Transition From Observational to Collaborative Learning to Augment Practical Skill Training in First-Year Medical Students

Introduction Students exhibit less interest in hematology demonstration experiments as they are not expected to do it during their examination. Adopting a different strategy, like collaborative learning, might spark interest, motivate them to work together towards a shared objective, and help further learning and understanding. The current study aimed to assess the effectiveness of collaborative learning in comparison with traditional practical demonstration. Methodology First MBBS students were divided into two groups of 50 each (1 - collaborative learning, 2 - traditional demonstration). In the traditional demonstration, the experiment was demonstrated by faculty using the required materials. In the collaborative learning method, 50 students were divided into groups (seven of seven each) and each group was provided with procedural details of the experiment and requisite materials. At the end of the experiment, assessment was done. In collaborative learning groups, the team cohesion scale (TCS) was employed to analyze group dynamics. Students' perceptions, and feedback regarding collaborative learning as a tool in practical experiments were collected using a five-point Likert scale. Results Post-experiment assessment scores in collaborative learning (8.65±1.54) were significantly higher than the traditional demonstration group (7.06±1.46). High scorers in TCS consistently belonged to groups that completed the experiment on time (positive outcome), whereas students with low scores often belonged to groups that did not complete the experiment (negative outcome). Conclusion Collaborative learning may be used for practical teaching in medical education as it fosters good communication, enables problem-solving, aiding the Indian medical graduate in fulfilling the role of a team member.

Implications of lifestyle medicine in medical practice

Globally, we are seeing a rise in non-communicable diseases such as obesity, hypertension, diabetes, metabolic syndrome, chronic respiratory diseases, cancer, etc., due to stressful lifestyle in this competitive world. Most of the non-communicable diseases are associated with lifestyle behavior. Presently, the role of lifestyle medicine is very critical and important in the management of chronic lifestyle-associated disorders. Considering the above facts, we decided to review the literature to gain a deeper insight into the implications of lifestyle medicine in medical practice. A literature search was conducted on PubMed, Scopus and Google Scholar databases. We observed that lifestyle medicine intervention is a growing and newer discipline and is being employed along with conventional management of non-communicable diseases by medical practitioners today, as they are strongly associated with lifestyle behaviors and practices. Motivation for change in lifestyle is challenging because it depends on the patient's determination and eagerness to adapt and accommodate to the newer lifestyle pattern. The medical practitioners should spend time in coaching patients on lifestyle-related health education. Guidance and coaching by medical practitioners will help patients adapt to practices of maintaining regular physical activity, a balanced diet, good sleep hygiene, and avoid addictions of tobacco and alcohol as part of life. Introducing real and progressive evidence-based behavioral changes to reduce the risks of lifestyle-related acute and chronic diseases in medical practice will reduce the burden of non-communicable disease.

An overview of prognostic value of neurologic and cardiac biomarkers in patients with COVID-19 sequelae

Many studies conducted after the pandemic period revealed that, while COVID-19 primarily injured the lungs, it also affects other organs in the form of cardiovascular complications, metabolic derangements, renal damage, and so on. Although we know that inflammatory cascades, complement activation, and pro-inflammatory cytokines are all involved in vasculitic processes that cause organ damage, we do not know the exact mechanism of complications such as acute respiratory distress syndrome (ARDS), cardiovascular ischemia, deep vein thrombosis, pulmonary thromboembolism, and brain injuries (embolism) that are frequently observed in COVID 19. The currently available biomarkers do not predict the severity of the aforementioned complications. As a result, more specific biomarkers such as serum calcium binding protein (S100B), glial fibrillary acid protein (GFAP), myelin basic protein (MBP), neuron-specific enolase (NSE), hs-TNI, (highly sensitive cardiac troponin) - HBDH, (Hydroxybutyrate Dehydrogenase), CK-MB (creatine kinase myocardial band), ST2 (suppression of tumorigenicity 2) are in need for early detection & improved clinical outcome.

Brain-Derived Neurotrophic Factor-Mediated Cognitive Impairment in Hypothyroidism

Brain-derived neurotrophic factor (BDNF), which is expressed at high levels in the limbic system, has been shown to regulate learning, memory and cognition. Thyroid hormone is crucial for brain development. Hypothyroidism is a clinical condition in which thyroid hormones are reduced and it affects the growth and development of the brain in neonates and progresses to cognitive impairment in adults. The exact mechanism of how reduced thyroid hormones impairs cognition and memory is not well understood. This review explores the possible role of BDNF-mediated cognitive impairment in hypothyroid patients.

Jigsaw Teaching VS Small Group Teaching: A Comparative Study Among Phase 3 MBBS Students in the Department of Paediatrics

Background: The traditional large group didactic lectures have many shortcomings, so small group discussions have been proposed to overcome some of these shortcomings. However, a typical Small Group Discussion (SGD) remains a mini-interactive lecture in most cases. To improve students’ participation and their better understanding, many newer teaching-learning methods have been tried. Jigsaw teaching method, a type of cooperative learning, is one of these new methods. Obviously, the usefulness of jigsaw teaching must be compared with other small group teaching methods. Objectives: The aim of this study was to compare the effectiveness of the Jigsaw teaching technique with the small group teaching method. Methods: A quasi-experimental study was conducted over one month in the Paediatrics Department of DM WIMS medical college. After obtaining written informed consent, 30 students were randomly selected and allocated to the SGD and jigsaw groups (15 students in each group). Four topics were taken to both the groups who were crossed over after one session (a total of eight exposures). Their post-intervention mean scores were tabulated and analyzed. The Likert scale was used to assess the students’ evaluations of the jigsaw method. Results: The results showed that the jigsaw method had better students’ performance, which was statistically significant with a P<0.05. Also, the students’ evaluation showed that they appreciated the jigsaw teaching method, but time constraints were noted as a drawback. Conclusions: Jigsaw teaching is an excellent small group teaching method to ensure better students’ participation and understanding and can add to our repertoire of teaching-learning methods, which Competency-Based Medical Education (CBME) warrants.

Gracilis Myocutaneous Flap: Adding to the Armamentarium of Complex Sacrococcygeal Defect Reconstruction

Background  With increasing radicality of rectal cancer surgeries, the postoperative defects are becoming more complex. This demands an ideal reconstructive option with minimal morbidity to the patient. Although vertical rectus abdominis myocutaneous (VRAM) flap is the commonly used flap, gracilis myocutaneous flap is increasingly being performed to avoid morbidity associated with VRAM flap. Results  We share our experience about two of our patients treated for rectal malignancy with pelvic exenteration who were reconstructed immediately with pedicled gracilis myocutaneous flap. Both the patients had an uneventful postoperative recovery period and were discharged on postoperative day 10. During follow-up period both patients had a healthy flap with no evidence of recurrence. No perineal hernias or gross dehiscence of skin closure occurred. Conclusion  Gracilis myocutaneous flap has its own place with unique advantages adding to the armamentarium of reconstructive options for complex perineal defects, thereby avoiding the morbidity associated with VRAM flap. It stands as a reliable alternative in patients where VRAM cannot be used.