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The human body is a system made of systems. The body is divided into bodily systems proper, such as the endocrine and circulatory systems, which are subdivided into many sub-systems at a variety of levels, whereby all systems and subsystems engage in massive causal interaction with each other and with their surrounding environments. Here we offer an explicit definition of bodily system and provide a framework for understanding their causal interactions. Medical sciences provide at best informal accounts of basic notions such as system, process, and function, and while such informality is acceptable in documentation created for human beings, it falls short of what is needed for computer representations. In our analysis we will accordingly provide the framework for a formal definition of bodily system and of associated notions.

Born in April 23th, 1748, at Valognes, in Normandy, Félix Vicq d'Azyr was at once a great doctor, a talented naturalist and a distinguished man of letters. Member of the "Académie des sciences" in 1774, he founded, in 1776, the "Société royale de médecine" in Paris, future "Académie", whose he was the permanent secretary. He is the originator of the comparative anatomy. The successor to Buffon at the "Académie française" in 1788, he became Principal Doctor to the Queen Marie-Antoinette in 1789. From that time, his aristocratic tendencies drew revolutionary court's attention to him. Already sick, summary executions of his friends terrified him. He escaped Guillotine, but tuberculosis killed him, on June the 20th, 1794. He left a great work, especially in anatomy and physiology, and a lot of historical eulogies.

Due to increasing demands in the amount of content to be learned within a medical and health sciences curriculum, there are benefits towards exploring options for new and effective delivery modes. Augmented reality technology has the potential to enhance learning in physiology and anatomy, where students require a three-dimensional knowledge of human organ systems and structures. This study aimed to assess the effectiveness of learning when an identical lesson was delivered through augmented reality using either the Microsoft HoloLens or a mobile handheld tablet device. Thirty-eight pre-clinical undergraduate participants completed a lesson detailing the physiology and anatomy of the brain. Pre- and post-intervention tests were provided to evaluate acquired knowledge. After the activity, participants also completed a Likert-style questionnaire to evaluate adverse health effects experienced and assess their perceptions of the module. There were no significant differences between test scores from lesson delivery in either the HoloLens or mobile-based augmented reality. However, a significant increase was reported in dizziness when using the HoloLens (25% higher, n = 19, p = 0.04). No other adverse health effects, such as nausea, disorientation or fatigue were observed. Both modes were effective for learning, providing evidence to support educators and developers wishing to adopt an augmented reality method of delivery in health sciences and medicine.

Purpose: The goal of this study was to present vocal aerodynamic measurements from pediatric and adult participant pools. There are a number of anatomical changes involving the larynx and vocal folds that occur as children age and become adults. Data were collected using two methods of noninvasive aerodynamic assessment: mechanical interruption and labial interruption. Method: A total of 154 participants aged 4-24 years old took part in this study. Ten trials were performed for both methods of airway interruption. To perform mechanical interruption, participants phonated /[alpha]/ for 10 s trials while a balloon valve interrupted phonation 5 times. For labial interruption, participants said /p[alpha]/ 5 times at comfortable and quiet volumes. Aerodynamic measures included subglottal pressure, phonation threshold pressure, mean airflow, laryngeal resistance, and others. Results: One hundred one participants (51 females) successfully completed testing with both methods. Eight out of 20 measurements were found to have a statistically significant effect of participant age on measurements. Sex alone had a significant effect on vocal efficiency for the labial quiet method. Conclusions: The data discussed here can be used to view age and sex trends in vocal aerodynamic measurements. When using either method of mechanical or labial interruption, participant age needs to be taken into account to properly interpret several aerodynamic parameters. A participant's sex is not as important when using these methods.

