Physiology Curriculum Research Articles

Standardized patients in physiology curriculum of India for effective learning of basic science concepts, clinical and communication skills: A proposed change

Clinical teachers often complain that medical students have forgotten the knowledge that has been taught at pre-clinical levels at the time of entering the clinical part of education.There has been an almost universal agreement that medical students should spend considerable time studying basic science and that a solid foundation in basic science is necessary pre-requisite for competent clinical practice.

Students’ perspective of the MBBS Physiology curriculum

Introduction: Rapid technological advances and information overload in the medical field calls for a redesigning of the medical curriculum especially in basic sciences. To incorpate change in the curriculum would require experts’ opinion in the area. At the same time, students’ opinion also forms an important basis for any modification. The present study is small one but it is an important step for this field. We have addressed this issue by evaluating students’ perspective of the physiology curriculum with the help of a semi-structured questionnaire. Aims & Objectives: This study was designed to • Obtain the views of students regarding the curriculum of physiology. • Invite suggestions for improvements. Materials & Methods: The study was conducted at Gian Sagar Medical College, Ram Nagar, Patiala, India using a semi-structured questionnaire. The questionnaire was given to 2nd professional MBBS students, were exposed to of basic science for further training. Results & Discussion: Our study has revealed students’ opinion about certain aspects of the existing physiology curriculum. The students emphasized that they wanted to learn only the clinical application oriented subject content and they the preferred interactive teaching methods. Most students felt the need to reemphasize these subjects in later clinical years. Their assessment is the crucial factor on how they would organize their learning. There is a need for modification in the existing curriculum though similar studies over longer duration of time should be conducted in other medical colleges to recommend changes.

Assessing formal teaching of ethics in physiology: an empirical survey, patterns, and recommendations

Ethics should be an important component of physiological education. In this report, we examined to what extent teaching of ethics is formally being incorporated into the physiology curriculum. We carried out an e-mail survey in which we asked the e-mail recipients whether their institution offered a course or lecture on ethics as part of the physiology teaching process at their institution, using the following query: "We are now doing an online survey in which we would like to know whether you offer a course or a lecture on ethics as part of your physiology teaching curriculum." The response rate was 53.3%: we received 104 responses of a total of 195 sent out. Our responses came from 45 countries. While all of our responders confirmed that there was a need for ethics during medical education and scientific training, the degree of inclusion of formal ethics in the physiology curriculum varied widely. Our survey showed that, in most cases (69%), including at our Medical University of Graz, ethics in physiology is not incorporated into the physiology curriculum. Given this result, we suggest specific topics related to ethics and ethical considerations that could be integrated into the physiology curriculum. We present here a template example of a lecture "Teaching Ethics in Physiology" (structure, content, examples, and references), which was based on guidelines and case reports provided by experts in this area (e.g., Benos DJ. Ethics revisited. Adv Physiol Educ 25: 189-190, 2001). This lecture, which we are presently using in Graz, could be used as a base that could lead to greater awareness of important ethical issues in students at an early point in the educational process.

Improving College Students' Success In Gateway Science Courses: Lessons Learned From An Anatomy And Physiology Workshop

In this study, we evaluated the effectiveness of a two-week pre-anatomy and physiology workshop intended to contribute to student success in anatomy and physiology. The study showed that workshop participants had significantly higher post-test scores, better study habits, and generally felt more confident or prepared for anatomy and physiology. The workshop participants also reported that they understood membrane transport the least and organization of the body the most, information that may be useful in anatomy and physiology curriculum development. Preliminary studies also show that students that participated in the workshop performed significantly better than the general student body, with lower attrition rates in anatomy and physiology.

Active physiology learning in a diverse class: an analysis of medical student responses in terms of sex, home language, and self-reported test performance

The student body at the Nelson R. Mandela School of Medicine (NRMSM) is very diverse, representing many cultures, religions, and languages. Research has shown that weakness in English can impact student performance. Recent studies have also highlighted sex-based differences in students' learning and listening styles. These factors pose both challenges and opportunities for teachers of physiology. Student presentations were incorporated for a number of years into the traditional didactic second-year medical physiology curriculum at the NRMSM. Feedback obtained about the perceived benefits of these presentations for the learning of gastrointestinal and endocrine physiology included demographic data pertaining to students' sex, home language, and self-reported performance in tests. Analysis of the 50-item questionnaire responses, obtained over a 2-yr period, provided some interesting insights. Student responses to the items differed significantly in 27 of the 50 items in the questionnaire, based on sex alone (22%), sex and home language (7%), home language alone (37%), performance alone (26%), and performance and home language (7%). Our analyses of student perceptions support the findings of other studies and show that factors such as sex, home language, and student performance can play an important role in the way students are motivated to learn. In designing active learning strategies, academics need to take into account the potential influences that might affect student learning in diverse, multicultural, and multilingual classes.

