Term Retention Research Articles

Anatomy integration: Effective change or change of affect?

Anatomy is fundamental to clinical practice, is considered a rite of passage in becoming a physician and is key to professional identity formation. Curricular gaps in content and process combined with Liaison Committee on Medical Education requirements for self‐directed learning, clinical reasoning, and problem‐solving prompted dissolution of the anatomy course that began the medical curriculum at the University of New Mexico School of Medicine. The stand‐alone anatomy block that began the otherwise integrated curriculum was integrated into the existing organ system blocks to make room for new courses to address content gaps. Previous reports of anatomy integration document more positive attitudes and perceptions to teaching anatomy in context, as compared to an independent course. Our prospective study compared two medical student cohorts to determine the effects of teaching anatomy in (integrated) and out (stand‐alone) of context on the cognitive and affective domains of learning. In a pre, post and follow‐up design, methods included content assessments, confidence probes, and attitude surveys informed by focus groups. Results indicated that anatomical knowledge and student confidence was gained and mastered in both curricula. Initial acquisition of content was higher in the integrated curriculum, but not maintained. Students in the integrated curriculum displayed a different relationship to learning anatomy, appearing more concerned with their personal progression than with the connection of anatomy to medical practice or patient care. We also detected less agreement to statements related to working in teams, reflective practices and professional identity formation. These results were validated by extending our study to an additional cohort as well as previous cohorts using historical data. Impact of anatomy integration on longer term attitudinal changes and retention of content mastery was determined using data from the AAMC Y2Q survey and USMLE Step. Results may guide recommendations for targeted timely interventions to improve learning outcomes for students and patient care.Support or Funding InformationThis project was supported by funding from the University of New Mexico School of Medicine Scholarship in Education Allocation Committee (SEAC).This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Retenção da aprendizagem após treinamento em Suporte Básico de Vida com uso de simulação de baixa fidelidade em uma unidade hospitalar odontológica

AIMS: To evaluate the learning retention of participants of a Basic Life Support course in a dental unit of a university hospital.METHODS: This study combined quantitative and qualitative methods in a quasi-experimental design, in which the same subjects were compared before and at two moments after an intervention, which consisted of a training course in Basic Life Support. The participants were employees of the Oral Health Unit of the University Hospital of Brasília. Three evaluations were performed: pre-test, post-test and late post-test, in order to assess participants' learning retention. In a second stage of the research, interviews were conducted with the participants approved in the retention learning test.RESULTS: At all, 66 professionals participated in the course and carried out the theoretical pre-test and the theoretical and practical post-test. One year and five months after the course, 10 participants were submitted to the late post-test, also theoretical and practical. Regarding the theoretical knowledge, the mean was 6.3±2.31 points in the pre-test, 8.3±1.25 points in the post-test and 5.1±1.44 points in the late post-test. Late post-test results revealed also that 70% of participants met the minimum theoretical knowledge requirement for approval (5 of 10 points) but only 20% passed the practical retention assessment. The two participants who passed the practical evaluation had repeated the training after the initial course.CONCLUSIONS: Basic Life Support training based on simulation resulted in practical and theoretical learning in cardiopulmonary resuscitation. However, the effect did not persist after one year and five months, except for participants who repeated the training during this period, indicating that the long term retention of this learning requires more opportunities for training or practice. Further studies are needed to investigate the ideal workload, the number of repetitions required during training and the appropriate frequency of training, as well as to obtain information about the influence of prior knowledge of the participants and the practice after training in retention of skills.

Sınama Etkisinde Farklı Öğrenme Koşullarının İncelenmesi: Güvenli İnternet Kullanımı Konusu Örneği

Tests in educational setting are often seen as an assessment tool. However, in the field of psychology, memory related studies have shown that being tested affects recall in a positive way. Studying on a material as testing rather than studying on it many times helps better to remember the information in the material. This phenomenon is called Testing Effect. It is stated in the literature that using testing effect in the field of education may have positive result. It is thought that one of the important skills that should be gained to learners is the Safe Internet Usage. The aim of this study is to examine whether the different learning conditions (Study-Study-Test, Study-Test-Test, Study-Study-Study-Test and Study-Test-Test-Test) are influential for middle school students to learn the topic of Safe Internet Use. The research results show that different learning conditions have an effect on the group's short-term retention performance but not on long term retention.

