There are many ways to deliver physiology education as an interdisciplinary subject, yet a lot of them can be dry or considered boring by students due to the subject matter. Several years ago, the idea was introduced of teaching physiology based on superheroes. Learning physiology in the context of these mythical people with superpowers is much more stimulating. However, it lacks a translational component because humans are not faster than a speeding bullet or stronger than a locomotive. We have taken this same basic concept and applied it to the extremes or outliers of human physiology. What is unique or special about the physiology of individuals like Lionel Messi? Michael Jordan? Usain Bolt? We give examples of two research reviews that we examine in a graduate course on physiology and also provide a framework for how the content is discussed in the classroom.

Although just-in-time teaching (JiTT) has proven effective in Western settings, its implementation in Asian nursing curricula, within China's distinctive pedagogical landscape, remains insufficient. Rain Classroom facilitates communication between students and teachers via smartphones or computers; however, its effective application to JiTT methodologies has yet to be evaluated. Two groups were compared: the JiTT group ( = 63, academic year 2024), assisted by the software plug-in Rain Classroom, and the traditional classroom (TC) group ( = 70, academic year 2023), who received traditional lecture-based instruction. Cohorts from consecutive years showed no baseline differences, with equivalence testing confirming comparability. Students in the JiTT group achieved significantly higher final examination scores than those in the TC group [77.21 points (SD 9.27) vs. 71.97 points (SD 11.69), degree of freedom = 131, = 0.006]. A moderate positive correlation was observed between final examination scores and in-class quiz performance among the JiTT participants (Spearman correlation = 0.42, < 0.001). Satisfaction scores, assessed per a five-point Likert scale, were significantly higher for JiTT than TC [mean 25.73 (SD 3.17) vs. mean 22.79 (SD 3.84), < 0.001]. Although students generally expressed positive attitudes toward the JiTT approach, some reported heightened academic stress. Qualitative analysis identified five major stressors. Overall, JiTT assisted by Rain Classroom significantly improved histology learning outcomes and student satisfaction in Chinese nursing education, although stress mitigation strategies are warranted for sustainable implementation. Although just-in-time teaching (JiTT) has been widely studied in Western educational settings, its implementation within Asian populations remains scarce. Rain Classroom, a mobile-friendly platform enabling real-time student-teacher interaction, presents a promising, though insufficiently researched, tool for applying JiTT. To address this gap, we evaluated the effectiveness of JiTT integrated with Rain Classroom in a cohort of Chinese nursing students. This method significantly outperforms traditional approaches in enhancing histology test performance, learning perception, and student satisfaction.

Recent reports describe a cultural shift in the average American's perception of the value of higher education. Additionally, and possibly as a consequence of this shifting perception, college enrollments have decreased in recent years. One major element identified in student's perception of college education is whether or not they receive career preparation. In facilitating career preparedness, many instructors have turned to experiential learning opportunities in the form of internships, laboratory-based courses, and simulation. In this manuscript, we describe an experiential learning course for undergraduate and graduate human physiology students in clinical cardiology skills, including electrocardiography, auscultation, manual blood pressure measurement, and cardiac ultrasonography. Student and instructor perspectives were solicited, and four student and two instructor perspectives are included from the author team as qualitative evidence of the efficacy of the described course in preparing students for a variety of jobs with tangible clinical measurement skills. We describe here our perspective that this course enhanced critical thinking, subjective knowledge in cardiology, application of cardiac principles to measurement techniques, and fostered confidence in translating classroom knowledge to the workforce.

This paper critically examines the exclusionary dimensions faced by the marginalised transgender, diverse Sexual Orientation, Gender Identity, and Expression (SOGIESC), and disability community in foundational medical physiology textbooks. A literature review of both international and Indian textbooks was conducted to identify stereotypes, and other forms of discriminatory language. These linguistic choices are not neutral-they shape the attitudes of future healthcare professionals and contribute to the systemic inaccessibility of care for these communities. Our analysis revealed a pervasive presence of exclusionary terms and implicit biases which we feel perpetuate stigma, erase identities, and normalise marginalisation of these population. Recognising that merely correcting isolated terms is insufficient, we propose an Inclusive Language Textbook Audit Tool grounded in a multi-loop learning framework. This tool moves from surface-level corrections (single-loop learning) to questioning underlying assumptions (double-loop learning) and transforming the cultural and institutional contexts that sustain exclusion (triple-loop learning). Embedding this framework into textbook audits offers a systematic path from tokenistic edits to systemic inclusion. We call on textbook authors, publishers, and educators to adopt this tool to ensure linguistic equity in medical education. Revising foundational texts is not only a matter of accuracy; it is an ethical imperative to cultivate a generation of healthcare professionals committed to equity, dignity, and justice for all patients.

