Journal of contemporary medical education最新文献

{"title":"Perceptions of the preparedness of medical graduates for their responsibilities as “physicians of first contact”: a pilot study -","authors":"Sajitha M. F. Rahman, P. Christopher, K. David, V. Sankarapandian","doi":"10.5455/jcme.20161007104004","DOIUrl":"https://doi.org/10.5455/jcme.20161007104004","url":null,"abstract":"The objectives of the medical graduate training program are laid down by the Medical Council of India (MCI) since 1997 that was subjected to amendment till 2012. The graduate medical students are envisaged to provide first contact care inclusive of preventive, promotive, curative and rehabilitative aspect of medicine. However, significant gap in the clinical skills of graduate doctors in India are echoed by the team of medical education experts. This study aims to explore the perceptions of medical graduates in their preparedness towards their role as first contact clinicians and in management of common problems. Qualitative methodology was used to explore the perceptions, experiences and ideas of medical graduates during medical training, internship and tenure in a Family medicine unit. The themes emerged from the data include disappointment with the lack of opportunity for experiential learning and clinical reasoning, passiveness and perceived incompetence in clinical work and appreciation of learning opportunities in Family Medicine unit. The participants’ perception of lack of confidence in their role of first contact physician reflects the opportunities in the training schedule that needs further research and intervention to improve medical graduates’ preparedness for their role as primary care providers in India.","PeriodicalId":90586,"journal":{"name":"Journal of contemporary medical education","volume":"4 1","pages":"125-131"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70813016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of effectiveness of small group teaching among Medical Students","authors":"Kashmir Singh, Rashmi Katyal, A. Singh, H. Joshi, Shalini Chandra","doi":"10.5455/JCME.20161016115304","DOIUrl":"https://doi.org/10.5455/JCME.20161016115304","url":null,"abstract":"Introduction: Small group teaching has grown in popularity in medical education as it offers a dynamic and collaborative setting for learning. It improves the retention of knowledge and students thinking. Conflicting reports in literature regarding effectiveness of small group teaching vs didactic lectures. Aim and objectives: 1. To assess the effectiveness of small group tutorials versus didactic lectures 2. To know the Students' and faculties’ perceptions regarding small group tutorials. Methods: Eighty final year MBBS students with informed consent were divided randomly into two groups. Two topics on head injury were taken in two sessions. In which pre and post assessment was done based on MCQs. In first session, one group was subjected to didactic lecture and the other group to tutorials followed by the cross-over in the second session. The same group of teachers took the didactic lectures and tutorials respectively. Perception of faculty based on likert scale taken. The data analysed in SPSS software using paired t-test. Results: There is a significant statistical difference in the pre-test and the post-test scores of each modality of teaching on the application of paired t-test (p-value","PeriodicalId":90586,"journal":{"name":"Journal of contemporary medical education","volume":"4 1","pages":"145-148"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70813032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune-class regulation in chronic Hepatitis B virus (HBV) infection and the effects of liver micro-environment on this regulation -","authors":"Mahmut Yigit, S. Gul, Yavuz F Yazicioglu","doi":"10.5455/jcme.20160107115910","DOIUrl":"https://doi.org/10.5455/jcme.20160107115910","url":null,"abstract":"The immune system contains a lot of humoral and cellular components and defends the human body. But in the case of chronic HBV infection, it becomes ineffective. HBV is a hepatotropic virus infecting 350 million people around the World chronically. HBV can be transmitted through sexual intercourse, blood transfusion and prenatally. After viral entry into the hepatocytes, the virus uncoats itself in the nuclear area and tries to escape from the immune system. This escape may occur only in the 4% of the cases which ends up with chronic HBV infection. In the first 6-8 weeks of the infection, a very weak innate immune response may be detected. In the following 12 weeks, delayed and poor adaptive immune response is mounted due to the weak innate immune response. As it’s known, the immune response against viruses is T cell-mediated. T cells defend against HBV by removing infected hepatocytes. This