Spit Classroom : Technology enhanced experimental learning of Salivary Biology for NUS dental students

Transcription

1 Spit Classroom : Technology enhanced experimental learning of Salivary Biology for NUS dental students Assistant Professor Jaya Seneviratne Oral Sciences Faculty of Dentistry National University of Singapore

2 Prologue Death is caused by swallowing small amounts of saliva over a long period of time. George Carlin( )

3 What is saliva? Saliva is the mixed glandular secretion which constantly bathes the teeth and the oral mucosa. It is constituted by the secretions of the three paired major and minor salivary glands. The presence of saliva is vital to the maintenance of healthy hard (teeth) and soft (mucosa) oral tissues.

4 Major salivary glands Parotid: serous Submandibular: mixed, more serous Sublingual: mixed, more mucous

5 Why is saliva important? 1. Moisten oral mucosa 2. Aid speech,mastication and swallowing 3. Mechanical cleansing 4. Taste perception 5. Buffering 6. Maintain tooth integrity 7. Digestion 8. Maintain healthy oral microbiota

6 What if we don t have saliva Saliva is an important element for a healthy life

7 Salivary flow rate Unstimulated: ml/min Stimulated: ml/min Negligible flow rate during sleep

8 Salivary biomarkers

9 Clinical context of salivary diagnostics Salivary analysis much the same as blood analysis aims to identify diverse set of specific biomarkers of certain diseases/conditions while providing a relatively simple tool for both early diagnosis and prognosis.

10 Salivary diagnostics in systemic diseases Salivary analysis, with the help of current technological advances, will be valued much more in the near future.

11 Potential biomarkers for breast cancer Proof-of-principle has been demonstrated for salivary c-erbb-2, whose elevation has been shown to correlate strongly with breast malignancy in women.

12 Salivary markers in Psychobiology Sex differences in salivary cortisol in response to acute stressors among healthy participants, in recreational or pathological gamblers, and in those with posttraumatic stress disorder Salivary alpha-amylase (saa) has been proposed as a sensitive biomarker for stress-related changes in the body that reflect the activity of the sympathetic nervous system

13 Spit classroom: the background Oral Biology Programme at the Faculty of Dentistry (FOD), provides the foundational basic science knowledge necessary for dental undergraduate students to understand and manage clinical conditions when they graduate as dental practitioners. Rapid advancement of science and technology in last few decades has influenced our knowledge, understanding and decision making in the clinical settings. Dental schools are in need of reforming Oral Biology curricular with the addition of innovative approaches that introduce concepts regarding new advances in science, technology, and translational research in patient care (Iacopina, 2007).

14 The problem addressed Traditional lecture-based learning environment is being questioned within the context of emerging information/technologies. A study in US and Canadian dental schools found that dental students consider subjects that focus on memorization as a weakness in their curriculum (Henzi et al., 2007). New scientific advances require major revisions in how we learn, what we learn, and how we integrate information and knowledge into the curricular of health professions (DePaola and Slavkin, 2004).

15 Spit classroom: the idea Salivary Biology in the Dentistry, NUS was taught in a lecture-based unidirectional teaching method. Lack of active student participation Aim: To develop an innovative new learning environment, spit classroom for teaching/leraning Salivary Biology for dental students in which they can actively take part in the classroom activity.

16 Spit classroom: Methods Ethical (IRB) approval Invitation to the students (via ) Instructions (video, demonstrations) Collections of saliva (single-blinded) Analysis of salivary biomarkers Release of the results (Cortisol, SIgA, alpha-amylase) Feedback

17 Spit classroom: Salivary biomarker analysis Results Salivary cortisol, salivary alpha-amylase and secretary-iga levels by ELISA

18 Results of the salivary assays Results of the salivary biomarkers were provided to the students on the day of the salivary biology lecture. Because there is something relate to the real-life, students were expected to show more enthusiasm and learn more from this learning environment compared to the traditional lectures.