Ethylene carbonate-free fluoroethylene carbonate-based electrolyte works better for freestanding Si-based composite paper anodes for Li-ion batteries

Fluoroethylene carbonate (FEC)-based electrolytes using FEC as the co-solvent (50 wt%) are investigated and compared with the electrolyte using FEC as the additive (10 wt%) for freestanding Si-carbon nanotubes (CNTs) composite paper anodes for Li-ion batteries. The ethylene carbonate (EC)-free FEC-based electrolyte is found to achieve higher specific capacity and better capacity retention in terms of long-term cycling. After 500 cycles, the capacity retention of the cell using diethyl carbonate (DEC)-FEC (1:1 w/w) is increased by 88% and 60% compared to the cells using EC-DEC-FEC (45:45:10 w/w/w) and EC-FEC (1:1 w/w), respectively. Through SEM-EDX and XPS analyses, a possible reaction route of formation of fluorinated semicarbonates and polyolefins from FEC is proposed. The inferior cell performance related to the EC-containing electrolytes is likely due to the formation of more polyolefins, which do not favor Li ion migration.

Assessing Knowledge Retention, With and Without Simulations

ABSTRACTThis study examines the effectiveness of teaching with simulations, compared to active learning without simulations. It utilizes an anonymous extra-credit pop quiz on four topics, each taught with a different method: (1) simulation and in-class debriefing; (2) simulation only; (3) in-class discussions with an accompanying research essay; and (4) in-class discussions only. The study presents a range of assessment techniques used in simulation literature, and suggests the use of the anonymous extra-credit pop quiz as a simple and familiar teaching practice, but an overlooked assessment tool for simulations. The study presents the “Iranian Plane” simulation developed to teach decision making in crisis situations to political science undergraduates. It analyzes empirical evidence on knowledge retention with and without simulations based on students’ performance on the pop quiz 3 months after the simulation. The analysis shows that learning with simulation and debriefing together attains teaching goals set in advance. Simulation with debriefing was the most effective teaching mode for knowledge retention in terms of students’ performance in the quiz, simulation only was almost as successful, but learning without simulation was less efficient.

Hepatocyte Aggregate Formation on Chitin-Based Anisotropic Microstructures of Butterfly Wings.

Scaffold nanotopography plays the most significant role in the mimicry of the in vivo microenvironment of the hepatocytes. Several attempts have been made to develop methods and substrates suited to growing hepatocytes into aggregates. Functional biomaterials, particularly biodegradable polymers, have been used in several studies aimed to develop improved scaffolds with ordered geometry and nanofibrous architecture for tissue engineering. However, there are still some limitation in their fabrication: it is not cost-efficient, is time-consuming, and exhibits some technological complications. The synthetic scaffolds are usually non-biodegradable and can be non-biocompatible compared to the naturally derived biomaterials. Here, we utilized a simple, cost-effective, and green method with two-step chemical treatment to get more selected hydrophilic butterfly wings from Morpho menelaus, Papilio ulysses telegonus, and Ornithoptera croesus lydius as a chitin-based natural scaffolds to growing hepatocyte aggregates. We established a three-dimensional (3D) in vitro model for culture of HepG2 cells and aggregate formation that maintained the hepatocytes function on these natural anisotropic microstructures. Cells cultured on these substrates show higher viability than those cultured on a two-dimensional (2D) culture plate. Methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay results revealed excellent viability of HepG2 cells on P. u. telegonus wings (fibrous area). The results also demonstrated appropriate cell activity, cell retention, and stable and functional expression in terms of albumin secretion and urea synthesis activity compared to the 2D monolayer culture of hepatocytes on the culture dish surface. With a slightly different degree, the other substrates also shown similar results. We anticipate that these natural anisotropic, biodegradable, and biocompatible substrates can maintain long-term hepatic culture as an in vitro 3D model for potential therapeutic applications and regenerative tissue applications. The model presented here provides a feasible alternative to the synthetic scaffolds and is expected to be more reliable for 3D organotypic liver culture models based on such scaffolds.

