How and Why Preclerkship Students Set Learning Goals and Assess Their Achievement: A Qualitative Exploration.

PURPOSE: Health professionals are expected to routinely assess their weaknesses, set learning goals, and monitor their achievement. Unfortunately, it is well known that these professionals often struggle with effectively integrating external data and self-perceptions. To know how best to intervene, it is critical that the health professionals community understand the cues students and practitioners use to assess their abilities. Here the authors aimed to gain insights into how and why medical students set learning goals, monitor their progress, and demonstrate their learning. METHOD: In 2012, the authors conducted semistructured interviews with Year 2 students (n = 20), applying an inductive approach to data analysis by iteratively developing, refining, and testing coding structures. RESULTS: Themes were constructed through discussion and consensus: (1) Students were diverse in how they set learning goals, (2) they used a range of approaches to monitor their progress, and (3) they struggled to balance studying for exams with preparation for clinical training. Tensions observed highlight assumptions embedded in medical curricula that can be problematic. CONCLUSIONS: Educators often treat medical students as a cohesive whole, thereby creating a mismatch between assessments that are intended to be formative and information students use to monitor their progress. Despite limited exposure to clinical contexts, goal generation and monitoring often stem from a desire to prepare for clinical practice. In grappling with these tensions, it is important to be mindful that students are individualistic in how they balance their commitment to prepare for clinical work and the need to concentrate on exams.

Dedifferentiation of adult human myoblasts induced by ciliary neurotrophic factor in vitro.

Ciliary neurotrophic factor (CNTF) is primarily known for its important cellular effects within the nervous system. However, recent studies indicate that its receptor can be highly expressed in denervated skeletal muscle. Here, we investigated the direct effect of CNTF on skeletal myoblasts of adult human. Surprisingly, we found that CNTF induced the myogenic lineage-committed myoblasts at a clonal level to dedifferentiate into multipotent progenitor cells--they not only could proliferate for over 20 passages with the expression absence of myogenic specific factors Myf5 and MyoD, but they were also capable of differentiating into new phenotypes, mainly neurons, glial cells, smooth muscle cells, and adipocytes. These "progenitor cells" retained their myogenic memory and were capable of redifferentiating into myotubes. Furthermore, CNTF could activate the p44/p42 MAPK and down-regulate the expression of myogenic regulatory factors (MRFs). Finally, PD98059, a specific inhibitor of p44/p42 MAPK pathway, was able to abolish the effects of CNTF on both myoblast fate and MRF expression. Our results demonstrate the myogenic lineage-committed human myoblasts can dedifferentiate at a clonal level and CNTF is a novel regulator of skeletal myoblast dedifferentiation via p44/p42 MAPK pathway.

Distribution of neuropeptide Y-immunoreactive neurons in the human brainstem, cerebellum, and cortex during development.

1. Neuropeptide Y is found throughout the central nervous system where it appears to play a wide range of often poorly understood functions. In this study, the distribution of neuropeptide Y immunoreactive (NPY-ir) neurons in the brainstem, cerebellum, and cerebral cortex of human fetuses ranging in age from 11 gestational weeks to term was investigated by immunohistochemistry. 2. The NPY-ir cells were detected in the dorsal and ventral rostral midbrain and the interpeduncular nucleus by 21 weeks and 32 weeks of gestation, respectively. Although no positive cells were found in the pons, the NPY-ir fibers were detected there at 32 gestational weeks. 3. The vagal, hypoglossal, and olivary nuclei of the medulla oblongata contained immunoreactive cells by week 21 and the medullary reticular formation by week 25 of gestation. In most of these locations, both the number and size of neuropeptide Y positive cells were greater at birth and reached maximal values of 100-400 cells per 1 mm2 and 2-5 microm in diameter, respectively. 4. In the cerebellum, numerous NPY-ir horizontal and granule cells, as well as the cells within the dentate nucleus were observed as early as 21 weeks of gestation. 5. The NPY-ir cells were also detected in the developing cerebral cortex, with the earliest activity observed within the temporal cortex at 14 weeks of gestation. By week 21, positive cells appeared in the visual, frontal, sensory, and motor cortices. Most of these cells were bipolar or multipolar in morphology but their numbers at birth were relatively low. 6. Our results show a wide distribution of the NPY-ir cells in the developing human brain and offer supporting evidence for the important modulatory role of NPY in both the fetus and adult.