Nagaswami Vasan

A survey of student perceptions of team-based learning in anatomy curriculum: favorable views unrelated to grades.

Team‐based learning (TBL) combines independent out of class preparation with in class small group discussion. We adopted TBL in teaching first year medical gross anatomy. In this study, we evaluated student perceptions of TBL by using a survey that elicited perceptions of both pedagogy and mode of learning. Anatomy lectures were replaced with required preclass readings, self‐assessment quizzes, small group discussions of assignments, and groups retaking the same quizzes for deeper learning. At the course conclusion, students were surveyed to assess their preference for TBL, their perceptions of TBL effectiveness, and their perceptions of successful interpersonal relationships within groups. Respondents (n = 317; 89% response) were asked to rate the extent that they agreed (−2 = strongly disagree; −1 = disagree; 0 = neutral; 1 = agree; and 2 = strongly agree). A principal components factor analysis with varimax rotation identified two 8‐item factors: “perceptions of TBL” and “perceptions of teamwork.” Internal consistency for each was high [Cronbachs alpha = 0.908 (preference for TBL); 0.884 (preference of teamwork)]. Results of one‐way analysis of variance between Honors/High Pass/Pass/Fail students indicated that Honors (n = 73) tended to rate perceptions of TBL higher than Pass (n = 54) [mean difference = 2.92; 95% CI (0.05, 5.79)], and also higher than Fail (n = 11) [mean difference = 6.30; 95% CI (1.13, 11.47)]. However, each had overallpositive ratings. No difference was noted between mean ratings of teamwork, which were also, overall, positive. We conclude that medical students view TBL favorably irrespective of their grades. Anat Sci Educ 2:150–155, 2009.

Team-based learning in anatomy: an efficient, effective, and economical strategy.

Team‐based learning (TBL) strategy is being adopted in medical education to implement interactive small group learning. We have modified classical TBL to fit our curricular needs and approach. Anatomy lectures were replaced with TBL that required preparation of assigned content specific discussion topics (in the text referred as “discussion topics”), an individual self‐assessment quiz (IRAT), analysis of the discussion topics, and then the team retaking the same quiz (GRAT) for discussion and deeper learning. Embryology and clinical correlations were given as lectures. Unit examinations consisted of graded IRAT and GRAT. The National Board of Medical Examiners (NBME) Subject Examination was the comprehensive final examination. To evaluate the effect of TBL on student performance we compared the departmental and NBME subject examination scores between the traditional and TBL curricula. We collected five years of data on student performance in TBL‐based anatomy and lecture‐based preclinical courses. Our results show that departmental and NBME subject examination scores for TBL‐based anatomy were higher than those for lecture‐based anatomy. We subsequently compared average NBME scores for anatomy with those in other preclinical courses that were lecture‐based. Average NBME anatomy scores were significantly higher than those for all the lecture‐based preclinical courses. Since the introduction of TBL in anatomy, student performance has progressively improved in the NBME subject examination. Students perceived TBL as a motivator to be a responsible team member and to contribute to collective learning by the team. Further, it reinforced self‐directed learning and fostered an appreciation for peer respect. Interestingly, these perceptions were uniform irrespective of student course performance. Anat Sci Educ.

Somite Chondrogenesis in vitro: Differential Induction by Modified Matrix- a Biochemical and Morphological Study*

The stimulation of somite chondrogenesis by extracellular matrix components was studied by monitering the synthesis of cartilage‐specific large proteoglycan aggregates. Chick embryonic sternal proteoglycans were separated into various components: monomers, hyaluronic acid, link protein and glycosaminoglycan side chains. The effects of these components, either individually or in various combinations, on somite chondrogenesis was examined. Proteoglycan monomers, alone or in a mixture with other components, induced chondrogenesis. The other components did not have any stimulating effect of their own. The results of these induction studies were also observed on a Sepharose CL–2B column and correlated using electron microscopy. Stimulation of somites resulted in an increase in the amount of proteoglycan aggregation (material excluded from the column) and was in agreement with the morphological appearance of the matrix in that there was increased accumulation of large proteoglycan granules. A matrix mixture of collagen and proteoglycans showed significant stimulation. When the matrix environment of the somites was altered to be unfavorable to the explants (medium containing hyaluronic acid) there was altered synthesis of cartilage‐specific molecules. The results presented in this report strongly suggest that the composition of the extracellular matrix material is critical for somite chondrogenesis.

The Role of Macrophages in the Placenta

Placenta formation occurs through a complex and coordinated effort between the fetus’s extraembryonic tissues and the gravid endometrial tissues. Many macrophages are present in the placenta throughout pregnancy and have been detected as early as day 10 of pregnancy (Chang et al., 1993). Placental macrophages include Hofbauer cells of the fetal chorionic villi and decidual macrophages of the maternal decidua basalis (Figure 1) (Bulmer & Johnson, 1984). Functions of placental macrophages include the production of substances that regulate local immune reactions (such as factors that regulate maternal immunological tolerance and fetal protection) and that promote angiogenesis in the placenta during its development (Mues et al., 1989; Sevala et al., 2007). Although they represent a significant presence on both the maternal and fetal sides of the placenta, placental macrophage functions have not been completely elucidated and still remain a significantly studied area of investigation.

