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1.
PLoS One ; 15(1): e0228257, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31978206

RESUMO

INTRODUCTION: In acute care medicine, knowledge of the underlying (patho)-physiology is of paramount importance. This may be especially relevant in intensive care medicine, where individual competence and proficiency greatly depend on knowledge and understanding of critical care physiology. In settings with time constraints such as intensive care units (ICUs), time allotted to education is often limited. We evaluated whether introduction of a short, interactive, peer-led flipped classroom session is feasible and can provide ICU residents with a better understanding of critical care physiology. MATERIALS AND METHODS: Using the flipped classroom concept, we developed a 15-minute peer-led interactive "physiology education" session to introduce a total of 44 residents to critical care physiology. Using a nine-item electronic survey with open questions and a five-point Likert scale, we analysed the overall concept with regard to feasibility, motivation, and subjective learning of critical care physiology. RESULTS: The overall rate of response to the survey was 70.5% (31/44). The residents reported that these sessions sparked their interest (p = 0.005, Chi square 10.52), and that discussion and interaction during these sessions had promoted their knowledge and understanding. Both novice and experienced residents reported that new knowledge was imparted (both p<0.0001, Chi-square 32.97 and 25.04, respectively). CONCLUSIONS: In an environment with time constraints such as the ICU, a 15-minute, interactive, peer-led flipped classroom teaching session was considered feasible and generally appeared useful for teaching critical care physiology to ICU residents. Responses to questions on questionnaires indicated that teaching sessions sparked interest and increased motivation. This approach may theoretically induce a modification in professional behaviour and promote self-directed learning. We therefore support the use of peer-led flipped classroom training sessions in the ICU. Whether these sessions result in improved ICU care should be addressed in subsequent studies.


Assuntos
Cuidados Críticos , Fisiologia/educação , Avaliação Educacional , Humanos , Unidades de Terapia Intensiva , Internato e Residência , Aprendizagem , Competência Profissional , Inquéritos e Questionários , Centros de Atenção Terciária , Pensamento
2.
Adv Physiol Educ ; 43(4): 512-518, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31553640

RESUMO

Historically, attendance has been a marker of academic performance, but the current medical education literature has had mixed results. In addition, attendance is dropping in the preclinical curricula, whereas, at the same time, the focus on United States Medical Licensing Examination Step 1 performance is increasing. This present study is a mixed-method approach correlating student attendance and access to the formal curriculum in a second-year pathophysiology course to performance on Step 1. Additionally, survey and focus group data evaluated the usage and importance of both the formal curriculum and third-party resources. Out of 112 eligible students, 77 participated in the study. There was no correlation between attendance or access to the learning materials and Step 1 performance. There was a strong correlation between the performance on the final examination and that of Step 1 (r = 0.813; P < 0.001) and a moderate correlation between formative quiz (r = 0.321; P = 0.005) and individual readiness assessment test performance (r = 0.351; P = 0.002) and Step 1 performance. Survey and focus group data show that students place high importance on faculty-developed materials that they can use on their own, but not attendance. The third-party resources are highly used as an adjunct to the formal curriculum and to focus on Step 1 study. Attendance and access to the formal curriculum do not predict Step 1 performance, whereas performance on high- and low-stakes internal assessments do. Further study on how the lack of social interaction gained from attendance affects development of other competencies and the learning climate are warranted.


Assuntos
Desempenho Acadêmico , Educação de Graduação em Medicina/métodos , Fisiologia/educação , Aprendizagem Baseada em Problemas/métodos , Estudantes de Medicina , Desempenho Acadêmico/normas , Educação de Graduação em Medicina/normas , Avaliação Educacional/métodos , Humanos , Estados Unidos/epidemiologia
3.
Adv Physiol Educ ; 43(4): 486-494, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31553641

RESUMO

An accurate self-assessment of student work can enhance student learning and subsequently improve academic performance. Instructors can facilitate this process by providing "standards" that students can utilize as feedback when self-evaluating their understanding. Traditional forms of feedback, such as marked assessment tasks, are limited in their ability to serve as standards, as they do not adequately capture variations corresponding to different levels of understanding. To develop a complex understanding in physiology, students have to integrate concepts pertaining to different subcomponents of body systems. The present study attempted to ascertain if exposing students to variations in complexity would refine their ability to self-evaluate their understanding and capacity to integrate concepts. Students were tasked to answer an essay-length, open-ended physiology question to expose their current understanding of the topic. The change in students' self-marking of their answer before and after being exposed to the variations in conceptual understanding of the topic were used to determine whether improvements in self-evaluation accuracy occurred. These variations were presented as instructor-generated answers to the open-ended question, framed using the structure of the observed learning outcome (SOLO) taxonomy. Student scores in the integrative questions of the end-of-semester exam were used as a measure of student ability to integrate concepts. Findings indicated that this intervention led to improvements in student self-evaluation and exam performance, and the positive outcomes were replicated across multiple iterations of the activity.


