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The movement of air into and out of the lungs is facilitated by changes in pressure within the thoracic cavity relative to atmospheric pressure, as well as the resistance encountered by airways. In this process, the movement of air into and out of the lungs is driven by pressure gradients established by changes in lung volume and intra-alveolar pressure. However, pressure never sucks! The concept that pressure never sucks, pressure only pushes encapsulates a fundamental principle in the behavior of gases. This concept challenges common misconceptions about pressure, shedding light on the dynamic forces that govern the movement of gases. In this Illumination, we explore the essence of this concept and its applications in pulmonary ventilation. Pressure is one of the most important concepts in physics and physiology. Atmospheric pressure at sea level is equal to 1 atmosphere or around 101,325 Pascal [Pa (1 Pa ¼ 1 N/m[superscript 2])]. This huge pressure is pushing down on everything all the time. However, this pressure is difficult to understand because we do not often observe the power of this incredible force. We used five readily available, simple, and inexpensive demonstrations to introduce the physics and power of pressure. This extraordinarily complex physics concept was approached in a straightforward and inexpensive manner while still providing an understanding of the fundamental concepts. These simple demonstrations introduced basic concepts and addressed common misconceptions about pressure.

Laboratory practicals in life science subjects are traditionally assessed by written reports that reflect disciplinary norms for documenting experimental activities. However, the exclusive application of this assessment has the potential to engage only a narrow range of competencies. In this study, we explored how multiple modes of laboratory assessment might affect student perceptions of learned skills in a life science module. We hypothesized that while a mixture of assessments may not impact student summative performance, it might positively influence student perceptions of different skills that varied assessments allowed them to practice. This was informed by universal design for learning and teaching for understanding frameworks. In our study, in a third-year Bioscience program, written reports were complemented with group presentations and online quizzes via Moodle. Anonymous surveys evaluated whether this expanded portfolio of assessments promoted awareness of, and engagement with, a broader range of practical competencies. Aspects that influenced student preferences in assessment mode included time limitations, time investment, ability to practice new skills, links with lecture material, and experience of assessment anxiety. In particular, presentations were highlighted as promoting collaboration and communication and the quiz as an effective means of diversifying assessment schedules. A key takeaway from students was that while reports were important, an overreliance on them was detrimental. This study suggests that undergraduate life science students can benefit significantly from a holistic assessment strategy that complements reports with performance-based approaches that incorporate broader competencies and allow for greater student engagement and expression in undergraduate modules.

The traditional case study has been used as a learning tool for the past 100 years, and in our program, graduate physiology students are presented with a real-world scenario and must determine the diagnosis and treatment of the patient. We found that students defaulted to memorization of disease with treatment and bypassed gaining an understanding of the mechanistic physiology behind disease and treatment. To adjust our student's approach, we developed a novel way to enhance student learning. To accomplish this shift from memorization to physiological mastery, we created the Inverted Case Study. This approach diverges from the traditional model in that students are given the diagnosis and treatment beforehand and are tasked with explaining the actual physiology of the case. In this way, students can no longer rely on the memorization of symptoms-disease-treatment but rather gain a solid understanding of the physiological mechanisms of the disease since that is the focus of the Inverted Case Study Technique. The Inverted Case Study approach is an effective approach to apply and hone critical thinking skills.

Student engagement while learning a new, unfamiliar vocabulary is challenging in health science courses. A group role-play activity was created to teach students medical terminology and learn why its correct usage is important. This activity brought engagement and relevance to a topic traditionally taught through lecture and rote memorization and led to the development of an undergraduate and a stand-alone introductory course to teach students medical terminology. The undergraduate course was designed to be a fully online medical terminology course for health science students and a face-to-face course for first-year dental students founded in active learning and group work. The course's centerpiece learning activity focused on using published case studies with role-play. In this group activity, students are challenged to interpret a published patient case study as one of the members of a healthcare team. This course models the group work inherent in modern health care to practice building community and practicing professional skills. This approach gives students the capacity to work asynchronously in a team-based approach using our learning management system's wiki tool and requires students to take responsibility for their learning and group dynamics. Students practice identification, writing, analyzing, and speaking medical terms while rotating through the roles. Students in both classes self-reported a 92% to 99% strong or somewhat agreement using a five-point Likert scale that the course pedagogy was valued and helpful in their learning of medical terminology. Overall, this method has proven to be an engaging way for students to learn medical terminology.

Much of the research on science, technology, engineering, and mathematics (STEM) students' motivation measures the relationship between student motivation and academic outcomes, focusing on the student's mindset. Our mixed-methods research takes a different approach and considers the relationship between student motivation and instructional practices. Teaching practices and student motivation were analyzed simultaneously in undergraduate Biology classes using a self-determination theory-based survey to measure students' motivation during courses that were observed using the Classroom Observation Protocol for Undergraduate STEM (COPUS), and observation notes were collected to document instructor and student behaviors. Quantitative data were used to differentiate students' motivational levels, and qualitative data were collected to describe how instructors use specific teaching practices. The results provide a lens into how students' intrinsic motivation varies alongside the instructional practices and interactions in these classes. We found a correlation between higher levels of student motivation in interactive lectures and student-centered teaching profiles. This study highlights how the same practice can be implemented by multiple instructors with varying student motivation scores, pointing out the importance of fidelity to evidence-based instructional practice methods. The results of this study are discussed in the context of published empirical studies examining evidence-based instructional practices that are conceptually supportive of autonomy, competence, and relatedness. Active learning practices observed in this study correlated to positive learning outcomes are discussed and may serve as a guide for instructors interested in implementing specific active learning practices. Recommendations for instructors and departments that are interested in flexible methods to monitor progress toward active learning practices in biology and other STEM disciplines by combining the COPUS and self-determination survey results are presented.

First-year medical students are often challenged by the rapid pace and large volume of content that must be learned. Peer teaching has emerged as a supportive educational strategy. However, the most effective strategies for training peer tutors (PTs) for their role are not known. This paper examines the use of an Objective Structured Teaching Exercise (OSTE) to augment PT training sessions. Applying deliberate practice as a conceptual framework, an OSTE was used to provide tutors with an opportunity to practice their skills and receive feedback about their performance when meeting with a student presenting with a challenge. The newly trained PTs were required to assess a standardized student, determine challenge(s) being experienced, and present options to address the challenge(s). Standardized students evaluated the tutors' performance and a pre- and post-OSTE questionnaire was used to determine whether the OSTE was effective in increasing the confidence level of PTs to effectively assess and support students seeking help. Participants reported an increase in confidence in their ability to assess areas requiring improvement, understand the active learning strategies, and suggest appropriate active learning study strategies. Evaluations completed by standardized students documented that newly trained PTs accurately diagnosed the challenge presented in the OSTE and in most cases PTs asked all relevant questions to assess. Increased self-efficacy promotes PT's capacity to perform their work and feedback during an OSTE can further advance required skills. Aggregate OSTE results can also inform efforts to enhance the PT training program.