Certainty-based marking (CBM) requires students to indicate their certainty levels alongside their answers. CBM has been shown to enhance self-assessment and metacognitive awareness. This study aimed to explore the implementation of CBM in multiple-choice assessments in physiology. The CBM assessment tool was developed with an artificial intelligence (AI) assistant, Claude 3.5, with prompts focused on functional rather than technical requirements. The assessment consisted of 15 multiple-choice questions (MCQs), which were administered as a pretest and posttest during a small group teaching session to first-year medical students. Following the assessment, students completed a survey to evaluate their perceptions regarding the format, knowledge-gap identification, and overall acceptability. Answers from 195 students were analyzed, and significant improvements were observed in performance measures and certainty indices from the pretest to the posttest. Most students (80.9%) found the certainty scale beneficial, and 78.3% changed their answers after reflecting on their certainty. CBM demonstrated metacognitive benefits, with 86.4% of students better recognizing their knowledge gaps and 85.8% feeling more aware of their learning progress. About 73% of students preferred the CBM format and expressed greater engagement (82.8%) than traditional MCQs. CBM implemented through a web-based platform functioned as an assessment tool and an instructional intervention that enhanced students' metacognitive awareness and self-monitoring skills in physiology education. Our study focused on a single physiology topic and showed improvements in knowledge retention and certainty calibration. However, further longitudinal studies across multiple topics are needed to determine whether students maintain these self-assessment skills over time. To introduce certainty-based marking (CBM) to novice students, a custom web-based multiple-choice question (MCQ) test was developed with assistance from an artificial intelligence (AI) tool. This enhanced accessibility and allowed for data collection to evaluate and analyze student performance. The integration of AI in creating this assessment tool highlights the potential of technology to improve educational practices, especially in designing various assessment strategies.

Physiology core concepts (CCs) are essential for understanding physiology and enhancing students' learning outcomes, but their impact in flipped learning (FL) settings remains unclear. This study evaluated whether integrating CCs into FL improves medical students' performance in a 3-wk cardiovascular physiology module. Third-year medical students were divided into two groups: a control group receiving standard FL ( = 85) and an experimental group receiving FL+CCs ( = 90). Performance was assessed via a formative quiz (30-35% participation rate) to identify early learning trends and a final exam. Quiz results were compared by the Mann-Whitney test, and final exam responses were analyzed with chi-square tests. Students' perceptions were collected via questionnaires. The FL+CCs group had a higher median quiz score (68.75%) than the FL group (62.50%), but the difference was not statistically significant ( = 0.14). On the final exam, the FL+CCs group had significantly more correct responses (695/900 vs. 609/850; 77.2% vs. 71.6%; = 0.008), driven primarily by improved performance on the homeostasis questions (56.7% vs. 40%; = 0.003). In addition, 60% of students in the FL+CCs group reported that the FL+CCs approach enhanced their understanding of cardiovascular physiology. Integrating CCs into FL was associated with improved medical student performance in cardiovascular physiology, primarily due to better performance on the homeostasis CC. Studies with a broader assessment scope and extended implementation periods are needed to further evaluate educational benefits of the FL+CCs approach. This study is among the first to investigate core concept-based teaching within a flipped learning setting in a cardiovascular physiology module. Despite the module's short duration, core concept-based teaching was associated with enhanced performance among medical students.

