Unpacking and validating the "cell-cell communication" core concept of physiology by an Australian team.

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.NEW & NOTEWORTHY Seven core concepts, including cell-cell communication, were identified by an Australian Delphi task force of physiology educators. The previously "unpacked" concept was adapted for Australian educators and students to develop a framework with seven themes and 60 subthemes. The framework was successfully validated by the original Delphi panel of educators and will provide a valuable resource for teaching and learning in Australian universities.

Establishing consensus for the core concepts of physiology in the Australian higher education context using the Delphi method.

A set of core concepts ("big ideas") integral to the discipline of physiology are important for students to understand and demonstrate their capacity to apply. We found poor alignment of learning outcomes in programs with physiology majors (or equivalent) from 17 Australian universities and the 15 core concepts developed by a team in the United States. The objective of this project was to reach Australia-wide consensus on a set of core concepts for physiology, which can be embedded in curricula across Australian universities. A four-phase Delphi method was employed, starting with the assembling of a Task Force of physiology educators with extensive teaching and curriculum development expertise from 25 Australian universities. After two online meetings and a survey, the Task Force reached agreement on seven core concepts of physiology and their descriptors, which were then sent out to the physiology educator community across Australia for agreement. The seven core concepts and their associated descriptions were endorsed through this process (n = 138). In addition, embedding the core concepts across the curriculum was supported by both Task Force members (85.7%) and educators (82.1%). The seven adopted core concepts of human physiology were Cell Membrane, Cell-Cell Communication, Movement of Substances, Structure and Function, Homeostasis, Integration, and Physiological Adaptation. The core concepts were subsequently unpacked into themes and subthemes. If adopted, these core concepts will result in consistency across curricula in undergraduate physiology programs and allow for future benchmarking.NEW & NOTEWORTHY This is the first time Australia-wide agreement has been reached on the core concepts of physiology with the Delphi method. Embedding of the core concepts will result in consistency in physiology curricula, improvements to teaching and learning, and benchmarking across Australian universities.

Virtual delivery: a panacea for the financial and ethical challenges associated with physiology laboratory classes?

There has been a gradual shift in the delivery of physiology laboratory classes over the last 30 years. For many, wet-lab demonstrations using animal tissues have been reduced or replaced with student-led investigations where students are both subjects and researchers. Despite these changes, expectations remain that physiology courses should include a practical component to encourage deeper and higher-order learning. Wet-lab tissue experiments and student-based group research formats can be expensive to run, associated with various ethical constraints, and, as discovered in these times of COVID-19, difficult to operate while adhering to physical distancing. We address the proposition that online and/or remote delivery of laboratory classes using digital technologies may provide a solution to both financial and ethical constraints of on-campus laboratory classes. Our discussions, as an international group of 10 physiologists from the United States, the United Kingdom, Canada, and Australia, revealed that although some of the financial and ethical constraints of using animal tissues and student-led investigations were addressed by the introduction of online alternatives, the construction and maintenance of online delivery modes could also be expensive and ethical issues, not previously considered, included digital equity and student data security. There was also a collective perception that if face-to-face laboratory classes were changed to an entirely virtual mode there was a risk that some intended learning outcomes would not be met. It was concluded that the "ideal" approach is likely a hybrid model whereby student attendance in face-to-face, on-campus classes is supported with interactive digital content either developed in house or obtained through third-party providers.

Are virtual physiology laboratories effective for student learning? A systematic review.

It is unclear if the transition from traditional, in-person physiology laboratories to virtual alternatives has educational impacts on students. This study used a systematic review to critically evaluate research papers that investigated the effectiveness of virtual physiology laboratories for student learning. Eleven studies, retrieved from the Education Resources Information Center (ERIC) and Ovid MEDLINE databases, were selected for inclusion in this review, based on predetermined eligibility criteria. Subsequently, the studies went through a power analysis for potential biases before their results were synthesized and analyzed. This systematic review found that virtual physiology laboratories are effective for students' learning of concepts. However, it was inconclusive as to whether virtual physiology laboratories are effective for students' motivation for learning and learning of technical skills. It was found that blended models of virtual laboratories are at least as effective as in-person laboratories for conceptual learning. Overall, this systematic review provides useful insights for educators regarding the educational impacts of implementing virtual laboratories into the physiology curriculum and suggests research models for future evaluation of virtual laboratories.

International educators' attitudes, experiences, and recommendations after an abrupt transition to remote physiology laboratories.

