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The Human Anatomy & Physiology Society (HAPS) has published a set of learning outcomes to be used for curriculum design of a one-semester introductory physiology course. The outcomes are competency-based and are mapped to core concepts and skills students should develop as undergraduates. This paper is an introduction to how the physiology learning outcomes are organized and how they can be used.

The Physiology Core Concept of flow down gradients is a major concept in physiology, as pressure gradients are the key driving force for the bulk flow of fluids in biology. However, students struggle to understand that this principle is foundational to the mechanisms governing bulk flow across diverse physiological systems (e.g., blood flow, phloem sap flow). Our objective was to investigate whether bulk flow items that differ in scenario context (i.e., taxa, amount of scientific terminology, living or nonliving system) or in which aspect of the pressure gradient is kept constant (i.e., starting pressure or pressure gradient) influence undergraduate students' reasoning. Item scenario context did not impact the type of reasoning students used. However, students were more likely to use the Physiology Core Concept of "flow down [pressure] gradients" when the pressure gradient was kept constant and less likely to use this concept when the starting pressure was kept constant. We also investigated whether item scenario context or which aspect of the pressure gradient is kept constant impacted how consistent students were in the type of reasoning they used across two bulk flow items on the same homework. Most students were consistent across item scenario contexts (76%) and aspects of the pressure gradient kept constant (70%). Students who reasoned using "flow down gradients" on the first item were the most consistent (86, 89%), whereas students using "pressures indicate (but don't cause) flow" were the least consistent (43, 34%). Students who are less consistent know that pressure is somehow involved or indicates fluid flow but do not have a firm grasp of the concept of a pressure gradient as the driving force for fluid flow. These findings are the first empirical evidence to support the claim that using Physiology Core Concept reasoning supports transfer of knowledge across different physiological systems.

Pressure gradients serve as the key driving force for the bulk flow of fluids in biology (e.g., blood, air, phloem sap). However, students often struggle to understand the mechanism that causes these fluids to flow. To investigate student reasoning about bulk flow, we collected students' written responses to assessment items and interviewed students about their bulk flow ideas. From these data, we constructed a bulk flow pressure gradient reasoning framework that describes the different patterns in reasoning that students express about what causes fluids to flow and ordered those patterns into sequential levels from more informal ways of reasoning to more scientific, mechanistic ways of reasoning. We obtained validity evidence for this bulk flow pressure gradient reasoning framework by collecting and analyzing written responses from a national sample of undergraduate biology and allied health majors from 11 courses at five institutions. Instructors can use the bulk flow pressure gradient reasoning framework and assessment items to inform their instruction of this topic and formatively assess their students' progress toward more scientific, mechanistic ways of reasoning about this important physiological concept.

In recent years, there has been a strong push to transform STEM education at K-12 and collegiate levels to help students learn to think like scientists. One aspect of this transformation involves redesigning instruction and curricula around fundamental scientific ideas that serve as conceptual scaffolds students can use to build cohesive knowledge structures. In this study, we investigated how students use mass balance reasoning as a conceptual scaffold to gain a deeper understanding of how matter moves through biological systems. Our aim was to lay the groundwork for a mass balance learning progression in physiology. We drew on a general models framework from biology and a covariational reasoning framework from math education to interpret students' mass balance ideas. We used a constant comparative method to identify students' reasoning patterns from 73 interviews conducted with undergraduate biology students. We helped validate the reasoning patterns identified with >8000 written responses collected from students at multiple institutions. From our analyses, we identified two related progress variables that describe key elements of students' performances: the first describes how students identify and use matter flows in biology phenomena; the second characterizes how students use net rate-of-change to predict how matter accumulates in, or disperses from, a compartment. We also present a case study of how we used our emerging mass balance learning progression to inform instructional practices to support students' mass balance reasoning. Our progress variables describe one way students engage in three dimensional learning by showing how student performances associated with the practice of mathematical thinking reveal their understanding of the core concept of matter flows as governed by the crosscutting concept of matter conservation. Though our work is situated in physiology, it extends previous work in climate change education and is applicable to other scientific fields, such as physics, engineering, and geochemistry.

We provide a tutorial on differential item functioning (DIF) analysis, an analytic method useful for identifying potentially biased items in assessments. After explaining a number of methodological approaches, we test for gender bias in two scenarios that demonstrate why DIF analysis is crucial for developing assessments, particularly because simply comparing two groups' total scores can lead to incorrect conclusions about test fairness. First, a significant difference between groups on total scores can exist even when items are not biased, as we illustrate with data collected during the validation of the Homeostasis Concept Inventory. Second, item bias can exist even when the two groups have exactly the same distribution of total scores, as we illustrate with a simulated data set. We also present a brief overview of how DIF analysis has been used in the biology education literature to illustrate the way DIF items need to be reevaluated by content experts to determine whether they should be revised or removed from the assessment. Finally, we conclude by arguing that DIF analysis should be used routinely to evaluate items in developing conceptual assessments. These steps will ensure more equitable--and therefore more valid--scores from conceptual assessments.