Assuntos
Autoavaliação Diagnóstica , Avaliação Educacional/métodos , Fisiologia/educação , Aprendizagem Baseada em Problemas/métodos , Estudantes/psicologia , Universidades , Humanos
4.
Adv Physiol Educ ; 43(4): 495-503, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31553643

RESUMO

Physiology is commonly taught through direct experience and observation of scientific phenomena in "hands-on" practical laboratory classes. The value of such classes is limited by students' lack of understanding of the underlying theoretical concepts and their lack of confidence with the experimental techniques. In our experience, students follow experimental steps as if following a recipe, without giving thought to the underlying theory and the relationship between the experimental procedure and the research hypotheses. To address this issue, and to enhance student learning, we developed an online virtual experiment for students to complete before an inquiry-based practical. The virtual experiment and "live" practical laboratory were an investigation of how autonomic nerves control contractions in the isolated rabbit ileum. We hypothesized that the virtual experiment would support students' understanding of the physiological concepts, as well as the experimental design associated with the practical. Anonymous survey data and usage analytics showed that most students engaged with the virtual experiment. Students thought that it helped them to understand the practical physiological concepts and experimental design, with self-reported time spent on the virtual experiment (and not on lectures or practical class notes) a significant predictor of their understanding. This novel finding provides evidence that virtual experiments can contribute to students' research skills development. Our results indicate that self-paced online virtual experiments are an effective way to enhance student understanding of physiological concepts and experimental processes, allowing for a more realistic experience of the scientific method and a more effective use of time in practical classes.


Assuntos
Compreensão , Músculo Liso/fisiologia , Fisiologia/educação , Estudantes , Realidade Virtual , Animais , Trato Gastrointestinal/fisiologia , Humanos , Coelhos
5.
Adv Physiol Educ ; 43(3): 441-442, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31408380

RESUMO

Physiology education was well represented at the 2nd Pan American Congress of Physiological Sciences in Havana, Cuba, with two symposia, a workshop, and a poster session.


Assuntos
Congressos como Assunto/tendências , Internacionalidade , Fisiologia/educação , Fisiologia/tendências , Cuba , Humanos
8.
Adv Physiol Educ ; 43(3): 397-400, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31408385

RESUMO

Twenty-eight undergraduate students in a health sciences program volunteered for an exercise in the history of examinations. They had completed a second-year course in anatomy and physiology in which they studied modern texts and took standard contemporary exams. For this historical "experiment," students studied selected chapters from two 19th century physiology texts (by Foster M. A Textbook of Physiology, 1895; and Broussais FJV. A Treatise on Physiology Applied to Pathology, 1828). They then took a 1-h-long exam in which they answered two essay-type questions set by Thomas Henry Huxley for second-year medical students at the University of London in 1853 and 1857. These were selected from a question bank provided by Dr. P. Mazumdar (University of Toronto). A questionnaire probed their contrasting experiences. Many wrote thoughtful, reflective comments on the exercise, which not only gave them an insight into the difficulties faced by students in the past, but also proved to be a valuable learning experience (average score: 8.6 ± 1.6 SD).