The COVID-19 pandemic triggered university lockdowns, forcing physiology educators to rapidly pivot laboratories into a remote delivery format. This study documents the experiences of an international group of 10 physiology educators surrounding this transition. They wrote reflective narratives, framed by guiding questions, to answer the research question: "What were the changes to physiology laboratories in response to the COVID-19 pandemic?" These narratives probed educators' attitudes toward virtual laboratories before, during, and after the transition to remote delivery. Thematic analysis of the reflections found that before COVID-19 only a few respondents had utilized virtual laboratories and most felt that virtual laboratories could not replace the in-person laboratory experience. In response to university lockdowns, most respondents transitioned from traditional labs to remote formats within a week or less. The most common remote delivery formats were commercially available online physiology laboratories, homemade videos, and sample experimental data. The main challenges associated with the rapid remote transition included workload and expertise constraints, disparities in online access and workspaces, issues with academic integrity, educator and student stress, changes in learning outcomes, and reduced engagement. However, the experience generated opportunities including exploration of unfamiliar technologies, new collaborations, and revisiting the physiology laboratory curriculum and structure. Most of the respondents reported planning on retaining some aspects of the remote laboratories postpandemic, particularly with a blended model of remote and on-campus laboratories. This study concludes with recommendations for physiology educators as to how they can successfully develop and deliver remote laboratories.

Professional skills for physiology majors: defining and refining.

Changing labor markets require a workforce that is broadly trained for a variety of possible careers. Recognizing this, government and industry representatives, along with students and their families, are encouraging universities and colleges to focus more on developing transferable skills to maximize employability of their graduates. In response, academic institutions and professional organizations have begun to develop lists of transferable professional skills that they expect students to have acquired on graduation. At the 2018 Physiology Majors Interest Group (P-MIG) meeting, participants stated that there was a need to define a list of professional skills for undergraduates completing a physiology major. To this end, a professional skills committee was established. Initially members of the committee worked together to develop a draft list of skills. An iterative process of refining the list was then undertaken through presentations/small-group discussions at appropriate international meetings and via an online survey. Over 60 physiology educators, the majority of whom teach in undergraduate programs, provided input. The final list (presented here) consists of 13 skills grouped in four broad categories: think critically, communicate effectively, behave in a socially and scientifically responsible manner, and demonstrate laboratory proficiency. It is anticipated that the list will be used for curriculum mapping and to guide the development of new physiology courses and major programs. The professional skills committee now plans to develop rubrics and tools that will allow for the assessment of these skills.

A virtual experiment improved students' understanding of physiological experimental processes ahead of a live inquiry-based practical class.

Physiology is commonly taught through direct experience and observation of scientific phenomena in "hands-on" practical laboratory classes. The value of such classes is limited by students' lack of understanding of the underlying theoretical concepts and their lack of confidence with the experimental techniques. In our experience, students follow experimental steps as if following a recipe, without giving thought to the underlying theory and the relationship between the experimental procedure and the research hypotheses. To address this issue, and to enhance student learning, we developed an online virtual experiment for students to complete before an inquiry-based practical. The virtual experiment and "live" practical laboratory were an investigation of how autonomic nerves control contractions in the isolated rabbit ileum. We hypothesized that the virtual experiment would support students' understanding of the physiological concepts, as well as the experimental design associated with the practical. Anonymous survey data and usage analytics showed that most students engaged with the virtual experiment. Students thought that it helped them to understand the practical physiological concepts and experimental design, with self-reported time spent on the virtual experiment (and not on lectures or practical class notes) a significant predictor of their understanding. This novel finding provides evidence that virtual experiments can contribute to students' research skills development. Our results indicate that self-paced online virtual experiments are an effective way to enhance student understanding of physiological concepts and experimental processes, allowing for a more realistic experience of the scientific method and a more effective use of time in practical classes.

Using stimulation of the diving reflex in humans to teach integrative physiology.

