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An Australia-wide consensus was reached on seven core concepts of physiology, one of which was cell-cell communication. Three physiology educators from a "core concepts" Delphi task force "unpacked" this core concept into seven different themes and 60 subthemes. Cell-cell communication, previously unpacked and validated, was modified for an Australian audience to include emerging knowledge and adapted to increase student accessibility. The unpacked hierarchical framework for this core concept was rated by 24 physiology educators from separate Australian universities, using a five-point scale for level of importance for student understanding (ranging from 1 = Essential to 5 = Not Important) and level of difficulty (ranging from 1 = Very Difficult to 5 = Not Difficult). Data were analyzed with the Kruskal-Wallis test with Dunn's multiple comparison test. The seven themes were rated within a narrow range of importance (1.13-2.4), with ratings of Essential or Important, and statistically significant differences between the themes (P < 0.0001, n = 7). The variance for the difficulty rating was higher than for importance, ranging from 2.15 (Difficult) to 3.45 (between Moderately Difficult and Slightly Difficult). Qualitatively, it was suggested that some subthemes were similar and that these could be grouped. However, all themes and subthemes were ranked as Important, validating this framework. Once finalized and adopted across Australian universities, the unpacked core concept for cell-cell communication will enable the generation of tools and resources for physiology educators and improvements in consistency across curricula. [This article was written with Task Force.]

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.

Bioscience is a foundational unit (subject) of undergraduate allied health degree programs, providing students the scientific basis underpinning their clinical practice. However, despite its significance, bioscience is a difficult academic hurdle for many students to master. The introduction of active learning strategies, including small team-based guided-inquiry learning approaches, has been shown to significantly reduce this hurdle and improve assessment outcomes for the learner. Guided team-based activities can aid in this approach by also building broader skills and capabilities, like teamwork and communication, as well as subject-specific knowledge and skills, thereby positively influencing student assessment outcomes. This paper details the redesign and evaluation of two first-year Bioscience for Paramedics units with the introduction of guided-inquiry learning, as well as other active learning strategies, and assesses their impact on student performance. Results indicate that active learning used within a classroom and in the large lecture theater setting improved students' grades with positive student perception of their learning experience.

Evidence shows that factors contributing to success in physiology education for allied health students at universities include not only their high school achievement and background but also factors such as confidence with their teachers and quality of their learning experience, justifying intensive and continued survey of students' perceptions of their learning experience. Here we report data covering a 3-yr period in a physiology subject that has been redesigned for blended and online presentation. Consistent with previous reports, we show that when we undertook a blended mode of delivery, students demonstrated better grades than traditional modes of teaching; however the absence of didactic teaching in this subject resulted in lower grades overall. Students have very strong positive attitudes to weekly quizzes (80% positive approval) but report ambivalent attitudes to online self-directed learning (61% negative perception), even though they had 2-h weekly facilitated workshops. Overwhelmingly, students who undertook the subject in a self-directed online learning mode requested more face-to-face-teaching (70% of comments). From these data, we suggest that there is a quantifiable benefit to didactic teaching in the blended teaching mode that is not reproduced in online self-directed learning, even when face-to-face guided inquiry-based learning is embedded in the subject.

The study of human bioscience is viewed as a crucial curriculum in allied health. Nevertheless, bioscience (and particularly physiology) is notoriously difficult for undergraduates, particularly academically disadvantaged students. So endemic are the high failure rates (particularly in nursing) that it has come to be known as "the human bioscience problem." In the present report, we describe the outcomes for individual success in studying first-year human physiology in a subject that emphasises team-based active learning as the major pedagogy for mastering subject learning outcomes. Structural equation modeling was used to develop a model of the impact team learning had on individual performance. Modeling was consistent with the idea that students with similar academic abilities (as determined by tertiary entrance rank) were advantaged (scored higher on individual assessment items) by working in strong teams (teams that scored higher in team-based assessments). Analysis of covariance revealed that students who studied the subject with active learning as the major mode of learning activities outperformed students who studied the subject using the traditional didactic teaching format (lectures and tutorials, P = 0.000). After adjustment for tertiary entrance rank (via analysis of covariance) on two individual tests (the final exam and a late-semester in-class test), individual student grades improved by 8% (95% confidence interval: 6-10%) and 12% (95% confidence interval: 10-14%) when students engaged in team-based active learning. These data quantitatively support the notion that weaker students working in strong teams can overcome their educational disadvantages.