Assuntos
Avaliação Educacional/métodos , Ocupações em Saúde/educação , Fisiologia/educação , Estudantes de Ciências da Saúde , Humanos , Estudantes de Ciências da Saúde/psicologia
9.
Adv Physiol Educ ; 43(3): 423-429, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31408386

RESUMO

An understanding of the complexity of the cardiovascular system is incomplete without a knowledge of the venous system. It is important for students to understand that, in a closed system, like the circulatory system, changes to the venous side of the circulation have a knock-on effect on heart function and the arterial system and vice versa. Veins are capacitance vessels feeding blood to the right side of the heart. Changes in venous compliance have large effects on the volume of blood entering the heart and hence cardiac output by the Frank-Starling Law. In healthy steady-state conditions, venous return has to equal cardiac output, i.e., the heart cannot pump more blood than is delivered to it. A sound understanding of the venous system is essential in understanding how changes in cardiac output occur with changes in right atrial pressure or central venous pressure, and the effect these changes have on arterial blood pressure regulation. The aim of this paper is to detail simple hands-on physiological assessments that can be easily undertaken in the practical laboratory setting and that illustrate some key functions of veins. Specifically, we illustrate that venous valves prevent the backflow of blood, that venous blood pressure increases from the heart to the feet, that the skeletal muscle pump facilitates venous return, and we investigate the physiological and clinical significance of central venous pressure and how it may be assessed.


Assuntos
Compreensão , Modelos Cardiovasculares , Fisiologia/educação , Veias/fisiologia , Pressão Venosa/fisiologia , Volume Sanguíneo/fisiologia , Débito Cardíaco/fisiologia , Humanos
10.
Adv Physiol Educ ; 43(4): 443-450, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31460774

RESUMO

Students from three undergraduate programs at James Cook University, Queensland, Australia, studying combined first-year anatomy and physiology courses, showed different academic achievement in physiology. Physiotherapy students were more active and social when completing learning tasks and achieved significantly higher grades in physiology compared with students enrolled in Sport and Exercise Science and Occupational Therapy programs. To promote academic engagement and achievement by all three groups, discussion questions, case studies, and study guides were included. The aim of this study was to investigate the effectiveness of using these modified resources to promote active learning, enhance academic social interactions, and provide a supportive learning environment. The occupational therapy students showed increased academic achievement (from 57.9 to 66.5%) following implementation of the new resources, but there was no change in the already high-performing physiotherapy students (73.1%) and, more concerningly, the sport and exercise science students (from 54.6 to 56.7%). Fewer sport and exercise science students had prior learning in chemistry (30.4% of participants) and also spent little time outside class studying (8 h/wk), compared with the physiotherapy cohort (70.0% chemistry; 13 h/wk studying). Findings of this research demonstrate that creating a supportive and active learning environment are important factors in promoting the learning of physiology for some cohorts. Background knowledge, academic self-regulatory skills, and the experience of teaching staff are factors that must be considered when endeavoring to increase student academic achievement. Future studies should examine the effect of students' academic self-regulation and the use of remedial chemistry classes when learning physiology.


Assuntos
Sucesso Acadêmico , Anatomia/educação , Fisiologia/educação , Aprendizagem Baseada em Problemas/métodos , Estudantes de Ciências da Saúde , Adolescente , Avaliação Educacional/métodos , Avaliação Educacional/normas , Feminino , Humanos , Masculino , Aprendizagem Baseada em Problemas/normas , Estudantes de Ciências da Saúde/psicologia , Universidades/normas , Adulto Jovem
13.
Adv Physiol Educ ; 43(4): 458-466, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31460777

RESUMO

In this teaching laboratory, students design and perform an experiment to determine estrogen's role in imprinting the brain of neonatal rats to express either male or female sexual behavior. A discussion question is provided before the laboratory exercise in which each student is asked to search the literature and provide written answers to questions and to formulate an experiment to test the role of estrogen in imprinting the mating behavior of male and female rats. Students discuss their answers to the questions in laboratory with the instructor and design an experiment to test their hypothesis. In male rats, testosterone is converted by aromatase expressed by neurons in the brain to estrogen. Production of estrogen in the brain of neonatal rats imprints mating behavior in males, where a lack of estrogen action in the brain imprints female sexual behavior. The model involves administering exogenous testosterone to imprint male behavior in female pups or administration of an aromatase inhibitor (letrozole) or an estrogen receptor antagonist (ICI 182,780) to imprint female sexual behavior in male pups. In the model, litters of neonatal pups are treated with either carrier (control), testosterone propionate, aromatase inhibitor (letrozole), or an estrogen receptor antagonist (ICI 182,780) postnatally on days 1 and 3. Alteration of mating behavior is evaluated through the numbers of males and females that breed and establish pregnancy. This is a very simple protocol that provides an excellent experiment for student discussion on the effects of hormone action on imprinting brain sexual behavior.


