Showing papers in "Advances in Physiology Education in 1998"
TL;DR: 3 undergraduates in three different research universities were asked to predict the changes in heart rate and strength of cardiac contraction and breathing frequency and depth of breathing under conditions that result in predicted that heart rate would increase but that the strength of contraction would decrease or stay unchanged.
Abstract: Students' misconceptions about scientific phenomena can arise from at least two possible sources, the students' personal experience with those phenomena and things learned in the classroom. Misconc...
76 citations
TL;DR: Go GI and GI Rummy were developed to assist students in the understanding of GI physiology and were designed to function as a tool for learning lecture material.
Abstract: In the last few years, there has been an emphasis on the development of creative educational materials that supplement the traditional lecture format. The new materials should engage students in in...
67 citations
TL;DR: This report describes a two-semester PBL sequence in organ-systems physiology that aims for students to learn and be able to apply the disciplinary content, develop critical thinking abilities, and acquire skills of life-long learning, communication, and team building.
Abstract: In small-group problem-based learning (PBL), students work cooperatively to solve complex, real-world problems. The problems lead the students to learn basic concepts rather than being presented as applications of concepts they have already learned. The goals are for students to learn and be able to apply the disciplinary content, develop critical thinking abilities, and acquire skills of life-long learning, communication, and team building. PBL has been widely used in recent years in medical and related areas of professional education. In those settings each small group typically has its own faculty facilitator. PBL can be successfully adapted for teaching undergraduate and graduate basic science students, in part by having multiple groups meet in one room with a roving facilitator. This report describes a two-semester PBL sequence in organ-systems physiology. To keep the interest of a diverse group of seniors and graduate students, several types of problems were used: clinical, laboratory research-based, real-life scenarios, and published research articles. The majority of students have responded enthusiastically.
49 citations
TL;DR: Teaching Ca21 and phosphate homeostasis in a physiology survey course for medical or graduate students is done very effectively with an integrated approach.
Abstract: Teaching Ca21 and phosphate homeostasis in a physiology survey course for medical or graduate students is done very effectively with an integrated approach. The material can be taught in the endocrine section of the course, where the renal and gastrointestinal (GI) handling of Ca21 and phosphate and bone remodeling can be linked under the umbrella of teaching parathyroid hormone (PTH), vitamin D, and calcitonin. This allows one teacher to pull the whole story together (and it really does hang together!).
35 citations
TL;DR: Beginning the renal physiology section with a detailed consideration of renal microvascular dynamics allows a smooth transition from cardiovascular-related topics to kidney- related topics and requires a very discriminating selection of specific topics.
Abstract: Beginning the renal physiology section with a detailed consideration of renal microvascular dynamics allows a smooth transition from cardiovascular-related topics to kidney-related topics. In addition, reductions in renal blood flow (RBF) and glomerular filtration rate (GFR) are often associated with many pathophysiological conditions including hypertension, renal failure, heart failure, and diabetes, and it is essential for the student to obtain a solid foundation regarding the principal mechanisms regulating renal hemodynamics. The following learning objectives provide a clear guide for the student. 1) Be able to define and calculate the renal fraction of the cardiac output and the factors that influence it. 2) Know the average values for RBF and GFR in adult humans. 3) Be able to define and calculate the filtration fraction. 4) Know the major sites of renal vascular resistance and describe the hydrostatic pressure profile along the renal vasculature. 5) Describe the roles of hydrostatic and colloid osmotic pressures in regulating glomerular and peritubular capillary dynamics. 6) Explain in a quantitative manner the determinants of GFR and how these are regulated. 7) Identify the extrinsic, neural, and hormonal systems that regulate renal hemodynamics. 8) Describe the roles of the major paracrine systems that participate in the intrinsic control of renal vascular resistance. 9) Define the phenomenon of renal autoregulation and describe the myogenic mechanism and the tubuloglomerular feedback mechanism in mediating autoregulatory behavior. It is not possible to discuss all these learning objectives in the present article. Consequently, attention has been focused on those aspects that are conceptually more difficult or that cause confusion among the students. In particular, the recent recognition of multiple humoral and paracrine factors regulating renal microvascular dynamics requires a very discriminating selection of specific topics.