Endocrine physiology is a complex subject for students. Game-based learning (GBL) and case-based learning (CBL) are active methodologies that are widely used because of their potential for motivation and greater proximity to the reality of modern students. We evaluated the effectiveness of GBL and CBL among veterinary medicine students compared with a control group using peer tutoring. Students (n = 106) from two institutions volunteered to participate in this study. The participants were submitted to a pretest questionnaire and subsequently were divided into three paired groups by their performance on the pretest exam: (1) traditional class + peer tutoring, (2) traditional class + GBL, and (3) traditional class + CBL. After the students completed the activities, their performance was once again evaluated by applying a new test with the same initial 10 questions and another set of 10 different questions. The students' perceptions and satisfaction with the methodologies and learning strategies were assessed. Anxiety was assessed with the State-Trait Anxiety Inventory before and after the conventional class and after the active methodologies. The GBL group significantly improved their correct answers compared with the baseline (P < 0.05), with no significant difference from CBL and peer tutoring. Anxiety levels did not differ regardless of the time of evaluation or the teaching methodology applied. GBL promoted a greater perception of the stimulus for self-study and problem-solving ability and contributed to the development of group dynamics compared with the group who received CBL (P < 0.05). In conclusion, GBL showed better results than peer tutoring and CBL.

Diving into the realm of game-based learning, the "CARBGAME" (CARd & Board GAmes in Medical Education) is an innovative series of games that reimagines the way medical students learn complex but essential chapters. In the pilot study, there was a highly significant improvement in the academic performance of students in the chapter "Vitamins." All the students perceived CARBGAME to be highly rewarding in terms of creating engaging and meaningful learning experiences. Recognizing the benefit of games in medical education, we strongly recommend the implementation of CARBGAME for essential topics in physiology education to create a more dynamic and engaging learning environment for students.

Medical graduates are expected to apply scientific principles and explain the processes underlying common and important diseases. Evidence shows that integrated medical curricula, which deliver biomedical science within the context of clinical cases, facilitate student learning in preparation for practice. However, research has also shown that the student's perception of their knowledge can be lower in integrated compared to traditional courses. Thus the development of teaching methods to support both integrated learning and build student confidence in clinical reasoning is a priority. In this study, we describe the use of an audience response system to support active learning in large classes. Sessions, delivered by medical faculty from both academic and clinical backgrounds, were designed to build on the knowledge of the respiratory system in both health and disease through the interpretation of clinical cases. Results showed that student engagement was high throughout the session and students strongly agreed that the application of knowledge to real-life cases was a better way to understand clinical reasoning. Qualitative free text comments revealed that students liked the link between theory and practice and the active, integrated method of learning. In summary, this study describes a relatively simple but highly effective way of delivering integrated medical science teaching, in this case respiratory medicine, to improve student confidence in clinical reasoning. This educational approach was applied within the early years of the curriculum in preparation for teaching within a hospital setting, but the format could be applied across many different settings.

This study assessed the impact of an "active learning" strategy employed alone or in combination with traditional lectures on the learning of mammalian physiology by undergraduate students. The study investigated the impact of three teaching strategies, namely (1) traditional lecture, (2) group discussion alone, and (3) combination of lecture and group discussion. For all strategies, students were given homework in a textbook and they completed written assignments before each session. Every student led the discussion of at least one assigned theme during each group session. The students had no access to the textbook or notes during group discussions. Four examinations (3 in-semester and a final) assessed the students' knowledge of fundamental concepts of physiology of specific organ systems. Part of the final examination reassessed knowledge of previously tested topics. The results show that the teaching modality employed to introduce physiology topics influenced students' learning. The average marginal effect of the lecture þ discussion modality (average improvement linked to lecture þ discussion strategy) on students' performance was 6.45% [95% confidence interval (CI[subscript 95]) (4.73, 8.16), P = 1.74 10[superscript -13]], and the average improvement associated with the discussion-only modality was 5.5% [CI[subscript 95] (3.84, 7.16), P = 7.84 10[superscript -11]]. On average, all class ranks performed better on materials covered under active learning settings than under lecture-only conditions. Moreover, students' performance under combined lecture and discussion conditions is predictive of their overall performance in the course. The results support the positive effect of student-centered learning and demonstrate the efficacy of a combination of lectures and group discussions on learning of physiology by nonmajor students.

The development of science writing and presentation skills is necessary for a successful science career. Too often these skills are not included in pre- or postsecondary science, technology, engineering, and mathematics (STEM) education, leading to a disconnect between high schoolers' expectations for college preparedness and the skills needed to succeed in college. The Young Scientist Program Summer Focus recruits high school students from historically marginalized backgrounds to participate in 8-week summer internships at Washington University in St. Louis. Students conduct hands-on biomedical research projects under the mentorship of Washington University scientists (graduate students, postdoctorates, lab staff). Here, we present the curriculum for a science communication course that accompanies this early research experience. The course is designed to strengthen students' communication skills (critical reading, writing, presenting, and peer review) through a combination of weekly lectures and active learning methods. It prepares students for the capstone of their summer internship: writing a scientific paper and presenting their results at a closing symposium. We administered pre- and postprogram surveys to four Summer Focus cohorts to determine whether the course met its learning objectives. We found significant improvements in students' self-confidence in reading, interpreting, and communicating scientific data. Thus, this course provides a successful model for introducing science literacy and communication skills that are necessary for any career in STEM. We provide a detailed outline of the course structure and content so that this training can be incorporated into any undergraduate and graduate research programs.

Physiologically based pharmacokinetic (PBPK) modeling requires an understanding of chemical, physiologic, and pharmacokinetic principles. Active learning with PBPK modeling software (GastroPlus) may be useful to teach these scientific principles while also teaching software operation. To examine this issue, a graduate-level course was designed using learning objectives in science, software use, and PBPK model application. These objectives were taught through hands-on PBPK modeling to answer clinically relevant questions. Students demonstrated proficient use of software, based on their responses to these questions, and showed an improved understanding of scientific principles on a pre- and post-course assessment. These outcomes support the effectiveness of simultaneous teaching of interdependent software and science.

