ObjectiveTeam-based learning (TBL) is an increasingly popular teaching method in medical education. However, TBL hasn’t been well-studied in the ophthalmology clerkship context. This study was to examine the impact of modified TBL in such context and to assess the student evaluations of TBL.MethodsNinety-nine students of an 8-year clinical medicine program from Zhongshan Ophthalmic Centre, Sun Yat-sen University, were randomly divided into four sequential units and assigned to six teams with the same faculty. The one-week ophthalmology clerkship module included traditional lectures, gross anatomy and a TBL module. The effects of the TBL module on student performance were measured by the Individual Readiness Assurance Test (IRAT), the Group Readiness Assurance Test (GRAT), the Group Application Problem (GAP) and final examination scores (FESs). Students’ evaluations of TBL were measured by a 16-item questionnaire. IRAT and GRAT scores were compared using a paired t-test. One-way analysis of variance (ANOVA) and subgroup analysis compared the effects among quartiles that were stratified by the Basic Ophthalmology Levels (BOLs). The BOLs were evaluated before the ophthalmology clerkship.ResultsIn TBL classes, the GRAT scores were significantly higher than the IRAT scores in both the full example and the BOL-stratified groups. It highlighted the advantages of TBL compared to the individual learning. Quartile-stratified ANOVA comparisons showed significant differences at FES scores (P < 0.01). In terms to IRAT, GRAT and GAP scores, there was no significant result. Moreover, IRAT scores only significantly differed between the first and fourth groups. The FES scores of the first three groups are significantly higher than the fourth group. Gender-specific differences were significant in FES but not the IRAT. Overall, 57.65% of student respondents agreed that TBL was helpful. Male students tended to rate TBL higher than female students.ConclusionThe application of modified TBL to the ophthalmology clerkship curriculum improved students’ performance and increased students’ engagement and satisfaction. TBL should be further optimized and developed to enhance the educational outcomes among multi-BOLs medical students.
Finely tuning mechanosensitive membrane proteins holds great potential in precisely controlling inflammatory responses. In addition to macroscopic force, mechanosensitive membrane proteins are reported to be sensitive to micro-nano forces. Integrin β 2 , for example, might undergo a piconewton scale stretching force in the activation state. High-aspect-ratio nanotopographic structures were found to generate nN-scale biomechanical force. Together with the advantages of uniform and precisely tunable structural parameters, it is fascinating to develop low-aspect-ratio nanotopographic structures to generate micro-nano forces for finely modulating their conformations and the subsequent mechanoimmiune responses. In this study, low-aspect-ratio nanotopographic structures were developed to finely manipulate the conformation of integrin β 2 . The direct interaction of forces and the model molecule integrin α X β 2 was first performed. It was demonstrated that pressing force could successfully induce conformational compression and deactivation of integrin α X β 2 , and approximately 270 to 720 pN may be required to inhibit its conformational extension and activation. Three low-aspect-ratio nanotopographic surfaces (nanohemispheres, nanorods, and nanoholes) with various structural parameters were specially designed to generate the micro-nano forces. It was found that the nanorods and nanohemispheres surfaces induce greater contact pressure at the contact interface between macrophages and nanotopographic structures, particularly after cell adhesion. These higher contact pressures successfully inhibited the conformational extension and activation of integrin β 2 , suppressing focal adhesion activity and the downstream PI3K-Akt signaling pathway, reducing NF- κ B signaling and macrophage inflammatory responses. Our findings suggest that nanotopographic structures can be used to finely tune mechanosensitive membrane protein conformation changes, providing an effective strategy for precisely modulating inflammatory responses. Electronic Supplementary Material Supplementary material (primer sequences of target genes in RT-qPCR assay; the results of solvent accessible surface area during equilibrium simulation, the ligplut results of hydrogen bonds, and hydrophobic interactions; the density of different nanotopographic structures; interaction analysis of the downregulated leading genes of “focal adhesion” signaling pathway in nanohemispheres and nanorods groups; and the GSEA results of “Rap 1 signaling pathway” and “regulation of actin cytoskeleton” in different groups) is available in the online version of this article at 10.1007/s12274-023-5550-0.
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