Performance in Kahoot! activities as predictive of exam performance.

BACKGROUND: Game-based learning (GBL) is effective for increasing participation, creativity, and student motivation. However, the discriminative value of GBL for knowledge acquisition has not yet been proven. The aim of this study is to assess the value of Kahoot! as a discriminative tool for formative assessment in medical education in two different subjects. METHODS: A prospective experimental study was conducted on a sample of 173 students enrolled in neuroanatomy (2021-2022). One hundred twenty-five students individually completed the Kahoot! prior to the final exam. In addition, students enrolled in human histology during two academic courses were included in the study. The control group course (2018-2019) received a traditional teaching methodology (N = 211), while Kahoot! was implemented during 2020-2021 (N = 200). All students completed similar final exams for neuroanatomy and human histology based on theory tests and image exams. RESULTS: The correlation between the Kahoot score and the final grade was analyzed for all students enrolled in neuroanatomy who completed both exercises. The correlation between the Kahoot exercise and the theory test, image exam and final grade was significantly positive in all cases (r = 0.334 p < 0.001, r = 0.278 p = 0.002 and r = 0.355 p < 0.001, respectively). Moreover, students who completed the Kahoot! exercise obtained significantly higher grades in all parts of the exam. Regarding human histology, the theory tests, image exams and final grades were significantly higher when using Kahoot! versus the "traditional" methodology (p < 0.001, p < 0.001 and p = 0.014, respectively). CONCLUSIONS: Our study demonstrates for the first time that Kahoot! can be used to improve and predict the final grade in medical education subjects.

Interaction effect of tegmen tympani and superior semicircular canal statuses on the thickness of the roof of the glenoid fossa: a cross-sectional descriptive study.

PURPOSE: Homogeneous development of temporal bone structures is explained by their ontogenic origin; tegmen tympani (TT) and superior semicircular canal (SSC) are related with the glenoid fossa at the temporomandibular joint (TMJ). Therefore, our objective was to determine a possible relationship between TT status (dehiscence or integrity) and the roof of the glenoid fossa (RGF) thickness; SSC status has also been considered. METHODS: This cross-sectional descriptive study was conducted in two tertiary hospitals on 95 patients (109 ears) presenting hypoacusia, facial palsy, vertigo, tinnitus, and other single or combined symptoms, and submitted to a thin-section multidetector-row computed axial tomography (CT) scan. RESULTS: A significant interaction effect of TT × SSC statuses on RGF thickness was found (p = 0.049). A significant difference in RGF thickness was found only for SSC integrity status between TT integrity and TT dehiscence (p = 0.004). The TT dehiscence increased the risk for RGF dehiscence 12.047 times (p = 0.002). CONCLUSIONS: There is an interaction effect of the statuses of both TT and SSC on the thickness of the RGF, instead of an independent effect of the TT status. When RGF dehiscence is found, TT and SSC statuses should be assessed, to discard associated dehiscences.

Development of ossification in the vertical semicircular canals: tomographic study.

PURPOSE: To describe the ontogeny of vertical semicircular canals using computed tomography. MATERIALS AND METHODS: We have studied 39 human fetuses aged between 17 and 38 weeks of development through multi-helicoidal CT. RESULTS: The first signs of ossification in the semicircular canals, superior and posterior, are from 19 weeks of development, through two primary ossification centers in each canal, which will take part in the formation of the outer cover oriented towards the middle and posterior brain fossae, respectively. In this process it must be added the intervention of the common branch. Internal bone covers are formed by ossification of the fossa subarcuata in the superior semicircular canal, and from the compact center of the labyrinthine capsule into the posterior canal. The tomographic study has allowed us to demonstrate how ossification follows a variable rate, establishing a period between 21 and 26 weeks where there are completely closed canals with others still open to the brain fossae. CONCLUSIONS: The tomographic study of the semicircular canals has enabled us to establish a critical period in its ossification that could explain the etiology of the congenital-type dehiscence.

Radiological patterns of the posterior semicircular canal.

