Student perception on the integration of simulation experiences into human physiology curricula

A cross-disciplinary approach to learning medical physiology and behavioral skills involving drama students performing as simulated patients

The early years of physiology education in medical curricula provide unique challenges. As well as inculcating concepts that are seen as difficult, modern curricula require that students learn in context in case-based learning courses. Additionally, regulating bodies stress that the soft skills of compassion, communication, and empathy are embedded throughout curricula. This has driven work in our organization involving drama and final-year medicine students during which they collaborate in realistic simulations of doctor/patient interactions. We adapted this transdisciplinary approach to second-year physiology tutorials. This emphasized the holistic importance of physiology to patient care, while also embedding "human factors" skills from the very earliest stages of the curriculum. After preparing by attending acting classes based on aspects of Konstantin Stanislavski's "System," the authors supervised tutorials in which drama students participated in a "physiology of hypofertility" session for second-year medical students, playing a 34-year-old woman with premature menopause (or their partner). Opinion (from all students) was evaluated by Likert questionnaires (which included open questions). A focus group of drama students was also interviewed, and the conversation was recorded for thematic analysis. Positive Likert scores were recorded for the authenticity of the tutorials, skills development, fostering empathy, and motivating students to improve. All participants evaluated the tutorial as highly enjoyable. These scores are reflected in positive open commentary on the questionnaires and in the focus group interviews. The results suggest that even basic science tutorials give opportunities for interdisciplinary study and enhancement of behavioral skills while gaining enthusiastic student acceptance.NEW & NOTEWORTHY This work details how physiology tutorials for early years medical students are transformed by taking the clinical case off the two-dimensional page and instead having the case scenario acted by drama students. This adds context and authenticity. The benefits are twofold: emphasizing the importance of physiology to the budding clinician and embedding empathy and compassion from the earliest points in a clinician's career.

Unpacking and validating the "integration" core concept of physiology by an Australian team

Consensus was reached on seven core concepts of physiology using the Delphi method, including "integration," outlined by the descriptor "cells, tissues, organs, and organ systems interact to create and sustain life." This core concept was unpacked by a team of 3 Australian physiology educators into hierarchical levels, identifying 5 themes and 10 subthemes, up to 1 level deep. The unpacked core concept was then circulated among 23 experienced physiology educators for comments and to rate both level of importance and level of difficulty for each theme and subtheme. Data were analyzed using a one-way ANOVA to compare between and within themes. The main theme (theme 1: the body is organized within a hierarchy of structures, from atoms to molecules, cells, tissues, organs, and organ systems) was almost universally rated as Essential. Interestingly, the main theme was also rated between Slightly Difficult to Not Difficult, which was significantly different from all other subthemes. There were two separate subsets of themes in relation to importance, with three themes rating between Essential and Important and the two other themes rating as Important. Two subsets in the difficulty of the main themes were also identified. While many core concepts can be taught concurrently, Integration requires the application of prior knowledge, with the expectation that learners should be able to apply concepts from "cell-cell communication," "homeostasis," and "structure and function," before understanding the overall Integration core concept. As such, themes from the Integration core concept should be taught within the endmost semesters of a Physiology program.NEW & NOTEWORTHY This article proposes the inclusion of a core concept regarding "integration" into physiology-based curricula, with the descriptor "cells, tissues, organs, and organ systems interact to create and sustain life." This concept expands prior knowledge and applies physiological understanding to real-world scenarios and introduces contexts such as medications, diseases, and aging to the student learning experience. To comprehend the topics within the Integration core concept, students will need to apply learned material from earlier semesters.

Using Simulated Patient Avatar and Monitor (SPA©M) to Advance Learner's Knowledge of Pathophysiology and Pharmacology

A novel method was implemented in the Interprofessional education (IPE) program, which incorporated a Simulated-Avatar© case presentation preceding the virtual breakout segments. Simulated real-time clinical interactions replaced the in-person encounters, leading to the translation of the participants' basic science knowledge of pathophysiology and pharmacology (P&P) into effective treatment of the patient-avatar's condition.

To Infinity and Beyond: Expanding the Scope of Basic Sciences in Meeting Accreditation Standards

Interprofessional training, social sciences curricula, service-learning, pre-clerkship integration, and self-directed learning are all cornerstones of medical education and closely align with accreditation elements for most accreditation bodies within health professions education. As a sequel to the Winter 2022 series, the Spring 2022 Webcast Audio Seminar (WAS) of the International Association of Medical Science Educators (IAMSE) continued to examine the evolving roles of basic science educators. From March 3 to March 31, 2022, the five-part webinar series was broadcast live to audiences at academic institutions worldwide; recordings are available on the IAMSE website. This series built a framework through which basic scientists can leverage their content to meet various accreditation standards.

