Understanding Of Medical Students Research Articles

Using Echocardiography as a Promising Adjunctive Teaching Tool for Cardiac Anatomy and Physiology

A transformation in medical education is currently underway which prioritizes competency and clinical integration with basic sciences. Here we are exploring the feasibility of early echocardiography (Echo) experience as an adjunct tool for teaching heart anatomy and physiology to second year medical students.The study was conducted on 100 students in a problem‐based learning curriculum. Students were introduced to cardiac anatomy and physiology as well as the basic principles of ultrasonography before the Echo sessions. A pretest was conducted at the beginning of the Echo theoretical session, consisting of 10 questions on Echo images. The practical sessions included hands‐on experience on standardized patients with a checklist of structures that are commonly demonstrated in left parasternal and apical four chamber windows. A post‐test with the same questions was repeated after the clinical sessions.The post‐test outcome revealed a significant improvement in identifying the cardiac structures and function in comparison to the pre‐test (P value 蠄 0.0001) imageAlthough the students were very accurate in identifying heart chambers and valves without assistance, the pulmonary artery and valve in the parasternal short axis were mostly able to be identified with assistance. Furthermore 95% of students admitted that prior basic knowledge is essential for Echo images identification and 86% stated that integrating this experience is helpful in consolidating different phases of the cardiac cycle.ConclusionSpatial orientation offered by Echo with prior basic knowledge seems to provide an effective tool in consolidating medical student's understanding of heart anatomical relations and cardiac physiology.

An animated, non-compensating pulmonary model for teaching ventilation and perfusion relationships to medical students

Medical students, in their study of gas exchange within the lung, are typically challenged by the complexities and interactions resulting from the non-uniform ventilation, diffusion, blood flow maldistribution, and the mechanisms of blood gas transport. The model uses simple animated graphics to show how a non-compensating, alveolus / capillary lung model would respond to changes in systemic and environmental parameters. The alveolus acts like a well-mixed compartment and has a non-cyclical bulk-flow input that is determined by frequency and depth of respiration. The resulting volume and partial pressures of the gas compartment are obtained by integrating the difference between this inflow and the outflow caused by simple diffusion into the blood compartment. Diffusion of oxygen from alveolus to blood is influenced by the mean-capillary oxygen partial pressure that is obtained by expressing Fick's first law of diffusion in terms of blood O2 concentration and integrating between pulmonary artery and end-capillary values of concentration and time. This procedure also provides the end-capillary oxygen concentration which varies as diffusion characteristics and blood flow influence gas exchange. The student can observe the effect on arterial oxygen by changing frequency or depth of breathing, dead space volume, diffusion coefficient, rate of blood flow, and the hemoglobin content of blood. After perturbing the system from steady-state, the student can try to return to normal values by altering blood flow, rate and depth of breathing, or metabolism. Clinical interventions, such as O2 supplementation or transfusion, may also be used. Students observe the clinical effects of diffusion impairment, increased dead space, venous admixture, hyper- and hypoventilation, altered cardiac output, anemia, and high altitude. Our goal is to facilitate the medical student's understanding of a complex system and to emphasize the benefits and limitations of physiologic compensation and clinical interventions.