Inquiry-based learning (IBL) is a promising educational framework that is understudied in graduate medical education. To determine participant satisfaction and engagement with phases of an IBL postgraduate education program, a mixed-methods study collected data via survey statements and open-ended responses. The authors included participants attending an intensive care medicine (ICM) IBL program from May to November 2020. Quantitative outcomes included participants' satisfaction with the IBL format and impact of engagement with IBL on the learning experience. Qualitative outcomes explored determinants of engagement with IBL phases and the impact on the learning experience. Of 378 attendees, 167 submitted survey responses (44.2%). There was strong agreement relating to overall satisfaction (93.4%). Responses indicated engagement with "orientation" (94.6%), "conceptualization" (97.3%), "discussion" (91.1%), and "conclusion" (91.0%) but limited engagement with the "investigation" phase (48.1%). Greater engagement with IBL phases had positive impacts, with repeat attenders having clearer learning objectives (79.1% vs. 56.6%, P < 0.05) and enhanced learning through collaborative discussion (65.9% vs. 48.7%, P < 0.05). Qualitative analysis showed that ICM learners value active learning principles, clear objectives, and a safe environment to expand their "knowledge base." Sessions facilitated "clinically relevant learning," with application of theoretical knowledge. Learners transformed and "reframed their understanding," using the input of others' experiences. ICM learners were highly satisfied with the IBL format and reported valuable learning. Participants engaged strongly with all IBL phases except the investigation phase during the sessions. IBL facilitated learners' active construction of meaning, facilitating a constructivist approach to learning.

Active learning and practices are strongly encouraged or made mandatory by local, national, and European organizations. Therefore, we set up an interactive practical classroom, engaging all of the attending students of the year (n = 47). Each student was assigned a physiological role (marked on a cardboard sign) in the following events: stimulation on motoneuron dendrites, sodium ions (Na[superscript +]) influx and potassium ions (K[superscript +]) efflux, action potentials onset and saltatory conduction along the axon, acetylcholine (ACh) neurotransmitter exocytosis following Ca[superscript 2+] influx, ACh binding to postsynaptic membrane receptors, ACh-esterase action, excitatory postsynaptic potential, release of Ca[superscript 2+] from the sarcoplasmic reticulum, mechanism of muscular contraction and relaxation, and rigor mortis. A sketch was drawn with colored chalks on the ground outside the room: the motoneuron with its dendrites, cell body, initial segment, myelinated axon, and synaptic bouton; the postsynaptic plasma membrane of the muscle fiber; and the sarcoplasmic reticulum. Students each had their own role and were asked to position themselves and move, accordingly. This resulted in a complete, dynamic, and fluid representation being performed. The evaluation of the effectiveness of the students' learning was limited at this pilot stage. However, positive feedback was received in the self-evaluation reports that were written by students on the physiological meaning of their own role, as well as in the satisfaction questionnaires requested by the University. The rate of students who successfully passed the written exam and the rate of correct answers that included the specific topics addressed in this practice were reported.

The usefulness of virtual reality (VR) technology in physiology education is largely unexplored. Although VR has the potential to enrich learning experience by enhancing the spatial awareness of students, it is unclear whether VR contributes to active learning of physiology. In the present study, we used a mixed-method research approach to investigate students' perceptions of physiology learning based on VR simulations. Quantitative and qualitative data indicate that the implementation of VR learning environments improves the quality of physiology education by promoting active learning in terms of interactive engagement, interest, problem-solving skills, and feedback. In the Technology-Enabled Active Learning Inventory, which consisted of 20 questions to which students responded along a 7-point Likert scale, the majority of students agreed that VR learning of physiology not only stimulated their curiosity (77%; P < 0.001) but also allowed them to obtain knowledge through diverse formats (76%; P < 0.001), participate in thought-provoking dialogue (72%; P < 0.001), and interact better with peers (72%; P < 0.001). Positive responses in the social, cognitive, behavioral, and evaluative domains of active learning were received from students across different disciplines, including medicine, Chinese medicine, biomedical sciences, and biomedical engineering. Their written feedback showed that VR enhanced their interest in physiology and facilitated the visualization of physiological processes to improve their learning. Overall, this study supports that the integration of VR technology into physiology courses can be an effective teaching strategy.

The online flipped classroom (OFC) has emerged as a new teaching method in universities worldwide, which combines asynchronous and synchronous online learning. OFC differs from the traditional flipped classroom as it does not involve face-to-face interaction between teachers and students. Instead, the class meeting is conducted online, and it is focused on active and collaborative learning (e.g., discussion rather than lecturing). To evaluate the effectiveness of the Physiology OFC, we compared it with online live teaching (OLT) offered in the same school and semester. We analyzed the exam scores of the Physiology course as well as the scores for other courses offered in the same semester and after the Physiology course. We categorized the top 27% of the exam takers as high-achieving students and the bottom 27% as low-achieving students. Our analysis found no statistically significant difference between OFC and OLT in terms of overall exam scores for all students. However, high-achieving students in OFC scored higher on the total exam score and short answer questions, but the score of case study questions (CSQs) of low-achieving students was lower. Furthermore, students in OFC scored higher in Medical Immunology and courses dominated by logical thinking such as Pharmacology and Diagnostics than students in OLT. In conclusion, our findings suggest that OFC can achieve the same teaching effectiveness as OLT, with a more positive impact on high-achieving students. The positive impact extends beyond the Physiology course to other courses where logical thinking is critical. However, the lower performance of low-achieving students in CSQs highlights the need for further research to determine the reasons for their lower performance and potential strategies to improve their learning outcomes.

Graduate students intending to pursue an academic career in the sciences have much to gain by learning to teach science but often have limited training opportunities. In response to this need, we designed a one-semester course, Learning Design in Science Education (LDSE), in which students receive formal training in pedagogical theory with role model demonstration of current best practices in active learning. Building from previous descriptions of similar courses, we added a practical experience for the students to utilize their new skills to design and teach a mini science course at the end of the semester. Additionally, students developed a teaching portfolio, complete with a personal teaching statement, syllabus, course materials, and evaluations from peers and faculty. Overall, the course was well received by the students and there are early indications that students benefited from their participation in the course. In this manuscript, we present the design and outcomes of the course, faculty and student perceptions, and thoughts on improvements for future semesters and its potential for use by others.

The physiology core concepts are designed to guide instructors in undergraduate physiology courses. However, although past work has characterized the alignment of physiology programs with the core concepts, it is unclear to what extent these core concepts have influenced instructors' pedagogical decisions or how represented these core concepts are across physiology courses. We surveyed undergraduate physiology instructors to determine their familiarity with the core concepts, the impact of the core concepts on their teaching, as well as the alignment of their courses with these core concepts. Instructors report predominantly relying on textbooks and past syllabi of their courses as resources that influence their instructional decisions on which topics to include in a course. However, many instructors report reorganizing their physiology courses in subsequent iterations or reducing the number of concepts covered to allow more time for critical thinking and active learning. In addition, we find that the majority of instructors indicate that they are not knowledgeable about the list of physiology core concepts and that the influence of these core concepts is limited even for those who report familiarity with the list of core concepts. Finally, we find that instructors report uneven coverage of physiology core concepts in their courses, with some core concepts ubiquitous while others are sparsely covered. We conclude by discussing implications of our work for the physiology education community and call for the continued development of resources to support new physiology instructors and the need to promote coverage of certain core concepts in physiology courses.