Nonuniformity within Embryonic Somites: Differental Response to Retinoic Acid in Vitro

Recent studies have shown that in the developing chick embryo, at physiological level retinoic acid (RA) causes mirror‐image duplication of limb skeletal elements. This has led to the suggestion that RA could be the endogenous morphogen or isgnal substance. In this study, in order to explore the effect of RA on somite chondrogenesis, we have standardized a serum‐free chemically defined medium that supports the growth of somite explants in vitro. The results indicate that in somites RA at 10 ng/ml level induces cell proliferation, DNA and sulfated proteoglycan synthesis, and at higher concentrations is toxic. The results further show that RA induced stimulation of somite chondrogenesis is sclerotomal specific and the dermamyotemal portion of the somites does not exihibit a similar response. Retinoic acid also increases heparan sulfate synthesis and aggregation of isolated sclerotomal cells in culture. These results thus suggest that in amplifying chondrogenesis, RA acts at all phases such as cell proliferation (may increase cell viability) and aggregation, increased DNA synthesis and increased synthesis of matrix components. In otherwords, RA seems to initiate a chain of inter‐related events.

FAMILIAL EXPRESSION OF DUPLEX KIDNEY AND BIFID URETERS: IMPLICATIONS IN PATIENT CARE

Address for Correspondence: Dr. Nagaswami Vasan, D.V.M., M.V.Sc., Ph.D., Professor of Anatomy, Department of Biomedical Sciences, Cooper Medical School of Rowan University, 401 South Broadway, Camden, New Jersey 08103, USA. Phone: +1 (856) 361-2890 E-Mail: vasan@rowan.edu Background: A duplex kidney or bifid ureteric collecting system is one of the common congenital urinary tract abnormalities but familial occurrence is much less frequent. While considered an anatomical variant, duplexcollecting systems may be complicated by vesicoureteric reflux, obstruction or ureterocoele. Furthermore, accessory renal arteries, while frequently encountered, might cause hydronephrosis. Materials and Methods: We report here a case of 77and 82-years male siblings who donated their body to a willed body program with unilateral double and bifid ureter and accessory renal arteries. The siblings died approximately 15 months apart; the 77-year old sibling (donor 1) was the first to die of lung cancer. The 82-year older sibling (donor 2) died later from a cerebrovascular incident. Results and Observations: During dissection of the 77-yearold donor, (donor 1) we observed that the right kidney had two ureters, one emerging from the upper pole and the other from the lower pole. Probing the ureters revealed that the lower pole ureter entered the bladder via a superior orifice while the upper pole ureter opened into an inferior orifice. In the dissection of the 82-year older sibling (donor 2), we observed that the left kidney had two ureters emerging one each from the upper and lower poles. The two ureters on the left kidney fused caudally and opened into the bladder via a single orifice. Both donors had accessory renal arteries. Conclusions: Familial nature of the variance in the renal system is uncommon and only a few reports have been described. In the absence of the medical history of the donors we are unable to comment on whether their conditions caused any kidney problems. Additionally, in the absence of family history we are unable to expand the study to include other members of the donor’s family; however early recognition of this condition is vital in patient care.

University of Medicine and Dentistry of New Jersey (UMDNJ)-New Jersey Medical School.

The Dean is the chief academic officer of the medical school. Management of the educational programs is a shared responsibility of the academic departments and the Office of Education reporting to the Vice Dean. The faculty organization solicits and provides input to the Committee on Committees, which selects members for the nine standing committees that are approved by the Faculty Council (Figure 1). The Committee on Academic Programs and Policies (CAP2), a standing committee of Faculty Council, is charged with the design, evaluation, revision, approval, and oversight of the curriculum and overall educational program. CAP2 also makes recommendations to the Dean and to the Faculty Council regarding implementation of various programs. CAP2 represented by faculty, students, and administrators (ex officio) is a surrogate for the faculty at large. Members on the CAP2 are not representational of the various departments. The Dean or his designee, the Vice Dean, in concert with the CAP2 provides the strategic leadership in managing the educational programs and developing policies and procedures. The Vice Dean works closely with the academic departmental chairs, course and clerkship directors, and faculty to implement innovations in education, assessment, and evaluation as they pertain to undergraduate medical education. Two subcommittees report to the CAP2—the Preclinical and Clinical advisory subcommittees, which consist of course and clerkship directors, respectively. Subcommittees assist in achieving horizontal and vertical integration of the curriculum. A major curriculum revision was rolled out in 2004-05 (see Curriculum Renewal Process). Interdepartmental and interdisciplinary courses are managed jointly by departments and the Office of Education (OE). Office of Education

Somitic Mesoderm: Modulation of Chondrogenic Expression by Retinoic Acid

Somites are mesodermal structures that appear transiently along both sides of the neural tube in a repetitive manner. Embryologically, somites are the first segmented structures to form, and possibly these are aggregates of cells (mesodermal) in part arising from the primitive streak (“pre-somite clusters”-Bellairs, 1985). There is now extensive evidence that somitomeres in the segmental plate exist in all the vertebrate groups and that these presomitic collections of cells are arranged in a characteristic rosette-like pattern (see Jacobson and Meier, 1986 and references therein). When first formed from the unsegmented mesoderm, somites appear as epithelial vesicles consisting of one cell type (Trelstad, et al., 1967). After segmentation, the medial portion of the somite soon becomes mesenchymal. This is the sclerotome, the cartilage forming part of the somite. The rest of the somite, the dermamyotome remains a compact mass for a longer time. Subsequently, the sclerotome cells disperse and migrate medially towards the notochord and neural tube.