AJP: Advances in Physiology Education current issue

Corrigendum

Mon, 30 Nov 2009 04:27:12 PST

Living history: F. Eugene Yates

Urquhart, J. — Mon, 30 Nov 2009 04:27:12 PST

In 2005, the American Physiological Society (APS) initiated the Living History of Physiology Archival Program to recognize senior members who have made significant contributions during their career to the advancement of the discipline and the profession of physiology. During 2008, the APS Cardiovascular Section selected Francis Eugene Yates to be profiled in Advances in Physiology Education.

Living history: Elsworth R. Buskirk

Tipton, C. M. — Mon, 30 Nov 2009 04:27:12 PST

In 2005, the American Physiological Society (APS) initiated the Living History of Physiology Archival Program to recognize senior members who have made significant contributions during their career to the advancement of the discipline and the profession of physiology. Subsequently, the leadership of the APS Section of Environmental and Exercise Physiology selected Prof. Elsworth R. Buskirk of Pennsylvania State University to be profiled in Advances in Physiology Education.

A section devoted to profiles of renowned teachers and to the recognition and accomplishments of physiology teachers within the society

Mon, 30 Nov 2009 04:27:12 PST

Too much content, not enough thinking, and too little FUN!

DiCarlo, S. E. — Mon, 30 Nov 2009 04:27:12 PST

Teachers often overrate the importance of their content and underrate their influence. However, students forget much of the content that they memorize. Thus, attempts to teach students all that they will need to know is futile. Rather, it is important that students develop an interest and love for lifelong learning. Inspiring and motivating students is critical because unless students are inspired and motivated our efforts are pointless. Once students are inspired and motivated, there are countless resources available to learn more about a subject. Thus, teachers must abandon the mistaken notion that unless they "cover the content" students will be unprepared for the future and they will have failed as teachers. Teachers must not worry about "losing" or "wasting" valuable lecture time for in-class discussion, collaborative problem-solving, and inquiry-based activities that take time away from covering content. Rather than worrying about covering content, teachers must design activities to focus student learning on how to use scientific knowledge to solve important questions. This is important because learning is not committing a set of facts to memory but the ability to use resources to find, evaluate, and use information. In fact, memorizing anything discourages deep thinking. Deep thinking is essential because understanding is the residue of thinking! To encourage thinking we must create a joy, an excitement, and a love for learning. We must make learning fun; because if we are successful, our students will be impatient to run home, study, and contemplate-to really learn.

Clinical physiology: a successful academic and clinical discipline is threatened in Sweden

Arheden, H. — Mon, 30 Nov 2009 04:27:12 PST

Clinical physiologists in Sweden are physicians (the majority with a PhD degree) with thorough training in system physiology and pathophysiology. They investigate patients in a functional approach and are engaged in basic and applied physiology teaching and research. In 1954, clinical physiology was founded as an independent academic and clinical discipline by the Swedish government to ensure "contact between routine clinical work and the scientific progression." Up until 2008, clinical physiology was an independent clinical discipline but was then made a subdiscipline to radiology, a fundamentally different discipline. Individuals wishing to become clinical physiologists are required to be trained and certified as European radiologists, after which training and certification as clinical physiologists may be pursued. This means that radiologists without training in clinical physiology have become gatekeepers for future clinical physiologists. Unfortunately, this development takes place at a time when research and education in preclinical integrative physiology have diminished in favor of other organizational levels, such as cellular and molecular biology. The responsibilities for education and research in integrative human physiology have therefore mainly been transferred to clinical physiologists. Clinical physiology has been a successful independent clinical discipline in Sweden for the past 55 years and could serve as a model for other countries. Unless clinical physiologists regain control over their own discipline, systems physiology as a knowledge base and resource for patient care, education, and research will be severely impaired.

Ethical approval for research in physiology education

Kibble, J. D. — Mon, 30 Nov 2009 04:27:12 PST

The goal of this article is to reflect on the contemporary ethical standards that should be applied to the publication of physiology education research. As teachers, we are all education researchers to some degree but our appreciation of when and how regulatory requirements apply to our work is variable. A significant number of articles in Advances in Physiology Education that might be classified as "research involving human participants" do not document ethical safeguards such as Institutional Review Board approval and informed consent, which are required according to journal policy. I elaborate my personal view that we should strive to maintain the present community standards for conducting and publishing education research. And, as always, I hope the road to hell is not paved with good intentions!

