacin, with a cyclooxygenase-2 selective inhibitor, nimesulide. Indomethacin downregulated the crypt cell production rate in the proximal small intestine, and nimesulide reduced cell proliferation in the proximal and distal small intestine. Compared to controls, there were smaller proliferating compartments in the crypts in midintestinal segments in both indomethacin- and nimesulide-treated groups, but more dividing cells in the distal intestine in indomethacin-treated group. Crypt cellularity, numbers, and width were unchanged from control values in both treated groups, suggesting a reduction in crypt cell emigration. Despite its selectivity for inhibiting cyclooxygenase-2, nimesulide induces similar but widespread initial effects on intestinal cell kinetics when compared to indomethacin.

Crypt cell production rate in the small intestine of the zinc-supplemented mouse.

Zinc is a trace element which is necessary in the body and the daily requirement is usually provided mainly through food intake. The effects of zinc deficiency are multisystemic and in the gastrointestinal tract include ulceration and inflammation. Many of these effects in the mammalian small intestine are reversible by zinc replenishment in a manner that is thought to be linked to the effect of this element on intestinal mucosal cell kinetics. However, the effects of continued replenishment (supplementation) have not been closely examined. This study examined the effects of zinc supplementation on gut crypt cell production in zinc-replete animals. Fifteen CD-1 mice were given zinc sulphate (0.3 mmol/l) in tap water while a second (control) group of 15 mice received only tap water. After 14 days, the small intestine was removed, measured and divided into four equal lengths and then sampled at the midpoint of each of the resulting four segments. Whole crypt numbers and crypt cell production rate were determined for each intestinal site for both groups of mice. While crypt dimensions and crypt numbers in zinc-fed mice showed no significant change from control levels, the crypt cell production in zinc-fed mice was significantly increased and duration of mitosis reduced in the third (distal) intestinal segment when compared to values from control mice. These findings show that the addition of subtoxic quantities of zinc to diet in zinc-replete animals enhances cell production and indicate that the reversal of zinc deficiency-induced gut damage following dietary zinc replenishment may be due to a direct effect on cell kinetics.