Study of mindset among learners and educators in an Indian medical school-A questionnaire-based survey.

BACKGROUND: Mindset varies along a spectrum of two extremes- fixed and growth. Individuals with growth mindset embrace new challenges readily and believe that intelligence is malleable. Mindset theory has gained focus as a principal underpinning value of health professions education, as it is aligned with the goals of competency-based education. The study aims to assess the mindset of health professional educators and learners. MATERIALS AND METHODS: A cross-sectional questionnaire-based survey was conducted in a private medical college in South India. A pre-validated modified version of Dweck's (2000) Implicit Theories of Intelligence Questionnaire was administered to the study participants. Participants responded to 10 items using a four-point Likert scale, rating the degree to which they agreed or disagreed with each statement. The quantitative data were expressed in means and percentages. RESULTS: A total of192 students and 25 faculty participated in the study. Among students, 45.8% (n = 88) had strong growth mindset, 42.1% (n = 81) had growth mindset with some fixed ideas, 10.9% (n = 21) had fixed mindset with some growth ideas, and 1% (n = 2) had strong fixed mindset. Among faculty 4% (n = 1) had fixed mindset with growth ideas, 44% (n = 11) had growth mindset with fixed ideas, and 52% (n = 13) had strong growth mindset. DISCUSSION: In this study, educators and learners of a medical school were found to have predominantly growth mindset. Fostering growth mindset among stakeholders of health professions education is essential for effective teaching and learning in competency-based education.

Association of serum adiponectin levels and ADIPOQ SNP rs2241766 with breast cancer risk in Indian women.

Context: Adiponectin, an adipokine, and its gene polymorphisms have been associated with breast cancer risk in various populations. Subjects and Methods: In this study, we evaluated the association of the circulating levels of adiponectin and adiponectin gene polymorphism SNP rs2241766 with breast cancer and its clinicopathological characteristics in Indian women. A case-control study was carried out with 60 Ductal Infiltrating Breast Carcinoma patients and 60 age-matched healthy controls. Serum adiponectin levels were measured by ELISA. SNP genotyping was done by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism. Statistical Analysis: Serum adiponectin levels were compared using the Mann Whitney U test. The frequency of genotypes was compared using the Chi-square test. The odds ratio was calculated using logistic regression. Results: Lower serum adiponectin level was associated with increased risk of breast cancer in postmenopausal women (OR - 7.69; 95% CI - 2.16-27.43, P = 0.002) but not in the reproductive age group women. There was no association between adiponectin levels with the TNM stage of the tumor, histopathological grade, erbB2, and ER/PR status. The SNP rs2241766 polymorphism was not associated with breast cancer risk but the mutant genotypes TG/GG was found to be significantly associated with the lower histopathological grade of the tumor (X2 (2, N = 60) = 8.62, P = 0.01). Conclusion: Our results suggest that low serum adiponectin levels are associated with an increased risk of breast cancer in postmenopausal women. The TG/GG genotypes of SNP rs2241766 polymorphism were associated with a lower histological grade of the tumor.

Developing a module for early clinical exposure: Experience of five years.

BACKGROUND: Preclinical students often fail to appreciate the clinical relevance of basic sciences during the first year of undergraduate medical training, leading them to lose interest in the subject, and preventing them from achieving the desired goals. In order to rectify this gap in the curriculum, Medical Council of India (MCI) in 2011 published a document announcing curricular strategies including Early Clinical Exposure (ECE) to effectively modify the Indian system of education. Lack of proper guidance prevented many institutions from implementing ECE. Since our institution had run a similar program of "Clinical Observership" as early as 2001, we were able to implement ECE in an efficient way. MATERIALS AND METHODS: Early clinical exposure was implemented as a structured program, with the participation of 10 clinical departments since 2013. Feedback from the students, soon after ECE and also from the batch of CRRIs, who had undergone this program while they were preclinical students amply support the effectiveness of ECE in its contents and methods of implementation. Manual content analysis was performed on open comments. After reading the responses, they were broken down to meaning units, and these were then condensed. The condensed meaning units were labeled with codes. The codes were grouped into categories. Themes were derived from the categories. RESULTS: Out of the 70 CRRIs, 52 responded to the questionnaire. All the CRRIs except one said that ECE was very helpful during their clinical postings and internship period. They suggested that the number of hours of posting should be increased and also reiterated the fact that a greater number of clinical departments could be included in the program. Though the beneficial effects were felt in all the domains of learning, the most remarkable impact was felt in the affective domain, wherein changes are not easy to come by. DISCUSSION: Recently, National Medical Council has come out with plans of including ECE in the syllabus with strict time schedule. It is felt that the faculty will find our experience of running the program for the past five years helpful in implementing this program, for the fullest benefit of the preclinical students.

