Even students that obtain a high grade in neurophysiology often carry away a serious misconception concerning the final result of the complex set of events that follows the arrival of an action potential at the presynaptic terminal. The misconception consists in considering that "at a synapse, information is passed on from one neuron to the next" is equivalent to (and often expressed explicitly as) "the action potential passes from one neuron to the next." More than half of four groups of students who were asked to comment on an excerpt from a recent physiology textbook that openly stated the misconception had no clear objection to the text presented. We propose that the first culprit in generating this misconception is the term "synaptic transmission," which promotes the notion of transferring something or passing something along (implicitly unchanged). To avoid establishing this misconception, the first simple suggestion is to use words like "synaptic integration" rather than "synaptic transmission" right from the start. More generally, it would be important to focus on the function of synaptic events rather than on rote listing of all the numerous steps that are known to occur, which are so complex as to saturate the mind of the student.

About four decades ago, Perl and collaborators were the first ones who unambiguously identified specifically nociceptive neurons in the periphery. In their classic work, they recorded action potentials from single C-fibers of a cutaneous nerve in cats while applying carefully graded stimuli to the skin (Bessou P, Perl ER. Response of cutaneous sensory units with unmyelinated fibers to noxious stimuli. J Neurophysiol 32: 1025–1043, 1969). They discovered polymodal nociceptors, which responded to mechanical, thermal, and chemical stimuli in the noxious range, and differentiated them from low-threshold thermoreceptors. Their classic findings form the basis of the present method that undergraduate medical students experience during laboratory exercises of sensory physiology, namely, quantitative testing of the thermal detection and pain thresholds. This diagnostic method examines the function of thin afferent nerve fibers. We collected data from nearly 300 students that showed that 1) women are more sensitive to thermal detection and thermal pain at the thenar than men, 2) habituation shifts thermal pain thresholds during repetititve testing, 3) the cold pain threshold is rather variable and lower when tested after heat pain than in the reverse case (order effect), and 4) ratings of pain intensity on a visual analog scale are correlated with the threshold temperature for heat pain but not for cold pain. Median group results could be reproduced in a retest. Quantitative sensory testing of thermal thresholds is feasible and instructive in the setting of a laboratory exercise and is appreciated by the students as a relevant and interesting technique.

Self-assessment tools have previously been used to assess the impact of a faculty development program on the teaching skills of medical educators. In this study, we aimed to assess the impact of a faculty development program on the teaching performances of faculty members in relation to their medical disciplines and academic positions. A faculty-training program consisted of "training skills" and "student assessment instruments" courses. The impact of the program was evaluated by self-reporting of faculty members (a total of 225 reports) 1–2 yr after the program. Both courses were found to be beneficial by nearly all of the attendants. Clinicians benefited more from some topics in the student assessment course and could apply the structured learning and assessment guides, structured oral examination, and objective structured clinical examination more efficiently than their peers from preclinical departments. In conclusion, the results demonstrated that the participants of the faculty development program modified their teaching activities according to the demands of their clinical practice. The correlations between the benefits and behavioral changes were statistically significant.

Learning about statistics is a lot like learning about science: the learning is more meaningful if you can actively explore. This fifth installment of Explorations in Statistics revisits power, a concept fundamental to the test of a null hypothesis. Power is the probability that we reject the null hypothesis when it is false. Four things affect power: the probability with which we are willing to reject–by mistake–a true null hypothesis, the magnitude of the difference we want to be able to detect, the variability of the underlying population, and the number of observations in our sample. In an application to an Institutional Animal Care and Use Committee or to the National Institutes of Health, we define power to justify the sample size we propose.

Nutrient digestion and absorption is necessary for the survival of living organisms and has evolved into the complex and specific task of the gastrointestinal (GI) system. While most people simply assume that their GI tract will work properly to use nutrients, provide energy, and release wastes, few nonscientists know the details about how various nutrients are digested and how the breakdown products traverse the cells lining the small intestine to reach the blood stream and to be used by the other cells of the body. There have been several recent discoveries of new transporters that likely contribute to the absorption of oligopeptides and fatty acids. In addition, details are being clarified about how transporters work and in what forms nutrients can be absorbed. The enzymes that digest basic carbohydrates, proteins, and fats have been identified in various segments of the GI tract, and details are becoming clearer about what types of bonds they hydrolyze. Usually, detailed information about the digestion of basic nutrients is presented and learned in biochemistry courses and detailed information about absorption via transepithelial transport of the breakdown products of digestion is studied in physiology courses. The goal of this Staying Current article is to combine the details of the biochemistry of digestion with the updated information about the physiology of nutrient absorption into one source for teachers of physiology. Insights are included about some of the diseases and conditions that can bring about malabsorption of food in the GI tract and their consequences.