Although active learning improves student outcomes in science, technology, engineering, and mathematics (STEM) programs, it may provoke anxiety in some students. We examined whether two psychological variables, social anxiety (psychological distress relating to the fear of negative evaluation by others) and academic self-efficacy (confidence in one's ability to overcome academic challenges), interact with student perceptions of evidence-based instructional practices (EBIPs) and associate with their final grades in a STEM-related course. Human anatomy and physiology students in community college courses rated various EBIPs for their perceived educational value and their capacity to elicit anxiety (N = 227). In general, practices causing students the most anxiety (e.g., cold calling) were reported by students as having the least educational value. When controlling for students' self-reported grade point averages, socially anxious students rated several EBIPs as more anxiety inducing, whereas high-efficacy students reported less anxiety surrounding other EBIPs. Furthermore, mediation analysis revealed that individual differences in academic self-efficacy at the beginning of the term explained some of the negative association between students' social anxiety levels and final grades in the course. Our results, obtained in a community college context, support a growing body of evidence that social anxiety and academic self-efficacy are linked with how students perceive and perform in an active-learning environment.

The amalgamation of educational technologies in higher education is widespread and has become essential for contemporary practice on a large scale. Foundational anatomy and physiology knowledge is integral to all courses in health education. To tackle the volume and complexity of the content taught at the foundation level, the incorporation of online tools embedded within curricula provides a unique opportunity to engage students through active learning strategies in a blended design (Means B, Toyama Y, Murphy R, Baki M. "Teach Coll Rec" 115: 1-47, 2013). This article reports on the use of H5P as a platform to foster self-paced and self-directed learning, critically outlining the developmental process involved in scaffolding activities to learning outcomes. The H5P activities were embedded within the online learning management system, which enabled tracking of student access to these resources. Students were asked to complete an online survey about their perspectives on the effectiveness of H5P activities. This work is part of a comprehensive study evaluating the blended design for delivery of first-year physiology subjects.

Developments in biology and genetics in recent decades have caused significant shifts in the understanding and conceptualization of human biological variation. Humans vary biologically in different ways, including individually, due to age, ancestry, and sex. An understanding of the complexities of all levels of biological variation is necessary for efficient health care delivery. Important steps in teaching medical students about human variation could be carried out in anatomy classes, and thus, it is important that anatomical education absorbs new developments in how biological variation is comprehended. Since the early 1990s biological sex in humans has been vigorously investigated by scientists, social scientists, and interest groups. Consequently, the binary division in male and female sex has been called into question and a more fluid understanding of sex has been proposed. Some of the major textbooks teach anatomy, particularly of the urogenital system, as a male-female binary. Anatomical sciences curricula need to adopt a more current approach to sex including the introduction of the category of "intersex"/"differences in sexual development" and present sex as a continuum rather than two sharply divided sets of characteristics. This approach offers a better understanding of the complexity of sex differences and, at the same time, provides students with an improved theoretical framework for understanding human variation in general, transcending the limitations of biological typology. When well delivered, the non-binary approach could play a significant contribution to the formation of competent and responsible medical practitioners and avoidance of problematic practices such as non-consensual "normalizing" surgeries.

Students around the world demonstrate a limited conceptual understanding of sexual reproduction. A lack of understanding of how the human reproductive system works has been linked with risks such as sexually transmitted diseases and unintended pregnancies. Our focus in this paper is to explore the level of knowledge of reproductive physiology and anatomy among postgraduate students of educational sciences. Administering a questionnaire to 65 educational sciences postgraduate students we traced (a) the level of their knowledge concerning the organs of the male/female reproductive system before and after they were shown pictures of internal/external genitalia and (b) the level of their knowledge concerning the organs where the production of sperm/egg cells and the fertilisation happen. About two-thirds of the students failed to name prostate and external female genitals such as the clitoris and labia, even after detailed pictures were provided to them. Moreover, about one out of five of students appeared to believe that egg cells are produced in the uterus, which -- according to the majority of the students asked -- seems also to be the organ where the fertilisation occurs. Relevant literature and possible implications are discussed.

Formative assessments have been shown to improve student success; however, the format in which these assessments are implemented has not been well researched. In this study, individual Anatomy and Physiology lab sections were administered formative assessments composed of either a projected (i.e. 'shared-display') quiz presentation or a pen-and-paper quiz presentation. Students' performance, as well as their answer-changing behaviours, were recorded to compare the effect of these two assessment formats. We found no significant difference in mean quiz grade between shared-display and pen-and-paper assessments, nor did answer-changing frequency differ by treatment. Student answer-changing "success rate" -- a measure of how often a student changed an answer and their new response was correct -- was found to have a weak but significant positive correlation with mean quiz grade. Our findings suggest that the assessment presentation format does not significantly affect student performance and that, given the population sampled, answer-changing tended to benefit students' final quiz grade. Therefore, projecting images for use in formative assessments provides an alternative to traditional pen-and-paper administration with no apparent detriment or advantage to student success.