Critical thinking and scientific communication are common learning objectives in physiology education. However, a lack of realworld application can limit the transfer of these skills to professional settings. For example, health and wellness professionals are often asked to give advice to clients and patients regarding the use of nutritional supplements, diets, and exercise programs. Giving sound advice on these questions requires the ability to find, interpret, and communicate the evidence to support or reject the use of a given intervention. "Evidence-based practice" (EBP) provides a philosophical framework for combining personal experience, client/patient values, and scientific evidence to give informed advice in a professional setting. Here, we describe the development and implementation of a semester-long EBP project in an introductory exercise physiology course. We discuss how specific components of the project are designed to enhance classroom equity, improve scientific communication, and integrate course content with the student's lived experience and personal interests.

Recommendations for enhancing scientific literacy, inclusivity, and the ecosystem for innovation call for transitioning from teacher-centered to learner-centered science classrooms, particularly at the introductory undergraduate level. Yet little is documented about the challenges that undergraduates perceive in such classrooms and the students' ways of navigating them. Via mixed methods, we studied undergraduates' lived experience in one form of learner-centered teaching, hybrid project-/problem-based learning (PBL), in introductory organismal biology at a baccalaureate institution. Prominent in qualitative analyses of student interviews and written reflections were undergraduates' initial expectation of and longing for an emphasis on facts and transmission of them. The prominence diminished from semester's middle to end, as students came to value developing ideas, solving problems collaboratively, and engaging in deep ways of learning. Collaboration and personal resources such as belief in self emerged as supports for these shifts. Quantitative analyses corroborated that PBL students transformed as learners, moving toward informed views on the nature of science, advancing in multivariable causal reasoning, and more frequently adopting deep approaches for learning than students in lecture-based sections. The qualitative and quantitative findings portray the PBL classroom as an intercultural experience in which culture shock yields over time to acceptance in a way supported by students' internal resources and peer collaboration. The findings have value to those seeking to implement PBL and other complex-learning approaches in a manner responsive to the lived experience of the learner.

This article describes an assignment used in an undergraduate Advanced Exercise Physiology course for seniors. Students' backgrounds in chemistry varied from adequate to almost nonexistent. This presented several challenges for teaching and students' understanding of aerobic oxidation of a glucose molecule. This article presents an assignment for an active-learning team-based approach in the classroom and the adapted version for virtual learning. Students in active, team-based learning were asked to create a short video of glucose oxidation using Lego bricks, coins, or other toys to represent the glucose molecule, the by-products, and the enzymes involved in each pathway. During virtual learning, the assignment was modified to create a video independently in both synchronous and asynchronous course sections. Based on students' responses to an instructor-developed survey on their perceptions of the assignment, 71% reported that the assignment was helpful to understand glucose metabolism.

Although there is increased uptake of active learning approaches in especially developed countries, this is still lagging within the African context. The current study therefore focused on the implementation of group learning at Stellenbosch University, with several modifications versus our earlier, pilot study. Students freely formed small groups at the start of a 5-wk cardiovascular physiology lecture series and were apportioned three separate assignments to complete over this period. This included three in-class group-learning sessions, while students also completed group work outside class times. The active learning element was embedded within a constructive alignment framework. Our data revealed that 75% of the students felt that the in-class sessions was a good use of their time and that they progressively improved their assignment scores, i.e., 67.5 ± 9.3%, 72.4 ± 9.8%, and 76.1 ± 9.5% for the first, second, and final ones, respectively (P < 0.0001). Moreover, the average class score for their final test (68 ± 15.1%) was higher when compared with the average class score (57.5 ± 19.4%) calculated for the previous 3 yr (P < 0.0001). This study revealed two major findings: i.e., 1) students displayed a strong positive response regarding the adoption of in-class collaborative group work, and 2) the introduction of such active learning elements correlated with improved student assignment and test scores. Based on these findings, we propose additional modifications (including a shift to more formative assessments) to ensure even greater success with the roll-out of such active learning elements within the African context.

The COVID-19 pandemic required a shift to online learning that posed particular challenges for the education of dental students. Basic science courses were presented in an online, asynchronous format to facilitate small group rotations through preclinical work. The success of active learning was previously examined in a Dental Physiology course, and it was desired to reassess those methods in an online environment. Students were provided with prerecorded lectures containing learning activities, and the effectiveness was compared with traditional lecture recordings. On surveys, dental students had more positive perceptions of online recordings that incorporated active learning strategies, with higher perceived effectiveness of the lecturer, ability to pay attention, motivation to study, and confidence with the material. This was similar to the previous study, in which face-2-face (F2F) active learning was more positively reviewed than traditional lectures. Compared with these past sections, the online cohort expressed similarly positive perceptions of the active learning sections, but the online traditional lectures were perceived to be less effective than F2F lectures. Despite the differences in student perceptions, unit exam scores were similar for didactic lectures in both online and F2F settings. Unit exam scores were significantly higher when active learning strategies were employed, with the highest performance levels in the F2F cohort. While active learning strategies continue to be effective, further research is needed to optimize these methods and engage students in online coursework. The results suggest the importance of active and collaborative learning opportunities in the education of students in physiology coursework.

The physiology of respiration is a challenging subject for many medical students. To assist students, we have developed an active learning game that physically places students within a model outlining the respiratory control pathway. Participants were provided with a vodcast describing the physiology of respiratory control and instructed to view this before the activity. Once in the classroom, groups of students sat at tables marked to represent components of the respiratory control pathway (e.g., apneustic center, diaphragm etc.). Tables were connected with green and red ropes indicating excitatory or inhibitory effects, respectively. Students were presented with various scenarios (e.g., diabetic ketoacidosis) and asked to predict and illustrate the scenario's effect on subsequent steps in the respiratory pathway by waving the appropriate connecting rope. The next table would continue the pattern to simulate the collective physiological adaptation of the respiratory pathway. Thirty first-year medical students participated in this study. Following the activity, 25 out of the 30 participants completed an optional survey. The survey aimed to assess the benefits of adding this activity to our first-year medical curriculum to build a foundational understanding of the physiology of respiration. Responses were overwhelmingly favorable, and participants reported that playing the game significantly improved their perceived understanding of the physiology of respiratory control. All but one of the participants recommended using the activity in future classes. Because the small size of the study group may limit generalizability, future larger scale studies are planned.

