Concept mapping a potential pedagogical strategy to foster meaningful learning in physiology students.

BACKGROUND: Understanding of human physiology is critical for clinical practice and disease management. Escalating the teaching-learning method to improve conceptual knowledge may help the students to apply their knowledge in clinical scenarios. The present study was conducted to teach the use of concept mapping as a learning strategy to foster meaningful learning in physiology, compare its impact as a learning tool with traditional methods on meaningful learning, assess the cognitive gain, and find student's perception regarding concept mapping. MATERIALS AND METHODS: The interventional study was conducted on first-year MBBS students. Depending upon marks obtained in previous internal assessments, the students were classified into "rapid learners" (RL) and "potential learners" (PL). By simple random sampling technique, both groups were divided into interventional (concept mapping) and control groups (question-answer discussion). After a pretest, all students had a lecture on glomerular filtration. The assignment was given to the interventional group to prepare a concept map on glomerular filtration, and question-answer were discussed for control groups. A surprise posttest was conducted after 2-3 days. RESULT: In our study, all four groups showed significant differences in the pretest and posttest scores using a paired t-test (P < 0.05). The mean score of gain in learning, raw gain (G0), absolute learning gain, relative learning gain, and average normalized gain compared between the interventional group and controls group showed statistically significant performance improvement in both RL and PL groups. CONCLUSION: The concept mapping strategy was more efficacious than the question-answer discussion. Concept mapping is an impactful learning tool to improve cognitive gain and potential pedagogical strategy to foster meaningful learning in physiology students.

The Role of the Flipped Classroom Method in Short-Term and Long-Term Retention Among Undergraduate Medical Students of Anatomy.

Introduction Medical education is changing towards more flexible, effective, active, and student-centred teaching strategies that reduce the limitations of traditional methods of education. Recently, the flipped classroom method has been suggested to support this transition. However, research on the use of flipped classroom methods in medical education pertaining to short- and long-term retention of the topics is at an early stage. The present paper aims to determine and compare the effects of traditional and flipped classroom methods on first-year medical students' short-term and long-term retention. Method Fifty first-year medical students were subjected to traditional and flipped classroom modules in the form of five sessions each on gross anatomy topics of the thoracic region. These sessions were conducted during independent teaching slots for anatomy. Assessments were done at the completion of each module for both methods. Then, after a gap of two months, the students were again assessed on the content taught in the modules as a part of formative assessment. The data so obtained were compared and analysed statistically. Ethical approval was obtained prior to beginning the study. Written informed consent was obtained from the participating students. Result A total of 50 first-year medical students participated in the study. 33 (67%) participants were males, with a median age of 19.47 years, and 17 (33%) participants were females, with a median age of 19.39 years. The assessment scores showed differences between the two methods of teaching in the short and long term. The flipped classroom method was observed to have significant short-term retention with a p-value <0.0001, which is statistically significant. Conclusion The study concludes that the flipped classroom method serves as an advantageous tool and motivating factor for effective learning, understanding, and retention of conceptual and factual anatomical content.

Performance of Large Language Models (ChatGPT, Bing Search, and Google Bard) in Solving Case Vignettes in Physiology.

Background Large language models (LLMs) have emerged as powerful tools capable of processing and generating human-like text. These LLMs, such as ChatGPT (OpenAI Incorporated, Mission District, San Francisco, United States), Google Bard (Alphabet Inc., CA, US), and Microsoft Bing (Microsoft Corporation, WA, US), have been applied across various domains, demonstrating their potential to assist in solving complex tasks and improving information accessibility. However, their application in solving case vignettes in physiology has not been explored. This study aimed to assess the performance of three LLMs, namely, ChatGPT (3.5; free research version), Google Bard (Experiment), and Microsoft Bing (precise), in answering cases vignettes in Physiology. Methods This cross-sectional study was conducted in July 2023. A total of 77 case vignettes in physiology were prepared by two physiologists and were validated by two other content experts. These cases were presented to each LLM, and their responses were collected. Two physiologists independently rated the answers provided by the LLMs based on their accuracy. The ratings were measured on a scale from 0 to 4 according to the structure of the observed learning outcome (pre-structural = 0, uni-structural = 1, multi-structural = 2, relational = 3, extended-abstract). The scores among the LLMs were compared by Friedman's test and inter-observer agreement was checked by the intraclass correlation coefficient (ICC). Results The overall scores for ChatGPT, Bing, and Bard in the study, with a total of 77 cases, were found to be 3.19±0.3, 2.15±0.6, and 2.91±0.5, respectively, p<0.0001. Hence, ChatGPT 3.5 (free version) obtained the highest score, Bing (Precise) had the lowest score, and Bard (Experiment) fell in between the two in terms of performance. The average ICC values for ChatGPT, Bing, and Bard were 0.858 (95% CI: 0.777 to 0.91, p<0.0001), 0.975 (95% CI: 0.961 to 0.984, p<0.0001), and 0.964 (95% CI: 0.944 to 0.977, p<0.0001), respectively. Conclusion ChatGPT outperformed Bard and Bing in answering case vignettes in physiology. Hence, students and teachers may think about choosing LLMs for their educational purposes accordingly for case-based learning in physiology. Further exploration of their capabilities is needed for adopting those in medical education and support for clinical decision-making.