Outcome Evaluation of Early Implementation of Option B+ in Cameroon: A Prospective Cohort Observational Survey in the Northwest and Southwest Regions

Background: Mother to child transmission (MTCT) of HIV constitutes a major source of new pediatric infections in Cameroon. Objective: The aim of this implementation research was to assess outcomes and effectiveness of providing life-long antiretroviral therapy (ART) for HIV-positive pregnant and breastfeeding women (Option B+). Methods: From October 2013 to July 2014, HIV-positive pregnant and breastfeeding women, not on antiretroviral (ARV) prophylaxis and ART, were recruited from 22 purposefully selected health facilities in the Northwest and Southwest regions for a prospective, observational cohort evaluation. Option B+ was offered to participants and outcome indicators were measured. Results: Out of 680 women eligible for this assessment, 669 (98%) were initiated on Option B+. Retention-in-care was 90% (95% CI, 87.85 - 92.61) and 79% (95% CI, 75.20 - 81.88), and loss to follow up (LTFU) was 7% (95% CI: 4.95 - 8.90) and 15% (95% CI: 12.06 - 17.56) at 6 and 12 months respectively. Maternal mortality at 12 months after ART initiation was 2% (13). As of March 2015, 538 HIV exposed infants (HEIs) were enrolled and received postpartum nevirapine prophylaxis within 72 hours of birth and 84% (454) were on cotrimoxazole at 6 to 8 weeks. By 8 weeks of age, 498 (93%) infants had HIV DNA PCR test with 486 (97.6%) negative and 12 (2.4%) positive. Conclusion: In Cameroon, successful implementation of Option B+ increased retention-in-care to 79% at one year for pregnant and breastfeeding women and reduced MTCT rate below 5% for HEIs at 8 weeks of age. Long term retention, maternal and infant mortality and final MTCT rate after cessation of breastfeeding require further evaluation.

The influence of learning style in understanding analogies and 2D animations in embryology course.

Undergraduate students struggle to comprehend embryology because of its dynamic nature. Studies have recommended using a combination of teaching methods to match the student's learning style. But there has been no study to describe the effect of such teaching strategy over the different types of learners. In the present study, an attempt has been made to teach embryology using the combination of analogies and simple 2D animations made with Microsoft powerpoint software. The objective of the study is to estimate the difference in academic improvement and perception scale between the different types of learners after introducing analogies and 2D animation in a lecture environment. Based on Visual, Aural, Read/Write, and Kinesthetic (VARK) scoring system the learners were grouped into unimodal and multimodal learners. There was significant improvement in post-test score among the unimodal (P<0.001) and multimodal learners (P<0.001). When the post-test score was compared between the two groups, the multimodal learners performed better the unimodal learners (P=0.018). But there was no difference in the perception of animations and analogies and long-term assessment between the groups. The multimodal learners performed better than unimodal learners in short term recollection, but in long term retention of knowledge the varied learning style didn't influence its outcome.

Making assessment promote effective learning practices: An example of ipsative assessment from the School of Psychology at UEL

There is a wealth of literature that attests to the benefits of retrieval practice in the long term retention of academic material (see Roediger &amp; Butler, 2011 for a review). Unfortunately, there is also evidence indicating that students rarely report using this method of study (e.g. Karpicke, Butler, Roediger, 2009). The authors have piloted the use of an Ipsative format of assessment that imposes the use of retrieval practice via self-administered testing in the virtual learning environment Moodle. The purpose of this paper is to identify the rationale for the use of Ipsative Assessment in a programme’s pedagogical repertoire and to briefly overview the implementation of this format of assessment.

Digital Preservation: Issues and Possible Solutions

Digital objects are more vulnerable to destruction or loss as compared to conventional library materials. Issues like format obsolescence, software obsolescence, hardware obsolescence and storage media fault/deterioration are some of the major threats that make the digital resources vulnerable to destruction. Digital resources require special attention and application of strategies for long term retention and accessibility. The purpose of this paper is to outline the basic issues that threaten the retention and accessibility of digital resources in the long term. The paper also attempts to provide an outlook of the possible solutions for overcoming these issues.