27 citations
TL;DR: The renin-angiotensin system is of considerable interest from the historical point of view because it continues to be a major field of biomedical research.
Abstract: I have lectured on the renin-angiotensin system for many years to medical, pharmacy, and other professional and graduate students. I find it to be a most worthwhile and satisfying subject to teach, mainly because there is so much that is relevant in the areas of physiology, pathophysiology, and pharmacology. The renin-angiotensin system is also of interest because it continues to be a major field of biomedical research. Finally, it is of considerable interest from the historical point of view.
26 citations
TL;DR: The approach is described, which begins with an overview of acid-base balance and then proceeds to describe the details of renal H1 transport and the important role the production and excretion of NH 4 plays in the ability of the kidneys to generate new HCO 3.
Abstract: This article reviews the role of the kidneys in the regulation of acid-base balance. It is intended as a guide for those who teach this aspect of renal physiology to health professions students. An approach is described, which begins with an overview of acid-base balance and then proceeds to describe the details of renal H1 transport and the important role the production and excretion of NH 4 plays in the ability of the kidneys to generate new HCO 3 . In the overview, the role of the kidneys in acid-base balance is placed in context for the student by examining the impact of diet and cellular metabolism on acid-base balance. Also, the interactions between the kidneys and lungs to maintain extracellular HCO 3 concentration within a narrow range are described. This is followed by a detailed look at the cellular mechanisms of H1 secretion along the nephron, how these mechanisms are regulated, and how they result in the reabsorption of the filtered load of HCO 3 . Finally, the important role of NH 4 production and excretion in the generation of new HCO 3 is reviewed and highlighted.
24 citations
TL;DR: In the described exercise, students are assigned a current study and then write three two-page critiques of the article, and in using this method students also gain an appreciation for the difficulty of judging the merit of a peer's work.
Abstract: Students often have difficulty grasping the advantages of the various peer review systems used in scientific publishing. In the described exercise, students are assigned a current study and then wr...
19 citations
TL;DR: The discipline of physiology is challenging to teach because it has ill-defined boundaries and no agreed sequence for learning; students' needs depend on the goals of the specific degree programs in which they are enrolled.
Abstract: The discipline of physiology is challenging to teach. It has ill-defined boundaries and no agreed sequence for learning; students' needs depend on the goals of the specific degree programs in which...
16 citations
TL;DR: Student-centered problem-based learning has been implemented as an alternative curriculum by several medical schools in the United States and elsewhere, but attempts to integrate PBL with lecture-based curricula have created "hybrid" curricula with varying amounts of the philosophical underpinnings of student-centered PBL.
Abstract: Student-centered problem-based learning (PBL) has been implemented as an alternative curriculum by several medical schools in the United States and elsewhere. Recently, attempts to integrate PBL with lecture-based curricula have created "hybrid" curricula with varying amounts of the philosophical underpinnings of student-centered PBL. Greater clinical and research demands on faculty time threaten to diminish the use of PBL in existing curricula, whereas opportunities for expansion of PBL in medical education are being created by community-based and interdisciplinary education programs.
15 citations
TL;DR: An inexpensive laboratory experience that introduces students to the scientific process by investigating the physiological concepts of muscle biomechanics using only supplies that can be found at any school.
Abstract: Many students have limited opportunities to develop scientific expertise. This is caused, in part, by the scarcity of scientific educational materials and the expense of supplies and equipment. To address these concerns, we developed an inexpensive laboratory experience that introduces students to the scientific process. Our objective was to create an interactive experiment that requires minimal equipment. To this end, we created an exercise that examines muscle biomechanics. The students conduct a hands-on experiment as researchers and as subjects by investigating the physiological concepts of muscle biomechanics using only supplies that can be found at any school. Questions are interspersed throughout the text to highlight key principles and challenge student thinking on the important concepts. This exercise not only provides an opportunity for students to interact and discuss the important physiological principles but also provides a window through which students may see a future in science.
TL;DR: The impact of legislation against animal experimentation in the United Kingdom, which was replaced in 1986, on the teaching of practical physiology to undergraduate students is reviewed.