The renal renin-angiotensin system

Harrison-Bernard, L. M. — Mon, 30 Nov 2009 04:27:12 PST

The renin-angiotensin system (RAS) is a critical regulator of sodium balance, extracellular fluid volume, vascular resistance, and, ultimately, arterial blood pressure. In the kidney, angiotensin II exerts its effects to conserve salt and water through a combination of the hemodynamic control of renal blood flow and glomerular filtration rate and tubular epithelial cell sodium chloride and water transport mechanisms. Pharmacological inhibition of the actions of the RAS are widely used in the treatment of patients with hypertension, congestive heart failure, left ventricular dysfunction, pulmonary and systemic edema, diabetic nephropathy, cirrhosis of the liver, scleroderma, and migraines. Therefore, a thorough understanding of the influences of the RAS on normal renal physiology is of major importance for first-year medical students.

The kidney and acid-base regulation

Koeppen, B. M. — Mon, 30 Nov 2009 04:27:12 PST

Since the topic of the role of the kidneys in the regulation of acid-base balance was last reviewed from a teaching perspective (Koeppen BM. Renal regulation of acid-base balance. Adv Physiol Educ 20: 132–141, 1998), our understanding of the specific membrane transporters involved in H⁺, HCO₃^–, and NH₄⁺ transport, and especially how these transporters are regulated in response to systemic acid-base disorders, has advanced considerably. In this review, these new aspects of renal function are presented, as are the broader and more general concepts related to the role of the kidneys in maintaining the acid-base balance. It is intended that this review will assist those who teach this aspect of human physiology to first-year health profession students.

Active learning strategies to teach renal-cardiovascular integration with high student-to-teacher ratios

Brands, M. W., Schumacher, L. — Mon, 30 Nov 2009 04:27:12 PST

To address the challenge of increasing opportunities for active learning into a medical physiology course with ~190 students enrolled, we chose an integrated approach. This was facilitated by the availability of a patient simulator facility at the School of Nursing at the Medical College of Georgia, and an ~20-min simulation of acute hemorrhage on the simulators comprised the first of three components in our approach. The second component was a small-group problem-solving session that each group conducted immediately after their patient simulator session. It brought in the more complex physiological responses to acute hemorrhage using an exercise we designed using free downloadable simulation software from the Department of Physiology and Biophysics at the University of Mississippi Medical Center. The third component was a student worksheet exercise that was built around data collected from 12 students who volunteered to collect a 24-h urine sample and have blood pressure measured after 3 days on either high or low salt intake. The worksheet was completed independently, and the answers and student data formed the basis for a classroom lecture. The approach has met with increasingly positive reviews due to testing the first two components on second-year medical student volunteers before its implementation, keeping the first component as simple as possible, keeping the second component to <30 min, and continued revision of the third component to increase clinical context of the study questions. An integrated active learning approach can enhance student interest in integrating cardiovascular-renal physiology, particularly if faculty members are willing to revise the approach in response to student feedback.

Explorations in statistics: the bootstrap

Curran-Everett, D. — Mon, 30 Nov 2009 04:27:12 PST

Learning about statistics is a lot like learning about science: the learning is more meaningful if you can actively explore. This fourth installment of Explorations in Statistics explores the bootstrap. The bootstrap gives us an empirical approach to estimate the theoretical variability among possible values of a sample statistic such as the sample mean. The appeal of the bootstrap is that we can use it to make an inference about some experimental result when the statistical theory is uncertain or even unknown. We can also use the bootstrap to assess how well the statistical theory holds: that is, whether an inference we make from a hypothesis test or confidence interval is justified.

Hooke's law: applications of a recurring principle

Giuliodori, M. J., Lujan, H. L., Briggs, W. S., Palani, G., DiCarlo, S. E. — Mon, 30 Nov 2009 04:27:12 PST

Students generally approach topics in physiology as a series of unrelated phenomena that share few underlying principles. However, if students recognized that the same underlying principles can be used to explain many physiological phenomena, they may gain a more unified understanding of physiological systems. To address this concern, we developed a simple, inexpensive, and easy to build model to demonstrate the underlying principles regarding Starling's Law of the Heart as well as lung and arterial elastic recoil. A model was chosen because models significantly enhance student understanding. Working with models also encourages research-oriented learning and helps our students understand complex ideas. Students are drawn into discussion by the power of learning that is associated with manipulating and thinking about objects. Recognizing that the same underlying principles can be used to explain many physiological phenomena may help students gain a more complete understanding of physiological systems.