Sales’ on Retention of Title terms. Is the English law analysis broken?

Hard cases make bad law. The history of the Bunkers litigation in the English courts demonstrates, as is often the case, that the history and context of litigation can have a strong and decisive effect on both the result and the legal reasoning leading to that result. This article argues that, while the decision of the Supreme Court in the Bunkers case was understandable given its context and background, it, together with the decision of the Court of Appeal in Caterpillar v Holt, has led to such uncertainty surrounding the use of retention of title (‘ROT’) clauses in inventory financing, that it is time for a reanalysis of the legal position. This article sets out suggested options for that reanalysis, some more radical than others.

An immersive learning model using evolutionary learning

In this article, we have proposed an educational model using virtual reality on a mobile platform by personalizing the simulated environments as per user actions. We have also proposed an evolutionary learning algorithm based on which the user learning path is designed and the corresponding simulated learning environment is modified. The main objective of this study is to create a personalized learning path for each student as per their calibre and make the learning immersive and retainable using virtual reality. Our proposed model emulates the innate natural learning process in humans and uses that to customize the virtual simulations of the lessons by applying the evolutionary learning technique. A quasi-experimental study is conducted by taking different case studies to establish the effectiveness of our learning model. The results show that our learning model is immersive and gives long term retention while enhancing creativity through reinforced customization of the simulations.

On Inverse Coefficient Heat-Conduction Problems on Reconstruction of Nonlinear Components of the Thermal-Conductivity Tensor of Anisotropic Bodies

The authors are the first to present a closed procedure for numerical solution of inverse coefficient problems of heat conduction in anisotropic materials used as heat-shielding ones in rocket and space equipment. The reconstructed components of the thermal-conductivity tensor depend on temperature (are nonlinear). The procedure includes the formation of experimental data, the implicit gradient-descent method, the economical absolutely stable method of numerical solution of parabolic problems containing mixed derivatives, the parametric identification, construction, and numerical solution of the problem for elements of sensitivity matrices, the development of a quadratic residual functional and regularizing functionals, and also the development of algorithms and software systems. The implicit gradient-descent method permits expanding the quadratic functional in a Taylor series with retention of the linear terms for the increments of the sought functions. This substantially improves the exactness and stability of solution of the inverse problems. Software systems are developed with account taken of the errors in experimental data and disregarding them. On the basis of a priori assumptions of the qualitative behavior of the functional dependences of the components of the thermal-conductivity tensor on temperature, regularizing functionals are constructed by means of which one can reconstruct the components of the thermal-conductivity tensor with an error no higher than the error of the experimental data. Results of the numerical solution of the inverse coefficient problems on reconstruction of nonlinear components of the thermal-conductivity tensor have been obtained and are discussed.

Long-enduring primary hepatocyte-based co-cultures improve prediction of hepatotoxicity

The failure of drug candidates during clinical trials and post-marketing withdrawal due to Drug Induced Liver Injury (DILI), results in significant late-stage attrition in the pharmaceutical industry. Animal studies have proven insufficient to definitively predict DILI in the clinic, therefore a variety of in vitro models are being tested in an effort to improve prediction of human hepatotoxicity. The model system described here consists of cryopreserved primary rat, dog or human hepatocytes co-cultured together with a fibroblast cell line, which aids in the hepatocytes' maintenance of more in vivo-like characteristics compared to traditional hepatic mono-cultures, including long term viability and retention of activity of cytochrome P450 isozymes. Cell viability was assessed by measurement of ATP following treatment with 29 compounds having known hepatotoxic liabilities. Hμrelrat™, Hμreldog™, and Hμrelhuman™ hepatic co-cultures were treated for 24h, or under repeat-dosing for 7 or 13days, and compared to rat and human hepatic mono-cultures following single-dose exposure for 24h. The results allowed for a comparison of cytotoxicity, species-specific responses and the effect of repeat compound exposure on the prediction of hepatotoxic potential in each model. Results show that the co-culture model had greater sensitivity compared to that of the hepatic mono-cultures. In addition, “time-based ratios” were determined by dividing the compounds' 24-hour TC50/Cmax values by TC50/Cmax values measured after dosing for either 7 or 13days. The results suggest that this approach may serve as a useful adjunct to traditional measurements of hepatotoxicity, improving the predictive value of early screening studies.