We present the Homeostasis Concept Inventory (HCI), a 20-item multiple-choice instrument that assesses how well undergraduates understand this critical physiological concept. We used an iterative process to develop a set of questions based on elements in the Homeostasis Concept Framework. This process involved faculty experts and undergraduate students from associate's colleges, primarily undergraduate institutions, regional and research-intensive universities, and professional schools. Statistical results provided strong evidence for the validity and reliability of the HCI. We found that graduate students performed better than undergraduates, biology majors performed better than nonmajors, and students performed better after receiving instruction about homeostasis. We used differential item analysis to assess whether students from different genders, races/ethnicities, and English language status performed differently on individual items of the HCI. We found no evidence of differential item functioning, suggesting that the items do not incorporate cultural or gender biases that would impact students' performance on the test. Instructors can use the HCI to guide their teaching and student learning of homeostasis, a core concept of physiology.

We have created and validated a conceptual framework for the core physiology concept of "cell-cell communication." The conceptual framework is composed of 51 items arranged in a hierarchy that is, in some instances, four levels deep. We have validated it with input from faculty who teach at a wide variety of institutional types. All items making up the framework were deemed essential to moderately important. However, some of the main ideas were clearly judged to be more important than others. Furthermore, the lower in the hierarchy an item is, the less important it is thought to be. Finally, there was no significant difference in the ratings given by faculty at different types of institutions.

Undergraduate students studying Science, Technology, Engineering and Mathematics (STEM) often fail to persist in critical "gateway" courses, resulting in students leaving the STEM pathway. Community college students leave STEM pathways at higher rates than students at universities. Implementation of a program designed to engage community college STEM students and faculty in a community of support was associated with increased persistence in STEM gateway courses and associate degree completion. Program elements included support staff, a STEM study room with peer tutors, faculty advisors, and transfer assistance. Over seven years, 415 students joined this opt-in support program. The majority of students in this program were economically disadvantaged and many were nontraditional college students. Using institutional data we tested the hypothesis that participation in this program was associated with increased student success and persistence in STEM courses and at the college. The mean GPA for students in the program in the ten courses with the highest STEM enrollments was higher (2.89) than that for other students (2.76). Quarter-to-quarter persistence was 87% for program students compared to 67% for non-program students in a matched student population. In STEM gateway courses, program students had between 1.2x to 3.5x greater likelihood than non-program students of progressing to precalculus-2 controlling for first-attempt GPA in precalculus-1. Similar persistence patterns were observed for other gateway STEM courses. Observed persistence for students in the program was higher than comparable groups of students, including persistence for those who experienced early failure in STEM courses. These data suggest students should be supported through early failure to enable persistence in critical STEM sequences, especially in gateway Math and Chemistry courses. [ABSTRACT FROM AUTHOR]

Physiology faculty members at a wide range of institutions (2-yr colleges to medical schools) were surveyed to determine what core principles of physiology they want their students to understand. From the results of the first survey, 15 core principles were described. In a second survey, respondents were asked to rank order these 15 core principles and, independently, to identify the three most important for their students to understand. The five most important core principles were "cell membrane," "homeostasis," "cell-to-cell communications," "interdependence," and "flow down gradients." We then "unpacked" the flow down gradients core principle into the component ideas of which it is comprised. This unpacking was sent to respondents who were asked to identify the importance of each of the component ideas. Respondents strongly agreed with the importance of the component ideas we had identified. We will be using the responses to our surveys as we begin the development of a conceptual assessment of physiology instrument (i.e., a concept inventory). (Contains 7 tables.)

As a college biology instructor, I often see graphs in lab reports that do not meet my expectations. I also observe that many college students do not always adequately differentiate between good and poor (or misleading) graphs. The activity described in this paper is the result of my work with students to improve their graphing literacy. The process has benefited from my involvement in Summer Institutes and projects designed to help faculty integrate Mathematics Across the Curriculum (MAC), engage students in active learning in biology courses and develop student self-assessment strategies.

The explosion of knowledge in all of the biological sciences, and specifically in physiology, has created a growing problem for educators. There is more to know than students can possibly learn. Thus, difficult choices have to be made about what we expect students to master. One approach to making the needed decisions is to consider those "core principles" that provide the thinking tools for understanding all biological phenomena. We identified a list of "core principles" that appear to apply to all aspects of physiology and unpacked them into their constituent component ideas. While such a list does not define the content for a physiology course, it does provide a guideline for selecting the topics on which to focus student attention. This list of "core principles" also offers a starting point for developing an assessment instrument to be used in determining if students have mastered the important unifying ideas of physiology. (Contains 3 tables.)

We have developed and tested a dynamic approach to assist positive, department-wide change at institutions of higher education. Here we describe a workshop strategy designed to empower faculty as agents of change. This strategy incorporates tools and concepts including systems thinking, visual facilitation, and action planning to drive transformation at the department/program level. Although our workshops were developed for life sciences faculty, the processes we adopted, and the lessons learned from the project, provide a framework for the faculty of any STEM discipline at any type of higher education institution to develop skills to effect changes in approach and pedagogy that will improve learning outcomes. While our workshops were carried out in person, we describe approaches that can be adapted for online use. [ABSTRACT FROM AUTHOR]