Active learning by play dough modeling in the medical profession

Learning the nervous system has always been a difficult task for undergraduate students. In particular, the complexity of the system and the condensed time available present a difficult challenge. Regardless of audiovisual aids (blackboard, PowerPoint presentations, ready-made models, or CD-ROMs),

The Physiology undergraduate major in the University of Arizona College of Medicine: past, present, and future

The American Physiological Society (APS) and APS Council encourage the teaching of physiology at the undergraduate, graduate, and medical school levels to support the continued prominence of this area of science. One area identified by the APS Council that is of particular importance for the development of future physiologists (the "physiology pipeline") is the teaching of physiology and physiology-related topics at the undergraduate level. In this article, we describe the historical development and implementation of an undergraduate program offered through the Department of Physiology, a basic science department in the College of Medicine at the University of Arizona, culminating in a Bachelor of Science in Health Sciences degree with a major in Physiology. Moreover, we discuss the current Physiology curriculum offered at our institution and explain how this program prepares our students for successful entry into a variety of postbaccalaureate professional programs, including medical school and numerous other programs in health professions, and in graduate study in the Masters and Doctoral programs in biomedical sciences. Finally, we cover the considerable challenges that we have faced, and continue to face, in developing and sustaining a successful physiology undergraduate major in a college of medicine. We hope that the information provided on the Physiology major offered by the Department of Physiology in the College of Medicine at the University of Arizona will be helpful for individuals at other institutions who may be contemplating the development and implementation of an undergraduate program in Physiology.

Comparative evaluation of active learning and the traditional lectures in physiology: a case study of 200 level medical laboratory students of imo state university, Owerri.

Currently, understanding of physiology and disease patterns is undergoing a fundamental paradigm shift with attendant shift in education of health professionals worldwide towards active learning to encourage exploration of connections and their relationships. We introduced problem-based learning to physiology teaching of medial laboratory students to confirm worldwide reports that active learning environments offer better learning opportunities over the traditional methods which is the predominant teaching method in Nigerian universities. Our findings indicate that problem-based learning increases students' attendance/participation in classes and performance in examination. We recommend the integration of active learning into physiology curriculum of Nigerian Universities.

Use of the APS Medical Physiology Objectives as a foundation for solo teaching of medical physiology

At many small medical schools, one instructor teaches medical physiology alone, including preparation and delivery of up to ten hours of lecture per week. For such day‐to‐day lecture preparation within a systems approach to physiology, the materials provided by the APS Medical Physiology Curriculum Objectives Project (http://www.the‐aps.org/education/MedPhysObj/medcor.htm) are invaluable starting point for direct student use but lacking in organization. For his course, the author compressed and collated many overlapping objectives, both within and between systems, to provide a more general understanding of systems topics. For example, renal objectives R20, R26, and R29 all involve Starling forces at the glomerulus. These were combined and associated with related cell and cardiovascular objectives CE45, CE47, and CV71. Four other objectives, e.g. R22‐23‐24 (CV94‐95), were also integrated within the topic of glomerular filtration. Other examples of this integration will be provided. The author's approach to application of these objectives over an entire course might be of use to others faced with similar challenges.

Using genomics to contemplate microbial physiology

A major objective of a microbial physiology curriculum is to cement a comprehensive understanding of central carbon metabolism (glycolysis/gluconeogenesis, the pentose phosphate pathway, and the citric acid cycle). One way to meet this goal is to have students consider the catabolic and anabolic roles of these pathways in organisms with diverse physiologies (e.g., respiratory heterotrophs; nonrespiratory, fermentative heterotrophs; autotrophs). In MCB4404 Microbial Physiology Lab, we query microbial genome sequences to elucidate the presence and absence of genes encoding enzymes catalyzing steps of central carbon metabolism in a variety of microorganisms. This genome‐level approach exposes students to bioinformatics tools and allows them to test hypotheses for gene presence/absence based on their understanding of microbial physiology. This project is generously supported by the USDA Cooperative State Research and Extension Service: US Department of Agriculture Higher Education Challenge Grants Program.