Collaborative teaching strategies such as peer instruction and conventional group work have previously been shown to enhance meaningful learning, but they have not previously been compared. In this present study, we compared the impact of solving quizzes with peer instruction and conventional group work on immediate learning in a laboratory exercise. A total of 186 second-year medical students were randomized to solve two quizzes by either a peer instruction strategy (n = 93) or conventional group work (n = 93) during a mandatory laboratory exercise on respiratory physiology, after which all students completed an individual test. There was no difference in total test scores between groups, but students randomized to peer instruction obtained the highest test scores in solving simple integrated questions. Conversely, students randomized to conventional group work provided the best evaluations of the overall assessment of the laboratory exercise. In conclusion, different collaborative teaching strategies implemented during a laboratory exercise appear to affect immediate learning and student satisfaction differently.

Although active learning is highly recognized and recommended in the educational community, instructors are still struggling with how to incorporate active learning tools into writing courses. This study aims to 1) describe specific challenges encountered in the course of Molecular Cell Biology Laboratory--Critical Thinking through Writing (BIOL3810-CTW); 2) introduce the active learning approaches and metacognition integrated into this writing-intensive course; 3) demonstrate the effectiveness of these active learning approaches in engaging students in classes; and 4) share the principles of integrating active learning activities into writing courses in science, technology, engineering, and mathematics (STEM) and beyond.

Active learning promotes the capacity of problem solving and decision making among learners. Teachers who apply instructional processes toward active participation of learners help their students develop higher order thinking skills. Due to the recent paradigm shift toward adopting competency-based curricula in the education of healthcare professionals in India, there is an emergent need for physiology instructors to be trained in active-learning methodologies and to acquire abilities to promote these curriculum changes. To address these issues, a series of International Union of Physiological Sciences (IUPS) workshops on physiology education techniques in four apex centers in India was organized in November 2018 and November 2019. The "hands-on" workshops presented the methodologies of case-based learning, problem-based learning, and flipped classroom; the participants were teachers of basic sciences and human and veterinary medicine. The workshop series facilitated capacity building and creation of a national network of physiology instructors interested in promoting active-learning techniques. The workshops were followed by a brainstorming meeting held to assess the outcomes. The aim of this report is to provide a model for implementing a coordinated series of workshops to support national curriculum change and to identify the organizational elements essential for conducting an effective Physiology Education workshop. The essential elements include a highly motivated core organizing team, constant dialogue between core organizing and local organizing committees, a sufficient time frame for planning and execution of the event, and opportunities to engage students at host institutions in workshop activities.

Substantial, involved, and expensive efforts to promote the dissemination of scientific knowledge and career interest in Science, Technology, Engineering, and Mathematics (STEM) are enthusiastically supported by many scientific, federal, and local organizations. The articulated underlying goals for these efforts include an enhanced public understanding of science and science-related policy, an increased diversity in STEM careers, and an increase in the future STEM workforce. This effort is primarily driven by an underperformance of the United States that includes poor test performance and limited number of students pursuing STEM degrees. Despite this investment, attitudes toward STEM have not notably changed. The goal of this project was to determine students' attitudes toward STEM in response to a previously established scientific outreach event. This event was used to address three common goals in STEM outreach: STEM literacy, diversity and inclusion, and career preparedness. We found there was a notable difference in the attitudes toward scientific activities and interest in pursuing a "Science Career" after participation in this event. Strikingly, interest in hypothesis development, the keystone of all STEM disciplines, was the least liked of all the activities offered during the event. Our data suggest that events designed to enhance interest in pursuing a STEM career may benefit from different elements compared with events designed to increase understanding of STEM literacy concepts, such as hypothesis development.

Physiology is an integrative science that requires an understanding of the organism as a whole to acquire a deep comprehension of its functions and avoid misconceptions that may impair further learning. Thus it is necessary to develop resources that promote the integrative vision that Physiology requires. Chronobiology is a challenging discipline and one of the least addressed concepts in Physiology curricula. The activity here presented proposes a workshop with a theoretical-practical perspective in the context of the Neuroscience Conferences held annually at our university. All conference presentations are neuroscience-related topics, in combination with practical activities, some of them analyzing variables of the students themselves. We chose to assess this informal teaching scenario to involve the students with a scientific perspective while learning and hoping to increase their appreciation for different topics related to neuroscience. Specifically for this activity on chronobiology, the evaluation was carried out via a survey study including quantitative and qualitative questions and semistructured personal interviews. In general, the results reveal a very positive opinion from students regarding aspects such as the teaching methodology, the organization before and during the activity or the added value of the experience for their future professional performance. Some of the students stated they were more aware of the importance of their circadian system and even changed some of their personal daily routines after the activity. Such positive feedback encourages us to continue working in this theoretical-practical format in the future, as it contributes to improving students' perception of their own learning.

Before COVID-19, the use of case studies to learn science was well established in high school and postsecondary classrooms. Once the pandemic ensued, many faculty continued to use the method as a way to infuse elements of active learning remotely. The results of a survey taken by 600 faculty reveal how they accomplished this feat. Respondents to the survey found that the case method readily transferred to online learning. Most used a mixture of synchronous and asynchronous classrooms. Serious challenges were encountered, primarily due to the difficulty instructors had in keeping track of learner participation. Many obstacles were overcome by creative strategies such as using Google Forms. Some semblance of a normal classroom was achieved by using online conferencing tools and using small groups in synchronous breakout rooms. Cases were commonly broken into chunks and spread over several days. This worked especially well with cases that were already structured this way, including interrupted cases and problem-based learning exercises. Assessment of student performance largely followed the traditional path of exams, projects, and essays, although a third of the faculty attempted to evaluate participation. Classes conducted via an asynchronous approach were largely lecture based, with cases given to learners to complete as homework either individually or as groups. The greatest challenge in this setting was that answers to case questions were often readily available to learners on the internet. This was avoided by faculty modifying questions or creating their own.

Although traditional didactic lecturing is the principal instructional approach used in numerous medical schools, this method has several limitations. Experiential learning approaches place students in the center of the learning process and creates a positive and supportive classroom learning environment. In this article, we propose an active pedagogical approach for teaching a basic physiology concept, namely, neuromuscular transmission (NMT), and we evaluate the effectiveness of this approach among undergraduate medical students. One-hundred forty-two undergraduate medical students were involved in this study ("cohort A, n = 62"; "cohort B, n = 80"). "Cohort A" received a didactic lecture on NMT and subsequently tested their knowledge of the topic via "test 1," after which their perceptions of didactic lectures were recorded. The students were then asked to participate in a touch-and-go (TAG) active-learning session regarding NMT, after which their learning was subsequently tested by taking "test 2." Their perceptions about the TAG game were also recorded. Students in cohort B were first administered "test 1" regarding NMT. Then, they were asked to attend a didactic lecture blended with a TAG active-learning session, after which "test 2" was administered, and their perceptions were recorded. Both the didactic lecture and active learning sessions facilitated student learning regarding the concepts involved in NMT. A comparison of the lecture followed by the game used in "cohort A" with the game blended lecture used in "cohort B" revealed no significant differences. However, both formats created a positive influence on students' interest in learning the concept, and the students preferred active learning over didactic sessions alone.

