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This study investigated the educational benefits of system-based lecture notes and interactive learning objects in a peripheral nervous system component of a traditional first-year medical school human anatomy course. The impetus for the investigation was anecdotal evidence suggesting enhanced learner satisfaction with the learning resources. Retrospective review of existing data from 2006 to 2009 was undertaken to quantify (1) the effects of Web-based system courseware on examination item performance, and (2) differences among learner opinions regarding the benefit level of the five different types of interactive learning objects as evaluated by instructional design questionnaires. Interactive patient-based case studies (IPCS) and review games (Games), simulated interactive patients (SIP), flashcards, and unit quizzes (Quizzes) developed in-house have been peer-reviewed and published in MedEdPORTAL. Statistics included one-way analysis of variance, Tukey's post hoc test, and power meta-analysis (d). Examination item analysis scores remained significantly higher (P less than or equal to 0.05; d = 0.3938) for learners receiving the instructional treatment incorporating system-based lecture notes and interactive learning objects than for those not receiving this treatment. Using questionnaires with a five-point Likert scale, students reported favorably on the benefit level of all learning objects. They rated the SIP and IPCS significantly higher (P less than or equal to 0.05) and games significantly lower (P less than or equal to 0.05) than in previous years, indicating a change in learner preferences. This study reaffirms that online system-based instructional techniques improve student examination performance and overall student satisfaction. Learners indicated stronger preferences for SIP and IPCS over exercises encouraging passive memorization of anatomical content. (Contains 5 tables.)

Background: We re-examine the adequacy of an albino (hairless) mouse dorsal distally based skin flap model by determining elastic modulus and by assessing viability after application of rapid intermittent stretch to facilitate wound closure., Material/methods: Modulus of elasticity was determined with materials testing. Viability was accessed by laser Doppler flowmetry and by quantifying marginal tissue necrosis (mm2) at 5 days. Effective length gained and tension relieved were measured by subjecting flaps to simple undermining plus 3-10 g of initial tension (linear stretch) using a skin hook. Immediate hemispherical stretch was applied with an implanted subcutaneous silicone balloon (Rapid Intraoperative Tissue Expansion or RITE) at 1 or 2 cycles of 3-8 min and 6-12 ml for each cycle. Flaps subjected to simple and extensive undermining with or without application of initial linear stretch served as postoperative controls., Results: The elastic modulus of 9.85 (1.02) N/mm2 approximated the skin of the human face. Flowmetry demonstrated that all flaps were adequately perfused. Stretching significantly decreased flap tension and increased flap length over simple undermining alone. It drastically improved flap viability by provoking a 50-75% decline in 5-day necrosis. The benefits were dependent upon the initial linear tension applied, but independent of the timing, cycling, and volume selected for RITE and the flap dimensions at closure., Conclusions: Results demonstrate that the albino (hairless) mouse dorsal distally based skin flap is a reliable model for studying wound closure and that rapid intermittent stretching in this model facilitates closure and wound healing.