Advantages of melodic over rhythmic movement sonification in bimanual motor skill learning

An important question for skill acquisition is whether and how augmented feedback can be designed to improve the learning of complex skills. Auditory information triggered by learners’ actions, movement sonification, can enhance learning of a complex bimanual coordination skill, specifically polyrhythmic bimanual shape tracing. However, it is not clear whether the coordination of polyrhythmic sequenced movements is enhanced by auditory-specified timing information alone or whether more complex sound mappings, such as melodic sonification, are necessary. Furthermore, while short-term retention of bimanual coordination performance has been shown with movement sonification training, longer term retention has yet to be demonstrated. In the present experiment, participants learned to trace a diamond shape with one hand while simultaneously tracing a triangle with the other to produce a sequenced 4:3 polyrhythmic timing pattern. Two groups of participants received real-time auditory feedback during training: melodic sonification (individual movements triggered a separate note of a melody) and rhythmic sonification (each movement triggered a percussive sound), while a third control group received no augmented feedback. Task acquisition and performance in immediate retention were superior in the melodic sonification group as compared to the rhythmic sonification and control group. In a 24-h retention phase, a decline in performance in the melodic sonification group was reversed by brief playback of the target pattern melody. These results show that melodic sonification of movement can provide advantages over augmented feedback which only provides timing information by better structuring the sequencing of timed actions, and also allow recovery of complex target patterns of movement after training. These findings have important implications for understanding the role of augmented perceptual information in skill learning, as well as its application to real-world training or rehabilitation scenarios.

Effect of real-time biofeedback on peak knee adduction moment in patients with medial knee osteoarthritis: Is direct feedback effective?

BackgroundGait modifications can reduce the knee adduction moment, a representation of knee loading. Reduced loading may help to slow progression of medial knee osteoarthritis. We aimed to investigate the response of patients with medial knee osteoarthritis to direct feedback on the knee adduction moment as a method for modifying the gait pattern, before and after training with specific gait modifications. MethodsForty patients with medial knee osteoarthritis underwent 3D gait analysis on an instrumented-treadmill, while receiving real-time feedback on the peak knee adduction moment. Patients were trained with three different modifications; toe-in, wider steps and medial thrust gait. The response to real-time feedback on the knee adduction moment was measured before and after training. To evaluate the short term retention effect, we measured the changes without feedback. We also evaluated the effects on the knee flexion moment and at the hip and ankle joints. FindingsWith direct feedback on the knee adduction moment, patients were initially unable to reduce the knee adduction moment. After training with specific modifications, peak knee adduction moment was reduced by 14% in response to direct feedback. Without feedback a 9% reduction in peak knee adduction moment was maintained. Hip moments were not increased with modified gait, but small increases in ankle adduction moment and knee flexion moment were observed. InterpretationReal-time biofeedback directly on the knee adduction moment is a promising option for encouraging gait modifications to reduce knee loading, however only when combined with specific instructions on how to modify the gait.

GI+100: Long Term Preservation of Digital Geographic Information — 16 Fundamental Principles Agreed by National Mapping Agencies and State Archives

This paper states 16 principles for the long term retention and preservation of digital geographic information. The paper is mainly aimed at public sector geographic information providers in Europe (particularly those involved in mapping and cadastre) with the intention of highlighting the significance of fundamental concepts for digital geographic data archiving. Geographic information providers are mainly mapping agencies, but also archives preserving geographic data among a wider range of digital information. A supplementary objective is that the paper may provide useful information for providers of all types of geographic information right around the world. This paper states 16 principles for the long term retention and preservation of digital geographic information. The paper is mainly aimed at public sector geographic information providers in Europe (particularly those involved in mapping and cadastre) with the intention of highlighting the significance of fundamental concepts for digital geographic data archiving. Geographic information providers are mainly mapping agencies, but also archives preserving geographic data among a wider range of digital information. A supplementary objective is that the paper may provide useful information for providers of all types of geographic information right around the world. There are many reasons why people wish to retain access to information, though the main drivers for archiving digital geographic information are meeting legislative requirements, the short and long term exploitation (re-use not only access) of archived data for analyzing social, environmental (e.g. global climate changes) and economic changes over time as well as efficiency savings in managing superseded datasets. This paper sets out the path and describes what needs to be done now to future-proof the investment government agencies around the world have made in creating digital Geographic Data.Â

Retention of Content Utilizing a Flipped Classroom Approach.