A remote laboratory course on experimental human physiology using wearable technology

To help educators deliver their physiology laboratory courses remotely, we developed an inexpensive, customizable hardware kit along with freely available teaching resources. We based the course design on four principles that should allow students to conduct insightful experiments on different physiological systems. First, the experimental setup should not be constrained to laboratory environments. Second, students should be able to take this course without prior coding and electronics experience. Third, the hardware kit should be relatively inexpensive, and all other resources should be freely available. Fourth, all resources should be customizable for educators. The hardware kit consists of commercially available electronic components, with a microcontroller as its hub (Arduino friendly). All measurement systems can be assembled without soldering. The hardware kit is cost-effective (approximately the cost of a textbook) and can be customized depending upon instructional needs. All software is freely available, and we share all necessary codes in open-access online repositories for simple use and customizability. All lab manuals and additional video tutorials are also freely available online and customizable. In our particular course, we have weekly asynchronous physiology lectures and one synchronous laboratory session, where students can get help with their equipment. In this article, we only focus on the novel and open-source laboratory part of the course. The laboratory includes four units [data acquisition, ECG, electromyography (EMG), activity classification] and one final project. It is our intent that these resources will allow other educators to rapidly implement their own remote physiology laboratories or to extend our work into other pedagogical applications of wearable technology.

Medical students' perceptions of understanding skills needed in treating cardiac patients through simulation-based encounters in a clinical skills curriculum

CONTEXT

Simulation-based education can enhance medical students' understanding of clinical concepts as they learn the key elements needed to treat patients with various medical conditions. The integration of simulation programs into medical school curricula increases students' exposure to this type of learning.

OBJECTIVES

To determine the effectiveness of simulation activities on medical students' perceptions of understanding cardiac rhythm identification and the pharmacology skills necessary to manage a stable patient with cardiac arrhythmia.

METHODS

A retrospective secondary data analysis was conducted utilizing a quasi-experimental one-group pretest/posttest study of a convenience sample of 159 second-year medical students in the southeastern United States during the 2017-2018 academic year. Because this was a one-group pretest/posttest study, only second-year medical students whose data could be matched were included. A 5-point Likert scale, previously developed as part of the clinical skills course, was utilized to collect ordinal understanding of cardiac rhythm identification and the pharmacologic management of a stable patient with cardiac arrhythmia. The intervention was an 18-min simulated patient encounter involving a high-fidelity mannequin (SimMan 3G or Essential) with supraventricular tachycardia.

RESULTS

Of the 159 students, the number of students who reported a good perception of understanding of cardiac rhythm identification presimulation activity increased from 44.0% (70) to 52.2% (83) postsimulation activity. The number who reported a good perception of understanding of the pharmacologic management of a stable patient with cardiac arrhythmia presimulation increased from 37.7% (60) to 49.1% (78) postsimulation. A Wilcoxon signed-rank test model was fitted to examine improvements in perceptions of understanding of cardiac rhythm identification and the pharmacologic management of cardiac arrhythmia. The results suggested that participation in simulation activities elicited a statistically significant improvement in the students' perceptions of understanding of cardiac rhythm identification and the pharmacologic management of cardiac arrhythmia (p=0.000).

CONCLUSIONS

As medical education continues to evolve, simulation-based education may be helpful in enhancing medical students' understanding of cardiac rhythm identification and the pharmacology skills necessary to manage a stable patient with cardiac arrhythmia.

Improving the university teaching-learning process with ECO methodology: Teachers' perceptions

This study presents the results of research focused on university teachers' perceptions of the implementation of ECO (Explore, Create, and Offer) methodology. Through teachers´ responses, the objective was to learn about the impact ECO has on both teaching and learning. The sample consists of 22 teachers from four academic fields; they implemented ECO methodology during the 2018-19 academic year with 1,350 undergraduate students and 175 Master's-level students. The participating teachers belong to five universities: Universidad de Sevilla (Spain), Universitat de Barcelona (Spain), Universidade de Vigo (Spain), Universidad de Las Palmas de Gran Canaria (Spain) and Universidad Nacional de La Plata (Argentina). An exploratory and descriptive study was carried out, and the data were gathered from an online survey filled in by the teachers. Twenty-eight cases were obtained, one for each course that was involved in the project. The mean values were analysed by running a Kruskal-Wallis H test and ER2 for the effect size. In addition, the thematic analysis method was used to analyse the teachers' perceptions while representing their opinions faithfully. The results showed that ECO methodology has a very positive effect on the personal development of the teachers. ECO is a methodology that comes to have revolutionary effects, improving the relationship between teachers and students, who strengthen their commitment to their own learning. It is also an excellent means for connecting students with the social and professional world outside of academia.

Is memorization the name of the game? Undergraduates' perceptions of the usefulness of physiology songs

The possible benefits of using music to enhance learning of STEM content are numerous, diverse, and largely unproven. We sought to determine which (if any) of these possible benefits are commonly experienced by undergraduate students and are thus especially worthy of further investigation. Four hundred ninety-three students in nine physiology courses at two midsized American universities rated the usefulness of short instructor-penned mathematical physiology songs and explained in their own words why each song would or would not be a useful study aid. The students collectively perceived the usefulness of each song to depend on both academic factors (e.g., the lyrics' clarity or relevance to the course) and aesthetic values (e.g., the appeal of the rhythm or the quality of the singing). Most strikingly, although students' free responses were brief (median length: 18 words in study phase 1, 16 words in study phase 2), nearly one-half of them (1,039 of 2,191) concerned memory, suggesting that many students see educational songs primarily as mnemonic devices. A second major theme of students' comments concerned the conciseness and information density of the songs. Though all 10 songs were brief, lasting 17-54 s, students seemed to prefer shorter songs (perhaps better called "jingles"). This first-of-its-kind data set on student perceptions of educational songs should inform the creation and usage of such songs, as well as further research on their possible value.