The value of active learning for increasing student comprehension and retention of science, technology, engineering, and mathematics (STEM) concepts within undergraduate courses has proven to be beneficial many times over; however, barriers still exist for both instructors and students. For example, instructors are often left to decide what type of active learning activities to incorporate and how to implement them yet receive little to no formal training about how to do this effectively. Additionally, student resistance to active learning persists, which adds to the pressure faced by some instructors. Compounding these issues is the absence of high-speed Internet in some regions, which makes accessing active learning activities, many of which are offered through online commercial programs, impractical if not impossible for some students. This problem was highlighted during the pandemic when courses transitioned to being partially or fully online. In this article, I describe a novel active learning method that encourages students to cognitively engage with physiology concepts by using digital images to build structures and processes using an approach that is more accessible to everyone, regardless of Internet capabilities. This approach also provides instructors an option for creating their own active learning activity that may be more suitable for their specific level of students or learning outcomes.

Advances in physiology and other fields are strongly associated with a solid base knowledge of biochemistry and cell metabolism. On the other hand, the complex and abstract nature of metabolic pathways, the traditional lecture method, and other factors made the teaching-learning process of biochemistry a challenging endeavor. To overcome this, we developed and tested a novel active learning tool called Interactive Metabolism ("i"M-tool). The "i"M-tool was developed with simple and low-cost materials. We used it for interactive teaching of several metabolic pathways and physiological mechanisms for students enrolled in the Biochemistry subject belonging to different undergraduate courses. The results of evaluation tests showed that the "i"M-tool significantly (ANOVA, P < 0.01) and consistently improved the biochemistry knowledge of students in classrooms with up to 50 students for 7 different and consecutive academic semesters. A survey intended to mine students' opinions on the tools showed significant satisfaction with the teaching using the "i"M-tool over traditional lecture-based teaching, and the "i"M-tool contributed to collaborative learning among students. Therefore, our results showed that the "i"M-tool improves the biochemistry and cell metabolism teaching-learning process in a more attractive and interactive manner.

Certain physiology concepts can be difficult for students to understand, and new strategies need to be implemented to teach these concepts. Cell signaling is a core concept in physiology and is presented to undergraduate students starting with their first-year Principles of Biology course. Flipped teaching (FT) combined with dramatizations were used to teach steroid hormone and protein hormone cell signaling in an Animal Physiology course. Student knowledge level improved, as demonstrated by posttest scores compared to pretest scores. Their confidence level in the material improved after the dramatization activities were completed. In conclusion, the combination of FT with dramatizations enhances student learning and confidence level.

This article discusses the chalk talk's potential as an active learning method. Although chalk talks are a form of interactive lecture, they have received little attention in the medical education literature compared with other active learning methods such as team-based learning and simulation. One of the authors (C. K. L. Phoon) has used chalk talks to teach congenital heart defects to first- and third-year NYU medical students for many years. His chalk talks have consistently earned among the highest teaching scores, and students have noted their strengths of being more interesting, clear, and tangible than didactic lectures. Using the teacher and student perspectives, we examine the chalk talk's strengths and weaknesses compared with common passive and active learning methods. Chalk talks create a real-time, shared space that facilitates the active learning goals of helping students build, test, and revise mental models (conceptual frameworks). The limited amount of information that can be presented and the ability to solicit and arrange students' ideas on the board lead to the cocreation of valuable conceptual frameworks. Chalk talks require less restructuring of teaching sessions than other active learning methods and are best suited to topics that hinge on understanding of concepts. We advocate for the chalk talk to be reexamined as a promising educational tool given its strengths and the successes that other active learning methods have shown. Furthermore, we provide guidance to help educators deliver chalk talks and discuss future studies that would advance understanding of this powerful teaching tool.

The teaching-learning process is complex and requires continuous research and dedication. Research has been important to prove that student achievement can improve when active methodologies are properly implemented, either in isolation or integrated with a short lecture. The purpose of this work was to evaluate the performance and perception of first-year medical students subjected to a protocol involving the integration of a short lecture and collaborative compilation of portfolios on the topic of digestive physiology. After the lectures and elaboration of the portfolios, the students completed two tests: cognitive monitoring test (CMT) and integrative cognitive test (ICT), and then, they gave their opinions of the strategy. For CMT, the percentage of grade exceeding 7.0 was higher for the group who performed the portfolio activity, compared with the group who did not undertake the activity, and there was a lower percentage of incorrect answers among the portfolio group students, compared with the group that did not perform the activity. For ICT, the percentage of grades exceeding 7.0 was higher for the students who used the portfolio, compared with those who did not perform the activity, and there was also a reduction in incorrect answers among students who performed the portfolio activity, compared with those who did not perform the activity. The combination of short lectures and collaborative group work using a portfolio improved the grades obtained for digestive physiology. Most of the students believed that the collaborative work contributed to their learning about digestive physiology. In addition, most of them were comfortable working in their groups and did not feel dominated by other group members.

In the wake of COVID-19, the postgraduate activities in physiology were shifted from live (face-to-face teaching) to virtual mode. This transition posed a challenge to postgraduate students and faculty moderators, especially for participant-centric group discussion, wherein face-to-face interaction contributes significantly to active learner engagement. To bridge the gap between live group discussion (GD) and virtual GD in the conventional format (VGD), we implemented an innovative yet feasible multistep approach of conducting structured virtual group discussion (sVGD). It involved priming of students during the preparatory phase and incorporation of the Tuckman model of group dynamics, which consists of sequential substages of forming, storming, norming, and performing into the virtual format. Unsupervised synchronous and asynchronous, as well as supervised synchronous interactions within and in between the minigroups in a structured way, led to active engagement of students with one another and the moderator, despite the constraints imposed by the virtual format. After establishing the feasibility of the approach during the first GD (sVGD-1), sVGD-2 was conducted, further refining the approach, and feedback was obtained from the postgraduate students. Pre-GD feedback revealed that the live session was preferred over virtual for the conduct of GD, whereas both live GD and sVGD were perceived to be more effective than VGD in the post-GD feedback. Such pedagogical innovations may also help to address the challenges posed in traditional teaching across the undergraduate and postgraduate courses in medical education and beyond during such unforeseeable circumstances.