Creating summative assessments that accurately test students' breadth of knowledge and critical thinking can be a difficult task. Instructors often rely upon overly complex quick response questions or constructed response exams. However, students often have negative perceptions of the latter. The authors implemented an approach for administering constructed response exams called "Essay Roulette" in which students were given essay prompts a week prior to the exam, and the actual exam questions were chosen by the roll of a die. Students reported increased motivation, a reduction in stress, and saw improvement on their essay performance.

The practical work described here is designed for third-year bachelor students in Life Sciences attending a kidney physiology course. It illustrates how urinary biochemistry can be used for a medical diagnosis. Students have to measure glucose, proteins, and creatinine concentrations in three simulated urine samples. First, they independently elaborate detailed protocols from the biochemical kit's technical sheets. Second, after correction of the protocols by the teacher, they perform the biochemical assays. Finally, students write a report in which they interpret the biochemical data and use them in the context of histological images assigned to each urine sample. With their results, their theoretical background and scientific articles supplied by the teacher, they establish the diagnosis indicating which patients are diseased and from which disease they are suffering (diabetes without nephropathy, diabetic nephropathy or hypertensive nephropathy). The originality of this practical work is to give student autonomy from the start of the project by requiring them to write the protocols, and determine the diagnosis by themselves. Simple and inexpensive, this practical forces students to mobilize their knowledge in renal physiology and pathophysiology as well as those acquired in other disciplines such as biochemistry or cellular biology. A survey conducted on two classes of students confirmed that this type of training helps students to better understand renal physiology, to realize the importance of interdisciplinarity (biochemistry, histology, and physiology) and to develop confidence in their ability to work independently.

This article describes the use of feedback-oriented online assignments in large classes of undergraduate students studying anatomy and physiology to promote active learning, critical thinking, and effective written communication skills.

Education in science, technology, engineering, and math (STEM) is increasingly online, even the laboratory components of STEM courses. As online laboratory education trends upward in terms of enrollment and variety of course offerings, the central question remains: Is online equivalent to a traditional face-to-face (F2F) lab experience? In this study we conducted a retrospective analysis of student performance in an asynchronous online introductory Anatomy and Physiology course with about half of the students opting for a traditional F2F lab and the other half an asynchronous online lab. Although student demographics and level of preparation (incoming GPA) were nearly identical, students enrolled in the F2F laboratory section outperformed their peers in two of three course exams and in both laboratory practical exams. Our data indicate that the type of cognitive task being asked of the student is the main determinant in the efficacy of an online laboratory experience.

The study investigated how explicit instruction of argumentation-in the context of socioscientific issues (SSI)- and explicit instruction of NOS, compared with explicit instruction of argumentation only, can develop grade 10 students' argumentation skills and NOS conceptions. Participants were 36 grade 10 students enrolled in two sections that were randomly assigned into two groups: Treatment and Comparison. The treatment lasted for 4 months and involved two units about autotrophy and the nervous system. Both the Treatment and Comparison group participants received explicit instruction of argumentation -in the context of SSI. Yet, the Treatment group participants experienced explicit instruction of NOS. To assess participants' argumentation skills and NOS conceptions, they were pre- and post-tested using two open-ended questionnaires as well as individual semi-structured interviews. Results indicated that there were improvements related to the learning of argumentation skills for participants in both the Treatment and Comparison groups, who experienced explicit argumentation instruction. Yet, the degree of improvement varied between the two groups, favoring the Treatment group. Results also showed developments in the NOS conceptions of the Treatment group participants who experienced explicit instruction of NOS and argumentation. These results were interpreted along the following themes: instruction of argumentation, instruction of NOS, and coupling of instruction for argumentation and NOS.