Assuntos
Encéfalo/fisiologia , Hormônios Esteroides Gonadais/fisiologia , Fisiologia/educação , Comportamento Sexual Animal/fisiologia , Animais , Avaliação Educacional/métodos , Feminino , Humanos , Masculino , Vias Neurais/fisiologia , Ratos , Maturidade Sexual/fisiologia
14.
Adv Physiol Educ ; 43(4): 451-457, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31460778

RESUMO

Over the years, much criticism against animal use for physiology teaching has been made. Hence, replacement by suitable alternatives has increased in several pedagogical approaches. This study examined students' perceptions of animal versus virtual (video/computer) laboratory classes in physiological sciences associated with the effectiveness of the problem-based learning (PBL) hybrid curriculum. Three cohorts of medical students from the University of Ribeirão Preto, who participated in animal or virtual physiology classes or both, were asked to fill out a 5-point Likert questionnaire about knowledge acquisition/motivation, importance to PBL learning goals, skills acquired, need for animal use, academic formation, learning impairment, and alternative methods. We also assessed their grades in the final exam. A total of 350 students were included, in which 108 participated only in virtual classes, 120 only in practical animal laboratory classes, and 122 in both approaches. The majority agreed that the two methods improved their knowledge acquisition/motivation and helped to reinforce tutorial goals and to acquire skills. However, the cohort who experienced both approaches favored animal laboratory. Students believe animal use is needed and did not impair their learning. Conversely, their opinion about academic formation without animal laboratory classes was divided, as was whether this approach inspired them to seek alternative methods. Despite the different perceptions, there was no difference among the groups' final grades (7.3 ± 1 vs. 7.2 ± 1 vs. 7.2 ± 2 for virtual or practical animal laboratory classes or both, respectively). Therefore, virtual activities are not as effective as animal use in the opinions of the students, but they are successful strategies in physiology learning that can be used in practical classes in a hybrid PBL curriculum.


Assuntos
Currículo , Educação de Graduação em Medicina/métodos , Modelos Animais , Fisiologia/educação , Aprendizagem Baseada em Problemas/métodos , Estudantes de Medicina/psicologia , Animais , Estudos Transversais , Feminino , Humanos , Masculino , Percepção , Ratos , Inquéritos e Questionários
15.
J Med Syst ; 43(10): 313, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31451942

RESUMO

Nowadays, smartphones represent an invaluable tool to access educational material; however, the available information is not always accurate or evidence-based. Therefore, we aimed to evaluate the use of technology by medical students and assess the effect of a newly developed mobile app for the study of human physiology. We used a standardised questionnaire to assess the profile of educational technology use, from which a mobile app (PhysioQuiz) was developed. The effectiveness and user opinion were assessed in a randomised controlled study (n = 110). Of 1022 students enrolled in medical school, 489 (47.9%) participated in the study. Of the respondents, 96.7% used mobile applications, with the main purpose being entertainment (94.7%) and study (81.9%). Only 6.1% reported use of physiology apps. PhysioQuiz use did not yield higher average grades (p = 0.48); however, user opinion demonstrated that it was useful for assisted learning (82.1%) and identification of non-learned content (78.6%) and considered a tool for self-assessment (89.3%). Mobile app use is widespread among medical students but there is a lack of human physiology education apps. A newly developed app for the study of human physiology was useful for assisted learning and considered a tool for self-assessment.


Assuntos
Educação Médica/métodos , Tecnologia Educacional , Aplicativos Móveis/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Estudos Transversais , Humanos , Fisiologia/educação , Smartphone
16.
Adv Physiol Educ ; 43(3): 339-344, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31305148

RESUMO

Physiology is one of the major foundational sciences for the medical curriculum. This discipline has proven challenging for students to master due to ineffective content acquisition and retention. Preliminary data obtained from a survey completed by "low-performance" students (those maintaining a grade average below the passing mark of 70%) at Morehouse School of Medicine reported that students lacked the ability to adequately recognize and extract important physiological concepts to successfully navigate multiple-choice assessments. It was hypothesized that a specially designed, small-group, active learning, physiology in-course enrichment program would minimize course assessment failure rates by enhancing the ability of low-performance students to effectively identify important course content, successfully perform on multiple-choice assessments, and, thereby, improve overall course performance. Using self-report surveys, study skills and test-taking deficiencies limiting successful comprehension of course material and examination performance were identified. Mini-quiz assessments and assignments in formulating multiple-choice examination questions were given to help students recognize and solidify core concepts and improve test-taking ability. Lastly, self-report surveys evaluated the effectiveness of the enrichment program on overall course performance. Results showed a marked improvement in student confidence levels with regards to approaching multiple-choice assessments, and a significant improvement in grades achieved in the physiology component of the first-year curriculum, as 100% of participants achieved a final passing grade average of ≥70%. It was concluded that students became more proficient in identifying, understanding, and applying core physiological concepts and more successful in mastering multiple-choice questions.