Identifying entrustable professional activities for MD program in biochemistry-A modified Delphi approach.

Entrustable professional activities (EPAs) facilitate competency-based assessments. India is on the verge of implementing competency-based training for postgraduate programs. MD degree in Biochemistry is a unique program available exclusively in India. Postgraduate programs in most specialties have started working toward EPA-based curriculum, in both India and other countries. However, EPAs for MD Biochemistry course are yet to be defined. This study aims to identify EPAs for postgraduate training program in Biochemistry. Identification and attaining consensus on the list of EPAs for MD Biochemistry curriculum was done by modified Delphi method. The study was conducted in three rounds. In round 1, tasks expected from an MD Biochemistry graduate were identified by working group followed by expert panel validation. The tasks were organized and reframed to EPAs. Two rounds of online survey were conducted to achieve a consensus on the list of EPAs. Consensus measure was calculated. A cut-off value of 80% and above was considered to reflect good consensus. The working group identified 59 tasks. This was validated by 10 experts based on which, 53 items were retained. These tasks were reframed into 27 EPAs. In round 2, 11 EPAs achieved good consensus. Among the remaining EPAs, 13 achieved consensus of 60%-80% and were selected for round 3. Five EPAs achieved good consensus in this round. A total of 16 EPAs were identified for MD Biochemistry curriculum. This study provides a frame of reference for experts to develop an EPA-based curriculum in the future.

Online team based learning in teaching Biochemistry for first year MBBS students during COVID-19 pandemic.

The emergence of Corona Virus Disease-2019 (COVID-19) pandemic had unprecedented effects on medical education worldwide. Sustaining student engagement in virtual learning is an arduous task. Team based learning (TBL) is a learner-centered approach that can facilitate better student engagement. Adapting TBL to online platform may address the challenges faced in virtual learning. This study was conducted to implement and evaluate online TBL among first year MBBS students in Biochemistry. After obtaining informed consent, three online TBL sessions were planned. The Individual Readiness Assessment Test, Group Readiness Assessment Test, and team application were assigned in Google classroom. The students used online platforms for their team interactions. After submitting their assignments, they joined online discussion with facilitator. Peer evaluation was done via Google forms. At the end of all the sessions, the students' perceptions on the process were collected using a structured anonymous feedback with open comments. Analysis of their feedback showed that the students found the process useful and it helped in fostering their team skills. Five major themes emerged on content analysis of the open comments; 'Enriched team skills', 'Gain in knowledge', 'Impact on attitude', 'Interaction during pandemic', and 'Emotional responses'. Students perceived that the online TBL is effective in improving their engagement, learning, and team skills.

Effectiveness of team teaching in biochemistry lectures for undergraduate students.

Team teaching is an innovative method to engage the large group and make lectures more interesting. The aim of the study is to evaluate the impact of team teaching in first year biochemistry lecture classes. After obtaining ethical clearance, 150 first year medical undergraduate students participated in the study on a voluntary basis. Topic identified for team teaching was "Protein biosynthesis" in Biochemistry, which was designed to be carried out in 5 h of lecture by three teachers. At the end of the team teaching module and traditional lectures, a structured anonymous feedback was obtained from the students. At the end of each class, students' understanding of the lecture was assessed by an MCQ test comprising 5-6 items, which mainly tested the recollection and understanding levels of Bloom's taxonomy. This was compared with traditional lectures. The mean MCQ test score was significantly higher for team teaching when compared to traditional teaching. The students had increased attention span and were able to answer questions from later part of the class in team lectures. The students had reported that lectures taught by team were more interesting and informative. They also felt that the team was more receptive to the doubts raised, stimulated discussion on the topic and had a better rapport with the class.

