Julie E. Speer’s research while affiliated with A.T. Still University and other places

Physical therapy (PT) students often fail to master documentation skills, such as goal writing, because they struggle to engage in the material early in the curriculum. Therefore, we sought to leverage ChatGPT to create an active learning experience with personalized feedback and hands-on practice. During the activity, students (n=48) learned to use ChatGPT and employed these techniques to learn about goal writing in PT and the SMART (Specific, Measurable, Attainable, Relevant, Time-bound) framework. Next, students engaged in a clarifying lecture before using ChatGPT to generate scenarios for which they drafted or edited SMART goals and asked ChatGPT for feedback. Pre-tests and post-tests were used to measure the impacts of the experience and to capture student perspectives. As a function of the activity, students were better able to recognize the purposes of SMART goals (p<0.0001) and write better goals (p<0.0001). They also showed increased confidence in their abilities (p<0.0001). Furthermore, student responses suggested that they enjoyed the activity (m=3.5/4) and found it helpful (m=3.7/4). Following the activity, 27 students continued to use ChatGPT to practice or study. This activity represents a novel approach for using generative artificial intelligence (AI) in the classroom to help students actively explore the topic of goal writing. Additionally, this modeled responsible use of AI for health care applications. This well-received activity can be easily scaled to include more complex tasks or group discussions, or adapted for use as an asynchronous assignment related to documentation or topics across health science education.

Background Health disparities are often a function of systemic discrimination and healthcare providers’ biases. In recognition of this, health science programs have begun to offer training to foster cultural proficiency (CP) in future professionals. However, there is not yet consensus about the best ways to integrate CP into didactic and clinical education, and little is known about the role of clinical rotations in fostering CP. Methods Here, a mixed-methods approach was used to survey students (n = 131) from a private all-graduate level osteopathic health sciences university to gain insight into the training approaches students encountered related to CP and how these may vary as a function of academic progression. The research survey included instruments designed to quantify students’ implicit associations, beliefs, and experiences related to the CP training they encountered through the use of validated instruments, including Implicit Association Tests and the Ethnocultural Empathy Inventory, and custom-designed questions. Results The data revealed that most students (73%) had received CP training during graduate school which primarily occurred via discussions, lectures, and readings; however, the duration and students’ perception of the training varied substantially (e.g., training range = 1–100 hours). In addition, while students largely indicated that they valued CP and sought to provide empathetic care to their patients, they also expressed personal understandings of CP that often fell short of advocacy and addressing personal and societal biases. The results further suggested that clinical rotations may help students attenuate implicit biases but did not appear to be synergistic with pre-clinical courses in fostering other CP knowledge, skills, and attitudes. Conclusions These findings highlight the need to utilize evidence-based pedagogical practices to design intentional, integrated, and holistic CP training throughout health science programs that employ an intersectional lens and empowers learners to serve as advocates for their patients and address systemic challenges.

Background Most health care professionals get their start in academics without formal teaching training. As such, institutions encourage participation in opportunities to address gaps in faculty’s knowledge of pedagogy and learning theory in order to promote both successful student and patient outcomes. This study aimed to examine the reception of a faculty development program focused on teaching participants the basics of course design. Methods Applying a mixed-method approach, this retrospective study used pre/post-tests, assignment grades, self-assessment questionnaires, and focus groups to elucidate the impact of the faculty development intervention on course design. The participants ( n = 12) were health educators from a private all-graduate level university with campus locations across the United States, including in the Southwest and Midwest. In the Course Design Institute (CDI), the participating faculty learned evidence-based instructional approaches and techniques to implement contemporary teaching practices. Results The data from the pre/post-tests and focus groups suggest that participants learned about topics including instructional alignment, learning goals and objectives, instructional strategies, assessment planning, feedback approaches, communicating expectations, and adult learning theories by participating in this course. The final deliverable scores indicate that the CDI graduates were able to apply a backward design process to plan their own instruction. Data from both the survey and the focus groups suggest that participants were satisfied with the experience and particularly appreciated that the course was relevant to them as educators in the health sciences. Conclusions The results of this study indicate that the CDI was influential in developing the faculty’s knowledge of the course design process, promoted the application of course design and pedagogy skills amongst CDI graduates, and positively impacted self-reported attitudes about their teaching abilities. In addition, feedback from participants indicates that they recognized the value of this program in their own development and they believed it should be a required course for all educators at the institution.

