ABSTRACT
Our sense of hearing is critically dependent on the spiral ganglion neurons (SGNs) that connect the sound receptors in the organ of Corti (OC) to the cochlear nuclei of the hindbrain. Type I SGNs innervate inner hair cells (IHCs) to transmit sound signals, while type II SGNs (SGNIIs) innervate outer hair cells (OHCs) to detect moderate-to-intense sound. During development, SGNII afferents make a characteristic 90-degree turn toward the base of the cochlea and innervate multiple OHCs. It has been shown that the Planar Cell Polarity (PCP) pathway acts non-autonomously to mediate environmental cues in the cochlear epithelium for SGNII afferent turning towards the base. However, the underlying mechanisms are unknown. Here, we present evidence that PCP signaling regulates multiple downstream effectors to influence cell adhesion and the cytoskeleton in cochlear supporting cells (SCs), which serve as intermediate targets of SGNII afferents. We show that the core PCP gene Vangl2 regulates the localization of the small GTPase Rac1 and the cell adhesion molecule Nectin3 at SC-SC junctions through which SGNII afferents travel. Through in vivo genetic analysis, we also show that loss of Rac1 or Nectin3 partially phenocopied SGNII peripheral afferent turning defects in Vangl2 mutants, and that Rac1 plays a non-autonomous role in this process in part by regulating PCP protein localization at the SC-SC junctions. Additionally, epistasis analysis indicates that Nectin3 and Rac1 likely act in the same genetic pathway to control SGNII afferent turning. Together, these experiments identify Nectin3 and Rac1 as novel regulators of PCP-directed SGNII axon guidance in the cochlea.
ABSTRACT
Introduction Virtual reality (VR) is a powerful tool in health professional education. It has been successfully implemented in various domains of education with positive learning outcomes. The three-dimensional (3D) visualization offered by VR can potentially be applied to learn complex pharmacology topics. This study aims to investigate whether VR technology can improve the learning of complex pharmacological concepts. Methods A VR learning module on cardiovascular drugs was developed using Kern's six-step framework. 32 medical students participated in the pilot study. Their pharmacology knowledge was assessed using pre- and post-intervention tests. Additionally, feedback from the participants were collected through a post-intervention survey that assessed learner satisfaction, ease of use, perceived usefulness, quality of visual elements, intention to use, and comfort level during the VR experience. Results Participants scored significantly higher in the post-intervention test than in the pre-intervention test (p <0.05). A majority of the participants (90%) were satisfied with the VR module, finding it easy to use, and time efficient. A minority of participants (15%) preferred a traditional learning format while some participants (20%) experienced discomfort in VR. Conclusion Our findings suggest that VR enhances pharmacology knowledge in medical students and is well-received as an innovative educational tool. By providing immersive 3D visualization of complex drug actions, VR has the potential to transform pharmacology education into an engaging and effective learning experience.
ABSTRACT
BACKGROUND: Sim Wars is a simulation-based competition wherein teams of medical trainees are presented a clinical scenario and provide patient care in front of a live audience. This non-traditional educational offering is a form of serious games in medical education and allows for experiential learning via direct observation. Although a well-described educational modality within graduate medical education, there is a dearth of literature regarding Sim Wars as an educational tool within undergraduate medical education. In this paper, we aim to share student perspectives after participating in Sim Wars. APPROACH: The Sim Wars competition was designed as a double-elimination bracket tournament with arena-style direct observation to maximise student engagement. Teams were provided formative feedback in areas of medical knowledge, clinical management and communication skills. A total of 64 students participated in a regional Sim Wars tournament over the course of 2 years. EVALUATION: A total of 36 students completed Likert-based surveys immediately after the Sim Wars competition. Quantitative data and open-ended responses were analysed. Fourteen students participated in focus groups held a few months after Sim Wars regarding their experiences during the competition. Thematic analysis was systematically performed on the qualitative data. IMPLICATION: Participation in Sim Wars was viewed by students as a high-yield learning experience that increased competence on subsequent clinical rotations. We conclude that this form of serious game can be a highly beneficial educational format for medical students especially if they spend time preparing for the competition and receive structured feedback on their performance.
