Can peer feedback substitute for faculty feedback in predoctoral dental education?

PURPOSE/OBJECTIVES: The ability to give and receive feedback is a key skill to develop during predoctoral dental education, and the use of peer feedback specifically offers distinct benefits including a different understanding of material due to peers' proximity of knowledge development and assisting with overburdened instructors. However, it is unclear if peer feedback offers similar quality to instructor feedback. METHODS: Dental students in two different graduation years provided quantitative and qualitative peer feedback on a case-based oral and maxillofacial pathology simulation. The data from these exercises were aggregated and analyzed to compare the quality of qualitative feedback to course examination scores. Student perceptions of peer feedback were also recorded. RESULTS: The mean quality of feedback was not correlated with course examination scores, though the number of times students gave high-quality feedback and received high-quality feedback was correlated with course examination scores. Student feedback overall had a lower quality than instructor feedback, though there was no significant difference between instructor feedback quality and the maximum student feedback quality received. Student perceptions of the utility of feedback were positive. CONCLUSION: While instructor feedback is more reliable and consistent, our findings suggest that in most instances, at least one peer in moderate-sized groups is able to approximate the quality of instructor feedback on case-based assignments.

From static web to metaverse: reinventing medical education in the post-pandemic era.

The World Wide Web and the advancement of computer technology in the 1960s and 1990s respectively set the ground for a substantial and simultaneous change in many facets of our life, including medicine, health care, and medical education. The traditional didactic approach has shifted towards more dynamic and interactive methods, leveraging technologies such as simulation tools, virtual reality, and online platforms. At the forefront is the remarkable evolution that has revolutionized how medical knowledge is accessed, disseminated, and integrated into pedagogical practices. The COVID-19 pandemic also led to rapid and large-scale adoption of e-learning and digital resources in medical education because of widespread lockdowns, social distancing measures, and the closure of medical schools and healthcare training programs. This review paper examines the evolution of medical education from the Flexnerian era to the modern digital age, closely examining the influence of the evolving WWW and its shift from Education 1.0 to Education 4.0. This evolution has been further accentuated by the transition from the static landscapes of Web 2D to the immersive realms of Web 3D, especially considering the growing notion of the metaverse. The application of the metaverse is an interconnected, virtual shared space that includes virtual reality (VR), augmented reality (AR), and mixed reality (MR) to create a fertile ground for simulation-based training, collaborative learning, and experiential skill acquisition for competency development. This review includes the multifaceted applications of the metaverse in medical education, outlining both its benefits and challenges. Through insightful case studies and examples, it highlights the innovative potential of the metaverse as a platform for immersive learning experiences. Moreover, the review addresses the role of emerging technologies in shaping the post-pandemic future of medical education, ultimately culminating in a series of recommendations tailored for medical institutions aiming to successfully capitalize on revolutionary changes.

The evolution of medical education from the Flexnerian era to the digital age provides valuable insight into how medical education has evolved and adapted to changing social needs, technological advancements, and educational paradigm shifts (Education 1.0, Education 2.0, Education 3.0, Education 4.0).The transition from static web to metaverse applications (Virtual Reality, Augmented Reality, and Mixed Reality) has brought about transformative changes in medical education merging physical and virtual reality, where users interact in real-time to have immersive and interactive learning experiences.Metaverse platforms enable external collaboration among medical learners, faculty educators, and other healthcare professionals from various parts of the world without the limitations of physical distance allowing them to exchange insights, discuss cases, and learn from diverse perspectives, including opportunities for collaborative research.Developing strategic implementation plans can help ensure that institutions and faculty educators can harness the benefits of emerging technologies while proactively addressing potential challenges, ensuring a well-rounded and effective learning experience for future medical professionals.

Variability of the Main Economically Valuable Characteristics of Cyperus esculentus L. in Various Ecological and Geographical Conditions.

This study includes an assessment of the VIR (Center N.I. Vavilov All-Russian Institute of Plant Genetic Resources) chufa collection, grown in various ecological and geographical conditions of the Russian Federation: "Yekaterininskaya experimental station VIR" in the Tambov region and "Kuban experimental station VIR" in the Krasnodar Region during the years 2020-2021. The main indicators of the economic value of chufa accessions were studied: yield structure and nutritional value (oil, protein, starch, and fatty acid profile). The accessions were grown in regions with different climatic conditions. As a result of the study, the variability of the biochemical and yield characteristics and the correlation between the studied indicators and the factor structure of its variability were established. Of the 20 accessions used in the study, the accessions with the highest protein, starch, oil and unsaturated fatty acid contents were selected, which are the most promising for their use as a raw material to expand the range of regional functional food products, as well as for future breeding efforts in the development of new, promising regional chufa varieties.