Assuntos
Desempenho Acadêmico/psicologia , Avaliação Educacional/métodos , Fisiologia/educação , Aprendizagem Baseada em Problemas/métodos , Programas de Autoavaliação/métodos , Estudantes de Medicina/psicologia , Currículo , Feminino , Humanos , Masculino , Inquéritos e Questionários
19.
Adv Physiol Educ ; 43(3): 345-349, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31305152

RESUMO

A small private online course (SPOC) supports blended learning on a small scale, enabling students to have a more comprehensive and deeper learning experience. It also provides instructors with a flexible and feasible model to better understand the students' learning needs and to supervise students' learning behaviors. In this study, we adopted SPOC flipped classroom blended teaching in the physiology course for clinical undergraduate students of Kunming Medical University. Compared with the control group [lecture-based learning (LBL)], the SPOC flipped classroom method significantly increased the scores of students in the preclass test (65.13 ± 12.45 vs. 53.46 ± 8.09, SPOC vs. LBL) and postclass test (80.43 ± 14.29 vs. 69.01 ± 12.81, SPOC vs. LBL), which is induced by students' increased interest in self-learning. More importantly, the significant difference between the preclass scores of the two groups suggested that the video lecture-based preview is more effective than the textbook-based preview. The study indicated that the SPOC flipped classroom was effective in enhancing the examination scores of students, reflecting an improved learning efficiency and a deeper understanding of the knowledge. In summary, the flipped classroom based on SPOC improves learning outcomes compared with LBL and has a wide application in the learning of basic medical courses.


Assuntos
Currículo , Educação a Distância/métodos , Fisiologia/educação , Aprendizagem Baseada em Problemas/métodos , Estudantes de Medicina/psicologia , Avaliação Educacional/métodos , Humanos , Programas de Autoavaliação/métodos
20.
Adv Physiol Educ ; 43(3): 324-331, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31305154

RESUMO

Positive attitude and self-evaluation are necessary for medical students and doctors. To explore how best to integrate physiology teaching in our Thai medical curriculum, we investigated relationships between student's academic performance, their attitude, self-evaluated knowledge, and proportion of physiology taught in an organ-system integrated block. We organized 13 physiology laboratory classes, during which students self-rated attitude and knowledge. Academic performance was measured by formative and summative assessments. One hundred thirty-six participants were categorized into most proactive (Most PA), more proactive (More PA), less proactive (Less PA), and least proactive (Least PA) attitude groups by self-preparation questionnaire. Eighty participants were categorized into high (HighE), moderate (ModerateE), and low (LowE) self-evaluation rating groups. Mean formatives score in the Most PA group was significantly higher than in the other PA groups (P = 0.003, P = 0.001, and P < 0.001, respectively). Mean summative score in the Most PA group was significantly higher than the Less PA and the Least PA groups (P = 0.017 and P = 0.015 respectively). There was no significant difference in mean assessment scores among HighE, ModerateE, and LowE groups. Proportion of teaching time dedicated to physiology positively correlated with student attitude (r = 0.84, P = 0.001) and negatively correlated with self-evaluation rating (r = -0.73, P = 0.007). Thai medical students may benefit from a proactive attitude to studying physiology, contrasting with traditional didactic expectations of Thai education. Proportion of teaching time dedicated to physiology does not influence academic performance; therefore, future adjustments to curriculum integration may incorporate classes that facilitate self-directed learning. Future study should explore other influences on learning and assessment performance.


Assuntos
Desempenho Acadêmico/psicologia , Atitude , Autoavaliação Diagnóstica , Fisiologia/educação , Estudantes de Medicina/psicologia , Desempenho Acadêmico/normas , Feminino , Humanos , Masculino , Inquéritos e Questionários , Tailândia/epidemiologia
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