Virtual and augmented reality have seen increasing employment for teaching within medical and health sciences programs. For disciplines such as physiology and anatomy, these technologies may disrupt the traditional modes of teaching and content delivery. The objective of this systematic review and meta-analysis is to evaluate the impact of virtual reality or augmented reality on knowledge acquisition for students studying preclinical physiology and anatomy. The protocol was submitted to Prospero and literature search undertaken in PubMed, Embase, ERIC, and other databases. Citations were reviewed and articles published in full assessing learning or knowledge acquisition in preclinical physiology and anatomy from virtual or augmented reality were included. Of the 919 records found, 58 eligible articles were reviewed in full-text, with 8 studies meeting full eligibility requirements. There was no significant difference in knowledge scores from combining the eight studies (626 participants), with the pooled difference being a non-significant increase of 2.9 percentage points (95% CI [-2.9; 8.6]). For the four studies comparing virtual reality to traditional teaching, the pooled treatment effect difference was 5.8 percentage points (95% CI [-4.1; 15.7]). For the five studies comparing augmented reality to traditional teaching, the pooled treatment effect difference was 0.07 (95% CI [-7.0; 7.2]). Upon review of the literature, it is apparent that educators could benefit from adopting assessment processes that evaluate three-dimensional spatial understanding as a priority in physiology and anatomy. The overall evidence suggests that although test performance is not significantly enhanced with either mode, both virtual and augmented reality are viable alternatives to traditional methods of education in health sciences and medical courses.

In this study, two sections of undergraduate Introductory Anatomy and Physiology taught in the traditional face-to-face format (n = 58) was compared to two hybrid classes (n = 38) using the flipped-classroom model taught by the same instructor. Formative and summative examination scores were compared to determine the effect of the different learning methods. Our results revealed no significant difference between the mean scores of summative examinations and between the traditional and hybrid classes (p > 0.05). Of five quizzes administered, students taught in the traditional format scored significantly higher in only one of five quizzes. In addition, comparison of in-class laboratory examination scores showed no difference (P > 0.05) in three out of four. However, student evaluations of the hybrid classes were more positive as determined by end-of-course evaluations (4.54 versus 2.9 on a 1-5 Likert scale). This is the first study that compares a hybrid versus a traditional science course at a historically black college or university. We conclude that comparison of student outcomes in traditional versus hybrid Anatomy and Physiology I classes were similar. At a time when all institutions of higher learning have adopted online learning and distance learning due to the COVID-19 pandemic, this is a timely comparison.

Human rights issues can be topics of conflict, resistance, and indifference; thus, these issues are seldom broached in traditional college STEM courses. In this article, I share process, content, and sources used to introduce college students to the biology of the singularity of race and the biology of sexual identity. One or two class meetings on the connections between biology and human rights were all that was necessary for students to recognize that science courses in fields such as human anatomy and physiology should address human rights issues; science courses can be used as venues to help explain human differences, and these discussions can be of personal significance and use to students.

When communicating with patients, doctors make assumptions as to their ability to comprehend and adjust the complexity of the information accordingly. We studied the knowledge of anatomy and physiology among young men. 150 men, 18 to 26 years old, serving mandatory military service, were interviewed during doctor consultations. The patients had a minimum of nine years of education; 93% had completed upper secondary school or started education at college level. In order to locate organs and indicate organ size, the patients were asked to draw an outline of the heart, kidneys, liver, spleen, appendix and thyroid gland on a pre-drawn outline of the human body. The patients were also asked to explain the major function(s) of these organs in lay terms. Responses were judged as "correct", "partially correct" and "incorrect" against pre-set criteria. The percentage of correct replies with respect to organ location ranged from 9% (spleen) to 49% (appendix), from 4% (liver) to 53% (appendix) with respect to organ size, and from 0.7% (thyroid gland) to 92% (heart) with respect to organ function. Young men have deficient knowledge of the locations and functions of important internal organs. In addition to correct diagnosis and the start of optimal treatment. consultations should include patient education.

