Integrating physiology core concepts into the clinical years of medical education has been challenging despite efforts. This article describes a fourth-year medical school elective, Advanced Physiology in Critical Care Medicine, that focused on integrating physiology core concepts in a case-based learning approach. The elective used interdisciplinary faculty in a virtual forum. Senior students were asked to generate mechanism of disease (MOD) maps, highlight the physiology core concepts associated with paper cases of critically ill patients, and discuss with faculty the relevance of the underlying basic science. The weekly footprint consisted of a student-led session presenting MOD maps for three cases, which examined aspects of core physiology concepts, and, later in the same week, student presentation of order sets for the management of the cases. Students ended the 4-wk elective with a mini-grand rounds presentation on a topic of their choice incorporating the core concept paradigm. Student perception data and faculty reflections of the elective course are included. Student data and faculty observations suggest that students appreciate and can apply physiological core concepts to patient care. Faculty experience in the course suggests that this senior elective helped them better approach all preclinical teaching with the Core Concepts framework in mind. This article presents an innovative approach to integration of physiology core concepts with clinical management using cases of critically ill patients in an online senior elective for medical students. It uses a multidisciplinary faculty conducting a course primarily using case-based learning led by student presentations and discussions of concept maps and order sets.

Undergraduates with depression report that they would benefit from science role models who also have depression. If biology instructors who have depression reveal it to their students, it could help meet this need. However, it is unknown how instructors revealing their depression would impact all undergraduate science students, not just those with depression, and whether it would cause some students to have a negative perception of the instructor. To address this gap, an instructor of an undergraduate physiology course revealed her depression to the whole class in less than 3 s on two occasions. Undergraduates were surveyed about whether they remembered the instructor revealing depression, whether they perceived it to be appropriate, and what impact it had on them. Of the 289 undergraduates who participated in the survey, 90.6% remembered the instructor revealing her depression. Seventy-two percent of those students reported that the instructor revealing depression had a positive impact on them, 21.3% reported no impact, and 6.7% reported a negative impact. Women were disproportionately likely to report that the instructor revealing depression had a positive impact on the student/instructor relationship and the instructor's approachability. LGBTQ+ students were disproportionately likely to report that the instructor revealing depression had a positive impact on the extent the classroom feels inclusive and students with more severe depressive symptoms were more likely to report that it normalized depression broadly and in the context of science. This work adds to recent studies highlighting the potentially positive impact of instructors revealing their concealable stigmatized identities to undergraduates in class. This research highlights the potential for instructors with depression to have a positive impact on students in their college science courses.

Assessing student mastery is often done by using exams. Inevitably, some students will complete remediation, which may include exam retakes. This method provides students an additional opportunity to take an exam that assesses the same objectives as the original exam, while using different questions. Although this form of remediation increases exam scores, it is also possible that students who prepare for an exam retake adversely affect preparation for an upcoming exam. Therefore, the purpose of this study was to determine whether studying for and taking an exam retake affected preparation for the next exam. We hypothesized that students who completed an exam retake would have lower than expected scores on their next exam. This study utilized data collected over five semesters from 467 students enrolled in a 200-level introductory human physiology class; 159 students (34.0%) completed at least one exam retake. Students who retook an exam increased their original exam score by 6.1% (SD 13.9). These findings suggest that retaking an exam leads to better outcomes, which could be explained by students improving their study habits or test-taking skills, which would help them perform better on future exams. Exam retakes provide students with an additional opportunity to demonstrate mastery of learning objectives. However, this preparation might adversely affect performance on subsequent exams. This study suggests that students who choose to prepare for and take an exam retake not only improve their original exam score but show a larger improvement on subsequent exam performance than those students who did not take an exam retake.