Taking Stock and Looking Ahead: Evolution of Accreditation Feedback for Simulation Centers Over 8 Years Using Epistemic Network Analysis.

INTRODUCTION: Since 2005, the American College of Surgeons Accredited Educational Institutes has provided accreditation of surgically focused simulation centers with the added benefit of identifying best practices defined as areas far exceeding the accreditation standards or novel methods of advancing high-quality, impactful education. This study aimed to examine the evolution of the best practices observed by accreditors during site visits over the 8-year period. METHODS: Accreditation included the completion of an application form followed by a site visit by a simulation expert and review of all materials by an accreditation committee to identify areas out of compliance along with areas far exceeding accreditation standards. These are termed "best practices." To evaluate the evolution of accreditation feedback and embedded associations, the compiled list of 337 best practices identified from all 247 site visits over an 8-year period was analyzed and visualized using epistemic network analysis, a quantitative ethnographic technique for modeling the structure of connections in qualitative data. RESULTS: The overall association network of the data indicates that the strongest associations were between assessment, curriculum development, faculty development, research, and teaching methods, demonstrating a highly interconnected model of accreditation feedback. Best practices evolved from an early focus on teaching methods, faculty, and curriculum development to more advanced educational topics including assessment, research, resources, and overall center governance. Distribution of associations also increased over the 8-year period with more nuanced and interconnected statements demonstrating higher-level feedback including explanations, contributing factors, impact on other areas, and, in some cases, recommendations to share best practices outside the organization. CONCLUSIONS: The epistemic network analysis of this 8-year database of simulation center feedback provides a novel perspective on an organization and the evolving field of simulation from an optional to essential modality in healthcare professions education.

Sequential Behavioral Analysis: A Novel Approach to Help Understand Clinical Decision-Making Patterns in Extended Reality Simulated Scenarios.

SUMMARY STATEMENT: Extended reality (XR)-based simulation training offers unique features that facilitate collection of dynamic behavioral data and increased immersion/realism while providing opportunities for training health care professionals on critical events that are difficult to recreate in real life. Sequential analysis can be used to summarize learning behaviors by discovering hidden learning patterns in terms of common learning or clinical decision-making sequences. This project describes the use of sequential analysis to examine differential patterns of clinical decision-making behaviors in observed XR scenarios, allowing for new insights when using XR as a method to train for critical events and to trace clinical decision making.

Evaluating Germplasm of Cultivated Oat Species from the VIR Collection under the Russian Northwest Conditions.

Oat is one of the most widespread and important cereal crops in the global agricultural production. Searching for new high-yielding and nutritious forms continues to be relevant, especially under the global trend of climate change, when most local oat cultivars may become economically inefficient. Spring oat accessions from VIR collection served as the material for this study; their origin is diverse, as they came from 11 countries. The basic nutritional value (the content of protein, oil, starch, and ß-glucans) and characters important for breeding (plant height, panicle length, number of spikelets, number of grains per panicle, 1000 grain weight, and grain yield) were analyzed in 49 accessions of the cultivated covered oat species: Avena sativa L., A. strigosa Schreb., A. abyssinica Hochst., and A. byzantina Coch., grown under the conditions of the Russian Northwest (Leningrad Province) for two years. Variability parameters, interspecific and intervarietal differences, and the effect of weather conditions were assessed. Sources of useful agronomic traits were identified; they can be used to expand the range of the source material for the development of new high-yielding and highly nutritious oat cultivars adapted to local cultivation conditions. It is demonstrated that the VIR collection has a great potential for contemporary food and feed production and for the breeding of new oat cultivars for various purposes. Thus, the contribution of Nikolai Vavilov to the plant genetic resources investigation for the benefit of humanity is invaluable.

Extended Reality International Grand Rounds: An Innovative Approach to Medical Education in the Pandemic Era.

PROBLEM: While bedside training has always presented its own unique challenges, the COVID-19 pandemic era has intensified barriers to suitable provider and trainee experiences for both patient care and medical education. APPROACH: This project introduced an innovative solution with the Extended Reality International Grand Rounds, a collaboration between the University of Michigan Center for Medical and Surgical Extended Reality and Imperial College London. Three complex cases were presented to trainees through a wireless, extended reality (XR) headset and augmented by holographic visual aids and expert commentary. This pilot rounding experience was performed through the first-person view of one clinician at the bedside. OUTCOMES: In 2020, 140 attendees participated in XR International Grand Rounds, and 82 (59%) and 61 (44%) completed pre- and postsurveys, respectively. Survey analysis showed that the majority of respondents (65, 79.3%) had very little to no baseline experience with XR technologies and nearly all (75, 91.5%) agreed that the development and implementation of XR curricula are important in medical training, indicating an unmet need. Nearly all respondents (59, 96.7%) found value in the ability to visualize patients' clinical findings in the XR rounding experience and 60 (98.4%) found value in the ability to visualize patient-specific imaging and test findings in an XR format. Limiting exposure to high-risk patients and care team members with this innovative format was believed to be important to 79 (96.3%) respondents at baseline and that perception was unchanged following the event. NEXT STEPS: This solution to a long-standing dilemma, newly stressed by a unique era in medicine, was a successful collaboration using state-of-the-art XR technology. Next steps will include introducing more advanced physical exam visualization and detection and comprehensive evaluation of the patient experience, as well as expanding the international experience in a format that is scalable to other interested institutions.

