Using systems modeling to facilitate undergraduate physiology student learning and retention of difficult concepts.

Physiology concepts, such as acid-base balance, may be difficult for students to understand. Systems modeling, a cognitive tool, allows students to visualize their mental model of the problem space to enhance learning and retention. We performed a within-subjects three-period randomized control comparison of systems modeling versus written discussion activities in an undergraduate asynchronous online Anatomy and Physiology II course. Participants (n = 108) were randomized to groups with differing treatment orders across three course units: endocrine, immune, and acid-base balance. Participants demonstrated content understanding through either constructing systems modeling diagrams (M) or written discussion posts (W) in a MWM, MMW, or WMM sequence. For each of three units, student performance was assessed on 6 standardized multiple-choice questions embedded within a 45-question exam. The same 6 questions per unit, 18 questions in total, were again assessed on the 75-question final exam. The groups demonstrated no significant difference in performance in the endocrine unit exam [mean difference (MD) = -0.036]. However, the modeling group outperformed the writing group in the immune unit exam (MD = 0.209) and widened the gap in the acid-base balance unit exam (MD = 0.243). On the final exam, performance was again higher for the modeling group on acid-base balance content, as mean difference increased to 0.306 despite the final exam content for acid-base balance being significantly more difficult compared to other units [modeling: F(2) = 29.882, P < 0.001; writing: F(2) = 25.450, P < 0.001]. These results provide initial evidence that participation in systems modeling activities may enhance student learning of difficult physiology content as evidenced by improved multiple-choice question performance.NEW & NOTEWORTHY Physiology educators often intuitively utilize systems thinking and modeling while teaching difficult concepts. Guiding students in development of their own systems modeling skills by enhancing their visualization of their mental model of the problem space may improve performance on multiple-choice test questions.

Exploring progressive mental model representation of core physiology concepts in physician assistant students through word frequency and association analyses.

A well-developed mental model is crucial for effectively studying physiology core concepts. However, mental models can be difficult for students to represent and for instructors to evaluate and correct. Systems modeling as a visualization cognitive tool may facilitate mental model development. On the other hand, evidence of mental model development may also be represented verbally, in writing, and therefore, be evaluated. In this study, analysis of writing prompt completions illustrated progress in physician assistant student mental model formation of physiology core concepts, such as homeostasis and cell-cell communication, over time. Two cohorts of physician assistant students were invited to voluntarily submit completions of writing prompts five times over 16 months. Sessions included submissions pre- and post-small group systems modeling participation. Word frequency and word association cluster dendrogram analyses were conducted on submissions using the tm text mining package in R to provide insight into progressive changes in core concepts of word use and associations. Students demonstrated expanded core concepts systems thinking over time. This was apparent through the increased use of systems process terms, such as homeostasis, in submissions immediately following systems modeling activities. Students also increasingly included terms and associations emphasizing cell-cell communication and systems integration. The inclusion of these concepts within student mental models was demonstrably enhanced by participation in systems modeling activities.NEW & NOTEWORTHY This study applies text mining, an artificial intelligence form of natural language processing, to evaluate a series of physiology student-written prompt completions. Text mining of student writing in physiology has not yet been reported in the literature. Through the application of this technique, longitudinal trends in student development of mental models of core concepts were identified and visualized through word frequency distributions and cluster dendrograms.

The role of subject presence type on student motivation in a PBL learning environment.

Students have been observed as underprepared or skipping steps during the problem-based learning (PBL) process due to fatigue or low motivation, potentially creating a barrier for effective learning. One way to explore resolving this issue is to consider whether variables of problem scenario design can be altered to optimize motivation. This mixed method study considered the impact of presentation modality of the PBL problem subject (i.e., the key character involved in the problem) on student motivation within the context of Speech and Voice Science curricula for forty-six undergraduate students at a midwestern, US university. The frequency of verbal and non-verbal engagement behaviors was monitored during four consecutive PBL problems. The problems were designed to provide increasing levels of social presence and used varied case presentation modalities (e.g., paper, audio-visual, face to face). Although the frequency of engagement behaviors declined during the study and fatigue appeared to play a role, most students identified problems with combination of higher subject presence (i.e., audio-visual, face-to-face) and challenging content as motivating. Students were able to develop a sense of ownership and responsibility for their problem-solving efforts with a problem designed with direct interaction (i.e., face to face) with the problem subject. This study sheds light on the impact of affective problem features (e.g., emotion, personal psychological connection) on students' motivation in the presence of fatigue, which is often undervalued during the design of PBL modules.

A review to identify key perspectives in PBL meta-analyses and reviews: trends, gaps and future research directions.

In the past 50 years, the original McMaster PBL model has been implemented, experimented, revised, and modified, and is still evolving. Yet, the development of PBL is not a series of success stories, but rather a journey of experiments, failures and lessons learned. In this paper, we analyzed the meta-analyses and systematic reviews on PBL from 1992 to present as they provide a focused lens on the PBL research in the past 5 decades. We identified three major waves in the PBL research development, analyzed their impact on PBL research and practice, and offered suggestions of research gaps and future directions for the field. The first wave of PBL research (polarization: 1990-mid 2000) focused on answering the question "Does PBL work?" and the outcomes. The results were conflicting. The researchers took polarizing positions and debated over the merits of PBL throughout this wave. However, the contradictory results and the debates in fact pushed the researchers to look harder for new directions to solve the puzzle. These efforts resulted in the second wave (from outcomes to process: mid 2000-mid 2010) that focused on the question "How does PBL work?" The second wave of PBL research targeted at investigating the effects of implementation constituents, such as assessment formats or single versus curriculum wide implementations. The third wave (specialization: mid 2010 and onward) of PBL research focused on "How does PBL work in different specific contexts?" These research widened our perspectives by expanding our understanding of how PBL manifests itself in different contexts. Given the diversification of PBL and more hybrid PBL models, we suggest "Why does PBL with particular implementation characteristics for specific outcomes work or not work in the condition where it is implemented?" to be the question to answer in the next wave of PBL research.

Perceived Benefit of Active Over Passive Strategies for Pathophysiology Learning and Retention Among Physician Assistant Students.

PURPOSE: This study examines physician assistant (PA) student perceived benefit of active vs. passive studying strategies for learning and retaining physiology and pathophysiology content knowledge. Identifying beneficial studying strategies is crucial to building a strong content knowledge foundation to support PA students' clinical rotations. METHODS: Three cohorts of PA students (n = 64) were anonymously surveyed regarding perceived benefit of studying strategies for learning and retention of physiology and pathophysiology content knowledge. Students also ranked strategies from most to least beneficial. RESULTS: Strategies were identified during survey development pilot study as either active or passive. Physician assistant students rated the active strategies perceived benefit mean as significantly greater than the passive strategies mean for both the learning (t(61) = 9.24, P < .001, d = 1.38) and retention (t(58) = 8.19, P < .001, d = 1.21) conditions. CONCLUSION: This study provides evidence that PA students perceive active studying strategies to be more beneficial than passive strategies for acquiring physiology and pathophysiology content and retaining it into the clinical year.