Active learning activities offer opportunities for medical students to facilitate the retention of knowledge and develop soft skills. We aimed to create a guide for an interdisciplinary mock trial learning activity within the medical curriculum of the College of Medicine, Anhembi Morumbi University--Laureate International Universities, Sao Paulo, Brazil. We designed an "Animal Experimentation Mock Trial" in which students are coached to search for scientific, legal, and ethical arguments pro and contra animal experimentation in medical research. The mock trial is prepared and staged with student teams to play the 1) presiding judge, 2) the plaintiff's attorney and expert witnesses contra animal research, 3) the defense attorney and expert witnesses pro animal research, and 4) the jury. The plaintiff and defense teams made presentations, and between each presentation the jury put questions to presenters (cross-examination). The jury team gave two evaluation scores after the plaintiff's presentation and then after the defense presentation. The formal feedback for this active learning activity indicated that students expressed satisfaction with the teaching strategies employed in the course. The mock trial with the lesson plan provides a learning mean to exemplify the complex relationship between animal experimentation, medical evidence, ethics, and law/regulations. This mock trial helps medical students to develop their soft skills, such as the ability to collaborate and also to recognize the limits of their own knowledge, important for professional development. The importance of interdisciplinary discussions is demonstrated by increasing the awareness of the multidisciplinary aspect of animal research.

We introduced the AliveCor KardiaMobile electrocardiogram (ECG), a Food and Drug Administration (FDA)-approved, iPad-enabled medical device, into the preclerkship curriculum to demonstrate the clinical relevance of cardiac electrophysiology with active learning. An evaluation showed that medical students considered the KardiaMobile ECG active learning activity to be a valuable educational tool for teaching cardiac physiology.

This paper describes the process involved in conducting an online spirometry practical through Zoom. The teacher demonstrated the practical from the medical school, and the students observed the procedure from the comfort of their own homes. Students were able to analyze the graphs captured in the teacher's laptop by remotely controlling the teacher's laptop. This method may be useful for places where face-to-face classes are suspended due to the COVID-19 pandemic.

This study is aimed at the implementation of a continuous assessment model in physiology for a large-enrollment classroom with 250 students. The readiness assurance process (RAP) and immediate feedback elements from team-based learning (TBL) methodology were adopted to test their ability to guide students to solve applications exercises individually. Three continuous assessments in physiology (CAPs) were conducted with the RAP to include individual (iRAT) and group readiness assurance tests (gRAT). Immediate feedback was provided with faculty-student discussion (FSD), and the individual application exercises (iAE) were designed to be answered individually. Each CAP was subjected to three types of experimental manipulation in subgroups created out of 250 students. The intervention began with iRAT for all three subgroups. The sequence of iRAT, gRAT, FSD, and iAE varied between subgroups within a CAP. In a cross-over study design, each subgroup of students was subjected to all three intervention types over three CAPs. The subgroup completing iAE after RAP and FSD showed higher scores than the subgroup with RAP alone. One hundred eight-two students (82.35% response rate; 101 women and 81 men) responded to the questionnaire. The majority of students (87.4%) felt that doing iRAT and gRAT at the beginning helped them to solve iAE better. Most of the students (86.8%) responded that they received useful feedback and clarification during the discussion with the teacher after the gRAT. In conclusion, the administration of iRAT first followed by gRAT and immediate feedback from faculty seem to be beneficial to prepare students to tackle application-based exercises.

The aim of this study was to evaluate the effect of an active methodology combined with a lecture on undergraduate student learning and levels of stress and anxiety. The active learning methodology consisted of a lecture of 50-min duration, study at home with a textbook, an educational game activity, and three formative assessments on the topic of the cardiac cycle. In a following class, the students provided saliva samples to evaluate their levels of stress, received an anxiety test, and then undertook an exam to assess their understanding of the cardiac cycle. The traditional teaching methodology consisted of two lectures (~2-h duration) on blood pressure control systems, delivered orally. In the third class, the students provided saliva samples, received an anxiety test, and then undertook an exam to assess their understanding of blood pressure control systems. The level of stress was assessed with the concentrations of the stress biomarkers cortisol and alpha-amylase in saliva. Anxiety was assessed with the State-Trait Anxiety Inventory (STAI) questionnaire. The students achieved significantly higher average scores in exams when the active learning strategy was applied compared with the use of traditional theoretical classes. The active methodology resulted in significantly lower levels of stress and anxiety, as well as improved student performance, compared with the use of traditional lectures.

Failed experiments are a common occurrence in research, yet many undergraduate science laboratories rely on established protocols to ensure students are able to obtain results. While it is logistically challenging to facilitate students' conducting their own experiments in the laboratory, allowing students to "fail" in a safe environment could help with the development of problem-solving skills. To allow students a safe place to fail and encourage them to think through a laboratory protocol, online decision trees were created to lead students through protocols and give them timely feedback. The online decision trees present students with a scenario, then students execute a protocol by selecting options that will lead them down different paths and result in various realistic results from their experiments. They receive feedback and instructional tutorials throughout the simulation that are dependent on their choices. The significance of this new resource for student learning is that it allows students to practice their problem-solving skills and gain theoretical knowledge about the purpose of various experimental steps. The purpose of this research study was to evaluate whether online decision trees affected students' self-efficacy, metacognition, and motivation for completing a wet laboratory. A mixed-methods approach was used; three surveys were administered throughout the academic term. For "survey 1," students completed the decision tree and survey before the wet laboratory. For "survey 2," students completed the survey before the wet laboratory but completed the decision tree after the wet laboratory. Students' reported self-efficacy and intrinsic motivation were increased with the administration of the online decision trees before the wet laboratory, but their extrinsic motivation and metacognitive scores were unchanged. For "survey 3," students provided written feedback about the impact of the online decision trees, and their responses highlighted the importance of the visual components of the approach.

Physiology students grapple with large amounts of subject content and hence memorize facts to pass examinations. In parallel, students display limited critical-thinking and creative skills, integration abilities, and/or a deeper engagement with subject content. This study aimed to assess the feasibility of introducing active learning methods (cooperative learning) in a relatively large class to final-year undergraduate physiology students (Bachelor of Science stream) at Stellenbosch University in South Africa. An assignment designed to enhance active and engaged learning was made available to the students (n = 225) during the second week of a 5-wk cardiovascular physiology series of lectures. Students were instructed to freely form working groups (n = 3/group) and the assignment was due by the end of the module. Student groups were expected and encouraged to continuously work on the assignment (outside class time). Three cooperative learning slots were also created during class time, with the lecturer and postgraduate students acting as guides. After the module, students anonymously completed an electronic questionnaire. This study revealed three major findings in terms of implementing cooperative learning in large classes within a South African context, i.e., (1) relatively good reception by students with some indication of group work; (2) it is logistically feasible in relatively large classes, although adequate support is crucial; and (3) additional measures need to be adopted to ensure its success.