Active learning fosters critical thinking, autonomy, and deep learning. While TBL is common, IBL offers a more student-centered, inquiry-driven alternative. This study aimed to compare the pedagogical effectiveness of IBL versus TBL in medical education, focusing on academic performance, learner engagement, autonomy, and satisfaction. An innovative IBL framework, grounded in the 5E instructional model, was designed and implemented with first- year medical students (n=548). The intervention involved five interactive clinical cases, each centered around a core medical concept. Students progressed through the cases using cascading multiple-choice questions with a conditional solution-revealing mechanism ("scratch film"), promoting autonomous exploration. A final gamified synthesis using crossword puzzles reinforced learning. Comparative data were collected across IBL and TBL sessions using quantitative performance metrics, behavioral observation, and student questionnaires. IBL significantly outperformed TBL in terms of retention of key learning concepts (64-100% vs. 14-38%; < 0.05), as well as in the acquisition of extended concepts, reflecting deeper cognitive processing. Students in IBL groups were more engaged and solved most clinical problems independently, with minimal use of revealed solutions, indicating high levels of autonomy. Questionnaire responses confirmed a high satisfaction rate (66%), a substantial perceived impact on learning (61%), and a reduced tendency toward group cheating (40%), all statistically significant ( < 0.000). Our results suggest that IBL seems to be more effective and engaging than TBL, as it promotes deeper learning, greater autonomy, and increased motivation, with promising potential to support innovation in basic science learning in medicine.

Most students believe they're learning. They're not. Highlighting, color-coding, rereading, and summarizing are familiar study routines-but they're often mistaken for genuine learning. These methods build familiarity, not understanding. They create comfort, not competence. We argue that studying supports recognition, whereas thinking cultivates understanding, transfer, and adaptive expertise. The distinction is not academic-it is foundational. In medical education and beyond, students are praised for discipline and test scores, yet often struggle to apply knowledge in uncertain, real-world contexts. The result is brittle knowledge: like glass, it shatters under pressure, facts without frameworks, recall without reasoning. Drawing on cognitive psychology and educational research, we outline three actionable shifts that educators can implement immediately: explanation-focused assessment, visible thinking routines, and practice with ill-structured problems. These strategies help students move beyond passive review and toward intellectual engagement. In an age of AI-generated answers, test-prep apps, and information overload, the ability to think clearly, flexibly, and ethically is more valuable than ever. Educators must decide: will we teach for recall-or for reasoning? Will we reward memorization-or cultivate minds that question, connect, and create? Reframing studying as a bridge to thinking is not just a pedagogical adjustment-it is a professional imperative. If we want learners who can diagnose, design, and decide, we must stop rewarding the illusion of learning and start building the habits of thought.

The Objective Structured Practical Examination (OSPE) is a structured, competency-based method for assessing practical skills. While OSPE is well established in clinical settings as Objective Structured Clinical Examination (OSCE), its feasibility and educational utility in preclinical subjects like Physiology in India remain underexplored.

Virtual reality (VR) has revolutionized medical education, yet its specific efficacy in teaching medical physiology remains underexplored. Conveying the complexities of physiological responses to hypoxia through traditional teaching methods poses logistical challenges, potentially hindering students' deep understanding. This study investigates the impact of incorporating VR into pre-clinical medical physiology teaching, focusing on students' self-reported 1) knowledge acquisition and understanding of body responses to hypoxia, 2) VR technology acceptance and satisfaction, and 3) overall learning experience. In 2022, an ANU Medical School teaching enhancement grant funded data collection to develop a comprehensive storyboard for a VR hypoxia simulation program. With support from the school's Technology-Enhanced Learning and Teaching team and the university's Centre for Learning and Teaching, we created an in-house limited prototype focusing on key aspects of the scripted VR simulation module to test its feasibility and perceived usefulness within our MChD program. The module was integrated into a year 1 practical session, followed by a two-part series of data collection, comprising a questionnaire and video interviews. The questionnaire used a mixed-methods approach, including 5-point Likert scale closed-ended questions rating VR perceived usefulness and ease of use, and open-ended questions allowing participants to provide qualitative responses. Interviews delved deeper into users' experience, interactivity, collaboration, realism, practicality, knowledge acquisition, improvement suggestions, and overall technology and learning satisfaction. Although the implemented intervention did not represent the full range of features envisioned for the final program, preliminary findings from the first round of data collection via questionnaires (n=45/96) reported positive user experiences. Sixty percent of responses showed agreement (agree (n=22) and strongly agree (n=5)) that learning outcomes were clear and aided by VR. Qualitative findings revealed higher motivation to use VR for learning as a complementary tool to traditional approaches and an intuitive interface. Thematic analysis identified improvement opportunities, including clearer user instructions and enhancing hypoxia symptom discernibility and refining visual resolution. These insights will inform the next study phase, refining features to improve the overall learning experience and address technical challenges. Grounded in constructivist learning theory and technology acceptance frameworks, our findings leverage on realistic VR simulations to enhance knowledge acquisition and understanding of complex physiological responses.