Abstract: Animal experimentation has been subject to legislative control in the United Kingdom since 1876. This paper reviews the impact of that legislation, which was replaced in 1986, on the teaching of practical physiology to undergraduate students. Highlights and case studies are also presented, drawing on Government reports and statistics, published books and papers, and unpublished archival data.
TL;DR: The ability of the kidneys to regulate extracellular fluid volume by altering sodium excretion by integrating physical, neural, and hormonal regulatory systems is important for maintaining adequate volume within the vascular system.
Abstract: The ability of the kidneys to regulate extracellular fluid volume by altering sodium excretion is important for maintaining adequate volume within the vascular system. Sodium excretion is controlled by integrating physical, neural, and hormonal regulatory systems. The major systems involved in retaining sodium include the renin-angiotensin-aldosterone and sympathetic systems, whereas natriuretic factors such as atrial natriuretic peptide and nitric oxide are important in promoting sodium excretion. In response to increased sodium intake, the sodium-retaining systems are inhibited and natriuretic hormones are activated. Pressures and flows within the microcirculation of the kidney, in concert with neural and hormonal systems, interact to regulate sodium excretion. The quantitative importance of each of these systems in regulating sodium balance is variable and is determined by the physiological or pathiophysiological condition.
TL;DR: This paper deals with the teaching of various unrelated topics found to be difficult to teach or likely not to be covered at all because of the way that the presentation of renal physiology is usually organized.
Abstract: This paper deals with the teaching of various unrelated topics. Several I have found to be difficult to teach or likely not to be covered at all because of the way that our presentation of renal physiology is usually organized. Several have been chosen to raise questions about how (and what) to teach at this time of unprecedented explosion of knowledge. The general topics chosen for review are 1) interactions of systems controlling the excretion of specific substances; 2) how vasoactive substances lower or raise glomerular filtration rate (GFR); 3) urea and urine concentration; and 4) feedbacks and bottom lines: ‘‘So what really happens?’’
TL;DR: A novel student course in membrane physiology in which students record their own nasal potential difference, i.e., the transepithelial potential difference of the respiratory mucosa in the nose, which monitors directly, and in vivo, changes in the apical cell membrane potential of the lungs induced by activators and inhibitors of ion channel activities.
Abstract: We describe a novel student course in membrane physiology in which students record their own nasal potential difference, i.e., the transepithelial potential difference of the respiratory mucosa in the nose. The nasal potential difference monitors directly, and in vivo, changes in the apical cell membrane potential of the respiratory mucosa induced by activators and inhibitors of ion channel activities. Basic principles of transepithelial fluid transport are taught by applying an appropriate perfusion protocol to the respiratory epithelium to either depolarize or hyperpolarize the membrane potential of the luminal cell side, thereby increasing or decreasing the nasal potential difference. This course was given at the Department of Physiology at the University of Wurzburg in 1997, and responses of the students as reported on questionnaires were mainly positive.
TL;DR: In an effort to teach the volume of material needed by physiology students as well as to enhance the student's understanding of physiological mechanisms, a combination of teaching methods is being used at the undergraduate level.
Abstract: In an effort to teach the volume of material needed by physiology students as well as to enhance the student’s understanding of physiological mechanisms, a combination of teaching methods is being used at the undergraduate level. Didactic lectures are used to convey the mass of information needed, experimental labs are used to aid the student in visualizing concepts, and situational labs [called round table labs (RTLs) here] are used to provide an opportunity for the student to learn, in a risk-free setting, how to answer application questions. The RTLs utilize discussion, writing, verbal communication, and analytic thinking. The major emphasis of the RTLs is on the integrative nature of physiology. Use of the RTLs bridges the gap among the facts learned in the didactic lecture, the hands-on learning of the experimental lab, and the need to be able to apply what is being learned. Using this combination facilitates student learning such that the student reaches a level of proficiency with the subject beyond that which can be attained with the more traditional lecture-exam format.
TL;DR: In my own lectures and discussions of renal ion and water transport systems, I try to avoid complex and detailed areas that are not essential to a basic understanding of renal function, and highlight the commonalities of transport processes among segments.