Intervertebral disc (IVD) degeneration is characterized by a loss of cellularity, and changes in cell-mediated activity that drives anatomic changes to IVD structure. In this study, we used single-cell RNA-sequencing analysis of degenerating tissues of the rat IVD following lumbar disc puncture. Two control, uninjured IVDs (L2-3, L3-4) and two degenerated, injured IVDs (L4-5, L5-6) from each animal were examined either at the two- or eight-week post-operative time points. The cells from these IVDs were extracted and transcriptionally profiled at the single-cell resolution. Unsupervised cluster analysis revealed the presence of four known cell types in both non-degenerative and degenerated IVDs based on previously established gene markers: IVD cells, endothelial cells, myeloid cells, and lymphoid cells. As a majority of cells were associated with the IVD cell cluster, sub-clustering was used to further identify the cell populations of the nucleus pulposus, inner and outer annulus fibrosus. The most notable difference between control and degenerated IVDs was the increase of myeloid and lymphoid cells in degenerated samples at two- and eight-weeks post-surgery. Differential gene expression analysis revealed multiple distinct cell types from the myeloid and lymphoid lineages, most notably macrophages and B lymphocytes, and demonstrated a high degree of immune specificity during degeneration. In addition to the heterogenous infiltrating immune cell populations in the degenerating IVD, the increased number of cells in the AF sub-cluster expressing Ngf and Ngfr, encoding for p75NTR, suggest that NGF signaling may be one of the key mediators of the IVD crosstalk between immune and neuronal cell populations. These findings provide the basis for future work to understand the involvement of select subsets of non-resident cells in IVD degeneration.

Intervertebral disc (IVD) degeneration is characterized by a loss of cellularity, and changes in cell-mediated activity that drives anatomic changes to IVD structure. In this study, we use single cell RNA-sequencing analysis of cells extracted from the degenerating tissues of the rat IVD following lumbar disc puncture. Two control, uninjured IVDs (L2-3, L3-4) and two degenerated, injured IVDs (L4-5, L5-6) from each animal were examined either at two- and eight-week post-operative time points. The cells from these IVDs were extracted and transcriptionally profiled at a single-cell resolution. Unsupervised cluster analysis revealed the presence of 4 known cell types in both non-degenerative and degenerated IVDs based on previously established gene markers: IVD cells, endothelial cells, myeloid cells, and lymphoid cells. As a majority of cells were associated with the IVD cell cluster, sub-clustering was used to further identify the cell populations of the nucleus pulposus, inner and outer annulus fibrosus. The most notable difference between control and degenerated IVDs was the increase of myeloid and lymphoid cells in degenerated samples at 2- and 8- weeks post-surgery. Differential gene expression analysis revealed multiple distinct cell types from the myeloid and lymphoid lineages, most notably macrophages and B lymphocytes and demonstrated a high degree of immune specificity during degeneration. In addition to the heterogenous infiltrating immune cell populations in the degenerating IVD, the increased number of cells in the AF sub-cluster expressing Ngf and Ngfr , encoding for p75NTR, suggest that NGF signaling may be one of the key mediators of the IVD crosstalk between immune and neuronal cell populations. These findings provide the basis for future work to understand the involvement of select subsets of non-resident cells in IVD degeneration.

Options for incarcerated individuals to participate in higher education in prison programs (HEPPs) have expanded in recent years to include courses in science, technology, engineering, and mathematics, however these students remain an underserved population in the United States. Thus, there are opportunities to expand the available offerings, increase the diversity of coursework available by introducing subjects such as biomedical engineering (BME), and include cocurricular and extracurricular activities widely considered critical components of undergraduate training including research experiences. As such, a year-long program was developed to introduce students pursuing a bachelor's degree in an HEPP through an R1 institution to research principles in BME. This course introduced students to disciplines within BME, offered opportunities to gain research experience as knowledge-creators, and supported engagement with a scientific learning community. Using a student-centered approach, the course was designed to incorporate activities for reflection, goal setting, and dialogue among participants and sought to leverage students' funds of knowledge and areas of personal scientific interest. This course represents a transferable model for offering BME courses and research-centered opportunities to students enrolled in other HEPPs and an opportunity to promote equity and access in higher education. Supplementary information: The online version contains supplementary material available at 10.1007/s43683-022-00071-6.