19 Unstimulated salivary flow rate Ref No. Gender Flow rate (ml/min) L7K F 1 FIZ F 0.34 DSX F 0.4 EZG M 0.88 WIX F ER F 0.8 PYJ M F F 0.4 XAD F 0.66 MMH M 0.4 RC1 F 0.46 TQT M 0.8 6JE F R4 F 0.2 UP5 F 0.64 JIQ F F F 0.6 ZNW M 0.38 T9E M 0.4 LBP M 0.64 QCE M GI M 0.5 Z8A F 0.5 S7M F 0.5 SIJ F 0.42 SFA F 0.4 Ref No. Gender Flow rate (ml/min) 6LM M 0.6 B8I M FS F 0.6 B72 M 1.04 VUE F X M 0.12 QEF M 0.16 AZ0 M 0.86 OLT F 0.16 V6L F 0.9 EDE F DT F 0.2 0RZ M 0.8 M9P M 0.14 T11 F U F 0.5 WM4 F 0.14 XUW F 0.4 IGZ F 0.6 SU4 F 0.4 RGQ F 0.24 YVM M 0.6 QRV F 0.96 W8J F SZ M Q8 M 0.6 EHP F T F 0.2

20 Salivary cortisol Ref No. Gender Cortisol (ng/ml) L7K F 3.8 FIZ F 4.4 DSX F 1.9 EZG M 3.3 WIX F 8.3 8ER F 4.7 PYJ M F F 1.8 XAD F 1.3 MMH M 0.6 RC1 F 1.1 TQT M 7.7 6JE F 2.6 6R4 F 0.8 UP5 F 1.7 JIQ F F F 2.4 ZNW M 9.6 T9E M 0.8 LBP M 1.5 QCE M 2.3 6GI M 7.3 Z8A F 1.7 S7M F 1.1 SIJ F 4.6 SFA F 4.5 Ref No. Gender Cortisol (ng/ml) 6LM M 3.4 B8I M 5.6 6FS F 7.6 B72 M 0.4 VUE F X M 10.3 QEF M 6.2 AZ0 M 1.7 OLT F 5 V6L F 0.3 EDE F 0.4 0DT F 7.7 0RZ M 1 M9P M 6.6 T11 F U F 0.7 WM4 F 1.9 XUW F 9.8 IGZ F 1.4 SU4 F 6.8 RGQ F 3.4 YVM M 1 QRV F 2.1 W8J F 1 3SZ M 3 5Q8 M 6.9 EHP F T F 4.7

21 Salivary α-amylase Ref No. Gender Amylase (U/ml) L7K F 43.7 FIZ F 30.5 DSX F 176 EZG M 2.8 WIX F ER F 44.7 PYJ M F F 3.5 XAD F 73 MMH M 25.2 RC1 F 3.8 TQT M JE F R4 F 37.4 UP5 F 25.2 JIQ F F F 10 ZNW M 18.7 T9E M LBP M 74.7 QCE M 3.3 6GI M 24.2 Z8A F 49.8 S7M F 19.3 SIJ F 2.8 SFA F 59.5 Ref No. Gender Amylase (U/ml) 6LM M 64.5 B8I M FS F 27.5 B72 M 8 VUE F X M 0.4 QEF M 30.4 AZ0 M 10.9 OLT F 51.6 V6L F EDE F DT F RZ M 3.3 M9P M 71.9 T11 F 21 79U F 18.7 WM4 F 84.9 XUW F 16.5 IGZ F 15.8 SU4 F 3.9 RGQ F 91.1 YVM M 26 QRV F 37.8 W8J F 11 3SZ M Q8 M 3.8 EHP F Girls Boys Average +/- SD (min-max) Average +/- SD (min-max) / ( ) / ( )

