There is low awareness about EBM and The Cochrane Library among physicians in Croatia, which creates a need for educational interventions about EBM for the benefit of health care in Croatia.
55www.cmj.hr Aim To evaluate daily-written 10-question quizzes in a medical anatomy course as a way to integrate assessment into the course and to evaluate their effect on the course success.Methods Students answering correctly 8/10 or more questions were awarded 0.5 points per quiz. There were 34 quizzes with a maximum point score 17. Measurable outcomes of academic progress in anatomy course (pass rates on 4 examination terms, total pass rate, and average marks) were calculated, and 2007/08 academic year was compared with the previous academic year in which daily written quizzes were not a part of the course. The relationship between cumulative points on daily quizzes and 3 components of the final examination (written, practical, and oral) for 2007/08 academic year was assessed by nonparametric correlation testing.Results Individual scores on quizzes ranged from 1.5 to 13.5 points. There was a positive correlation between scores on quizzes and grades on 3 components of the final examination: written (Spearman ρ = 0.784, P < 0.001, n = 79), practical (Spearman ρ = 0.342, P < 0.002, n = 79), and oral (Spearman ρ = 0.683, P < 0.001, n = 79) part. Compared with students in the previous academic year, students attending the course with daily quizzes significantly improved their academic achievement, expressed as the pass rate at the first examination term (39% vs 62%, respectively, χ 2 test, P = 0.006, ) and the average course grade (2.71 ± 1.08 vs 3.38 ± 1.26, respectively; t test, P < 0.001). ConclusionDespite their frequency and possible associated stress, daily quizzes were associated with better academic success in the anatomy course. Anatomy is one of the most important preclinical subjects; not only because of its shear volume and complexity, requiring the adoption of skills and attitudes, but also because it is the first truly medical course for university "novices, " who are still in the process of transition from secondary school pupils to university students. Furthermore, in the traditional medical curriculum, with separate preclinical and clinical subjects, anatomy is perceived as an introduction to "real" medicine, playing an important role in the process of professional socialization (1). Thus, anatomy teachers are not only teaching anatomy but are also university educators with distinct scholarly roles. One of these roles is encouraging students to take a widely cited "deep approach" to studying anatomy (2-4), leading to a more complete understanding of the subject matter. This should also include the capacity of independent, intrinsically motivated study. We believe that these, very much desired, educational aims can be reached only if the following 3 critical components of a good quality curriculum are optimally harmonized: recommended literature, teaching methods/learning activities, and assessment. It is argued that curriculum design, with a true integration of various forms of assessment into learning activities (5,6), should produce a measurable positive impact on students' knowledge and unders...
BackgroundWe investigated the immunohistochemical expression of p53, MAPK, topoisomerase II alpha (topoII alpha) and Ki67 in ovarian serous carcinomas (OSCs) along with mutational analysis for KRAS and BRAF.MethodsEighty one cases of OSCs were reviewed and examined immunohistochemically using antibodies against p53, MAPK, topoII alpha and Ki67. Staining was evaluated as a percentage of immunopositive cells with cut-off levels at 10% for p53 and topoII alpha, and 5% for MAPK. The Ki67 immunoexpression was assessed by means of Olympus Image Analysis System as a percentage of immunopositive cells in 1000 tumor cells. KRAS and BRAF mutational analysis was performed on 73 available microdissected samples.ResultsOf 81 cases of OSCs 13.6% were of low-grade and 86.4% were of high-grade morphology. In the high-grade group there was a significantly higher immunoexpression of p53 (P < 0.001) and topoII alpha (P = 0.001), with Ki67 median 56.5 vs. 19 in low-grade group (P < 0.001). The difference in immunoexpression of active MAPK between low- and high-grade group was also significant (P = 0.003). MAPK positive immunostaining was detected in 63.6% of low-grade vs. 17.1% of high-grade OSCs. The frequency of KRAS mutation was significantly higher in low-grade as compared to high-grade group (P = 0.006). None of the samples had BRAF mutation. In addition, we detected positive MAPK immunoexpression in 13/59 samples with wild-type KRAS, suggesting that activation of MAPK pathway is not ultimately related either to KRAS or BRAF mutation. Seven morphologically high-grade samples (11.7%) showed both KRAS mutation and p53 immunopositivity.ConclusionsAlthough this study is limited by its humble number of low-grade samples, our data fit the proposed dualistic pathway of ovarian carcinogenesis. Mutational analysis for KRAS and BRAF discloses some possible interactions between different tumorigenic pathways of low- and high-grade carcinomas. Immunohistochemical staining for MAPK was not sufficiently sensitive, nor specific, to precisely predict the KRAS mutation. However, it appears to be quite reliable in ruling out a KRAS mutation if the staining is negative.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9283563368804632ZusammenfassungHintergrundWir untersuchten die Immunohistochemische Expression der p53, MAPK, topoisomerase II alpha (topoII alpha) und Ki67 in Ovarialkarzinomen (OSCs) anbei mit Mutationsanalyse für KRAS und BRAF.Methode81 OSCs Fälle wurden analysiert und Immunohistochemisch untersucht mit Antikörper gegen p53, MAPK, topoII alpha und Ki67. Die Färbung war ausgewertet als der Prozent von immunopositiven Zellen mit den “cut-of” Niveau an 10% für p53 und topoII alpha und 5% für MAPK. Die Ki67 Expression war bewertet mittels Olympus Image Analysis System als der Prozent von immunopositiven Zellen in 1000 Tumorzellen. KRAS and BRAF Mutationsanalyse wurde in 73 verfügbaren microdissections Stichproben aufgeführt.ErgebnisseVon 81 OSCs Fälle 13.6% zeigte “lo...
Negative E-cadherin expression like presence of residual tumour after primary cytoreductive surgery and higher FIGO stage seem to predict unfavourable clinical outcome in patients with advanced-stage serous ovarian cancer. Negative expression of E-cadherin was shown to be a significant independent predictor of poorer OS. E-cadherin as marker has prognostic value.
Anatomy textbooks vary in the amount of text dedicated to different parts of topographical anatomy and are not quite concordant with curriculum recommendations and standard anatomical terminology. Planning the structure of an anatomy course should not be based on a single book or recommendation but on evidence.
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