Abstract: T he teaching of renal physiology is an ever-evolving and fascinating opportunity to learn as well as to teach. Regardless of the particular format of our teaching, a constantly waxing tide of detailed information forces us to be selective. We cannot teach it all. In my own lectures and discussions of renal ion and water transport systems, I try to 1) avoid complex and detailed areas that are not essential to a basic understanding of renal function, 2) highlight the commonalities of transport processes among segments, 3) relate the details of transporters to clinical conditions that are especially interesting, 4) make connections between physiological details and clinical therapy, and 5) stress quantitative problems. Although generally simple, the quantitative understanding is essential to appreciate the role of the kidney in homeostasis and derangements thereof. When I review what I have taught, I try to integrate multiple basic mechanisms in individual segments to produce a picture of ‘‘whole kidney’’ function.
TL;DR: A benchmarks curriculum process is developed that helps to determine what students need to learn in A&P and then to make sure there is alignment between those learning objectives and what the authors teach and how they assess their students.
Abstract: 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.
TL;DR: The objectives are to impart an enthusiasm for learning together with an improved capacity to understand concepts and the ability to solve problems in clinical medicine, relying heavily on the deductive capacities of the student.
Abstract: The virtual explosion in the amount of biomedical information, the switch away from a lecture-based style of teaching, and the perception that more of the student’s time should be directed to patient-oriented activities have created an intense competition for time in the undergraduate medical curriculum. Our objectives are to impart an enthusiasm for learning together with an improved capacity to understand concepts and the ability to solve problems in clinical medicine. We rely heavily on the deductive capacities of the student. We shall emphasize horizontal (basic) and vertical (clinical) integration of disciplines that relate energy metabolism with fluid, electrolyte, and acid-base balances. The setting in which we begin to define a problem is in ‘‘Paleolithic times’’ because this is when metabolic control systems evolved and were most likely to be retained. Students are asked to deduce the best possible solutions for that problem, to ask for data to test their hypotheses, and to consider the ramifications of that solution in integrative terms. Subject matter is presented by informed leaders in either a small or large group format initially to set the stage. An interactive computer program was written as a supplement to demonstrate how we would utilize the information and concepts to design an element for teaching. The implications are that controls that were designed for primitive needs may lead to disorders in modern times because the current stimuli and needs are different. The power of the student’s growing ability to solve problems should be reinforced by demonstrating the degree to which the properties deduced by the student to solve a particular problem are actually consistent with data from the literature.
TL;DR: To be effective, the focus on instruction must start with the learner and, from there, consider what should be done to enhance learning, and an emphasis on what is technologically appropriate, rather than what is technically possible, will improve the quality of both teaching and learning.
Abstract: There are at least three areas in which technology can impact education: teaching, learning, and assessment. Teaching, when viewed as communication of information, has been transformed by the technology revolution. Word processing, multimedia, distance learning, and access to the World Wide Web are some prominent examples. The impact of technology on learning, defined as knowledge or skill acquired by instruction or study, has been less dramatic, in part because of our limited understanding of cognitive processes. Some forms of assessment, the collection of evidence of learning, have benefited from technology, such as item analysis of multiple-choice questions. To be effective, the focus on instruction must start with the learner and, from there, consider what should be done to enhance learning. An emphasis on what is technologically appropriate, rather than what is technologically possible, will improve the quality of both teaching and learning.
TL;DR: The monograph differed from the generality of physiological texts in which the systems are considered, for the most part, independently of each other in that its primary object was not to convey information but to assist thinking about known physiological processes.
Abstract: He was approaching physiology from an unusual angle, ‘‘not from that of mere structure, whether the structure of organs or of chemical formulae, but from the principles of function.’’ In that way, the monograph differed from the generality of physiological texts in which the systems are considered, for the most part, independently of each other. It differed also in that its primary object was not to convey information but to assist thinking about known physiological processes. To do this, the circle must be completed by using information obtained from experiments. In this case the experiments were often Barcroft’s own. The reader therefore gathers information and thinks about interacting processes at one and the same time. Barcroft did not make any theoretical fuss about any of this, regarding it as the obvious way to proceed.