The advent of artificial intelligence (AI), particularly large language models (LLMs) like ChatGPT and Gemini, has significantly impacted the educational landscape, offering unique opportunities for learning and assessment. In the realm of written assessment grading, traditionally viewed as a laborious and subjective process, this study sought to evaluate the accuracy and reliability of these LLMs in evaluating the achievement of learning outcomes across different cognitive domains in a scientific inquiry course on sports physiology. Human graders and three LLMs, GPT-3.5, GPT-4o, and Gemini, were tasked with scoring submitted student assignments according to a set of rubrics aligned with various cognitive domains, namely "Understand," "Analyze," and "Evaluate" from the revised Bloom's taxonomy and "Scientific Inquiry Competency." Our findings revealed that while LLMs demonstrated some level of competency, they do not yet meet the assessment standards of human graders. Specifically, interrater reliability (percentage agreement and correlation analysis) between human graders was superior as compared to between two grading rounds for each LLM, respectively. Furthermore, concordance and correlation between human and LLM graders were mostly moderate to poor in terms of overall scores and across the pre-specified cognitive domains. The results suggest a future where AI could complement human expertise in educational assessment but underscore the importance of adaptive learning by educators and continuous improvement in current AI technologies to fully realize this potential. The advent of large language models (LLMs) such as ChatGPT and Gemini has offered new learning and assessment opportunities to integrate artificial intelligence (AI) with education. This study evaluated the accuracy of LLMs in assessing an assignment from a course on sports physiology. Concordance and correlation between human graders and LLMs were mostly moderate to poor. The findings suggest AI's potential to complement human expertise in educational assessment alongside the need for adaptive learning by educators.

The significance of assessment in driving learning is undeniable, particularly in oral assessments like viva voce where students express themselves verbally. However, traditional viva voce examinations' challenges include reliability, objectivity, content validity, time constraints, varying question difficulty levels, inconsistency in questioning among students, the influence of the "halo" effect, and issues with the test environment. Thus the study aimed to evaluate the effectiveness of Objective, Integrated, Clustered Examination Software (VOICES) compared to traditional viva voce methods. Using a mixed-method design with 103 students, questions were framed using VOICES software created by the National Informatics Center (NIC), Chhattisgarh State Center, Government of India, and students responded through voice messages. Faculty graded students based on personalized videos created by the app. Then, feedback was given, and a focused group discussion was conducted for the students. Traditional viva voce examinations were conducted as part of internal assessments, and the marks obtained from these assessments were compared to evaluate their effectiveness in comparison to the VOICES app. There was no significant difference in the marks obtained using both methods indicating that viva voce using an oral assessment app is equally effective. Students responded positively to the VOICES method. The formative oral assessment conducted through the use of the VOICES app successfully addresses the challenges typically associated with traditional viva voce examinations. Traditional viva voce examination encounters challenges including reliability, objectivity, content validity, time constraints, varying question difficulty levels, inconsistency in questioning among students, the influence of the "halo" effect, and issues with the test environment. Formative oral assessment conducted through the use of the Objective, Integrated, Clustered Examination Software (VOICES) app developed by the National Informatics Center (NIC) successfully addresses the challenges typically associated with traditional viva voce examinations.

The number of degrees conferred by postsecondary institutions in an academic field reflects institutional priorities, public interest in a domain of human knowledge, and overall societal and economic demand for certain skills and abilities. Public postsecondary institutions, which are obligated to serve the public interest, and professional organizations, which are meant to reflect the values and interests of their members, should monitor degrees conferred, in part, to understand the career pathways of their graduates or members. The current report describes secular trends in degrees conferred in exercise physiology in the United States since 2002-2003. Data were obtained from spreadsheets published by the National Center for Education Statistics. The number of bachelor's degrees conferred in exercise physiology plateaued starting in 2017-2018 before increasing again in 2020-2021. In 2021-2022, 31,066 bachelor's degrees were conferred in exercise physiology, representing the highest yearly total on record (1.5% of all U.S. bachelor's degrees). The increase has been driven by female graduates (2021-2022: 58.9% women). The number of male graduates started plateauing in 2016-2017. The number of master's degrees conferred has continued to increase (2021-2022: 51.6% women), and doctorate degrees have numbered between 245 and 300 per year since 2013-2014 (2021-2022: 52.2% women). Moving forward, exercise physiology organizations are encouraged to monitor secular trends in degrees conferred and include these data in large-scale graduate destination reports. The plateauing of male exercise physiology graduates over the past 6 years and the significantly lower proportion of male than female graduates averaged across all academic fields warrant continued discussion. The field of exercise physiology has experienced substantial growth at postsecondary institutions in the United States over the past 20 years. Growth has slowed in recent years, but the number of bachelor's degrees conferred in the field reached a record high in 2021-2022. The increase in bachelor's degrees conferred has been driven largely by increased numbers of female graduates (58.9% female). The number of male graduates plateaued starting in 2016-2017.

