The effect of flipped learning on students' basic psychological needs and its association with self-esteem.

BACKGROUND: Modification of the learning environment enhances academic performance, and meta-motivational skills. Yet it is largely unknown which underlying cause potentiates these effects. The study's goal is to analyse flipped classroom (FC) effect on basic psychological needs and self-esteem. METHODS: 40 undergraduate medical students participated in a one-site two phased study. In Phase I, students attended a traditional lecture-based classroom (TC). In Phase II, the same group attended FC. Upon completion of each Phase students completed two questionnaires: Basic Psychological Need Satisfaction and Frustration Scale, and Rosenberg self-esteem scale. RESULTS: Autonomy satisfaction was significantly higher in FC (n = 40, z = 5.520, p < .001), the same tendency was seen for Competence satisfaction in FC (n = 40, z = 5.122, p < .001). As for the frustration of all three needs, the statistical difference was observed for all three subscales between TC and FC. In FC, autonomy (n = 40, z = - 5.370, p < .001), relatedness (n = 40, z = 4.187, p < .001), and competence (n = 40, z = - 5.323, p < .001) frustration was significantly lower. Self-esteem was significantly higher in FC (n = 40, z = 5.528, p < .001). In TC self-esteem negatively correlated with autonomy frustration, (r(38) = - 0.430, p < .01), and competence frustration, (r(38) = - 0.379, p < .05). In FC, self-esteem positively correlated with autonomy satisfaction (r(38) = 0.316, p < .05), and competence satisfaction (r(38) = 0.429, p < .01). CONCLUSIONS: FC better fulfils students' basic psychological needs, specifically needs for autonomy and competence, and self-esteem compared to TC. Collaborative work, and academic scaffolding, contributes to behavioural engagement of students in the learning process. FC with the main focus on students' active involvement may better meet millennials' needs. Implementing validated questionnaires to measure students' psychological needs should become a regular practice in medical schools, specifically during the process of curriculum redesign.

Update of Takotsubo cardiomyopathy: Present experience and outlook for the future.

Takotsubo cardiomyopathy (TTS) has become a recognised clinical entity since the Japanese scientist Sato first described it in 1990. Despite an increasing number of confirmed cases, especially during the COVID-19 pandemic, its pathophysiology remains incompletely understood, and decision-making differs in the diagnosis and treatment. In addition, it is not evident whether a significant increase in TTS is due to better understanding among practitioners and widespread access to coronary angiography, or if it is a reflection of an actual increase in incidence. We analysed a series of international research studies from 1990 to 2021. Beyond epidemiology and clinical presentation, we evaluated and summarised fundamental knowledge about various predisposing factors, with particular attention to the iatrogenic impact of certain drugs, namely antidepressants, chemotherapy, and antiarrhythmics. Furthermore, we highlighted the main pathophysiological theories to date. In addition, based on published studies and clinical cases, we investigated the role of numerous diagnostic approaches in the differential diagnosis of TTS and identified predictors of TTS complications, such as cardiogenic shock, ventricular fibrillation, and left ventricular thrombi. Accordingly, we sought to propose a diagnostic algorithm and further treatment management of TTS under the presence of possible complications to help practitioners make more informed decisions, as the initial presentation continues to pose a challenge due to its close similarity to acute coronary syndrome with ST-elevation. In conclusion, this article examines Takotsubo cardiomyopathy from different perspectives and, along with future systematic reviews and meta-analyses, can be of particular interest to practising cardiologists and researchers in developing clinical guidelines.