22 Salivary S-IgA Ref No. Gender SIgA (ug/ml) L7K F 18.9 FIZ F 3.3 DSX F 7.3 EZG M 9.2 WIX F 0.4 8ER F 2.7 PYJ M F F 14.6 XAD F 5.9 MMH M 5.4 RC1 F 67.4 TQT M JE F R4 F 17.3 UP5 F 8.9 JIQ F F F 11.7 ZNW M 37 T9E M 15 LBP M 18.2 QCE M GI M 22.5 Z8A F 5.1 S7M F 16.9 SIJ F 22.7 SFA F 16.3 Ref No. Gender SIgA (ug/ml) 6LM M 7.9 B8I M FS F 21.3 B72 M 1.8 VUE F X M 13.3 QEF M 9.7 AZ0 M 12.1 OLT F 1.3 V6L F 13.8 EDE F 6.6 0DT F 0.3 0RZ M 20 M9P M 8.9 T11 F U F 1.4 WM4 F 43.3 XUW F 37.5 IGZ F 4.9 SU4 F 18.7 RGQ F 9.5 YVM M 10.8 QRV F 6.2 W8J F SZ M 4.3 5Q8 M 44.1 EHP F T F 14.2

23 Feedback Forty-nine students (90.7%) returned the feedback form. Responses were analyzed for each question and the comments were noted down.

24 Spit classroom activity enhanced my interest in Salivary Biology Strongly disagree Disagree Neutral Agree Strongly agree Of the respondents, 89.8% either strongly agreed or agreed that spit classroom activity enhanced their interest in Salivary Biology

25 I feel, technology-enhanced Spit classroom is a better learning platform than a theoretical lecture Strongly disagree Disagree Neutral Agree Strongly agree Interestingly, 93.8% either agreed or strongly agreed that technology-enhanced spit classroom is a better learning platform than a theoretical lecture.

26 Adequate instructions were provided prior to the classroom activity Of the students, 87.7% either agreed or strongly agreed that adequate instructions were provided prior to the classroom activity. However, 10.2% was neutral and 2% disagreed.

27 Spit classroom enabled me to understand the clinical relevance of Salivary Biology as a future healthcare provider Strongly disagree Disagree Neutral Agree Strongly agree Majority of the students (93.8%) agreed that spit classroom enabled them to understand the clinical relevance of the salivary biomarkers as future healthcare providers.

28 How would you rate the Spit classroom technology-enhanced experimental learning? Poor Fair Good Very good Excellent This activity received a high rating from the students as 83.7% scored the project as either excellent or very good, 14.3% scored good and 2% scored it as a fair project.

29 I would like to recommend Spit classroom activity to be included in the Oral Biology module Strongly disagree Disagree Neutral Agree Strongly agree Interestingly, 91.8% of the students recommended to include the spit classroom activity in the Oral Biology module.

30 Students comments and suggestions on the salivary research activity in Spit classroom Very Interesting, because I leant how much the biomarkers vary. All good, makes lessons more memorable Fun! It was interesting to see the possible reasons for the variation in biomarkers It is interesting to be able to contribute to the research and to be informed of the results/methods Clear instructions It was fun and engaging, definitely kept me awake and attentive More biomarkers to be included, is possible, bit it was very fun! Results could be better explained The instructions were slightly unclear as the audio of the video was too soft, but it became clearer afterwards

31 Students thoughts on the content and usefulness of technology-enhanced experimental learning platform compared to a theoretical lecture More interesting than theoretical lecture Definitely more impactful and leaves an impression It is very useful and helps to restore concepts Makes lessons a lot more interactive and interesting More engaging It is applicable and makes lecture easier to follow. Experimental learning is a great way to learn. Thank you! Video too soft, cannot hear the instructions More videos can be made, otherwise theoretical lectures are fun too. It was more useful for future applications than upcoming exams

32 Challenges encountered Salivary biology module is taught only once in the academic year of first year dental students. We had to use the first year for the pilot project. With the excellent feedback received from the pilot project, we went to apply for the ethical approval as the project involves human subjects. This process required considerable amount of time. However, finally we could successfully implement the project for the students cohort in the second year and yet again received an excellent positive feedback.

33 Conclusion and future directions Spit classroom activity enhanced students interest in Salivary Biology. This innovative method should be incorporated into the Oral Biology curriculum in future.

34 Epilogue

35 Thank you!