Degeneration of the intervertebral disc (IVD) is associated with significant biochemical and morphological changes that include a loss of disc height, decreased water content and decreased cellularity. Cell delivery has been widely explored as a strategy to supplement the nucleus pulposus (NP) region of the degenerated IVD in both pre-clinical and clinical trials, using progenitor or primary cell sources. We previously demonstrated an ability for a polymer-peptide hydrogel, serving as a culture substrate, to promote adult NP cells to undergo a shift from a degenerative fibroblast-like state to a juvenile-like NP phenotype. In the current study, we evaluate the ability for this peptide-functionalized hydrogel to serve as a bioactive system for cell delivery, retention and preservation of a biosynthetic phenotype for primary IVD cells delivered to the rat caudal disc in an anular puncture degeneration model. Our data suggest that encapsulation of adult degenerative human NP cells in a stiff formulation of the hydrogel functionalized with laminin-mimetic peptides IKVAV and AG73 can promote cell viability and increased biosynthetic activity for this population in 3D culture in vitro. Delivery of the peptide-functionalized biomaterial with primary rat cells to the degenerated IVD supported NP cell retention and NP-specific protein expression in vivo, and promoted improved disc height index (DHI) values and endplate organization compared to untreated degenerated controls. The results of this study suggest the physical cues of this peptide-functionalized hydrogel can serve as a supportive carrier for cell delivery to the IVD. Statement of Significance Cell delivery into the degenerative intervertebral disc has been widely explored as a strategy to supplement the nucleus pulposus. The current work seeks to employ a biomaterial functionalized with laminin-mimetic peptides as a cell delivery scaffold in order to improve cell retention rates within the intradiscal space, while providing the delivered cells with biomimetic cues in order to promote phenotypic expression and increase biosynthetic activity. The use of the in situ crosslinkable material integrated with the native IVD, presenting a system with adequate physical properties to support a degenerative disc.

With aging and pathology, cells of the nucleus pulposus (NP) de-differentiate towards a fibroblast-like phenotype, a change that contributes to degeneration of the intervertebral disc (IVD). Laminin isoforms are a component of the NP extracellular matrix during development but largely disappear in the adult NP tissue. Exposing human adult NP cells to hydrogels made from PEGylated-laminin-111 (PEGLM) has been shown to regulate NP cell behaviors and promote cells to assume a biosynthetically active state with gene/protein expression and morphology consistent with those observed in juvenile NP cells. However, the mechanism regulating this effect has remained unknown. In the present study, the integrin subunits that promote adult degenerative NP cell interactions with laminin-111 are identified by performing integrin blocking studies along with assays of intracellular signaling and cell phenotype. The findings indicate that integrin α3 is a primary regulator of cell attachment to laminin and is associated with phosphorylation of signaling molecules downstream of integrin engagement (ERK 1/2 and GSK3β). Sustained effects of blocking integrin α3 were also demonstrated including decreased expression of phenotypic markers, reduced biosynthesis, and altered cytoskeletal organization. Furthermore, blocking both integrin α3 and additional integrin subunits elicited changes in cell clustering, but did not alter the phenotype of single cells. These findings reveal that integrin- mediated interactions through integrin α3 are critical in the process by which NP cells sense and alter phenotype in response to culture upon laminin and further suggest that targeting integrin α3 has potential for reversing or slowing degenerative changes to the NP cell.

The nucleus pulposus (NP) of the intervertebral disc plays a critical role in distributing mechanical loads to the axial skeleton. Alterations in NP cells and, consequently, NP matrix are some of the earliest changes in the development of disc degeneration. Previous studies demonstrated a role for laminin-presenting biomaterials in promoting a healthy phenotype for human NP cells from degenerated tissue. Here we investigate the use of laminin-mimetic peptides presented individually or in combination on a poly(ethylene) glycol hydrogel as a platform to modulate the behaviors of degenerative human NP cells. Data confirm that NP cells attach to select laminin-mimetic peptides that results in cell signaling downstream of integrin and syndecan binding. Furthermore, the peptide-functionalized hydrogels demonstrate an ability to promote cell behaviors that mimic that of full-length laminins. These results identify a set of peptides that can be used to regulate NP cell behaviors toward a regenerative engineering strategy.

Participating in mentored undergraduate research experiences can improve students' grade point averages, retention, and job placement. Graduate students also benefit from serving as mentors, as they gain teaching and research management experience. In early 2020, the SARS-CoV-2 (COVID-19) pandemic caused many institutions to shut down physical work spaces and move research and teaching online. In this study, we explore how graduate student mentors and undergraduate student mentees at Washington University in St. Louis adapted to virtual research mentoring during the COVID-19 pandemic. We examined changes in mentoring methods, research productivity, and the impact on the future plans of both mentors and mentees across six science/engineering departments. Survey responses from 79 mentees and 38 mentors indicated that a majority of mentees were able to have meaningful and productive virtual mentoring experiences, while other mentors failed to adequately involve their mentees in continued mentoring. Focusing virtual research experiences on activities such as literature review and data analysis and collaborating on goal setting can serve as a way for mentors to engage mentees even when they are unable to access lab equipment. Data from the present study reveal opportunities and challenges of virtual mentoring and can be used to inform effective research mentoring practices in the future.