The advent of Generative Artificial Intelligence (GenAI) is already impacting pedagogic strategies and assessment methodologies in higher education, particularly in the biological sciences which have traditionally relied heavily on written assessments. GenAI's rapid and plausible text generation capabilities challenge traditional written assessments and prompt a shift towards more authentic assessment types. This paper explores innovative applications of GenAI in biology education through case studies presented at a recent workshop. These case studies illustrate how GenAI has the potential to enhance academic activities, from developing learning resources to fostering student engagement through active learning strategies. The discussion highlights a shift from product-oriented assessments to process-oriented approaches that prioritize continuous interaction, iteration, and reflection among learners. Despite GenAI's reliance on pre-existing data raising concerns about originality and contextual accuracy, and its limitations in tasks requiring high creativity and deep understanding, it has the potential to enhance educational practices when applied with awareness of its constraints. The paper concludes with a balanced analysis of the transformative impact and inherent challenges of integrating GenAI into biology education, advocating for thoughtful implementation to ensure it augments rather than replaces traditional teaching methods.

Undergraduate students in physiology and other life science programs commonly intend to pursue careers in research or health-care professions. Often, however, they are poorly prepared for research and are discouraged when they are not accepted into professional programs. To address this, we created , a third-year course for life science students. The course includes a scaffolded research proposal assignment along with online pre-class modules and extensive in-class group work on topics such as career planning, project management and commercialization. To assess the course, we surveyed students both during and one to three years post course completion. Students agreed or strongly agreed that the course prepared them for research opportunities (4.17 ± 0.07, mean ± SEM, 5 = strongly agree) and prompted them to consider flexible career paths (4.26 ± 0.06). Of the 63 former students (alumni) who completed the survey (a 29% response rate), almost two thirds were pursuing advanced degrees with most of the others in science-related positions. Alumni indicated that the course improved their skill set to achieve future goals (4.14 ± 0.10); consider flexible career paths (4.16 ± 0.10); and prepare for research opportunities (4.00 +/- 0.12). The most common themes to the question: "" were: working in teams (68%) and developing and writing an original research proposal (68%). Our findings will encourage others to contemplate a similar course or activities/assignments and illustrate the value of surveying former students.

The respiratory system encompasses a complex network of neural mechanisms that regulate not only ventilation and gas exchange but also vital protective reflexes such as coughing, sneezing, and swallowing. These reflexes are clinically relevant and functionally critical for maintaining airway integrity, especially in medical and surgical contexts. Moreover, they offer rich interdisciplinary potential by linking concepts from respiratory physiology, neurophysiology, and motor control. This study aimed to develop supplementary instructional materials using cordel literature, a traditional Brazilian poetic genre, and comic books to facilitate the teaching of airway reflexes in higher education. An extensive literature review was conducted focusing on six key reflexes: cough, expiration, sneeze, swallowing, laryngeal adduction, and the laryngeal chemoreflex. Based on this review, instructional resources were created combining scientific accuracy with accessible and culturally meaningful formats. The cordel texts used rhythmic and metaphorical language to support memorization and learner engagement, while the comics employed symbolic and anthropomorphized characters to visually represent neurophysiological processes. Although these materials have not yet been implemented in classroom settings, they present a creative and low-cost strategy to enrich physiology education and support more inclusive and contextualized learning.

The theoretical and practical aspects of science education are often uncoupled, resulting in decontextualized learning. To address this concern, the present work adopts the view that scientific discovery is a form of learning, and that its hypothetico-deductive and transformative processes are essential for learning in scientific disciplines. This paper presents an educational practice developed for a graduate-level translational neuroscience module, centered on the process of scientific inquiry through student-led, hypothesis-driven research design. The project adopts a multimodal framework, based on multiple pedagogical and philosophical concepts, including transformative learning, threshold concepts, social constructivism, and the philosophies of Popper and Kuhn, to integrate content knowledge with epistemological development. By mirroring the logistics and logic of scientific discovery, and through iterative cycles of discussion, reflection, and critical evaluation, the students navigate both cognitive and affective domains and engage with complex and often troublesome topics in translational neuroscience.

