Learning or Memorization: Self-Directed Medical School Curriculum and the Dangers of Overemphasizing Student Selected Ancillary Resources

This article is a response to an opinion article, authored by Wu JH et al. and published in JAMA 2021, vol 326 (20) which suggested the that pre-clinical (first two) years of medical school curriculum should revolve around “high-yield” resources as the dominant teaching tool. The article posited that this highly controversial view was the best way to engage with students and was published in a well-read and utilized medical journal. Due to the growing divide between learning resources provided by medical schools and outside resources actually utilized by students, the conclusions drawn in the mentioned opinion article were understandable but interpreted in the wrong vein. Herein, the authors review landmark changes in medical education over the last century and the underpinning rationale to preface their examination of the suggested changes from the mentioned opinion article. The authors conclude with recommendations from a student perspective and a continuation of the last 100 years of advancements

Oblong Mean Prime Labeling of Some Snake Graphs

A graph labeling is an assignment of integers to the vertices or edges or both subject to certain conditions. The graph for which every edge(uv),the labels assigned to u and v are oblong numbers and for each vertex of degree at least 2, the g c d of the labels of the incident edges is 1. Here we characterize some snake graphs for oblong mean prime labeling

Square Sum Difference Product Prime Labeling of Some Tree Graphs

Square sum difference product prime labeling of a graph is the labeling of the vertices with {0,1,2---------,p-1} and the edges with absolute difference of the sum of the squares of the labels of the incident vertices and product of the labels of the incident vertices. The greatest common incidence number of a vertex (gcin) of degree greater than one is defined as the greatest common divisor of the labels of the incident edges. If the gcin of each vertex of degree greater than one is one, then the graph admits square sum difference product prime labeling. In this paper we investigate some tree graphs for square sum difference product prime labeling

Antimicrobial functionalized genetically engineered spider silk

Genetically engineered fusion proteins offer potential as multifunctional biomaterials for medical use. Fusion or chimeric proteins can be formed using recombinant DNA technology by combining nucleotide sequences encoding different peptides or proteins that are otherwise not found together in nature. In the present study, three new fusion proteins were designed, cloned and expressed and assessed for function, by combining the consensus sequence of dragline spider silk with three different antimicrobial peptides. The human antimicrobial peptides human neutrophil defensin 2 (HNP-2), human neutrophil defensins 4 (HNP-4) and hepcidin were fused to spider silk through bioengineering. The spider silk domain maintained its self-assembly features, a key aspect of these new polymeric protein biomaterials, allowing the formation of b-sheets to lock in structures via physical interactions without the need for chemical crosslinking. These new functional silk proteins were assessed for antimicrobial activity against Gram e Escherichia coli and Gram þ Staphylococcus aureus and microbicidal activity was demonstrated. Dynamic light scattering was used to assess protein aggregation to clarify the antimicrobial patterns observed. Attenuated-total reflectance Fourier transform infrared spectroscopy (ATR-FTIR) and circular dichroism (CD) were used to assess the secondary structure of the new recombinant proteins. In vitro cell studies with a human osteosarcoma cell line (SaOs-2) demonstrated the compatibility of these new proteins with mammalian cells.Fundação para a Ciência e a Tecnologia (FCT) - Bolsa de doutoramento (SFRH/BD/28603/2006); Chimera project (PTDC/EBB-EBI/109093/2008); NIH and Tissue Engineering Resource Center EB003210, P41 EB002520, DE017207

Hexagonal Difference Prime Labeling of Some Path Graphs

Hexagonal difference prime labeling of vertices of a graph is the labeling of the vertices of the graph with hexagonal numbers and the edges with absolute value of the difference of the labels of the incident vertices. The greatest common incidence number (gcin) of a vertex of degree greater than one is defined as the greatest common divisor of the labels of the incident edges. If the gcin of each vertex of degree greater than one is 1, then the graph admits hexagonal difference prime labeling.  Here we identify some path related graphs for hexagonal difference prime labeling

Situational awareness within objective structured clinical examination stations in undergraduate medical training - a literature search

