Academy of Applied Science, Inc.

Endothelial lipase is synthetized almost exclusively in endothelial cells and then fixed on the luminal surface of the endothelium by means of heparan sulphate proteoglycans. The enzyme is expressed in the endothelium of nearly all tissues and the degree of expression is higher in richly vascularized tissues than in the less vascularized ones. The endothelial lipase expression in tissues is upregulated by shear and cyclic stress, angiotensin II and hypertension. The plasma enzyme level is elevated by pro-inflammatory cytokines, in metabolic syndrome and obesity. Prolonged exercise reduces the plasma enzyme level in the rat. The activity of the enzyme is inhibited by: sphingomyelin, angiopoietin-like protein 3 and 4, and insulin. Endothelial lipase reduces the plasma high density lipoprotein concentration and changes its properties. The enzyme is considered to be the main regulator of the plasma high density lipoprotein concentration. The plasma endothelial lipase concentration is elevated in coronary atherosclerosis and it is inversely correlated with the plasma high density lipoprotein level. The enzyme is considered to exert mostly pro-atherogenic effects. Its action as triglyceride lipase is important in hypertriglyceridemia.

Medical simulation has become an integral part of medical student education. There is a limited body of literature comparing virtual and high-fidelity simulation in terms of effectiveness and student perception.

A total of 130 medical students at the University of Rzeszów participated in this cross-sectional study. The respondents were divided into two groups: students who completed a selected scenario using a virtual patient (Body Interact) and students who completed a scenario using traditional high-fidelity (manikin-based) simulation (HFS). After completing the scenario, students filled in the following questionnaires: the Simulation Design Scale (SDS), the Educational Practices Questionnaire (EPQ), the Student Satisfaction and Self-Confidence in Learning Scale (SSCL) and a customized survey questionnaire.

The study found no significant difference in the effectiveness of HFS between students exposed to either type of simulation. Detailed analysis within specific categories – problem-solving, teamwork, and active learning – also showed no significant differences between virtual and traditional HFS. Furthermore, there were no notable differences between virtual and traditional simulations regarding specific aspects such as satisfaction with learning, self-confidence in learning, and expectations. However, within the virtual simulation group, females rated active learning significantly higher. Students aged 24–33 rated satisfaction with learning, self-confidence, overall effectiveness and perception of HFS, problem-solving, and active learning more favorably. Additionally, the levels of perceived effectiveness and satisfaction of higher years students with HFS increased.

Virtual patient simulation and traditional HFS foster the development of practical skills, as well as soft skills of medical students in challenging situations.