Hand-held model of a sarcomere to illustrate the sliding filament mechanism in muscle contraction

Jittivadhna, K., Ruenwongsa, P., Panijpan, B. — Mon, 30 Nov 2009 04:27:12 PST

From our teaching of the contractile unit of the striated muscle, we have found limitations in using textbook illustrations of sarcomere structure and its related dynamic molecular physiological details. A hand-held model of a striated muscle sarcomere made from common items has thus been made by us to enhance students' understanding of the sliding filament mechanism as well as their appreciation of the spatial arrangements of the thick and thin filaments. The model proves to be quite efficacious in dispelling some alternative conceptions held by students exposed previously only to two-dimensional textbook illustrations and computer graphic displays. More importantly, after being taught by this hand-held device, electronmicrographic features of the A and I bands, H zone, and Z disk can be easily correlated by the students to the positions of the thick and thin elements relatively sliding past one another. The transverse expansion of the sarcomere and the constancy of its volume upon contraction are also demonstrable by the model.

Is lactate production related to muscular fatigue? A pedagogical proposition using empirical facts

Macedo, D. V., Lazarim, F. L., Catanho da Silva, F. O., Tessuti, L. S., Hohl, R. — Mon, 30 Nov 2009 04:27:12 PST

The cause-effect relationship between lactic acid, acidosis, and muscle fatigue has been established in the literature. However, current experiments contradict this premise. Here, we describe an experiment developed by first-year university students planned to answer the following questions: 1) Which metabolic pathways of energy metabolism are responsible for meeting the high ATP demand during high-intensity intermittent exercise? 2) Which metabolic pathways are active during the pause, and how do they influence phosphocreatine synthesis? and 3) Is lactate production related to muscular fatigue? Along with these questions, students received a list of materials available for the experiment. In the classroom, they proposed two protocols of eight 30–m sprints at maximum speed, one protocol with pauses of 120 s and the other protocol with pauses of 20 s between sprints. Their performances were analyzed through the velocity registered by photocells. Blood lactate was analyzed before the first sprint and after the eighth sprint. Blood uric acid was analyzed before exercise and 15 and 60 min after exercises. When discussing the data, students concluded that phosphocreatine restoration is time dependent, and this fact influenced the steady level of performance in the protocol with pauses of 120 s compared with the performance decrease noted in the protocol with pauses of 20 s. As the blood lactate levels showed similar absolute increases after both exercises, the students concluded that lactate production is not related to the performance decrement. This activity allows students to integrate the understanding of muscular energy pathways and to reconsider a controversial concept with facts that challenge the universality of the hypothesis relating lactate production to muscular fatigue.

Learning style preferences and course performance in an undergraduate physiology class

Dobson, J. L. — Mon, 30 Nov 2009 04:27:12 PST

Learning styles may be classified according to the sensory modality that one most prefers to use when internalizing information. The four major sensory modalities are visual, aural or auditory, read/write, and kinesthetic. The purpose of this study was to investigate the relationship between preferred learning style, gender, and course scores in an undergraduate physiology class. Students from the fall 2008 and spring 2009 Applied Human Physiology courses completed an online questionnaire in which they were asked to both provide descriptive information about themselves (e.g., gender and major) and self-assess their preferred sensory modality. A total of 901 students completed the questionnaire, 75% of which were female and 25% were male. The results from a ²-analysis (² = 9.59, P < 0.05) indicated that females and males had significantly different learning style preferences. Females most preferred visual learning (46%) followed by aural (27%), read/write (23%), and kinesthetic (4%). Males most preferred visual learning (49%) followed by read/write (29%), aural (17%), and kinesthetic (5%). There was also a significant relationship (P < 0.05 by ANOVA) between preferred sensory modality and course scores. The mean overall course scores were 83.53 ± 8.25, 85.58 ± 8.18, 84.98 ± 7.78, and 76.70 ± 7.92 for those that preferred visual, aural, read/write, and kinesthetic modalities, respectively. These results support the findings of Wehrwein et al. (18): that female and male physiology students have different sensory modality preferences and that they provide the first step in determining if sensory modality preferences impact final course scores.

A model of locomotor-respiratory coupling in quadrupeds

Giuliodori, M. J., Lujan, H. L., Briggs, W. S., DiCarlo, S. E. — Mon, 30 Nov 2009 04:27:12 PST

Locomotion and respiration are not independent phenomena in running mammals because locomotion and respiration both rely on cyclic movements of the ribs, sternum, and associated musculature. Thus, constraints are imposed on locomotor and respiratory function by virtue of their linkage. Specifically, locomotion imposes mechanical constraints on breathing that require the respiratory cycle to be synchronized with gait. Thus, many mammals, including humans, synchronize respiration with the movement of the limbs during locomotion. For example, quadrupeds synchronize locomotor and respiratory cycles at a 1:1 ratio (stride/breath) over a wide range of speeds. Interestingly, quadrupeds maintain an almost constant stride frequency (and therefore respiratory frequency) at different speeds. To increase speed, quadrupeds lengthen their stride. Accordingly, to increase minute ventilation, quadrupeds must increase tidal volume since respiratory rate is coupled with stride frequency. We developed a simple, inexpensive, and easy to build model to demonstrate this concept. A model was chosen because models significantly enhance student understanding. Students are drawn into discussion by the power of learning that is associated with manipulating and thinking about objects. Building and using this model strengthen the concept that locomotor-respiratory coupling provides a basis for the appropriate matching of lung ventilation to running speed and metabolic power.