OBJECTIVES: The identification and definition of the radiological patterns of the posterior semicircular canal (PSC), with a view to obtain readily applicable conclusions. DESIGN: The parietal morphology of the PSC has been studied by multi-slice helical computed tomography (Philips Brilliance 6). We have determined the distribution of the different types of bone cover of the PSC, taking some previously notified, standardised measurements of normality as reference. RESULTS: 318 patients have been analysed (604 petrous bone) by CT and we have distinguished five different radiological patterns: type or normal, thick, thin, pneumatised and dehiscent. The first three patterns, normal, thick and thin, have in common the existence of a compact bone interposed between PSC and posterior fossa, being in the normal pattern has a thickness of between 0.9 and 2.5 mm (327 cases, 54.13%), in the thick pattern is ≥2.6 mm (99 cases, 16.39%) and in the thin pattern is ≤1.2 mm (158 cases, 26.15%). The fourth pattern, pneumatised, is characterised by having retro labyrinthine cells between PSC and media fossa (19 cases, 3.14%). Finally, a dehiscent pattern was observed in 2 cases (0.3%). CONCLUSION: We describe five different radiological patterns: type or normal, thick, thin, pneumatised and dehiscent. The thin type (<0.5 mm or papyraceous type) and the dehiscent type would be subject to producing pathology, and in some cases the latter could be a consequence of the former.

Congenital dehiscence in the posterior semicircular canal.

HYPOTHESIS: Posterior semicircular canal dehiscence (PSCD) may be of congenital origin. BACKGROUND: PSCD is characterized by the lack of bone coverage, which results in its lumen being exposed to the meninges of the posterior cranial fossa or to the gulf of the jugular vein. It has an incidence of 0.2%. Its presence has been associated with several well-defined entities, although a congenital origin has not been proven. METHODS: We have analyzed, from a macroscopic, microscopic, and radiologic (computed tomography) viewpoint, the right temporal bone of a 32-week-old human fetus that presented a defect in the bone coverage located in the rear. RESULTS: The macroscopic study showed a solution of continuity in the posterior semicircular canal, with elliptic morphology and smooth edges. This defect was 3.4 mm long with a width that varied between 0.67 mm in its apical portion and 1.42 in the basal portion. The radiologic study (computed tomography) showed the absence of bone coverage of the posterior semicircular canal, which was open to the intracranial space in the posterior fossa. Its histologic study showed good bone coverage of this canal at the expense of compact bone tissue. However, at the medial end, there is a lack of bone coverage, resulting in the lumen of the canal being open to the intracranial space. The bone edges of the defect did not present any osteoclast activity. CONCLUSION: The lack of bone coverage (dehiscence) of the posterior semicircular canal in a 32-week-old fetus suggests a congenital component of bony dehiscences of this canal. Even so, this single finding does not conclusively prove the congenital component, and the dehiscence is a finding that can be part of and not by itself a syndrome.

Radiological patterns of the bony roof of the superior semicircular canal.

OBJECTIVES: To study the radiological patterns of the bony roof of the superior semicircular canal with a view for obtaining readily applicable conclusions. DESIGN: 84 patients (163 petrous bones) have been studied by Multi-slice Helical Computed tomography (Philips Brilliance 6). We have determined the distribution of the different types of bone cover of the superior semicircular canal, taking some previously notified, standardised measurements of normality as reference. RESULTS: During the analysis of the roof of the superior semicircular canal, we have distinguished five different types, depending on their thickness and tomodensitometric aspect. Normal pattern in 121 cases (74.2 %), with a thickness of between 0.6 and 1.7 mm, papyraceous pattern or fine thickness ≤0.5 mm that appears in 23 of our cases (14.1 %), thick pattern ≥1.8 mm that we have observed in 11 cases (6.7 %), and pneumatised pattern in 5 cases (3.1 %), which is characterised by having supralabyerinthine cells. Finally, a dehiscent pattern was observed in three cases (1.8 %). CONCLUSION: We describe five patterns of superior semicircular canal roofs: normal, thick, papyraceous, pneumatised and dehiscent. The papyraceous type and the dehiscent type would be subject to producing pathology, and in some cases the latter could be a consequence of the former.