Learning the basics of human anatomy is challenging for schoolchildren due to its three-dimensional nature and complexity as a system. This study created educational materials for learning about and teaching the human circulatory system based on augmented reality (AR) technology and a structure-behavior-function (SBF) model, including 2D/3D animations, a game, and a video to complement the current 2D representations in school textbooks. To evaluate the effectiveness of the materials developed, an instructional activity was carried out among fifty-one seventh- and eighth-grade students from a school in central Slovenia. A pretest, posttest, and delayed posttest for the instructional activity tested students' knowledge, and their acceptance of the AR technology was explored through a questionnaire. The results showed significant improvements in students' understanding of the basic anatomy and physiology of the human heart and circulatory system and the effects of adrenaline on the human circulatory system. Students expressed moderate enthusiasm for AR technology, showing the greatest level of acceptance of AR technology making learning more interesting and fun, improving learning, and making it easy to use. Although students showing more knowledge on the pretest expressed higher acceptance of AR technology, the gain in knowledge after an instructional activity was equally beneficial for all participants. The study indicates a beneficial effect of applying 3D animation, videos, and AR technology to understand dynamic and complex biological phenomena.

Throughout the 20th century, philosophers have criticized the scientific understanding of the human body. Instead of presenting the body as a meaningful unity or Gestalt, it is regarded as a complex mechanism and described in quasi-mechanistic terms. In a phenomenological approach, a more intimate experience of the body is presented. This approach, however, is questioned by Jacques Lacan. According to Lacan, three basic possibilities of experiencing the body are to be distinguished: the symbolical (or scientific) body, the imaginary (or ideal) body and the real body. Whereas the symbolical body is increasingly objectified (and even digitalized) by medical science, the phenomenological perception amounts to an idealization of the body. The real body cannot be perceived immediately. Rather, it emerges in the folds and margins of our efforts to symbolize or idealize the body, which are bound to remain incomplete and fragile. In the first part of the article (section 1-section 3), Lacan's conceptual distinction between the symbolical, the imaginary and the real body will be explained. In the second part (section 4-section 5), this distinction will be further clarified by relying on crucial chapters in the history of anatomy (notably Mundinus, Vesalius, Da Vinci and Descartes).

By integrating concepts of computer graphics and artificial intelligence, novel ways of representing medical knowledge become possible. They allow unprecedented possibilities ranging from three-dimensional interactive atlases to systems for surgery rehearsal.

Anatomy and physiology teaching has undergone significant changes to keep up with advances in technology and to cater for a wide array of student specific learning approaches. This paper examines perceptions towards a variety of teaching instruments, techniques, and innovations used in the delivery and teaching of anatomy and physiology for health science students, and asks whether active learning through more progressive methods of teaching is beneficial for students across health science disciplines. In total, 138 health science students consisting of 32 biomedical science students, 52 exercise and sports science students, and 54 health and physical education students completed the retrospective study. Biomedical science students were least receptive to progressive teaching modalities, preferring anatomical dissections to laboratory workbooks (p <0.05) and body painting (p <0.05). In comparison, students from health and sport related degrees responded significantly better to anatomical models and laboratory workbooks than anatomical dissections (p <0.001). While gender differences were subtle, males responded positively to online multiple-choice question resources (p < 0.05) in comparison to females. Following a multimodal delivery of anatomy and physiology, students from all cohorts reported feeling significantly more confident (p < 0.005) when discussing all material in the course. The results obtained demonstrate differences amongst cohorts, which indicate that student perceptions to learning anatomy and physiology are dependent on individual course expectations. Moreover, these results support "hands on" practical teaching, and the use of a variety of teaching tools to foster learning and enjoyment of anatomy and physiology in health sciences.

The main purpose of the study was to investigate pre-service teachers' perceptions of the criteria used to classify animals. In this regard, it was also aimed at exploring conceptual structures and reasoning patterns shaping the pre-service teachers' perceptions. The participants of the present study were 324 pre-service teachers attending science education and biology education departments in Turkey. With the aim of gaining insight into pre-service teachers' perceptions of animal classification, qualitative research method was followed in which the participants were interviewed. In addition to qualitative data, quantitative data were also collected by classification forms and in this way it was aimed to bring variety to analysis results and reinforce them. As a result of the study, the conceptual structures shaping the pre-service teachers' perceptions leading to their evaluations are subsumed under the categories of "morphological, anatomic and physiologic characteristics", "behaviour", "habitat" and "systematic". In light of the findings of the current study, it can be argued that some characteristics of animals were given greater priority while classifying them and this leads to development of some erroneous information and alternative conceptions. More holistic evaluation of the characteristics of animals may allow the development of a better perception of animal classification.