Active learning in the classroom: a muscle identification game in a kinesiology course

McCarroll, M. L., Pohle-Krauza, R. J., Martin, J. L. — Mon, 30 Nov 2009 04:27:12 PST

It is often difficult for educators to teach a kinesiology and applied anatomy (KAA) course due to the vast amount of information that students are required to learn. In this study, a convenient sample of students (class A) from one section of a KAA course played the speed muscle introduction and matching game, which is loosely based off the premise of the adult game of "speed dating." The game involves student's taking on a "muscle" personality when introducing themselves to potential mates. The experimental group (class A) played the game at two time points throughout the semester after a series of lectures focusing on the body's muscles. A control group (class B) from another section of the KAA course still received the series of lectures but did not play the games throughout the semester. A postgame questionnaire given to class A revealed the following scores: 1) overall perception of the game (score: 4.43 ± 0.68), whether goals and objectives were met (score: 4.05 ± 0.67 to 4.95 ± 0.22), and perceptions of the organization of the game (score: 3.81 ± 0.81 to 4.48 ± 0.60). Overall, the game was well received by class A. When evaluating outcome scores of final grades between the two groups, class A improved final grades by 5.82% for a mean grade of 79.52 ± 10.0; however, the final grades were not statistically significant (P > 0.05) compared with class B (73.7 ± 15.6). The results show that an interactive game may contribute to improved final grades in a KAA course and could be an alternative means of disseminating kinesiology information.

Chemistry misconceptions associated with understanding calcium and phosphate homeostasis

Cliff, W. H. — Mon, 30 Nov 2009 04:27:12 PST

Successful learning of many aspects in physiology depends on a meaningful understanding of fundamental chemistry concepts. Two conceptual diagnostic questions measured student understanding of the chemical equilibrium underlying calcium and phosphate homeostasis. One question assessed the ability to predict the change in phosphate concentration when calcium ions were added to a saturated calcium phosphate solution. Fifty-two percent of the students correctly predicted that the phosphate concentration would decrease in accord with the common ion effect. Forty-two percent of the students predicted that the phosphate concentration would not change. Written explanations showed that most students failed to evoke the idea of competing chemical equilibria. A second question assessed the predicted change in calcium concentration after solid calcium phosphate was added to a saturated solution. Only 11% of the students correctly predicted no change in calcium concentration; 86% of the students predicted an increase, and many based their prediction on a mistaken application of Le Chatelier's principle to heterogeneous equilibria. These results indicate that many students possess misconceptions about chemical equilibrium that may hamper understanding of the processes of calcium and phosphate homeostasis. Instructors can help students gain greater understanding of these physiochemical phenomena by adopting strategies that enable students achieve more accurate conceptions of chemical equilibria.

Improving the effectiveness of physiology record books as a learning tool for first-year medical students in India

Vyas, R., Tharion, E., Sathishkumar, S. — Mon, 30 Nov 2009 04:27:12 PST

In compliance with the Medical Council of India, preclinical medical students maintain a record of their laboratory work in physiology. The physiology record books also contain a set of questions to be answered by the students. Faculty members and students had indicated that responding to these questions did not serve the intended purpose of being an effective learning tool. The purpose of this study was to obtain the views of the medical students and faculty members at our institution concerning the usefulness of responding to the questions and to gather suggestions for possible improvement. Data were collected through focus groups and questionnaires to first-year medical students and faculty members in physiology and were analyzed using qualitative and quantitative methods. The students and faculty members viewed the physiology record books as a potentially useful learning aid, but lack of time led the students to write the answers without understanding the topic rather than generating their own responses to the questions. Faculty members and students recommended that the students should write the responses to the questions on site during the practical classes, using relevant on-site resources and interacting with faculty members. The findings of the present study may be of value to other medical colleges in India and outside India with modifications based on their specific needs to improve the effectiveness of physiology record books as a learning tool.