The introduction of Competency-Based Medical Education Curriculum in India has endorsed many new concepts, like foundation course, self-directed learning (SDL), early clinical exposure, etc. Emphasis is being given to active teaching-learning approaches. One such approach is SDL. SDL is an active learning approach in which the students are responsible for their own learning outcome, with teacher acting as a facilitator of learning. A medical graduate, being a lifelong learner, should inculcate the habit of SDL. In the present study, the SDL abilities of first year Bachelor of Medicine, Bachelor of Surgery students were assessed using a questionnaire. Based on their experience, students were also asked about the prerequisites of SDL, how it can be promoted, and their expectations from the teachers. Students scored high in most of the SDL skills. However, they felt they need improvement in time management. Furthermore, the students are required to develop their interpersonal communication skills, and they also find it difficult to express messages effectively in oral presentations. Most of the students felt they need help in finding the correct learning resources. According to them, the students should be focused, motivated and stress-free, have time management skills, and be able to search learning resources for successful implementation of SDL. They felt that events that encourage active participation by students, if organized at regular intervals, could promote SDL. Some felt that evaluation of SDL would motivate them to take it seriously. According to the students, teacher should act as a facilitator, a mentor, as well as an evaluator.

The laboratory course is an excellent venue to apply content, practice inquiry, improve critical thinking, practice key clinical skills, and work with data. The use of inquiry-based course projects allows for students to propose open ended questions, form a hypothesis, design an experiment, collect data, analyze data, draw conclusion, and present their findings. This comprehensive experience is ideal for a capstone (senior level) laboratory course that is the culmination of 4 yr of study in the degree. At Michigan State University, the capstone laboratory has incorporated a formal course-based research experience in human physiology. The rationale and logistics for running such an experience are described in this paper.

Blood flow through the cardiovascular system is governed by the same physical rules that govern the flow of water through domestic plumbing. Using this analogy in a teaching laboratory, a model of the cardiovascular system constructed of pumps and pipes was used to demonstrate the basic interactions of pressure, flow, and resistance in a regulated system, with student volunteers providing the operational actions and regulatory components. The model was used to validate predictions and explore solutions prompted by student discussion. This interactive teaching laboratory provides an engaging experiential exercise that demonstrates regulation of flow and pressure in an intact cardiovascular system with apposite changes in heart rate and resistance. In addition, the system provides strong clinical correlates and illustrates how that regulated system responds to challenges such as heart failure, inappropriate vasodilation, and hemorrhage. The results demonstrate that, with limited practice, the instructor can effectively guide the students to reliably reproduce physiologically appropriate results.

The search for more efficient teaching methodologies is a great challenge for Brazilian educators, since most classes are still traditional (theoretical) and have little student involvement during the learning process. Active learning methodologies, where students play a central role in the learning process, are proving to be more effective and interesting when it comes to acquiring knowledge. Thus we decided to develop an innovative technique for teaching Human Endocrine Physiology, called "Endocrine Circuit." The circuit consisted of eight stations in which students were asked to organize a scheme with cards to answer a specific question about a gland or tissue with endocrine relevance. The effectiveness of the developed activity was validated through a pretest-posttest design, in which the students had to answer a 10-question test. We found out that, after the Endocrine Circuit application, students showed an improvement in the percentage of correct answers for 7 out of 10 questions contained in the questionnaire (P [less than or equal to] 0.05). In addition, the activity showed positive outcomes regarding student's engagement in this study, besides showing to be more efficient than the Brazilian traditional theoretical classes.

Flipped classroom teaching has been used by many educators to promote active learning in higher education. This andragogy is thought to increase student engagement by making them more accountable for their learning and increase time on task in the classroom. While there are several systematic reviews that point to improved student results, it remains unclear if flipped classrooms have positive learning effects in physiology education. Flipped classroom teaching was introduced in two advanced physiology subjects (advanced neuroscience, "semester 1," and cardiorespiratory and renal physiology, "semester 2"). Changing the mode of content delivery reduced the time students needed to spend listening to lectures by one-third, without sacrificing either learning content or academic standards. Higher pass rates were observed with larger number of students earning distinction and high-distinction grades. Statistically significant improvements in final grades were observed from both subjects ("semester 1": 2017, 49.28 ± 20.16; 2018, 53.29 ± 19.77, t[subscript 268] = 2.058, P = 0.0405; "semester 2": 2017, 58.87 ± 21.19; 2018, 67.91 ± 20.40, t[subscript 111] = 2.306, P = 0.023). Finally, students' perception of their learning experience remained at or above the university benchmarks (median score of [greater than] 80% for all iterations of the subjects). While the most frequent and persistent area that students suggested could be improved was reduction of content, equal numbers of students commented that no improvement in the subjects was required. Despite the generally positive attitude to recorded didactic teaching content, classroom attendance remained very low, and students did not engage with the active learning content. This suggests that more emphasis needs to be placed on promoting class attendance by developing better active learning content.

Promoting student engagement and academic achievement in first-year anatomy and physiology courses. "Adv Physiol Educ" 43: 443-450, 2019; doi:10.1152/advan.00205.2018. Students from three undergraduate programs at James Cook University, Queensland, Australia, studying combined first-year anatomy and physiology courses, showed different academic achievement in physiology. Physiotherapy students were more active and social when completing learning tasks and achieved significantly higher grades in physiology compared with students enrolled in Sport and Exercise Science and Occupational Therapy programs. To promote academic engagement and achievement by all three groups, discussion questions, case studies, and study guides were included. The aim of this study was to investigate the effectiveness of using these modified resources to promote active learning, enhance academic social interactions, and provide a supportive learning environment. The occupational therapy students showed increased academic achievement (from 57.9 to 66.5%) following implementation of the new resources, but there was no change in the already high-performing physiotherapy students (73.1%) and, more concerningly, the sport and exercise science students (from 54.6 to 56.7%). Fewer sport and exercise science students had prior learning in chemistry (30.4% of participants) and also spent little time outside class studying (8 h/wk), compared with the physiotherapy cohort (70.0% chemistry; 13 h/wk studying). Findings of this research demonstrate that creating a supportive and active learning environment are important factors in promoting the learning of physiology for some cohorts. Background knowledge, academic self-regulatory skills, and the experience of teaching staff are factors that must be considered when endeavoring to increase student academic achievement. Future studies should examine the effect of students' academic self-regulation and the use of remedial chemistry classes when learning physiology.