Understanding data collection in the modern physiology laboratory

IN A RECENT INFLUENTIAL REPORT by the National Research Council (2), the role of the laboratory was introduced as follows: Science courses and the laboratories associated with them should cultivate the ability of students to think independently. They should provide students with exposure to realistic scientific questions and highlight those aspects that are inherently interdisciplinary. They can also provide opportunities for students to learn to work cooperatively in groups. Our role as educators requires that we facilitate the students’ journey toward independent learning in accordance with current standards in science pedagogy, but we must also remain alert as to what students actually learn and how they learn it. The incorporation of digital data-acquisition systems into the human physiology curriculum has provided wonderful opportunities for student-centered investigative activities in the laboratory. With funding from the National Science Foundation (Division of Undergraduate Education Grant 0309546), we equipped our laboratory with eight complete data-acquisition systems (Biopac) to accommodate several small groups of students in the Human Physiology course working together (the class is capped at 16 students). The equipment was easy to set up and has high reliability, two elements that facilitate student learning by removing apprehension regarding their ability to collect and analyze data of high quality. Through these experiences, students gain confidence and are certainly more accepting of the possibility for independent research and discovery. In the experience of this instructor, these systems have successfully transformed the physiology laboratory. Students are now more willing than ever to work cooperatively in designing and carrying out their experiments. In accordance with modern science pedagogy guidelines, they collect, analyze, and present their own data while being careful to interpret their findings using established physiological principles. However, it has become apparent that students seldom gain an understanding of the process by which data are collected. In addition, more often than not, students could not interpret the values on their screen in real time. In other words, they accepted the data generated by these devices at face value without ever questioning the accuracy or application of these values. This realization, unexpected and unpleasant as it may have been, should not have been surprising as, up to that point, there was no place in our curriculum to discuss issues of instrument reliability and validity. The only prerequisite for this course is a semester-long course in Human Anatomy, where the emphasis is on dissection and identification of structure and form. The brief exercise described below is administered during the fifth week of our semester-long, sophomore-level Human Physiology course. By that time, students have become familiar with the data-acquisition systems and have even performed experiments of their own design using the EMG module (which includes a basic calibration). For a complete description of all laboratory activities and objectives, the reader is referred to the course website at www.willamette.

151: Development of a Core Physiology Curriculum for Postgraduate Training in UK Emergency Medicine Using a National Delphi Model

To devise and develop a national consensus-based physiology curriculum for postgraduate training in UK emergency medicine.

It's difficult to change the way we teach: lessons from the Integrative Themes in Physiology curriculum module project

The Integrative Themes in Physiology (ITIP) project was a National Science Foundation-funded collaboration between the American Physiological Society (APS) and the Human Anatomy and Physiology Society (HAPS). The project goal was to create instructional resources that emphasized active learning in undergraduate anatomy and physiology classrooms. The resources (activity modules and professional development) addressed two factors thought to be limiting science education reform: instructors' knowledge of how to implement active learning instruction and time to design innovative curricula. Volunteer instructors with a strong interest in using active learning in their classrooms were recruited to use the ITIP modules and provide ease-of-use feedback and student assessment data. As the study unfolded, instructor attrition was higher than had been anticipated, with 17 of 36 instructors withdrawing. More surprisingly, instructors remaining with the project failed to use the modules and reported specific obstacles that precluded module use, including lack of support from academic leadership, unplanned class size increases and heavy teaching loads, a union strike, insufficient time to develop a mindset for change, inadequate technology/funding, an adverse human subjects ruling, incompatibility of modules with instructors' established content and expectations, and personal factors. Despite the lack of module use and obstacles, 8 of 19 site testers began independently to introduce new active learning instruction into their classrooms. In the larger picture, however, it is important to note that only 8 of the initial 36 volunteers (22%) actually ended up changing their instruction to include opportunities for student active learning. These findings underscore the difficulty of implementing instructional change in college classrooms.

Learning approaches to physiology of undergraduates in an Indian medical school

Inventories monitoring students' learning approaches are widely used in medical education research. It is important that teaching interventions adopted in medical schools aim to develop a deep approach to learning in medical students. To study the changes in medical students' approaches to learning before and after the incorporation of clinically orientated physiology teaching (COPT) in the undergraduate physiology curriculum, using the Short Inventory of Approaches to Learning (SIAL). Medical students (n = 223) at Melaka Manipal Medical College (Manipal Campus) undertake a 9-week learning block of endocrine, reproductive and renal physiology in Year 1. During this period, COPT was incorporated along with regular didactic lectures with the intention of enhancing the use of the deep approach and decreasing the use of the surface and strategic approaches to learning taken by the students. The SIAL, which focuses on the learning approaches of students to physiology, was distributed both before and after COPT. The implementation of COPT seemed to affect the learning approaches of students as measured by the SIAL. After the introduction of COPT, there was a significant increase in the use of the deep learning approach, while the majority of subscales for the surface approach showed decreased use. Nevertheless, use of the strategic approach was found to have increased after COPT. The SIAL was found to be a fairly reliable tool with which to determine the learning approaches of medical students. Clinically orientated physiology teaching was successful in enhancing use of the deep approach to learning and reducing use of the surface approach among undergraduate medical students.