process changes the micro-environment of the liver determining which class of immune response should be mounted. The micro-environment and the tissue components educate dentritic cells to activate T-helper (Th) cells stimulating and recruiting proper immune cells controlling the proper immune-class. Two types of immune classes have been accounted for in this hypothesis: Th1, which is recruited in viral and bacterial infections and Th2 recruited basically in parasitic infections. The changes in the micro-environment of liver and some components of the HBV such as HBeAg may affect the immune class and even convert it from Th1 to Th2 in the case of HBV infection. The question in this hypothesis is whether the class switching (Th1 → Th2) may play role in chronicity of HBV and ineffectiveness of the adaptive immune response mounted against virus. In the light of this information, here we hypothesize that chronic HBV infection may be eradicated and prevented by keeping the liver micro-environment intact inducing Th1 immune-class and novel treatments as wells as new diagnosis methods for chronic HBV infections can be developed based on Th1 → Th2 immune class switching.","PeriodicalId":90586,"journal":{"name":"Journal of contemporary medical education","volume":"4 1","pages":"34-34"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70812605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Reflection on Some Key Pedagogical Competencies, Valuable to the Role of the Medical Educator -","authors":"A. Houldsworth","doi":"10.5455/jcme.20160315115157","DOIUrl":"https://doi.org/10.5455/jcme.20160315115157","url":null,"abstract":"The role of a university professor is multifaceted; as teacher, facilitator, assessor, evaluator, models of learning themselves as self-directed learners, addressing several key competencies for the effective teacher. It is not only about the transmission of knowledge, facts and skills but also about understanding how a student learns and being able to adapt and differentiate the delivery to personalise the learning. Appropriate questioning to assess prior knowledge and testing or challenging the understanding of the student learning is also a skill for the professor. Being able to access and use a variety of resources is important to deepen the understanding of student learning, including current IT skills. The relationship between learner and mentor is essential, developing trust and confidence. The development of appropriate medical and basic science language is an important element to the learning process. The professor’s collaboration and collegiate practices in a learning community enrich the learning experience, where best practice can be shared and communicated. It is important to be able to measure the impact of the teaching through assessment (formative and summative) and evaluation, which drives continued improvement in the learning experience. The innovative use of resources and environment that supports student and patient-centred learning and effectively engages with the students must be contextually and clinically relevant to the student’s experience.","PeriodicalId":90586,"journal":{"name":"Journal of contemporary medical education","volume":"4 1","pages":"26-32"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70812524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of stromal cells in anti-tumor immune responses -","authors":"R. Ayasun","doi":"10.5455/jcme.20160107115908","DOIUrl":"https://doi.org/10.5455/jcme.20160107115908","url":null,"abstract":"Pancreaticductal adenocarcinoma (PDAC) is a cancer of the exocrine pancreas with an aggressive prognosis (a 5-year survival rate of 6 months), resulting in more than 250,000 deaths per year. PDAC is the fourth most common cause of cancer-related mortality worldwide. PDAC is more resistant to chemotherapy than other types of cancer due to the dense fibrosis around it. Moreover, only 15% of patients who have PDAC tumors can have surgical resection. Consequently, the success of chemotherapy and surgery in PDAC treatments is limited, motivating researchers to turn to immunotherapy modalities. The dense fibrotic nature of the PDAC microenvironment makes it worthwhile to research the cancer-associated fibroblasts (CAF). The CAF cells play a role in the formation of fibrotic barriers, the altering of the anti-tumor immune response, and supporting to carcinogenesis. Many immune system elements, such as macrophages and cytotoxic T cells, play a role in the formation of the anti-tumor immune response. Macrophages play a particularly crucial role in that anti-tumor immune response but in two opposing manners, activating classically or in alternative ways. Macrophages that activate in alternative manners, the tumor associated macrophages (TAMs), have become a focus in cancer research in recent