Virtual reality simulation for critical pediatric airway management training.

BACKGROUND: Pediatric airway emergencies are relatively rare, but have potentially devastating consequences. Simulation based education is important in providing zero-risk management experience for these critical events. AIMS: The aim of the study was to assess usability and feasibility of combined interactive instructional videos and a novel Virtual Reality (VR) trainer for healthcare professionals and to evaluate the impact of this combination on learners' knowledge of critical airway events in children. METHODS: The study population included medical students, residents, faculty, and advanced practice nurses. Participants completed a short baseline knowledge pre-test of pediatric airway emergency management, followed by these consecutive interventions: (1) Interactive instructional pediatric airway videos and (2) VR trainer (HoloLens technology), simulating a pediatric critical airway event. Participants were randomized to manage anaphylaxis or foreign body aspiration. Finally, participants completed a second knowledge test (post-test) and a survey of their perceptions of the videos and VR trainer. RESULTS: Forty-one participants were included in the study. Overall, both interventions were well received. Positive perceptions included realism, interactivity, and active learning environment. Negative comments focused on video speed and the VR trainer learning curve. Participants reported preferences for future training of pediatric airway events to include videos and VR trainers, with or without didactic lectures. Most areas of knowledge showed slight to significant improvements following the interventions. Specifically, questions on pediatric anatomy, anaphylaxis, Heimlich maneuver, and foreign body removal showed the highest improvement in scores (P < 0.05). CONCLUSIONS: Interactive videos, in combination with a VR experience, provide promising zero-risk training for pediatric critical airway events. RELEVANCE FOR PATIENTS: Pediatric airway emergencies are relatively rare, but the potential consequences are devastating. VR is established as a valued mode of education with regard to medical emergency training. Multimedia informational and instructional formats result in greater understanding of information. Results from our intervention, combining an interactive video tutorial and a VR experience, show this was well received by a cross section of health-care providers. We demonstrated improved test scores in a pediatric airways quiz.

Bioactive Components in Oat and Barley Grain as a Promising Breeding Trend for Functional Food Production.

Cereal crops, such as oats and barley, possess a number of valuable properties that meet the requirements for functional diet components. This review summarized the available information about bioactive compounds of oat and barley grain. The results of studying the structure and physicochemical properties of the cell wall polysaccharides of barley and oat are presented. The main components of the flavonoids formation pathway are shown and data, concerning anthocyanins biosynthesis in various barley tissues, are discussed. Moreover, we analyzed the available information about structural and regulatory genes of anthocyanin biosynthesis in Hordeum vulgare L. genome, including ß-glucan biosynthesis genes in Avena sativa L species. However, there is not enough knowledge about the genes responsible for biosynthesis of ß-glucans and corresponding enzymes and plant polyphenols. The review also covers contemporary studies about collections of oat and barley genetic resources held by the N.I. Vavilov All-Russian Institute of Plant Genetic Resources (VIR). This review intended to provide information on the processes of biosynthesis of biologically active compounds in cereals that will promote further researches devoted to transcription factors controlling expression of structural genes and their role in other physiological processes in higher plants. Found achievements will allow breeders to create new highly productive varieties with the desirable properties.

Successful carotid thrombus aspiration, middle cerebral mechanical thrombectomy, and axillary artery clot disruption attempt in a patient with acute ischemic stroke and critical upper limb ischemia.

Acute thrombotic occlusions of the large vessels, such as internal carotid artery, arms and legs arteries, and intracranial vessels, frequently require multiple techniques such as selective thrombolysis, manual aspiration, and stent retrievers for mechanical thrombectomy with combination of the mentioned techniques. Because of the massive thrombotic burden associated with these conditions, the response to systemic intravenous thrombolysis is poor. We present a case of a successful massive thrombi aspiration in a single attempt using an 8Fr guide catheter with aspiration syringe, subsequent ipsilateral middle cerebral artery mechanical thrombectomy, and axillary artery clot disruption attempt in a patient with acute ischemic stroke, right arm critical ischemia, and persistent atrial fibrillation.