COVID-19 infection in pregnancy: a review of existing knowledge.

The world has been coping up with the grave pandemic of COVID-19 since its inception into the human race in December, 2019. By entering the host through the spike (S) glycoprotein, it paves way for its own survival and multiplication. Respiratory tract being the point of entry causes pulmonary compromise and leads to development of ARDS. Having non-specific clinical features that resemble flu makes the clinical diagnosis much more difficult. Pregnancy being an immunocompromised and a hypercoagulable state is prone to be a high-risk group for COVID-19. This study is an attempt to understand the maternal and fetal outcomes in COVID-19 and the vertical transmissibility of the virus. Evidence suggests that the contribution of COVID-19 is not very significant in maternal morbidity and mortality. However, due to some factors such as the immunological response in the mother, certain complications may arise in the neonate in the post-natal period. No vertical transmission of the virus has been reported yet. However, the management remains crucial as two lives are at stake. Some of the precautionary measures that can be implemented to prevent COVID-19 can be segregation of medical services from that of the general population in settings of outpatient care, inpatient care and labor room care. Also, triaging the patients into low risk, moderate risk and high risk can aid in faster delivery of health-care facilities to the pregnant and the newborn.

The Effect of High Temperature on Cardiovascular Autonomic Function Tests in Steel Plant Furnace Worker.

BACKGROUND: The high temperature in the working environment could be one of the risk factors for cardiovascular diseases in steel plant workers. The excessive high temperature at the working place leads to altered autonomic activity and is related to more cardiovascular risk. AIMS AND OBJECTIVES: The effect of high temperature on cardiovascular autonomic function tests in steel plant furnace worker. MATERIAL AND METHOD: This was a case-control study for which 50 steel plant furnace workers and 50 controls were selected. The cardiovascular sympathetic function status in worker and control were analyzed by three tests: (i) Blood pressure (BP) response to sustained isometric handgrip test, (ii) BP response to the cold pressor test, and (iii) BP response to standing from a supine position (orthostasis). Statistical analysis was done by using an independent t-test. RESULTS: Diastolic BP (DBP) response to sustained isometric handgrip and systolic BP (SBP) and DBP response to the cold pressor test showed that the increase BP in workers were more than controls but the difference was not statistically significant (P > 0.05). SBP response to standing from the supine position showed statistically significant (P < 0.001) greater fall in steel plant workers. CONCLUSION: The sympathetic autonomic dysfunction was seen in steel furnace workers in response to environmental stressor-excessive heat.

COVID-19 and geriatric population: from pathophysiology to clinical perspectives.

The COVID-19 pandemic has not only led to a worldwide socio-economic depression, but has also had the highest health impact on the geriatric population. Elderly population, due to various reasons such as low immunity, pre-existing co-morbidities such as hypertension, cardiovascular diseases or diabetes, are obviously predisposed to develop severe infections and exhibit a high mortality rate. This is because of many reasons which include the atypical presentation in the geriatric population which might have led to diagnostic delay. As per the WHO guidelines to perform RT-PCR only on the symptomatic individuals, a very small portion of individuals were tested, leaving a fraction of population undiagnosed. Therefore, there remained a chance that many asymptomatic individuals such caregivers, healthcare professionals, family members were undiagnosed and might have carried this virus to the geriatric patients. Also, many countries were not prepared to handle the burden on their healthcare system which included sudden increased demand of ICU beds, mechanical ventilation etc. As a result, they had to make decision on who to be admitted. Atypical presentation in geriatric population may include afebrile or low-grade fever, absence of cough, malaise, muscle pains, dyspnoea etc. Geriatric population shows a more severe type of pneumonia, significantly higher number of neutrophils and C-reactive protein, less lymphocytes and a higher proportion of multiple lobe involvement. Extreme social suppression during COVID-19 pandemic has increased the risk of mental and physical adverse effects that has made older adults more vulnerable to depression and anxiety.

COVID-19 and cardiovascular disease: a review of current knowledge.

The uncontrolled spread of the COVID-19 pandemic which originated in China created a global turmoil. While the world is still busy figuring out a cure for the deadly disease, scientists worked out on many theories and conducted several studies to establish a relationship between the infection and other known diseases. Cardiovascular diseases (CVD) are one of the major complications of this infection after the respiratory manifestations. Individuals with cardiovascular complication are said to be more susceptible to acquiring the infection because the novel coronavirus uses the ACE2 receptor for its entry inside the cell and there is a high level of ACE2 expression in individuals with cardiovascular complications because of the enzyme's anti-hypertrophic, anti-fibrotic and anti-hypertensive effects on the heart. Individuals who belong to the older age group are also more susceptible. Knowing the above information, it might seem that using ACE2 inhibitors would help to slow or prevent the entry of the novel coronavirus but it would also at the same time prove to have deleterious effects on the cardiovascular system as the protective functions of ACE2 would be lost. While the search for a cure still continues it has been stated many a times that the conditions might worsen with time and the only way to keep ourselves and our family safe would be to follow the appropriate social distancing methods and get a COVID test if we experience any of the major symptoms.