years due to their role in suppressing the anti-tumor response, in supporting angiogenesis and metastasis. However, there is no consensus on how the TAM cells are polarized from monocytes. This study aims to determine whether or not CAF cells play a role in the polarization of TAMs through CXCL12/ CXCR4 axis, and how this role affects survival and tumor volume in PDAC patients. If we explore that CAFs play a role in macrophage polarization viaCXCL12 / CXCR4 axis in this study, we may suppress this pathway and gain clinical benefit from this inhibition in PDAC patients.","PeriodicalId":90586,"journal":{"name":"Journal of contemporary medical education","volume":"12 1","pages":"35-35"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70812594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential role of the circadian rhythm in immune repertoire formation and pathogenesis of immune disorders","authors":"Yavuz F Yazicioglu, S. Gul, Mahmut Yigit","doi":"10.5455/jcme.20160331115901","DOIUrl":"https://doi.org/10.5455/jcme.20160331115901","url":null,"abstract":"The incidence of immune disorders such as autoimmunity and hypersensitivity reactions has been increasing in industrialized countries recently . Although some hypotheses based on epidemiological studies have been proposed to evaluate this increase among the immune disorder cases such as “Hygiene Hypothesis”, the underlying mechanism is not clear yet. It has been well studied that impairments in immune repertoire, total diversity among the antigenic receptors such as B cell receptor, T cell receptor and antibodies, may be causative factors of several immune disorders. Although genetic aspects of these immune disorders are well established, elucidating the responsible mutations in the genes encoding the molecules having key role in the formation of immune repertoire, we still lack knowledge on what kind of environmental factors take role in the pathogenesis of these diseases. Establishment of the diversity of immune repertoire depends on the recruitment of V(D)J re-arrangement which is basically Non-Homologous End Joining (NHEJ), one of the DNA repair mechanisms, mediated pathway. Circadian rhythm which DNA repair mechanisms may have effects on V(D)J recombination through NHEJ pathway especially in the early stages of life when immune repertoire is formed. The proteins recruited in the circadian regulation of the cells and regulation of DNA repair mechanisms such as Per1, Cry1, Parp-1 ve Tim are candidate molecules which may regulate V(D)J rearrangement. We suggested in our hypothesis that a novel molecular pathways linking circadian rhythm to immune system functioning and environmental factors disrupting circadian rhythm may have potential role in the pathogenesis of several immune disorders through epigenetic control of V(D)J recombination.","PeriodicalId":90586,"journal":{"name":"Journal of contemporary medical education","volume":"4 1","pages":"38-38"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70813209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do medical students develop the selfawareness as social entities during the longitudinal communication experience with citizens","authors":"Takuya Saiki, K. Abe, C. Kawakami, K. Fujisaki, Yasuyuki Suzuki","doi":"10.5455/JCME.20160330021106","DOIUrl":"https://doi.org/10.5455/JCME.20160330021106","url":null,"abstract":"Objective: Diverse interactions with local citizens are known to broaden the health perspectives of medical students, stimulating their motivation to learn, and improving their communication skills. In recent years, the rapid decrease in birth rates and the transition toward a nuclear family structure have posed a challenge for medical students in Japan, given their lack of experience in communicating with citizens who are older than they are or whose social backgrounds differ from their own. We aim at exploring how a longitudinal interaction with citizens can develop medical students’ communication skills and understanding of themselves as social entities. Method: Thematic analysis was used to analyze descriptive comments submitted to an e-portfolio by 100 first-year medical students who participated in longitudinal community-based experiential learning for six weeks with one of three different kinds of citizens such as the elderly, pregnant mothers, or nursery school children in 2011. Five independent researchers extracted themes from comments collected from 45 individual students on each six weekly encounters. The remaining data were used to confirm data saturation. Results: Two different themes emerged from the analysis: 1) understanding of citizen’s centeredness in communication, and 2) understanding of human relationship and expansion of world as a social existence. The first theme contained three different stages: i) survival, ii) trial