The flipped classroom experience promotes retention and accountability for learning. The authors report their evaluation of a flipped classroom for accelerated second-degree nursing students during their primary medical-surgical nursing course. Standardized HESI® scores were compared between a group of students who experienced the flipped classroom and a previous group who had traditional teaching methods. Short- and long-term retention was measured using standardized exams 3 months and 12 months following the course. Results indicated that short-term retention was greater and long- term retention was significantly great in the students who were taught using flipped classroom methodology.

Three-year retention in buprenorphine treatment for opioid use disorder nationally in the Veterans Health Administration.

Buprenorphine has become the major treatment for opioid use disorder (OUD) but data on long treatment term retention and its correlates are sparse. All veterans with OUD treated in Veterans Health Administration (VHA) facilities nationally in fiscal year (FY) 2012, and who began treatment with buprenorphine as indicated by a first prescription after the first 60 days of the year were identified with the date of and their last prescription from FY 2012-2015. Veterans were classified into four groups based on time from first to last prescription: (0-30 days, 31-365 days; 1-3 years; and more than 3 years). These groups were compared on socio-demographic, diagnoses and service, and psychotropic drug use. Kaplan-Meier curves and Cox proportional hazards models were used to identify variables independently associated with retention in buprenorphine treatment. Veterans newly started on buprenorphine (n = 3,151) were retained in treatment for a mean duration of 1.68 years (standard deviation [SD] 1.23), with 61.60% (n = 1,941) retained for more than a year and 31.83% (n = 1,003) for more than 3 years. Cox proportion hazards model showed that only black race (Hazards ratio [HR] 1.26; standard error [SE] .06; p.0003), the Charlson index (HR 1.03; SE .01; p.0132) and emergency room visits during FY 2012 (HR 1.03; SE .01; p < .0001) were the only available variables independently associated higher odds of buprenorphine discontinuation. Buprenorphine retention was substantial among veterans treated in VHA, but few individual characteristics correlated with retention. Future research focused on identifying further correlates of treatment retention is required to help devise interventions to improve treatment continuation. (Am J Addict 2017;26:572-580).

Teaching trainees how to critically evaluate the literature - a crossover study at two pediatric residency programs.

ObjectivesThe purpose of this study was to assess the efficacy of a concise, evidence based medicine curriculum in improving the knowledge of pediatric residents at two institutions. MethodsSixty first and second year pediatric residents at MassGeneral Hospital for Children and MedStar Georgetown University Hospital participated in a crossover study. The evidence based medicine curriculum, consisting of 4 ninety minute sessions grounded in adult learning theory principles, was developed using the methodology described in the book ‘Studying a Study’. A validated 20 question evidence based medicine multiple choice test was administered on three separate occasions to measure baseline knowledge, efficacy of the curriculum in improving knowledge, and long term retention of that knowledge. Results Post curriculum, the fall group’s scores improved 23% from baseline (M=10.3, SD=2.4) to (M=12.7, SD=3.0) students (t(26)=-3.29, p=0.0018) while the spring group improved by 41% (M=10.0, SD=2.8) to (M=14.1, SD=2.2) students (t(32)=-6.46, p<0.0001). When re-tested 4-6 months later, the fall group’s scores did not significantly decline from their immediate post curriculum scores (M=12.7, SD=3.0) to (M=11.7, SD=3.0) students (t(32) =1.33, p=0.190). There was an association between number of sessions attended and increase in post curriculum score (χ2(3, N=60) =11.75, p=0.0083). ConclusionsFindings demonstrate our curriculum was effective in teaching evidence based medicine to pediatric residents, and fostered long term retention of knowledge. Based on these results, we believe this curriculum could be implemented at any institution.