Implementation of structured team-based review enhances knowledge consolidation and academic performance of undergraduate medical students studying neuroscience.

Team-based learning (TBL) provides a systematic approach to teaching and learning and promotes critical thinking and enhances medical educational activities and professional development. TBL-based didactic methodology has proven beneficial in enhancing learning and consolidating key educational concepts throughout educational curricula. Such areas of application include neuroscience, which is traditionally considered to be one of the most difficult disciplines to be taught in undergraduate medical courses to the point where the scientific literature reports "neurophobia" among undergraduate medical students. Herein, we report the design and application of a modified version of TBL, which we termed team-based review (TBR) throughout two cohorts of undergraduate medical students undertaking neuroscience. We show that our TBR methodology enhanced student understanding of neuroscience, increasing average marks and grades achieved in final exams, while also increasing the proportion of students obtaining higher grades. Application of TBR also improved marks obtained by students throughout continuous assessment (midterms, TBL, and problem-based learning grades). In surveys taken following final exams, students strongly felt that TBR enhanced their learning experience and aided knowledge acquisition, consolidation, and exam preparation. Collectively, we show that TBR-based methodology was effective in enhancing the student learning experience and performance in neuroscience and could potentially be successfully used to enhance performance and learning in other subjects in the undergraduate medical curriculum.

The Integrated Clinical Anatomy Program at Alfaisal University: an innovative model of teaching clinically applied functional anatomy in a hybrid curriculum.

Anatomy has historically been a cornerstone in medical education regardless of specialty. It is essential for physicians to be able to perform a variety of tasks, including performing invasive procedures, examining radiological images, performing a physical examination of a patient, etc. Medical students have to be prepared for such tasks, and we can assist this by changing the way that we educate students in medical schools. Thus, newer medical curricula need to be designed according to needs of future physicians. In this report, we describe a unique program called the Integrated Clinical Anatomy Program (ICAP). The ICAP was developed at the College of Medicine of Alfaisal University in the Kingdom of Saudi Arabia. Here, we describe the unique features of this program, including the structure and facilities of the Anatomy Resource Center. The Anatomy Resource Center plays a pivotal role in engaging the students for faculty-directed structured laboratory sessions as well as peer-assisted uniform student-centered learning. The ICAP has shown great promise, as reflected by early results from a nationwide progress test. Students from all years of the Alfaisal University medical school scored significantly higher than the national average on the anatomy and physiology component of the nationwide progress test examination, with P values of 0.0179 and 0.0015, respectively. We believe that the ICAP can be used as a model for teaching clinically applied functional anatomy to medical students in a hybrid curriculum around the world.

Medical Students and Faculty Perceptions About Online Learning During COVID-19 Pandemic: Alfaisal University Experience.

Background and Objectives: Off-campus online learning methods abruptly increased and gained popularity during the COVID-19 pandemic. Previous studies have highlighted the limitations of online learning mode; however, further studies on the experiences of medical students are needed. This study aimed to investigate the preclinical medical students and faculty members' experiences with online education and learning. Subjects and Methods: In this cross-sectional study, data were collected using convenience sampling. Two hundred nine students and 13 faculty members who participated in the online courses offered during the spring semester of 2019-2020 completed an online questionnaire. A 30-item questionnaire for the students and a 25-item questionnaire for the faculty were used in this cross-sectional study. Results: Overall, 30% of the student sample was satisfied; importantly, high-achieving students (GPA > 3.5) were less satisfied (25 vs. 32%; p = 0.006). Satisfaction was also low (35%) for student-faculty interaction opportunities. About half of the student sample agreed that small-group interactive sessions would improve learning (53%). The most favored course format was the blended mode (43%), followed by traditional (40%) and online modes (17%). Six out of 13 (46%) faculty members were satisfied with their online experiences. Most of them found virtual teaching applications convenient (77%). Conversely, few faculty members agreed to interact effectively (54%), while 69% favored a blended format. Conclusions: The level of satisfaction in fully online courses offered during the COVID-19 pandemic remained low, especially among high-achieving students. Both students and faculty favored the blended format for future purposes. Small group active-learning strategies and web-based interactive tools may facilitate engagement and student-faculty interactions.

Vegan, Vegetarian and Meat-Based Diets in Saudi Arabia.