and error, and iii) shifting gaze. The second theme contained four different stages: i) narrow, self-centered worlds, ii) awareness of the citizen’s existence, iii) understanding the worlds of the citizens and expanding their views of life, and iv) self-realization as a social entity within an expanded worldview. These two themes became progressively deeper through the longitudinal and mutual interaction. Conclusion: The longitudinal, mutual communication experiences with citizens has an impact on the students’ development of self-awareness as social entities accompanied with improving their communication skills.","PeriodicalId":90586,"journal":{"name":"Journal of contemporary medical education","volume":"4 1","pages":"89-96"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70812993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Has mobile technology disrupted the pedagogy of Problem Based Learning: The tutors perspective -","authors":"Sarah Wood, Matthew Wix, Lucie Byrne-Davies, C. Lumsden","doi":"10.5455/JCME.20160315115145","DOIUrl":"https://doi.org/10.5455/JCME.20160315115145","url":null,"abstract":"Background: At Manchester Medical School (MMS), mobile tablet technology is embedded within problem based learning (PBL). Anecdotally, tutors perceived a disruption to PBL. Summary of work: We employed a census survey of phase 2 PBL tutors in MMS. We queried a) demographics b) technological abilities c) perceptions of ipad use, and d) of mobile technology in PBL. Nominal and ordinal data were analysed descriptively, text responses with content analysis. Summary of results: Response rate was 58%. 82% of tutors thought ipads had changed PBL, commenting that PBL was more interactive (44%). The strongest theme, was that facilitators did not feel ipads had altered preparatory work. Emerging themes concerned the reduction of interaction within group and with facilitators. Facilitators felt groups used their ipads to clarify the setting (20%), define the problem (14%) and document intended learning outcomes(18%). Many perceived students using ipads for individual learning (21%), and group feedback (13%). Few facilitators felt that mobile tablet use had changed the pedagogic order of PBL, but had altered students approach to information gathering and presentation. Conclusion: This survey has illustrated the influence of mobile technology on the process of PBL, demonstrating tablet use in most of the 7 stages. A strong perspective is that this enhanced this process. Original Research","PeriodicalId":90586,"journal":{"name":"Journal of contemporary medical education","volume":"4 1","pages":"8-12"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70812355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Hypothesis Competition-11 at Gulhane Military Medical Faculty, Ankara -","authors":"V. Tunçbilek, F. Yazar","doi":"10.5455/JCME.20160107115922","DOIUrl":"https://doi.org/10.5455/JCME.20160107115922","url":null,"abstract":"","PeriodicalId":90586,"journal":{"name":"Journal of contemporary medical education","volume":"4 1","pages":"33-33"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70812612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving teaching efficiency on Medical Universities A comparative study of Hungarian and foreign medical university students feedbacks regarding learning by KOLLAR method","authors":"J. Kollár, B. Babusa, A. Stauder, J. Pilling, R. E. Cserepes, E. Czeglédi","doi":"10.5455/JCME.20151223090800","DOIUrl":"https://doi.org/10.5455/JCME.20151223090800","url":null,"abstract":"Abstract Objective. KOLLAR method is a learning and teaching promoting method that frames the generally missing elements into education. The word is an acronym namely KO is for Keys of Originality, L is for Learning, L is for Lecturing, A is for Application of social media, and R is for Relaxation. The aim of the cross-sectional study was the assessment of the evaluation of the KOLLAR method among medical university students during the development and progress of the method. Methods. Participants were first and third grade medical university students of Debrecen University, (n=1893; 56% was foreign student). The evaluation of the method was rated on a six-item scale, each item scored from 0 to 6. The items were analyzed separately, and as an aggregated score. Data were collected between the years 2002-2012. Results. According to the results of analyses using the aggregated index of evaluation (principal component, R2=59%), the Hungarian, the first year, and the physiotherapy students evaluated the method more positively than the foreign (Z=-4.460, p","PeriodicalId":90586,"journal":{"name":"Journal of contemporary medical education","volume":"4 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70812701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}