Current trends in education advocate for the development of skills alongside knowledge. Biology laboratories serve as essential platforms for developing practical skills and competencies such as data analysis, scientific inquiry, critical thinking, and problem-solving that are crucial for health science students. This paper aims to identify a standardized, competency-based biology laboratory curriculum aligned with international educational frameworks. The curriculum may be integrated into undergraduate health curricula across European universities to ensure consistent and high-quality education. A systematic search of university curricula was conducted across 28 European countries and included 138 universities. Eligible programs included medicine, pharmacy, nursing, biology, biomedical sciences, and others. Of the 432 syllabi identified, 290 were retrieved, and about half included a laboratory. Course outlines were analyzed for laboratory content and extracted data were summarized. The most frequently integrated laboratories were Microscopy, Isolation of DNA and PCR, Agarose Gel Electrophoresis, Cell Division, Cell Structure and Function, Lab Safety, and Using Basic Lab equipment. Learning objectives for foundational and advanced biology laboratories are presented. The proposed two-semester curriculum maps to the European Tuning and Vision and Change to provide a structured progression from foundational to advanced laboratory techniques. It utilizes digital tools, such as virtual labs and AI, to enhance accessibility and modernize laboratory education. In conclusion, the proposed curriculum provides a practical framework for implementing biology labs providing the foundational knowledge and competencies to prepare students to progress to more advanced topics in other disciplines, including physiology. It ensures consistent skill development across geographical locations, enhancing education quality and preparing students to address global health challenges.

Mental health conditions can be highly relevant to a student's academic journey, given the challenges, and sometimes strengths, they can provide. However, medical school applicants may be unsure about whether to reveal mental health conditions in their application materials. Prior work has shown that medical school admissions committee members do not show bias against an applicant who revealed general mental health struggles on their application when explaining a unique instance of academic underperformance. However, it is unknown how admissions committees would perceive an applicant disclosing a specific stigmatized mental health condition. We used an audit design to examine medical school admissions committee members' perceptions of revealing bipolar disorder on a medical school application. We found no differences in how participants ranked an applicant's acceptability, competence, or likeability, but 25% of participants in the bipolar applicant condition did mention the applicant's bipolar disorder as a potential concern. The majority of participants in both conditions reported that an applicant revealing bipolar disorder would be perceived neutrally if done to explain a period of poor academic performance. However, many participants perceived that revealing would be detrimental if they do not highlight that they are managing the condition. Our results indicate it may be best for applicants not to disclose bipolar disorder in a medical school application unless they do so to explain a period of poor academic performance.

Early exposure to STEM through pathway programs leads to increased interest in its various fields and games can improve knowledge acquisition and increase motivation. This study explored the effects of implementing new sessions on cancer biology and pathophysiology that included a bingo game in two different pathway programs for middle and high school-aged students. 96 students participated in a new two-part cancer biology session taught by medical school faculty. One program's session was held in person, while one was held virtually. The study evaluated student perceptions of the sessions and their interest levels through pre- and post-session surveys, and knowledge acquisition through a multiple-choice quiz administered at three time points: prior to the lecture, prior to the bingo game, and after the bingo game. A one-way repeated measures ANOVA with Bonferroni post-hoc analysis found a statistically significant (p< 0.001) increase from pre-sessions to post-sessions quiz scores, but not between the individual time points. While post-session surveys showed that 65.06% of students reported an increased interest in pursuing a career in science, pre- to post-session data showed a slight decrease in interest in areas such as healthcare and pathology. There were also significant differences in some perceptions based on the program, including content difficulty and usefulness of different session components. Supplementation of a bingo game to STEM-based pathway programs can make complex content more approachable to younger students and increase knowledge acquisition. Early exposure can initiate interest in STEM and health professions.