Mastering the complexity of the nervous system is essential for education programs in physiology, anatomy, and neuroscience. Students often struggle when learning somatosensory pathways, which convey information from sensory neurons to the somatosensory cortex in the brain. Active learning activities incorporating physical models have been shown to increase content comprehension as well as enjoyment of the learning process. Here, we present a three-dimensional physical model of somatosensory pathways constructed of durable, affordable, and widely available materials. In an upper level human physiology lab, students assembled the model and then used it to complete case study questions connecting damage to the spinal cord to resulting sensory deficits. This model-based activity was highly effective as indicated by significant increases in content knowledge and positive responses to survey questions on the effectiveness of the activity. This activity incorporates many evidence-based teaching practices that have been shown to increase engagement, inclusion, and mastery of content and provides an effective and fun way for students to learn a challenging topic. This model-building activity for learning somatosensory neural pathways increases students' content knowledge and is an enjoyable way to learn a complex system. This activity adds to an ever-growing collection of evidence-based learning activities for human physiology courses.

Reading English academic articles is the cornerstone of innovative medical education and scientific research. However, limited by both language and professional knowledge, many nonnative English-speaking undergraduate medical students have a fear of reading English academic articles. The purpose of this study was to explore whether cognitive load theory can be a useful guiding strategy to promote English medical education article reading among Chinese undergraduates, while also evaluating students' attitudes toward the reading activities and cognitive load entailed in the last article they read. In the reading activities, students needed to read 19 English academic articles that are closely related to their courses. A questionnaire was administered after the students finished reading the 19th article to determine their attitudes toward reading English medical education articles and the cognitive load involved in reading the 19th article. The results showed that students' overall perceptions of reading English medical education articles were positive. Most students felt that their ability to read English academic articles and related skills had improved. The mean scores for students' intrinsic and germane cognitive loads in reading the 19th article were 6.44 ± 1.81 and 6.92 ± 2.05, respectively. The mean score for the extraneous cognitive load was 2.31 ± 2.63. In conclusion, the cognitive load theory can serve as the basis for an effective strategy to guide English medical education article reading activities among undergraduates in China. Meanwhile, students' attitudes toward the reading activities were favorable, and they read the latest article within an acceptable cognitive load. Many nonnative English-speaking undergraduates have a fear of reading English academic articles. This study was performed to explore whether cognitive load theory can be a useful guiding strategy to promote English article reading among Chinese medical undergraduates. The results showed that cognitive load theory can serve as the basis for an effective strategy to guide English medical education article reading activities among undergraduates in China, and students' attitudes toward the reading activities were favorable.

Introductory classes are often a student's first exposure to foundational knowledge, careers, and faculty in an academic major. The characteristics of introductory exercise science courses, as well as faculty impressions of course benefits and areas for improvement, were explored in this study. Electronic survey data from 181 universities around the United States were analyzed. A wide range of course content was reported. Institution type was related to the status of the faculty teaching the course, method of course delivery, class size, and class availability. The number of majors was related to faculty status, class availability, and class size. Specifically, private 4-year institutions were more likely to teach smaller, face-to-face classes. Introduction courses at R1, R2, Doctoral/Professional institutions, and programs with 300 or more majors were less likely to be taught by only tenured/tenure track faculty. Classes were more likely to be offered in various modalities as opposed to only face-to-face at community colleges, and programs with 300 or more majors were more likely to have classes with 50 or more students. Enrollment in the introductory course was more likely restricted to majors and minors at public 4-year schools and programs with 300 or more majors. Faculty perceived knowledge acquisition and relationship building as benefits of introductory classes for students and programs. The overarching themes for course improvement were modifying course content and characteristics of course delivery. Considering the varied course characteristics, we encourage faculty and administrators to be intentional when designing and implementing introductory exercise science courses.

Testing is a highly important tool, used ubiquitously in academia, to assess student comprehension and understanding of material. Unfortunately, the emphasis placed on test grades has resulted in a modern epidemic of test-related anxiety, which can have adverse health effects on students. Over time, novel testing strategies have been developed to more precisely assess individual skills such as remembering, analyzing, and synthesizing. Yet there exist few strategies that were also developed to simultaneously reduce stress in the testing environment. We posit here a teaching innovation whereby we modified the classic interteaching session developed in the social sciences to serve as a stress-reduction testing format that also builds student communication and critical thinking skills in an upper-level pathophysiology course. After implementing this novel testing approach, we anonymously surveyed the students in the class to understand how the testing format affected their self-perceived stress levels, their self-perceived learning, and to identify their testing preferences. Of 28 students, 12 responded (43%). Our survey data highlight that students largely preferred partnered, open-response, case-based exams to multiple choice exams. Moreover, students perceived themselves as having lower test-related stress when taking partnered, open-response, case-based exams, as well as strong overall agreement that partnered, open-response, case-based exams enhanced their learning. We posit this application of modified interteaching can be employed in upper-level physiology or pathophysiology courses as a stress-reduction testing strategy.