Recently, the use of animal laboratories has decreased in medical and basic science programs due to lack of trained faculty members, student concerns about animal welfare, and the increased availability of inexpensive alternatives such as computer simulations and videos. Animal laboratories, however, have several advantages over alternative forms of instruction, including an increased sense of learner responsibility, long-term psychomotor competency, and improved ability to examine functional relationships. While the use of animal laboratories has been studied in medical programs, it has not been examined in physical therapy or other allied health programs. The purposes of this study were to examine the attitudes of student physical therapists toward clinically relevant animal laboratories and to determine if student physical therapists felt that the laboratory modules prepared them for future course work and clinical internships. Written surveys completed by the study participants indicated that most students enjoyed the labs and believed that they helped prepare them for course examinations. Additionally, the majority of students believed that the laboratory modules helped them prepare for future course work and clinical internships.

The introduction of case studies on the autonomic nervous system in a fourth-semester physiology course unit for Pharmacy students is described in this article. This article considers how these case studies were developed and presents their content. Moreover, it reflects on their implementation and, finally, the reception of such a transformation among the students as well as the tutor's perception. Specifically, the following issues were addressed. First, how were the course unit and, within the course unit, case study components organized? Second, how was the transformation of the course unit from an originally interactive but rather teacher-centered lecture to an interactive course module achieved? Third, how were the case studies structured, what questions were asked, and what were the answers expected from the students; what additional information was provided by the tutor? Fourth, how did the implementation of these case studies work out in the actual course, i.e., how did the tutor guide the students in this interactive session and how did the students tackle the problems? Finally, how was the integration of interactive modules received by the students and what was their learning experience (as assessed by questionnaires) and learning success (as assessed through the final course exam)? Equally, the tutor's perception of this transformation and its implementation is described.

The curriculum in the University of Ruhuna Medical School is of the traditional type. Most teaching activities are faculty member-led activities. Since student-centered learning processes are considered to improve certain skills and attitudes, we introduced student-led group classes (SGCs) in physiology. Depending on the outcome of the SGCs, we planned to develop it further. We designed this study to compare student perceptions on newly introduced SGCs with traditional tutorials (TTs). Student perceptions were assessed using a mixed qualitative and quantitative method. Students recognized and appreciated some favorable features of the SGC, such as the opportunity for discussion, quality of the knowledge, active participation, improvement of presentation ability, and increased breadth of knowledge. However, the majority of students preferred the TT over the SGC despite the highlighted benefits of the SGC. Students appreciated the focused learning for examinations, written preparation, and more tutor involvement in the TT. Students requested a hybrid of the TT and SGC by incorporating mandatory written answers to the SGC with greater contributions from faculty members. Assessment methods that were not aligned with the SGC and ingrained passive didactic teaching-learning methods by students and faculty members had a negative effect on the implementation of SGCs. Cultural and economical factors also contributed adversely. In the second step of this Plan-Do-Check-Act process, we are planning to introduce new formative assessment to assess higher-order cognitive skills and a compulsory tutor training program. Some favorable components from the TT will be incorporated to the SGC.

This study aimed to develop, implement, and assess a distance module in endocrine physiology in TelEduc for undergraduate nursing students from a public university in Brazil, with a sample size of 44 students. Stage 1 consisted of the development of the module, through the process of creating a distance course by means of the Web. Stage 2 was the planning of the module's practical functioning, and stage 3 was the planning of student evaluations. In the experts' assessment, the module complied with pedagogical and technical requirements most of the time. In the practical functioning stage, 10 h were dedicated for on-site activities and 10 h for distance activities. Most students (93.2%) were women between 19 and 23 yr of age (75%). The internet was the most used means to remain updated for 23 students (59.0%), and 30 students (68.2%) accessed it from the teaching institution. A personal computer was used by 23 students (56.1%), and most of them (58.1%) learned to use it alone. Access to a forum was more dispersed (variation coefficient: 86.80%) than access to chat (variation coefficient: 65.14%). Average participation was 30 students in forums and 22 students in the chat. Students' final grades in the module averaged 8.5 (SD: 1.2). TelEduc was shown to be efficient in supporting the teaching-learning process of endocrine physiology.