It is easier to walk downhill than uphill. When walking uphill, muscles are shortening and doing work. When walking downhill, the same muscles are stretched. These lengthening muscles are said to be doing "negative work". Why do lengthening contractions utilize less energy than shortening contractions generating the same force? In search for an answer to this question, A. V. Hill and his collaborators preformed experiments measuring the mechanics and energetics of isolated muscles that were stretched during contraction (1) and intact muscles that were stretched during human exercise (2). There was at first a false trail based on an incorrect hypothesis. The key to understanding why muscles doing negative work utilize less energy than muscles doing the same amount of positive work is that muscle fibers that are stretched generate more force than shortening muscle fibers while using less energy. Thus to generate an equal amount of positive and negative work requires activation of more shortening muscle fibers utilizing more energy per fiber than fibers being stretched. This is a fascinating scientific and also human-interest story that started with a very colorful demonstration one evening at a soiree of the Royal Society London in 1951.

Identifying white blood cells (WBCs) is a critical skill for first-year medical students, but it is often challenging in the early years of medical education. Subtle morphological differences in size, granules, and nuclear shape can be confusing, especially when staining quality is inconsistent. Based on our teaching experience, we observed that during undergraduate practical sessions, students frequently encounter difficulty in achieving optimal staining quality, which often hampers accurate visualization and interpretation of cellular morphology. Reliance on color further increases the risk of misidentification. HIMO 1.0 is an educational game developed to address this challenge. Using black-and-white images, the game trains students to recognize WBCs based on reliable structural features rather than variable staining quality. Developed in Python, it presents randomly oriented images of WBCs and requires players to identify cell size, granules, nucleus shape, and overall type. A built-in database stores defining features of each cell type, enabling instant validation of user responses. Immediate feedback reinforces correct answers, supporting an iterative learning process. HIMO 1.0 provides a safe, engaging, and realistic environment for practicing WBC identification. While not a substitute for real smear examination, it strengthens foundational skills and complements traditional hematology teaching.

The venoarteriolar reflex (VAR) is a peripheral vascular response that limits edema formation in dependent limbs. Despite its physiological relevance, it is rarely addressed in teaching laboratories. The author describes a simple, low-cost protocol that uses photoplethysmography (PPG) and basic postural changes to demonstrate the VAR in real time. In most classroom sessions, a reduction in PPG amplitude is observed during limb dependency and rapid recovery when the limb is returned to heart level. These observations provide a basis for discussing hydrostatic pressure, Starling's forces, and myogenic mechanisms of vascular regulation. Because PPG reflects skin blood flow, the protocol also invites links to autonomic and endocrine physiology. Requiring minimal equipment and preparation, this demonstration offers an accessible and engaging tool for physiology education. This accessible and engaging protocol helps students integrate theoretical and experimental learning in vascular physiology.

Traditional laboratory practicals exploring cardiovascular physiology and pharmacology rely on mammalian models, presenting ethical, financial, and logistical challenges. (zebrafish) larvae offer a compelling alternative that aligns with the partial replacement principle of the 3Rs, whilst providing an opportunity for students to develop desirable skills to improve their employability. Here we introduce an engaging set of laboratory practicals suitable for large undergraduate cohorts, that utilizes larval zebrafish to investigate cardiac ion channels and receptors. The practical involves two 3-hour sessions where students measure heart rate in 72 and 96 hours post-fertilisation larvae in response to various treatments. The first session introduces students to handling larval zebrafish before exploring the effects of a reduced ambient temperature and application of the commonly used zebrafish anaesthetic Tricaine (MS-222) on both heart rate and the zebrafish startle reflex. Finally, students apply the well known adrenergic agonist, adrenaline. The second session empowers students to develop their own testable hypothesis regarding which ion channels or receptors are likely to influence zebrafish heart rate, providing them with the autonomy to select two pharmacologically active drugs from a carefully curated list (e.g. isoproterenol (β-adrenergic receptor agonist), propranolol (β-adrenergic receptor antagonist) and nifedipine (L-type calcium channel blocker)) that will enable them to address their hypothesis. Students' subsequent data for analysis allows them to develop an understanding of the conserved and divergent aspects of cardiac physiology between zebrafish and mammalian systems, and an appreciation of the importance of appropriate model selection in physiological and pharmacological research.