Introduction One of the most essential risk factors for chronic medical conditions is dietary intake. The dietary habits in Saudi Arabia shifted towards the Western diet, which is high in fat, salt and sugar. Plant-based diets like vegetarianism and veganism have gained popularity in the last few years. Individuals commit to a plant-based diet for many reasons. Plant-based diets are associated with various health benefits but can still cause nutrition deficiencies.  Purpose The aim of the study is to examine the proportion of vegan, vegetarian and omnivore diets in Saudi Arabia. To compare between plant-eaters and meat-eaters in health, lifestyle factors and nutritional status. Methods A cross-sectional study was conducted. A previously validated online questionnaire was distributed via social media platforms. The authors used convenience sampling to collect the data. Results A total of 1018 respondents answered the survey. Most respondents 885 (87%) were omnivores, 52 were vegetarians (5%) and 81 (8%) were vegans. Moreover, 61% of the total respondents never consumed vitamin B12 supplements, and 10% consumed vitamin B12 daily. The majority of respondents 548 (54%) used no other dietary supplements, and 470 (46%) used unspecified dietary supplements. Vegan respondents were more likely than other diet categories to have healthier lifestyle features, including >3 times/week exercise (standardized residual = 3.55) and >7 hours of sleep (standardized residual = 2.44). Conclusion Majority of Saudis follow omnivore diets and the frequency of those who follow plant-based diets is very low. Those who follow a vegan diet seem to have better health rating and lifestyle compared to the omnivores. Public health officials and healthcare providers are encouraged to increase awareness among the Saudi population about the health benefits of a plant-based diet.

Expression of DnMTs and MBDs in AlCl3-Induced Neurotoxicity Mouse Model.

Alteration in DNA methylation after aluminum exposure has been shown to contribute in pathogenesis of Alzheimer's disease (AD). This study is aimed to determine the effect of Al exposure (42 and 60 days) on learning and memory and the expression of proteins involved in DNA methylation (MBD1, MBD2, MBD3, MeCP2 (methyl CpG binding protein 2), DnMT1 and DnMT3a). Male BALB/c mice were treated with AlCl3 for either 42 days or 60 days. After treatment completion, learning and memory were compared to the control group using novel object recognition test, elevated plus maze test, open field test, and Morris water maze test. The treated animals and their respective controls were sacrificed after cognitive testing and samples from their whole cortex and hippocampus were harvested for gene expression analysis. Mice treated with AlCl3 showed significant cognitive deficit with impaired short-term memory, elevated anxiety, and deterioration in spatial and reference memory. The AlCl3 treatment showed significant reduction in the expression of MBDs in the whole cortex at 60 days of treatment as compared to control. AlCl3-treated animals showed decreased expression of MBDs and DnMT3a in the hippocampus for longer treated animals but strikingly, MBD2 showed significantly increased expression in AlCl3-treated animals at 60 days p ≤ 0.001. In conclusion, this study showed that AlCl3-treated animals showed significant memory and cognitive deficits and it is associated with significant changes in the expression of proteins involved in DNA methylation mechanism. Moreover, different Al exposure duration had slightly different effects.

Comparative Analysis of Effectiveness Between Flipped Classroom and Lecture-Based Classroom in Undergraduate Medical Education at Alfaisal University.

Objective The effectiveness of the flipped classroom is currently debated due to conflicting results from different studies. It is therefore important to evaluate its usefulness each time it is applied in a new setting. Thus, this study was conducted with the objective of evaluating the effectiveness and acceptability of the flipped classroom in undergraduate medical education at the College of Medicine, Alfaisal University. Methods This was a quasi-experimental study consisting of development and administration of a flipped classroom with one group of students receiving the flipped classroom (FG) and the other group with the traditional lecture-based teaching (LG). We compared the pre-university enrolment Cumulative Grade Point Average (CGPA), preceding progress test results and previous semester performance for the two groups, which showed no statistical difference. Results Since the FG had received the video lecture while the LG had not, there was a clear statistical difference between the groups with FG showing better performance in pre-test scores. The post-test performances were marginally not statistically different between FG and LG groups. Conclusion Our results did not show any long-term benefit of a flipped classroom in terms of retention of knowledge as manifested by grades obtained in midterm and final examinations. It was also not received positively by the students.