TL;DR: A series of strategies/tools designed to both optimize conceptual understanding and translate concepts to clinical practice are developed, requiring an enthusiastic and well-prepared faculty committed to a high level of consistency.
Abstract: W hen one is teaching students who are new to concepts of body fluid and electrolyte regulation, a major challenge is to convey the separate but interactive nature of the two systems that respectively regulate extracellular fluid (ECF) volume/Na content and total body fluid osmolarity/water. We have developed a series of strategies/tools designed to both optimize conceptual understanding and translate concepts to clinical practice. These include 1) clear delineation of the distinct differences between the two homeostatic systems, reinforced in instructional objectives, lectures, and small group sessions; 2) anticipation and direct confrontation of the common ‘‘Na content 5 Na concentration’’ error, soliciting student participation in ousting this misconception; 3) modification of terminology to clarify body fluid reality; 4) facilitation of active problem-based learning in small group sessions focused on clinical cases of increasing complexity (50% of course hours); 5) use of whole body/single-eyeful graphics to convey essential details within a clinically meaningful context; 6) standardization of diagnostic algorithms and pathophysiological graphs across lecturers and course components; and 7) provision of hands-on instruction/practice in physical examination of ECF volume in parallel with conceptual learning, thus emphasizing the importance of the bedside exam in detecting disorders of ECF volume/Na content. These approaches require an enthusiastic and well-prepared faculty committed to a high level of consistency and are designed for second-year students with a solid basic science background.
TL;DR: In this article, the basic mechanisms of urinary concentration and dilution and a presentation of some useful teaching aides are discussed, as well as common student questions are also discussed, and an educational philosophy synopsis is provided.
Abstract: Unless one is teaching the mechanisms of urinary concentration and dilution to medical students or graduate students, it is best to stay away from countercurrent multiplication mechanisms and concentrate more on the physiological results. When one is teaching medical or graduate students, an overview of the basic countercurrent multiplication and exchange mechanisms is important, because it provides a conceptual foundation for an understanding of water balance. In order not to lose the forest for the trees, teaching aides including demonstrations, relevant clinical examples, contemporary cellular and molecular findings, and a little comparative physiology can be mixed in with traditional educational approaches. In this paper, the teaching of urinary concentration and dilution is first addressed by an educational philosophy synopsis, followed by an outline of the basic mechanisms of urinary concentration and dilution and a presentation of some useful teaching aides. Common student questions are also discussed. This material can be wonderfully fun to teach and is extremely important. The danger is in getting bogged down in explanations involving overly complex mechanisms.
TL;DR: The use of venipuncture and subsequent blood analysis is described, with medical students serving as both subjects and experimenters, in a sequence of first-year physiology laboratories, which teach the principles of cardiovascular, respiratory, renal, nutritional, and gastrointestinal physiology.
Abstract: Medical physiology laboratories, traditionally devoted to animal experimentation, face unprecedented difficulties linked to cost, staffing, instrumentation, and the use of animals. At the same time, laboratory experiences with living creatures play a unique role in medical education. In this article we describe the use of venipuncture and subsequent blood analysis, with medical students serving as both subjects and experimenters, in a sequence of first-year physiology laboratories. These experiments are safe, robust, inexpensive, and time efficient, and they teach the principles of cardiovascular, respiratory, renal, nutritional, and gastrointestinal physiology. In addition, they enhance medical education in several other important dimensions. First, they teach safe venous blood collection and handling, a training appropriate for students at this level. Second, by serving each week as subjects as well as experimenters, students experience aspects of both sides of the doctor-patient relationship. Third, the laboratories can be used to teach fundamentals of research design and analysis. Finally, because blood analysis is central to medicine, and because the student's own blood data are discussed, students are enthusiastic and cooperative, and the clinical relevance of the data is clear.
TL;DR: An extensive field test of the MILES system has been applied as a common source for all kinds of materials used in teaching physiology to students of medicine, showing that the "new media" are powerful instruments for improving teaching and learning.