Muscle physiology is often perceived as a complex topic by students due to the hierarchical concepts and the need for integrative understanding. Breaking down content in a structured manner allows for segmented bite-sized learning that may enhance students' learning beyond conventional online lectures. We compared the effectiveness of (1) bite-sized structured learning (BSL) and (2) synchronous Zoom lecture (SZL) in teaching muscle physiology to first-year allied health undergraduates. For the same student cohort, the topic was divided into two lectures with the first taught via BSL, and the second via SZL. Pre- and post-quizzes were used to evaluate students' understanding of the topic. Mixed-methods online questionnaires were used to examine students' perceptions towards the two modes of learning, encompassing content coverage, delivery, engagement, effectiveness, preference and convenience. A total of 223 and 215 students completed both pre- and post-quizzes for BSL and SZL respectively. Student performances were improved via both modes (p<0.001) with a higher median score improvement in BSL when compared to SZL [3.0 (1.0-4.0) vs 2.0 (1.0-3.0)]. Among students who completed the survey, 65% expressed strong preference towards BSL over SZL (17%), which could be attributed to the benefits of self-paced microlearning such as higher motivation and improved attention. BSL was perceived to be manageable and well-structured to support learning. Our study suggests that BSL is equally effective as conventional lectures and is a learning approach favored by students. There could be merits in combining both instructional modes as their complementary advantages may enhance students' learning.

Physiology education in Africa faces challenges due to gaps in curricula across many of its universities, such as divergent content, a lack of standardized competencies, and suitable benchmarking. Here, we describe the development of Physiology Curriculum for African Universities (PhysioCAFUN), a competency-based curriculum development guideline, as a first step to address such shortcomings. A committee of 15 physiologists from different African regions, Europe, and USA was constituted to draft the PhysioCAFUN, which was introduced and revised during the joint East African Society of Physiological Sciences (EASPS) and African Association of Physiological Sciences (AAPS) conference held in Tanzania late 2023. The PhysioCAFUN consists of 23 modules. Modules 1-15 cover the organ systems, including principles and concepts of physiology, molecular biology and cell physiology. Modules 16-23 contain optional content, including environmental physiology, pharmacology, and topics related to skill development. PhysioCAFUN serves as a freely available resource document for African stakeholders regarding the desired undergraduate physiology training and competencies. It will help universities in Africa, and elsewhere, to draft a curriculum suitable for their local needs where there is a dearth of physiologists, or to benchmark and revise their curricula where physiology programs are already in place.

Here, we report a successful initiative between Brazil and Germany to stimulate neuroscience outreach: the POPNeuro Program. The POPNeuro Program is a neuroscience outreach project created in Brazil that has been active for over ten years. It was initiated in Uruguaiana/RS/Brazil and linked to the Physiology Research Group from the Federal University of Pampa. The neuroscience dissemination was developed mainly in school environments by a team that includes neuroscientists and university undergraduate and graduate students. One of the key focuses of POPNeuro is to identify and avoid the dissemination of neuromyths (misconceptions generated by a misunderstanding, a misreading, or a misquoting of scientific facts). Following an initial research cooperation, the Brazilian and German teams decided to replicate some of the POPNeuro activities in Germany. The POPNeuro spin-off developed the first activities in Germany included neuroscience disclosure activities during the TUC Open Campus Day and a Neuroscience of Learning course for sports and physical education teachers. During the activities, participants took a quiz to identify the prevalence of neuromyths and knowledge of neuroscience facts. The results demonstrate a high prevalence of neurotmyths between the different participants. Despite the socio-cultural differences, these results are in line with previous results from POPNeuro in Brazil. Considering our experience and the participants' evaluations, we are confident that promoting the internationalization of this successful neurophysiology outreach program, expanding the Brazilian POPNeuro program in Germany will have a positive impact. This initiative represents a model of international cooperation that should be stimulated.