To help students master challenging, threshold concepts in physiology, I used the flipped learning model in a human anatomy and physiology course with very encouraging results in terms of student motivation, preparedness, engagement, and performance. The flipped learning model was enhanced by pre-training and formative assessments that provided opportunities for retrieval practice. Students in flipped learning sections had much higher retention and pass rates than those in non-flipped learning sections. Students also achieved preset benchmarks for factual and procedural knowledge while falling slightly short for conceptual knowledge. I found that the flipped learning model effectively addresses the cognitive load involved in learning physiology, which typically has a high cognitive load. By lowering extraneous cognitive load via intentional content, managing intrinsic cognitive load via pre-training and retrieval practice, and increasing germane cognitive load via the extended class time reserved for problem solving, the flipped learning model offers a very supportive learning environment with numerous opportunities for self-regulated learning for students struggling to master this threshold concept. In future semesters, the increased available class time afforded by the flipped learning format will be used to emphasize conceptual understanding in the problem sets.

Academic content common to health science programs is often taught to a mixed group of students; however, content assessment may be consistent for each discipline. This study used a retrospective cluster analysis on such a group, first to identify high and low achieving students, and second, to determine the distribution of students within clusters based on their chosen program of study. Using a two-step cluster analysis based on five summative assessment scores for 773 undergraduate students, three distinct groups of students were identified: these are described as High Achievers, Standard Achievers, and Low Achievers. High Achievers scored higher in all five assessments compared with Standard Achievers and Low Achievers (all P < 0.01). Also, Standard Achievers scored higher than Low Achievers in all assessments. Membership of the High Achievers cluster comprised 15% Midwives, 20% Nurses, 10% Occupational Therapists, 11% Paramedics, 24% Physiotherapists, and 21% Standard Pathway students. This novel approach provides an opportunity for quantitative reflection on assessment in a large group of students with diverse career aspirations. It may be used to distinguish levels of achievement relative to peers within a group and potentially identify students within a program of study in need of academic assistance.

Students commencing tertiary education enter through a number of traditional and alternative academic pathways. As a result, tertiary institutions encounter a broad range of students, varying in demographic, previous education, characteristics and academic achievement. In recent years, the relatively constant increase in tertiary applications in Australia has not translated to an increase in student retention or graduate numbers. The Health Sciences discipline typically falls within this paradigm, prompting various approaches to promote academic success and overall student retention. In this study, the demographic and previous education of health science students at an Australian University, were analysed along with first year science grades from a core first year anatomy and physiology unit. A generalized linear model (GLM) demonstrated statistically significant relationships between performance in the unit (measured by grade point average) and year 12 Australian Tertiary Admissions Rank (ATAR) subjects (human biology and chemistry; p<0.001) and gender (p<0.001). No significant performance correlation was observed with household socioeconomic status, as measured by socio-economic indexes for areas. Taken together, the results from this study facilitate estimation of academic success by some parameters prior to their commencement at University.

We have studied the intensity of free radical and antioxidant processes in organs (liver, spleen, thymus, lymph nodes of the small intestine, and adrenal glands) and cells (lymphocytes) in the long-term period after combined exposure to a sublethal dose of ?-radiation (6 Gy) and emotional stress. Combined exposure was followed by accumulation of LPO CD and MDA (conjugated dienes and malonic dialdehyde) products in homogenates of the studied organs. To achieve the goal set, experiments were conducted on 40 outbred white mature male rats randomized into groups. The results of the study indicate major changes in lipid peroxidation and antioxidant system under emotional and radiation stress. Ionizing radiation has a dominating role under combined emotional and radiation aftereffect. This resulted in inhibition of antioxidant protection enzymes and development of dual-oxidative stress in experimental animals. Impaired functional relationships of catalytic redox system of glutathione accompanied by inhibiting orientation of changes in activity of glutathione-dependent enzymes, and prolonged tension of the links of antioxidant system can eventually lead to a decrease in antioxidant status of the body, which indicates the need for the development of advanced methods for adaptive correction.