Abstract: A teaching-oriented multimedia database authoring system, MILES ( Multimediales Informations- und Lehrsystem), has been in development since 1980 in our department. The hardware consists of a network of personal computers connected to digital and, until recently, audio/video storage devices. The system provides a database capable of handling all kinds of multimedia data and computer programs. User-friendly software provides input, editing, retrieval, and communication; the authoring system allows these components to be organized into structures of complex menus, combined with free database access. More than 12,000 components have been stored, including approximately 3,500 pictures. The paper reports on an extensive field test, in which the system has been applied as a common source for all kinds of materials used in teaching physiology to students of medicine. ResuIts show that the "new media" are powerful instruments for improving teaching and learning. However, they should not be expected to provide the sole basis for education. Their application still faces many problems regarding concepts, efficiency, and acceptance by students and staff.
TL;DR: Then I thought of another answer almost as facetious as the first, that many textbooks of medical physiology had become very discursive, written primarily by teachers of physiology for other teachers of biology and written in language understood by other teachers but not easily understood by the basic student ofmedical physiology.
Abstract: Then I thought of another answer almost as facetious as the first. This was that many textbooks of medical physiology had become very discursive, written primarily by teachers of physiology for other teachers of physiology, and written in language understood by other teachers but not easily understood by the basic student of medical physiology. This, I am afraid, is a failing of all of us in medical teaching. But, here again, I truly did not think of this at all when I began writing my own textbook of medical physiology.
Journal Article•
TL;DR: In 1919 Dr. Bernardo A. Houssay (later Nobel laureate) was appointed full-time Professor of Physiology in the School of Medicine at the University of Buenos Aires and argued that, in physiology, teaching and research should be associated.
Abstract: In 1919 Dr. Bernardo A. Houssay (later Nobel laureate) was appointed full-time Professor of Physiology in the School of Medicine at the University of Buenos Aires. Soon after his appointment he obtained full-time positions for some of his colleagues also. He argued that, in physiology, teaching and research should be associated. At this same time, laboratory work, with active participation by students, was added to a curriculum previously based entirely on formal, hourlong lectures given two or three times a week—a program that had allowed little active student participation. In the new curriculum selected students from each class were placed under the supervision of full-time faculty to carry out intensive laboratory procedures. Undergraduate and graduate students were encouraged to initiate research programs with the intention of providing, in due course, teachers and investigators for the future—in clinical as well as preclinical areas.
TL;DR: In this paper, the authors make the connections between good teaching and good testing, and make the connection between the two in the context of renal physiology, which is ideal for a discussion of these issues because of its inherent demand for problem solving and quantification.
Abstract: Making the connections between good teaching and good testing can be tricky. How, as faculty, do we complete the cycle of good teaching by testing our students fairly? How do we challenge the students to demonstrate what they have learned and, at the same time, evaluate them for purposes of grading? How do we ensure that they have learned what is important? The teaching and testing of renal physiology is ideal for a discussion of these issues because of its inherent demand for problem-solving and quantitation.
TL;DR: Results indicated that, whereas a significant number of undergraduate students are enrolled in prebaccaluareate physiology courses annually, those courses appear to lack formal, consistent formative evaluation.
Abstract: Two surveys were conducted between 1994 and 1996. The purpose of the initial survey was to obtain demographic information about prebaccaulareate human physiology courses. Of the 117 responding physiology departments, 50% offered human physiology at the prebaccalaureate level to 14,185 students during the 1994-1995 academic year. The mean was 245 students per year (+/- 30 SE). Class size was limited by 44% of the respondents. Prebaccaluareate human physiology was offered as a separate course from anatomy by 93% of the departments. Sixty-one percent scheduled the course once a year. The purpose of the second survey was to determine how physiology departments evaluated prebaccalaureate physiology courses and faculty. All responding departments utilized student feedback; 38% of the departments included physiology chair review, 38% peer review, and 9% allied health faculty review. Twenty-eight percent of allied health programs evaluated the course. Results indicated that, whereas a significant number of undergraduate students are enrolled in prebaccaluareate physiology courses annually, those courses appear to lack formal, consistent formative evaluation.