Background: Medical students may not be able to identify the essential elements of situational awareness (SA) necessary for clinical reasoning. Recent studies suggest that students have little insight into cognitive processing and SA in clinical scenarios. Objective Structured Clinical Examinations (OSCEs) could be used to assess certain elements of situational awareness. The purpose of this paper is to review the literature with a view to identifying whether levels of SA based on Endsley's model can be assessed utilising OSCEs during undergraduate medical training. Methods: A systematic search was performed pertaining to SA and OSCEs, to identify studies published between January 1975 (first paper describing an OSCE) and February 2017, in peer reviewed international journals published in English. PUBMED, EMBASE, PsycINFO Ovid and SCOPUS were searched for papers that described the assessment of SA using OSCEs among undergraduate medical students. Key search terms included "objective structured clinical examination", "objective structured clinical assessment" or "OSCE" and "non-technical skills", "sense-making", "clinical reasoning", "perception", "comprehension", "projection", "situation awareness", "situational awareness" and "situation assessment". Boolean operators (AND, OR) were used as conjunctions to narrow the search strategy, resulting in the limitation of papers relevant to the research interest. Areas of interest were elements of SA that can be assessed by these examinations. Results: The initial search of the literature retrieved 1127 publications. Upon removal of duplicates and papers relating to nursing, paramedical disciplines, pharmacy and veterinary education by title, abstract or full text, 11 articles were eligible for inclusion as related to the assessment of elements of SA in undergraduate medical students. Discussion: Review of the literature suggests that whole-task OSCEs enable the evaluation of SA associated with clinical reasoning skills. If they address the levels of SA, these OSCEs can provide supportive feedback and strengthen educational measures associated with higher diagnostic accuracy and reasoning abilities. Conclusion: Based on the findings, the early exposure of medical students to SA is recommended, utilising OSCEs to evaluate and facilitate SA in dynamic environment

A Comparison of Australian and American Medical School Admission Experiences

Attaining admission into medical school has been described as a very competitive process by successful matriculants. The processes that medical schools use to classify applicants can greatly differ among institutions. These systemic differences flow over onto the applicant level, such that individuals from different geographic regions can have varied and diverse application experiences depending on local medical school admissions protocols. This piece compares the medical school admission processes of Australia and the United States of America, in the form of a narrative recount of a successful medical school matriculant in each country, with the individual experiences of matriculants from alternative pathways blended into the piece. The authors discovered significant differences in admissions protocols between the two countries, with the greatest differences revolving around admissions exams, applicant profile (high school students versus college students), degree types, and alternative entrance pathways

Predictors of complications in gynaecological oncological surgery: a prospective multicentre study (UKGOSOC-UK gynaecological oncology surgical outcomes and complications)

Background: There are limited data on surgical outcomes in gynaecological oncology. We report on predictors of complications in a multicentre prospective study. / Methods: Data on surgical procedures and resulting complications were contemporaneously recorded on consented patients in 10 participating UK gynaecological cancer centres. Patients were sent follow-up letters to capture any further complications. Post-operative (Post-op) complications were graded (I–V) in increasing severity using the Clavien-Dindo system. Grade I complications were excluded from the analysis. Univariable and multivariable regression was used to identify predictors of complications using all surgery for intra-operative (Intra-op) and only those with both hospital and patient-reported data for Post-op complications. / Results: Prospective data were available on 2948 major operations undertaken between April 2010 and February 2012. Median age was 62 years, with 35% obese and 20.4% ASA grade ⩾3. Consultant gynaecological oncologists performed 74.3% of operations. Intra-op complications were reported in 139 of 2948 and Grade II–V Post-op complications in 379 of 1462 surgeries. The predictors of risk were different for Intra-op and Post-op complications. For Intra-op complications, previous abdominal surgery, metabolic/endocrine disorders (excluding diabetes), surgical complexity and final diagnosis were significant in univariable and multivariable regression (P<0.05), with diabetes only in multivariable regression (P=0.006). For Post-op complications, age, comorbidity status, diabetes, surgical approach, duration of surgery, and final diagnosis were significant in both univariable and multivariable regression (P<0.05). / Conclusions: This multicentre prospective audit benchmarks the considerable morbidity associated with gynaecological oncology surgery. There are significant patient and surgical factors that influence this risk