Because Human Anatomy and Physiology (A&P), a gateway course for allied health majors, has high dropout rates nationally, it is challenging to find a successful pedagogical intervention. Reports on the effect of integration of flipped classrooms and whether it improves learning are contradictory for different disciplines. Thus many educators are reluctant to explore the value of flipped classrooms. Therefore, in the present study we compare incorporating flipped classroom and minimal class discussion (control group) with flipped classroom and active learning activities (experimental group) in A&P and their impacts on both students' exam performance and their satisfaction with the course. Assessments consisted of a survey of students' attitudes and a comparison of exam performance in experimental and control groups. Exam performance among the students in flipped-classroom and active learning activities improved significantly relative to the control group [Mean ± SD: (76.93 ± 18.33 vs 67.8 ± 18.81), p<0.001. Student attitude, in which students rated the efficiency of pedagogical learning on a five-point Likert scale, was positive: the majority of students strongly preferred active-learning activities that were incorporated in the flipped-classroom. Students indicated that these activities helped them learn better and to connect the materials to the goals of their future careers (73.88% and 79.77% respectively). Therefore, we conclude that flipped classroom coupled with active learning strategies can improve students' performance and attitude in the introductory A&P course.

The integrated mechanisms of heart contraction are some of the most complex processes for undergraduate biomedical students to understand. Visual models have the potential to enhance learning environments by providing visual representations of complex mechanisms. Despite their benefits, the use of visual models in undergraduate classrooms is still limited. For this study, we tested the effect of a learning sequence of activities related to the cardiac cycle using an augmented reality (AR) application for smartphones and tablets. We were interested in understanding the ability of students to draw and label figures reflecting cardiac function after experiencing the learning sequence using AR. Undergraduate students of the biomedical sciences (control n = 43, experimental n = 58) were enrolled in the course, and their drawings were evaluated using multiple levels of complexity (1 = basic to 5 = complex) through a pre-/posttest structure that included a learning sequence based on AR in the experimental group and regular lecture-based activities in the control group. The complexity of students' drawings was evaluated on the anatomical, physiological, and molecular aspects of heart contraction. We used Cohen's kappa index for interrater reliability when determining the complexity of drawings. Control and experimental groups showed no differences in baseline knowledge (preexamination quiz). The students who experienced the AR activities showed an increase in the complexity of representation levels in posttest results and also showed a significant difference in scores for the final exam in the heart physiology course. Our results indicate that using AR enhances the comprehension of anatomical and physiological concepts of the cardiac cycle for undergraduate biomedical students.

Purpose: The larynx plays a role in swallowing, respiration, and voice production. All three functions change during ontogeny. We investigated ontogenetic shape changes using a mouse model to inform our understanding of how laryngeal form and function are integrated. We understand the characterization of developmental changes to larynx anatomy as a critical step toward using rodent models to study human vocal communication disorders. Method: Contrast-enhanced micro-computed tomography image stacks were used to generate three-dimensional reconstructions of the CD-1 mouse ("Mus musculus") laryngeal cartilaginous framework. Then, we quantified size and shape in four age groups: pups, weanlings, young, and old adults using a combination of landmark and linear morphometrics. We analyzed postnatal patterns of growth and shape in the laryngeal skeleton, as well as morphological integration among four laryngeal cartilages using geometric morphometric methods. Acoustic analysis of vocal patterns was employed to investigate morphological and functional integration. Results: Four cartilages scaled with negative allometry on body mass. Additionally, thyroid, arytenoid, and epiglottic cartilages, but not the cricoid cartilage, showed shape change associated with developmental age. A test for modularity between the four cartilages suggests greater independence of thyroid cartilage shape, hinting at the importance of embryological origin during postnatal development. Finally, mean fundamental frequency, but not fundamental frequency range, varied predictably with size. Conclusion: In a mouse model, the four main laryngeal cartilages do not develop uniformly throughout the first 12 months of life. High-dimensional shape analysis effectively quantified variation in shape across development and in relation to size, as well as clarifying patterns of covariation in shape among cartilages and possibly the ventral pouch.