Second-year medical students at the Nelson R. Mandela School of Medicine (Durban, South Africa) were given a brief to prepare oral presentations on topics related to disorders of the gastrointestinal tract and endocrine system in the form of "patient-doctor" role play and to submit written documents about their topics. This initiative was introduced to assist medical students in their application and understanding of physiology to clinical situations. The aims of the student presentations were to improve the understanding of the physiological basis of diseases; promote independent research, active, and group-based learning; encourage social interactions; and develop presentation and peer review skills. Students rose to the challenge, producing a variety of presentations reflecting a wealth of creativity, humour, sensitivity to local cultural issues, and analytic thinking skills. The quality of the supporting posters and computer-generated slides was outstanding. Numerous "fun" prizes for specific individual and group performances were given based on peer and staff evaluations. This exercise ran over a 5-yr period before the introduction of a problem-based learning medical curriculum. Student feedback obtained over these years is reported here. Students were asked to complete semistructured questionnaires, which elicited feedback on various aspects of the learning exercise, including whether it should be continued and how it could be improved upon, especially if they were in groups that did not function well. The feedback obtained revealed that most students perceived the presentations to be fun, informative, creative/innovative, and, most importantly, beneficial to their learning. The majority of students felt that this exercise improved their understanding of pathophysiology, taught them to research independently, and encouraged better class interactions and group learning. The inclusion of such initiatives is beneficial not only to students' understanding and their experience in studying physiology but also for the development of skills useful in their future careers.

This retrospective study compared the performance of preclinical medical students in the multiple-choice question (MCQ) and long essay question components of a comprehensive physiology final examination. During the 3 yr analyzed, 307 students had an average score of 47% (SD 9.9) in the long essay questions and 64% (SD 9.9) in the MCQs. Regression analysis showed a significant correlation (r = 0.62, P < 0.01) between MCQs and long essay questions. When student performance was grouped by final course grade, a statistically significant correlation between MCQ and long essay scores existed only for the 210 students who received a passing grade (r = 0.20, P < 0.01). The MCQ and long essay question scores were not correlated for the 57 students who failed (r = 0.25, P = 0.06) or for the 40 students who achieved honors and distinctions (r = –0.27, P = 0.11). MCQ scores were significantly higher (P < 0.01) than essay scores for each of the groups when analyzed by two-way ANOVA. The results of this study suggest that for most students, the strong correlation between scores on MCQs and essay questions indicates that student performance was independent of testing format. For students at either end on the performance spectrum, the lack of correlation suggests that the performance in one of the testing formats had a strong influence on the final course grade. In addition, those students who failed the course were likely to be weak in both testing modalities, whereas students in all grade groups were more likely to perform better in the MCQs than in the long essay questions.

We constructed a robust and low-priced finger pulse sensor from a singing greeting card beeper. The beeper outputs the plethysmographic signal, which is indistinguishable from that of commercial grade sensors. The sensor can be used in school for a number of experiments in human cardiovascular physiology.

This study tested the possibility that interactive lectures explicitly based on activating learners’ prior knowledge and driven by a series of logical questions might enhance the effectiveness of lectures. A class of 54 students doing the respiratory system course in the second year of the Bachelor of Medicine and Bachelor of Surgery program in my university was randomized to two groups to receive one of two types of lectures, "typical" lectures (n = 28, 18 women and 10 men) or "constructivist" lectures (n = 26, 19 women and 7 men), on the same topic: the regulation of respiration. Student pretest scores in the two groups were comparable (P > 0.1). Students that received the constructivist lectures did much better in the posttest conducted immediately after the lectures (6.8 ± 3.4 for constructivist lectures vs. 4.2 ± 2.3 for typical lectures, means ± SD, P = 0.004). Although both types of lectures were well received, students that received the constructivist lectures appeared to have been more satisfied with their learning experience. However, on a posttest conducted 4 mo later, scores obtained by students in the two groups were not any different (6.9 ± 3 for constructivist lectures vs. 6.9 ± 3.7 for typical lectures, P = 0.94). This study adds to the increasing body of evidence that there is a case for the use of interactive lectures that make the construction of knowledge and understanding explicit, easy, and enjoyable to learners.