Cognitive science principles can facilitate integrating and retaining basic science concepts during the clinical years of undergraduate medical education. We hypothesized that reinforcing foundational science concepts during the core clerkship experiences fosters the development of clinical reasoning in medical students. A patient simulation session on diabetic ketoacidosis (DKA) in the pediatric clerkship was chosen to pilot the program. We introduced an intervention in which a team of clinical and foundational science faculty facilitates student discussions, helping them connect important physiological and pathophysiological concepts to the disorder's clinical presentation, diagnosis, and management. The student survey reported that 87% strongly agreed that it helped them reinforce their understanding of foundational science concepts related to clinical cases. The NBME subject exam results of the pediatric clerkships from the corresponding years were subjected to a cognitive diagnostic assessment called the DINA model analysis. The student content mastery in acid-base disorders was improved following the intervention (student mastery of skills, 0.73 vs 0.80, P=0.035). Similarly, analysis of the Step 2 Clinical Knowledge (CK) skills from the NBME subject exam item analysis reports showed improvement in the skill "diagnosis" on the topic of diabetes (probability value- before and after the intervention, respectively, 0.73 and 0.85, p=0.04) following implementation. Our study shows the impact of foundational science reinforcement during clinical clerkships in developing undergraduate medical students' clinical reasoning and diagnostic skills.

Large language models (LLMs)-based chatbots use natural language processing and are a type of generative artificial intelligence (AI) that are capable of comprehending user input and generating output in various formats. They offer potential benefits in medical education. This study explored the student's feedback on the utilization of LLMs in medical education. We conducted an in-depth interview with open-ended questions with Indian medical students via telephone conversation. The recording (average time 55.28±18.04 min) was transcribed and thematically analyzed to find major themes and sub-themes. We used QDA Miner Lite v.2.0.8 (Provalis Research: Montreal, Canada) for the thematic analysis of the text. A total of 25 students from eight Indian states studying from the first to final year of studies participated in this study. Three major themes were identified about usage scenario, augmented learning, and limitation of LLMs. Students use LLMs for clarifying complex topics, searching for customized answers, solving MCQs, making simplified notes, and streamlining assignments. While they appreciated the ease of access, ready reference for getting clarity on doubts, lucid explanation of questions, and time-saving aspects of LLMs, concerns were raised regarding erroneous results, limited usage due to reliability and privacy issues, and the overreliance on chatbots for educational needs. Hence, they emphasized the need for training for the integration of LLM in medical education. In conclusion, according to students' perception, LLMs have the potential to enhance medical education. However, addressing challenges and leveraging the strengths of LLMs are crucial for optimizing their integration into medical education.

As public-facing global institutions, modern universities are subject to equality legislation (locally the United Kingdom Equality Act) and the need to represent an increasingly diverse student body. For effective education, this broad cohort needs to see itself represented, both in the curriculum, and in the very structures of the university. It is with this in mind that staff in the Centre for Biomedical Sciences Education in Queen's University Belfast recruited three students from diverse backgrounds to co-design aspects of the Undergraduate Physiology Curriculum for Medicine and Health and Life Sciences (MHLS) degrees. As part of a 6-week summer internship, our students set out to identify gaps in the physiology curriculum regarding those with protected characteristics as described by the UK Equality Act 2010 (race, sex, gender reassignment, marriage or civil partnership, pregnancy and maternity, religion and belief, disability and sexual orientation; Figure 1 ). Our aim was to incorporate Equality, Diversity and Inclusion (EDI) principles to create a learning environment that celebrates people's differences and represents individual students. Themes that developed over the six week period of the internship were recognizing oneself in the curriculum, cultural humility and intersectionality.

Newly acquired information is stabilized into long-term memory through the process of consolidation. Memories are not static; rather, they are constantly updated via reactivation, and this reactivation occurs preferentially during Slow-Wave Sleep (SWS, also referred to as N3 in humans). Here we present a scalable neuroscience research investigation of memory reactivation using low-cost electroencephalogram (EEG) recording hardware and open-source software, for students and educators across the K-12 and higher education spectrum. The investigation uses a method called targeted memory reactivation (TMR), whereby auditory cues that were previously associated with learning are re-presented during sleep, triggering the recall of stored memories and (through this) strengthening these memories. We demonstrated the efficacy of this technique on seven healthy human subjects (ages 19-35). The subjects learned to play a spatial memory game on an app where they associated pictures (e.g., a clock) with locations on a grid while they listened to picture-appropriate sounds (e.g., "tic-toc"); next, they took a nap while undergoing EEG recordings. During SWS, half of the sounds from the game were replayed by the app, while half were substituted with non-learned sounds. Subjects then played the memory game again after waking. Results showed that spatial recall was improved more for cued than uncued memories, demonstrating the benefits of memory replay during sleep and suggesting that one may intervene in this process to boost recall of specific memories. This research investigation takes advantage of the importance of sleep for memory consolidation and demonstrates improved memory performance by cueing sounds during SWS.