Effect of Red Yeast Rice and Coconut, Rice Bran or Sunflower Oil Combination in Rats on Hypercholesterolemic Diet.

INTRODUCTION: Dietary supplements provide a novel population based health approach for treating hyperlipidemias. Red yeast rice is known to have lipid lowering effects. Combination of red yeast rice with various oils is taken by different population around the world. AIM: In this present work, we aimed to compare the effects of red yeast rice with different oil (coconut, rice bran and sunflower oil) supplementations on lipid levels and oxidative stress in rats fed on hypercholesterolemic diet. MATERIALS AND METHODS: A Randomized controlled study was conducted on 28 male Sprague Dawley rats. It included 4 arms-Control arm (hypercholesterolemic diet), Test arm A (hypercholesterolemic diet +Red yeast rice + Rice bran oil), arm B (hypercholesterolemic diet +Red yeast rice + Coconut oil) and arm C (hypercholesterolemic diet +Red yeast rice + Sunflower oil). At the end of one month, serum cholesterol, triglycerides, MDA and paraoxonase was measured. The mean values of analytes between the different groups were compared using student 't-' test. RESULTS: The rats fed with red yeast rice and rice bran oil combination showed significantly lower levels of serum cholesterol, triglycerides and MDA when compared to the controls. The serum paraoxonase levels were significantly higher in this group when compared to the controls. The rats fed with red yeast rice and coconut oil combination showed significantly lower serum cholesterol and MDA levels when compared to the controls. The mean triglyceride and paraoxonase levels did not show any statistically significant difference from the controls. The rats on red yeast rice and sunflower oil combination did not show any statistically significant difference in the lipid levels and oxidative stress parameters. CONCLUSION: The food combination which had best outcome in preventing the development of hyperlipidemia and oxidative stress in rats fed with hypercholesterolemic diet was red yeast rice and rice bran oil. Combining red yeast rice with coconut oil and sunflower oil gave suboptimal benefits.

Plasma Myeloperoxidase and Total Sialic Acid as Prognostic Indicators in Acute Coronary Syndrome.

INTRODUCTION: Acute Coronary Syndrome (ACS) is the leading cause of death worldwide. Oxidative stress and inflammation play important role in the destabilization of plaques leading to ACS. Markers which reflect this pathophysiologic mechanism may have prognostic value. Myeloperoxidase (MPO) and Sialic acid are markers of inflammation and oxidative stress. Both these markers are increased in patients with ACS. Their prognostic value in ACS is not well established. AIM: To analyse the prognostic value of plasma myeloperoxidase and total sialic acid levels in patients with suspected acute coronary syndrome. MATERIALS AND METHODS: A prospective study was conducted on 93 consecutively admitted patients with chest pain from July 2011 to September 2011. Plasma MPO and total sialic acid levels on admission were estimated spectrophotometrically. These were compared with extent of disease, development of complications during the hospital stay, left ventricular ejection fraction and mean duration of stay in hospital. RESULTS: Plasma MPO and total sialic acid levels were significantly higher in patients with myocardial infarction than those with unstable and stable angina (p<0.001 and p<0.007 respectively). The levels of plasma MPO and sialic acid levels were significantly higher in patients who developed complications like heart failure, arrhythmias, renal failure during their stay in hospital (p<0.011 and p<0.006 respectively). Ejection fraction was significantly low in patients with high MPO levels (p<0.011). CONCLUSION: In patients with ACS, plasma MPO and total sialic acid levels on admission could predict the development of complications during their hospital stay. MPO levels correlated with ejection fraction in patients with ACS.