During underwater submersion, the body responds by conserving O2 and prioritizing blood flow to the brain and heart. These physiological adjustments, which involve the nervous, cardiovascular, and respiratory systems, are known as the diving response and provide an ideal example of integrative physiology. The diving reflex can be stimulated in the practical laboratory setting using breath holding and facial immersion in water. Our undergraduate physiology students complete a laboratory class in which they investigate the effects of stimulating the diving reflex on cardiovascular variables, which are recorded and calculated with a Finapres finger cuff. These variables include heart rate, cardiac output, stroke volume, total peripheral resistance, and arterial pressures (mean, diastolic, and systolic). Components of the diving reflex are stimulated by 1) facial immersion in cold water (15°C), 2) breathing with a snorkel in cold water (15°C), 3) facial immersion in warm water (30°C), and 4) breath holding in air. Statistical analysis of the data generated for each of these four maneuvers allows the students to consider the factors that contribute to the diving response, such as the temperature of the water and the location of the sensory receptors that initiate the response. In addition to providing specific details about the equipment, protocols, and learning outcomes, this report describes how we assess this practical exercise and summarizes some common student misunderstandings of the essential physiological concepts underlying the diving response.

Continuous and noninvasive recording of cardiovascular parameters with the Finapres finger cuff enhances undergraduate student understanding of physiology.

The Finapres finger cuff recording system provides continuous calculations of beat-to-beat variations in cardiac output (CO), total peripheral resistance, heart rate (HR), and blood pressure (BP). This system is unique in that it allows experimental subjects to immediately, continuously, and noninvasively visualize changes in CO at rest and during exercise. This study provides evidence that using the Finapres system improves undergraduate student engagement, understanding, and learning of how the cardiovascular system responds to exercise. Second-year science students undertaking a physiology practical class in 2009 (n = 243) and 2010 (n = 263) used the Finapres system to record CO, BP, and HR during graded exercise on a cycle ergometer. Student experiences with the Finapres was evaluated with a survey (a 5-point scale from strongly disagree to strongly agree). This indicated that students appreciated the immediacy of the recordings (88% of students agreed or strongly agreed, average for 2009 and 2010), gained an understanding of how to record physiological data (84%), enjoyed the practical (81%), and would recommend the Finapres to other students (81%). To determine if the practical enhanced student learning of cardiovascular physiology, identical tests were given to the students at the beginning (pretest) and end (posttest) of the class. There was a significant improvement from the pretest to the posttest (4% in 2009 and 20% in 2010). In summary, the ability of the Finapres to continuously display CO, BP, and HR during experimental protocols provides students with immediate feedback and improves their understanding of cardiovascular physiology.

Preserved left ventricular structure and function in mice with cardiac sympathetic hyperinnervation.

Cardiac-specific overexpression of nerve growth factor (NGF), a neurotrophin, leads to sympathetic hyperinnervation of heart. As a consequence, adverse functional changes that occur after chronically enhanced sympathoadrenergic stimulation of heart might develop in this model. However, NGF also facilitates synaptic transmission and norepinephrine uptake, effects that would be expected to restrain such deleterious outcomes. To test this, we examined 5- to 6-mo-old transgenic (TG) mice that overexpress NGF in heart and their wild-type (WT) littermates using echocardiography, invasive catheterization, histology, and catecholamine assays. In TG mice, hypertrophy of the right ventricle was evident (+67%), but the left ventricle was only mildly affected (+17%). Left ventricular (LV) fractional shortening and fractional area change values as indicated by echocardiography were similar between the two groups. Catheterization experiments revealed that LV +/-dP/dt values were comparable between TG and WT mice and responded similarly upon isoproterenol stimulation, which indicates lack of beta-adrenergic receptor dysfunction. Although norepinephrine levels in TG LV tissue were approximately twofold those of WT tissue, TG plasma levels of the neuronal norepinephrine metabolite dihydroxyphenylglycol were fivefold those of WT plasma. A greater neuronal uptake activity was also observed in TG LV tissue. In conclusion, overexpression of NGF in heart leads to sympathetic hyperinnervation that is not associated with detrimental effects on LV performance and is likely due to concomitantly enhanced norepinephrine neuronal uptake.

Cardiac nitric oxide: emerging role for nNOS in regulating physiological function.

Emerging evidence shows that neuronal nitric oxide synthase (nNOS) plays several diverging roles in modulating cardiac function. This review examines the nitric oxide (NO) pathway and the regulatory mechanisms to which nNOS signalling is sensitive. These mechanisms are diverse and include regulation of gene expression, posttranscriptional regulation, protein trafficking, allosteric modulation of nNOS and redox modification to alter NO bioavailability once synthesised. Functionally, alteration in nNOS-NO signalling in the heart may correlate with different cardiac regulatory states. The idea of this being associated with exercise-trained states and myocardial disease is discussed.