Impact of a Student-Driven, Virtual Patient Application on Objective Structured Clinical Examination Performance: Observational Study.

BACKGROUND: Peer-assisted learning (PAL) refers to a learning activity whereby students of similar academic level teach and learn from one another. Groupe de perfectionnement des habiletés cliniques (Clinical Skills Improvement Group), a student organization at Université Laval, Canada, propelled PAL into the digital era by creating a collaborative virtual patient platform. Medical interviews can be completed in pairs (a student-patient and a student-doctor) through an interactive Web-based application, which generates a score (weighted for key questions) and automated feedback. OBJECTIVES: The aim of the study was to measure the pedagogical impact of the application on the score at medical interview stations at the summative preclerkship Objective Structured Clinical Examination (OSCE). METHODS: We measured the use of the application (cases completed, mean score) in the 2 months preceding the OSCE. We also accessed the results of medical interview stations at the preclerkship summative OSCE. We analyzed whether using the application was associated with higher scores and/or better passing grades (≥60%) at the OSCE. Finally, we produced an online form where students could comment on their appreciation of the application. RESULTS: Of the 206 students completing the preclerkship summative OSCE, 170 (82.5%) were registered users on the application, completing a total of 3133 cases (18 by active user in average, 7 minutes by case in average). The appreciation questionnaire was answered online by 45 students who mentioned appreciating the intuitive, easy-to-use, and interactive design, the diversity of cases, and the automated feedback. Using the application was associated with reduced reported stress, improved scores (P=.04), and improved passing rates (P=.11) at the preclerkship summative OSCE. CONCLUSIONS: This study suggests that PAL can go far beyond small-group teaching, showing students' potential to create helpful pedagogical tools for their peers.

Changes in freezing rain occurrence over eastern Canada using convection-permitting climate simulations.

Freezing precipitation has major consequences for ground and air transportation, the health of citizens, and power networks. Previous studies using coarse resolution climate models have shown a northward migration of freezing rain in the future. Increased model resolution can better define local topography leading to improved representation of conditions that are favorable for freezing rain. The goal of this study is to examine the climatology and characteristics of future freezing rain events using very-high resolution climate simulations. Historical and pseudo-global warming simulations with a 4-km horizontal grid length were used and compared with available observations. Simulations revealed a northerly shift of freezing rain occurrence, and an increase in the winter. Freezing rain was still shown to occur in the Saint-Lawrence River Valley in a warmer climate, primarily due to stronger wind channeling. Up to 50% of the future freezing rain events also occurred in present day climate within 12 h of each other. In northern Maine, they are typically shorter than 6 h in current climate and longer than 6 h in warmer conditions due to the onset of precipitation during low-pressure systems occurrences. The occurrence of freezing rain also locally increases slightly north of Québec City in a warmer climate because of freezing rain that is produced by warm rain processes. Overall, the study shows that high-resolution regional climate simulations are needed to study freezing rain events in warmer climate conditions, because high horizontal resolutions better define small-scale topographic features and local physical mechanisms that have an influence on these events.

Superior in vivo efficacy of afucosylated trastuzumab in the treatment of HER2-amplified breast cancer.

The enhancement of immune effector functions has been proposed as a potential strategy for increasing the efficacy of therapeutic antibodies. Here, we show that removing fucose from trastuzumab (Herceptin) increased its binding to FcgammaRIIIa, enhanced antibody-dependent cell-mediated cytotoxicity, and more than doubled the median progression-free survival when compared with conventional trastuzumab in treating preclinical models of HER2-amplified breast cancer. Our results show that afucosylated trastuzumab has superior efficacy in treating in vivo models of HER2-amplified breast cancer and support the development of effector function-enhanced antibodies for solid tumor therapy.