Evaluation of the Virtual Physiology of Exercise Laboratory program

Dobson, J. L. — Mon, 30 Nov 2009 04:27:12 PST

The Virtual Physiology of Exercise Laboratory (VPEL) program was created to simulate the test design, data collection, and analysis phases of selected exercise physiology laboratories. The VPEL program consists of four modules: 1) cardiovascular, 2) maximal O₂ consumption (Vo_2max), 3) lactate and ventilatory thresholds, and 4) respiratory exchange ratio. The purpose of this investigation was to compare student learning from the VPEL program with that from traditional "hands-on" exercise physiology laboratory activities. Student participants from the spring 2009 Integrated Fitness Programming course were randomly assigned to either experimental group 1 or group 2. Group 1 completed a hands-on version of a typical Vo_2max laboratory activity, whereas group 2 completed the VPEL Vo_2max module. Both groups then completed the same assessment to evaluate their understanding of Vo_2max laboratory concepts. Group 1 then completed the VPEL lactate and ventilatory threshold module, whereas group 2 completed a hands-on version of that same activity. Both groups then completed the same assessment to evaluate their understanding of lactate and ventilatory threshold laboratory concepts. Mean Vo_2max assessment scores were 86.39 ± 4.13 and 85.64 ± 6.72 and mean lactate and ventilatory threshold assessment scores were 85.50 ± 8.05 and 86.15 ± 6.45 for groups 1 and 2, respectively. These findings lend additional support to the following conclusion of similar investigations (2, 4, 6): that virtual laboratories instruct students as effectively as hands-on laboratories.

Evaluation of gastrointestinal motility in awake rats: a learning exercise for undergraduate biomedical students

Mon, 30 Nov 2009 04:27:12 PST

Current medical curricula devote scarce time for practical activities on digestive physiology, despite frequent misconceptions about dyspepsia and dysmotility phenomena. Thus, we designed a hands-on activity followed by a small-group discussion on gut motility. Male awake rats were randomly submitted to insulin, control, or hypertonic protocols. Insulin and control rats were gavage fed with 5% glucose solution, whereas hypertonic-fed rats were gavage fed with 50% glucose solution. Insulin treatment was performed 30 min before a meal. All meals (1.5 ml) contained an equal mass of phenol red dye. After 10, 15, or 20 min of meal gavage, rats were euthanized. Each subset consisted of six to eight rats. Dye recovery in the stomach and proximal, middle, and distal small intestine was measured by spectrophotometry, a safe and reliable method that can be performed by minimally trained students. In a separate group of rats, we used the same protocols except that the test meal contained ^99mTc as a marker. Compared with control, the hypertonic meal delayed gastric emptying and gastrointestinal transit, whereas insulinic hypoglycemia accelerated them. The session helped engage our undergraduate students in observing and analyzing gut motor behavior. In conclusion, the fractional dye retention test can be used as a teaching tool to strengthen the understanding of basic physiopathological features of gastrointestinal motility.

A multiyear approach to student-driven investigations in exercise physiology

FitzPatrick, K. A., Campisi, J. — Mon, 30 Nov 2009 04:27:12 PST

Many undergraduate institutions offer individual research opportunities for upper-level students in independent study courses and summer undergraduate research programs. These are necessarily limited to a small number of students. Greater numbers of students can benefit from incorporating student-directed investigative experiences into laboratories in standard courses. In human performance investigations, any single course may not offer sufficient numbers of subjects to adequately test hypotheses comparing population groups or to examine longitudinal trends. In this exercise physiology course, exercise testing was conducted in three areas: 1) techniques of body composition analysis, 2) field tests for the estimation of maximal oxygen consumption, and 3) maximal anaerobic and aerobic power. All students enrolled over a 10-yr period participated as subjects and as testers. Working in small research groups, students added their results to those from previous years, generated a variety of hypotheses (correlations between tests, subgroup differences, etc.), and tested them statistically using the complete data set of 217 subjects. They then engaged in collaborative writing and peer review to prepare formal papers on their results. The multiyear approach allowed students to situate their work within and contribute to the accumulation of a large database and to practice essential scientific skills of hypothesis formation, data collection and analysis, collaborative work, and scientific communication. In addition, due to the larger number of subjects available to analyze, students observed statistically significant differences between test groups in the multiyear database that they were unable to demonstrate when conducting analysis on a single course. Finally, the large number of subjects and statistical power offered by the use of the database provides distinct pedagogical advantages.

A simple model to demonstrate the movements and the axes of the eyeball

Nayak, S., Soumya, K. V. — Mon, 30 Nov 2009 04:27:12 PST

Experimental case studies to engage higher cognitive skills

Guilford, W. H. — Mon, 30 Nov 2009 04:27:12 PST