Learning and teaching

Learning and teaching

Evaluating the impact of physical renovation, computerization, and use of an inquiry approach in an undergraduate, allied health human anatomy and physiology lab

This paper describes and evaluates a major renovation of a human anatomy and physiology lab for allied health students. A Howard Hughes Medical Institute award funded an extensive collaboration between faculty involved in teaching the course and faculty with expertise in industrial and furniture design. The resulting physical lab has unique features designed to improve work in groups, student movement, and integration of computers with wet laboratories. The anatomy curriculum was switched from fetal pig dissections to the use of human cadavers, computer animations, and plastic models. An inquiry approach was integrated into the physiology curriculum. Student attitude surveys suggest that the physical and curricular changes resulted in a significant increase in student learning. An experiment designed to specifically test the effect of new vs. old equipment did not support a benefit to new equipment independent of changes in the lab physical environment and curriculum. Because the improvements in student attitude surveys occurred in the physiology but not the anatomy labs, we suggest that at least a portion of the increase is due to the institution of the inquiry approach.

Integrating a primer course in biostatistics into the haematology practicals of first-year medical students in India.

In India, biostatistics in the medical curriculum is usually taught as a separate course, using either "imaginary" data or data from the literature. Knowledge of statistics is particularly important in the context of "evidence-based medicine". To evaluate the efficacy of a biostatistics course integrated into the practical haematology first-year medical course with the following special characteristics: (1) students learn statistics on data generated by and on themselves, (2) the course avoids mathematical computation,(3)the statistical exercises are linked to the learning objectives of the physiology curriculum, and (4) the course is without the threat of university examinations. Statistical exercises were incorporated into specific haematology practicals with the aim of covering simple descriptive and inferential statistics. Statistics tests were administered, without prior information, to 60 first-year medical students before the biostatistics course, immediately following the course, and nine months later. Fifty-four students completed all three evaluations. Students had a poor knowledge of statistics at baseline. They substantially increased their scores in the statistics test immediately following the biostatistics course. These scores remained higher than baseline nine months after completion of the course, although there was a small decline in the absolute scores when compared with scores soon after the biostatistics course. Integrating biostatistics into other subjects in the medical curriculum may be an important addition to "stand alone" courses in biostatistics.

Common misconceptions that arise in the first-year medical physiology curriculum concerning heart failure.

There are a number of misconceptions that first-year medical students have concerning the pathophysiology of heart failure. These stem from 1) a poor definition of heart failure, 2) a lack of care in distinguishing between similar but distinct concepts, and 3) the inability to recognize the relationship between the various stages of heart failure and the clinical manifestation of the disease. In this paper we provide a list of some of the misconceptions that we have encountered, some explanations of the distinctions to be made, and some of the rationale behind current surgical procedures and drug treatment. The misconceptions include failing to differentiate between the Frank-Starling mechanism and cardiac dilation as well as not grasping the significance that changes in cardiac beta-receptor function have in limiting the positive inotropic actions of circulating catecholamines. Finally, we review some of the altered neurohumoral mechanisms in heart failure and explain the basis for some common therapeutic approaches, including the use of angiotensin-converting enzyme inhibitors, in this disease.

Defining the boundaries of physiological understanding: the benchmarks curriculum model.

We set out to develop an anatomy and physiology (A&P) curriculum with a content that was relevant and well rationalized. To do this, we developed a benchmarks curriculum process that helps us to determine what our students need to learn in A&P and then to make sure there is alignment between those learning objectives and what we teach and how we assess our students. Using the benchmarks process, we first set the broad skill and content goals of the course. We then prioritize the topic areas to be covered, allocating the course time accordingly, and declare the learning objectives for each topic. To clarify each learning objective, a set of benchmark statements are written that specify in operational terms what is required to demonstrate mastery. After the benchmarks are written, we assemble the learning activities that help students achieve them and write assessment items to evaluate achievement. We have implemented the curriculum in a relational database that allows us to specify the numerous links that exist between its different elements. In the future, the benchmarks model will be used for ongoing A&P curriculum development with geographically distributed contributors accessing it via the World Wide Web. This mechanism will allow for the continuing evolution of the A&P curriculum.

Pulmonary circulation demonstration using an isolated rat lung model.

We have developed a pulmonary circulation laboratory exercise that effectively illustrates basic concepts typically taught in a graduate physiology curriculum. The demonstration uses an isolated, perfused rat lung model to delineate the mechanisms by which pulmonary vascular resistance can be altered either passively or in an active manner by contraction or relaxation of vascular smooth muscle. The exercise further offers an opportunity to closely observe an experimental preparation commonly used to study the pulmonary circulation and allows students the opportunity to interpret the resulting physiological data. Student evaluations indicate that the demonstration was received with enthusiasm and provides an effective teaching tool for reinforcing concepts in pulmonary vascular physiology.