The regulation of the glomerular filtration rate (GFR) is a particularly important and challenging concept for students to integrate into a memorable framework for building further knowledge and solving clinical problems. In this study, 76 first-year veterinary students and 19 veterinarians in clinical specialty training (house officers) participated in separate online exercises to evaluate the use of a computer-animated model of GFR regulation (www.aamc.org/mededportal) on learning outcome. Students were randomly allocated to study either the animated model or written materials before completion of a 10-question multiple-choice quiz. House officers completed a 35-question test before and after study of the animated model. Both groups completed a survey about the learning exercise. The ability of the model to enhance learning was demonstrated by a significant improvement (P < 0.001) in the test performance of house officers after studying the model. The model performed similarly to written materials alone in affecting the subsequent quiz performance of the students. The majority of students and house officers agreed or strongly agreed that the animated model was easy to understand, improved their knowledge and appreciation of the importance of GFR regulation, and that they would recommend the model to peers. Most students [63 of 76 students (83%)] responded that they would prefer the use of the animated model alone over the study of written materials but acknowledged that a combination of hardcopy written notes and the animated model would be ideal. A greater applicability of the model to more advanced students and an introduction in a didactic setting before individual study were suggested by the house officers. The results of this study suggest that the animated model is a useful, effective, and well-received tool for learning and creating a visual memory of the regulatory mechanisms of GFR.

Insects have many interesting behaviors that can be observed in an introductory biology laboratory setting. In the present article, we describe several reflexes using the housefly Musca domestica that can be used to introduce students to sensory and motor responses and encourage them to think about the underlying neural circuits and integration of sensory information that mediate the behaviors.

In the present article, the reorientation of a fourth-semester physiology course for pharmacy students is described. The motivation for the introduction of changes was to prepare the students to not only assimilate facts but to learn and understand how to integrate and apply them. The article considers how this reorganization was received by the students in both subjective and objective terms. Specifically, we investigate whether our changes resulted in both an enhanced learning experience and improved learning success. The following changes were introduced to the course: first, we integrated either experimental, computer-based teaching modules or case studies in five of the eight course units to give the students the opportunity to gain more hands-on experience; second, we organized regular meetings to enhance communication among the course tutors; and finally, we increased the pass mark for the entrance exam to the course from 50% to 60%. Student opinion was evaluated by means of a questionnaire that was distributed at the end of each course semester throughout the three-semester evaluation period (summer 2008, winter 2008/2009, and summer 2009). The students gave convincing positive feedback concerning the efficacy of the changes in both quantitative and qualitative terms. Moreover, their learning success improved significantly in objective terms as evidenced by enhanced final and State exam performance.

In the present article, I report on my experience in teaching and learning physiology in the first year of a new modular curriculum at the Faculty of Medicine of the National University of Rwanda. With self-reported questionnaires, I collected learning experience perceptions from 112 students who attended the module of physiology in 2008. The results showed satisfaction with active learning methods but complaints about the limited contact hours allocated to classroom lectures and practical classes. Student-centered learning was handicapped by the limited computer and internet access for students and by the limited number of textbooks in the library. In conclusion, the new teaching and learning style was appreciated by the students, but problems related to limited human and material resources need to be solved.

Integrated learning is the need of the hour. We at Shifa College of Medicine switched to an integrated modular curriculum last year. In the present article, we describe our experience with the renal module in year 2 of a 5-yr undergraduate medical curriculum. A multidisciplinary renal modular team developed the relevant objectives, themes, and clinical cases. The learning strategies used were large-group interactive sessions, small-group learning, problem-based learning, practicals, and self-directed learning. Assessment was both formative and summative. Student and faculty feedback questionnaires were administered at the end of the module. Forty-four percent of the students agreed that the basic science and clinical concepts were well balanced and integrated. Fifty-seven percent of the students believed that important learning issues could be identified and that participation and critical thinking were encouraged during the small-group sessions. Eighty-five percent of the facilitators agreed that they were able to motivate students for critical thinking and better learning through integrating various disciplines. In conclusion, the integrated method of curricular delivery was well received by students and faculty members, and it can be used successfully in undergraduate medical education in developing countries.