Pituitary height on magnetic resonance imaging observation of age and sex related changes.

OBJECTIVE: To establish measurements of selected pituitary parameters in cases with normal pituitary gland in < or = 30 year old selected samples from Karachi. METHODS: A total of 220 subjects of < or = 30 years of age with normal pituitary morphology were evaluated by using T2 weighted Magnetic Resonance (MR) Imaging. Pituitary height (PH) and shape of the superior surface of the gland was observed on midsaggital sections. Data was stratified into six groups on the basis of age and sex to observe the differences. RESULTS: After the second month of life, the pituitary height increased gradually to achieve its peak in the second decade of life in the females (6.3 +/- 1.4 mm, n = 43) and the third decade of life in the males (5.9 +/- 1 mm, n = 41). PH decreased gradually there after. Significant difference was observed in PH in different age groups in both genders. Gland was significantly higher in females than males in the second decade. Higher frequencies of convex superior surface followed the same pattern. CONCLUSION: This study provided the reference values for the Pituitary height and the shape of the superior surface of the pituitary gland, which may contribute to establish credible reference values.

Cyclooxygenase I and II inhibitors distinctly enhance hippocampal- and cortex-dependent cognitive functions in mice.

Cyclooxygenase (COX) enzymes are expressed in the brain; however, their role in hippocampus-dependent and cortex-dependent cognitive functions remains to be fully elucidated. The aim of the present study was to comparatively investigate the effects of piroxicam, a selective COX-I inhibitor, and celecoxib, a selective COX­II inhibitor, on cognitive functions in an AlCl3­induced neurotoxicity mouse model to understand the specific role of each COX enzyme in the hippocampus and cortex. The AlCl3 (250 mg/kg) was administered to the mice in drinking water and the drugs were administered in feed for 30 days. Assessments of memory, including a Morris water maze, social behavior and nesting behavior were performed in control and treated mice. The RNA expression of the COX enzymes were analyzed using reverse transcription­quantitative polymerase chain reaction analysis. An ex­vivo 2,2­Diphenyl­1­picrylhydrazyl assay was performed in the hippocampus and cortex. Following 30 days of treatment with thedrugs, the mice in the celecoxib­ and piroxicam­treated groups exhibited enhanced learning (6.84 ± 0.76 and 9.20 ± 1.08, respectively), compared with the AlCl3­induced neurotoxicity group (21.14 ± 0.76) on the fifth day of the Morris water maze test. Celecoxib treatment improved social affiliation in the AlCl3­induced neurotoxicity group, the results of which were superior to piroxicam. Piroxicam led to better improvement in nesting score in the AlCl3­induced neurotoxicity group. Both drugs decreased the expression levels of COX­I and COX­II in the hippocampus and cortex, and rescued oxidative stress levels. These findings suggested that each drug distinctly affected cognitive functions, highlighting the distinctive roles of COX-I and COX-II in learning and memory.

What is an objective structured practical examination in anatomy?

Assessing teaching-learning outcomes in anatomical knowledge is a complex task that requires the evaluation of multiple domains: theoretical, practical, and clinical knowledge. In general, theoretical knowledge is tested by a written examination system constituted by multiple choice questions (MCQs) and/or short answer questions (SAQ). The assessment of practical knowledge (three-dimensional anatomical concepts) involves oral, spot, or objective structured practical examinations (OSPE). Finally, the application of anatomical knowledge to patients is tested mainly through objective structured clinical examinations (OSCE). The major focus of this study is the OSPE. Although many schools challenge students using this tool in practical examinations in the early phase of the curriculum, the true meaning of OSPE is frequently forgotten and it becomes, in reality, a spot examination. This article, for the first time, describes how the concept of the OSPE has evolved and is currently being used to assess the practical domain of anatomical knowledge in a problem-based curriculum at Alfaisal University College of Medicine. In addition, it describes the main differences from the spot examination, which is normally used in traditional medical curricula. The authors believe that the OSPE remains the most efficient tool to assess the practical aspects of anatomical knowledge in a system where basic knowledge is integrated with the clinical or functional part of anatomy. However, this contention only holds true if the OSPE process revolves around structured objectives.