Many medical schools offer pre-professional programs to undergraduate students. The main purpose of the university pre-professional program (UPPP) is to equip students with the necessary knowledge and skills required to successfully cope with the academic demands of further education provided by professional colleges. The aim of this commentary article is to describe the role of UPPP at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in preparing students to continue studies at the College of Medicine (COM) and other health-related colleges. The anatomy and physiology course is presented as a representative model. An outline of the UPPP in the context of the curriculum, teaching strategies, learning facilities, and assessment is presented. The pre-professional program at KSAU-HS prepares school graduates to become self-learners and enable them to learn effectively in the clinical context in a problem-based learning curriculum at COM.

Anatomy and Physiology courses taught at community colleges tend to focus laboratory hours primarily on anatomy as opposed to physiology. However, research demonstrates that, when instructors utilize active learning approaches (such as in laboratory settings) where students participate in their own learning, students have improved outcomes, such as higher test scores and better retention of material. To provide community college students with opportunities for active learning in physiology, we developed two laboratory exercises to engage students in cardiac and skeletal muscle physiology. We utilized low-cost SpikerBox devices to measure electrical activity during cardiac (electrocardiogram) and skeletal muscle (electromyogram) contraction. Laboratory activities were employed in Anatomy and Physiology courses at two community colleges in southeast Michigan. A 2-h laboratory period was structured with a 20-min slide presentation covering background material on the subject and experiments to examine the effects of environmental variables on nervous system control of cardiac and skeletal muscle contraction. Students were asked to provide hypotheses and proposed mechanisms, complete a results section, and provide conclusions for the experiments based on their results. Our laboratory exercises improved student learning in physiology and knowledge of the scientific method and were well-received by community college students enrolled in Anatomy and Physiology. Our results demonstrate that the use of a SpikerBox for cardiac and skeletal muscle physiology concepts is a low-cost and effective approach to integrate physiology activities into an Anatomy and Physiology course.

Learning anatomy and physiology at university can be challenging, as students need to understand both the language of the discipline and complex topics, such as system integration. Yet learning strategies are rarely taught at university, making it difficult for students to adopt new strategies, if their approach to learning has not been effective or efficient. This study evaluated the use of small-group peer discussion boards as an avenue for sharing learning strategies between students in a first-year anatomy and physiology course. The majority of students (91%) identified strategies from the discussion board worth trying before they completed the midsemester exam. The most frequently reported type of strategy was transforming records. By the end of semester, 76% of students had adopted at least one new strategy; however, these students performed significantly worse on the exam compared with students who did not adopt new strategies. The students who adopted new strategies learned about them from peers (33%), the discussion board (32%), or through self-discovery (32%). The majority of students (83%) found the discussion boards to be useful as a source of new learning strategies and for insight into how others learn. Although the discussion boards provided an avenue for students to learn about new strategies from each other, further guidance from instructors may be required to help students evaluate the effectiveness of these learning strategies.

The authors determined whether positive perceptions of integrating lecture and lab in Anatomy and Physiology courses persisted from 2015-2018. Students (843) and instructors (56) completed the Student Assessment of Their Learning Gains survey; perceptions were positive and consistent between both groups. Participant narratives identified the ability to immediately apply theoretical knowledge in lab as an important positive attribute in improving student learning. The authors also determined whether student performance rates, including unsatisfactory grades (C-, D, F, W), improved during integrated years. Results showed that unsatisfactory grades fell in the integrated years, while results for quiz and exam grades, compared between integrated and traditional years, were inconclusive.

Gatekeeper courses such as Anatomy and Physiology are often referenced in discussions regarding the national shortage of persons in allied health professions. In an attempt to bolster access to STEM professions, some community colleges are mandating prerequisite courses such as Natural Sciences and/or General Biology for STEM gatekeeping courses. In this study, we examined which of these prerequisite courses helped students to pass Anatomy and Physiology and whether the courses are an additional barrier to STEM field completion. This was the first study to evaluate whether a prerequisite course was predictive of success in Anatomy and Physiology, and it contributes to the body of literature regarding student success in the sciences.

Every 40 seconds, someone in the United States has a heart attack (Heart Disease and Stroke Statistics 2017). Students may experience or be affected by several incidences of heart attacks throughout their life. As such, students should be aware of the risk factors and learn the underlying reasons for a heart attack. Most students believe they are too young for a heart attack and think symptoms will appear gradually (Roth and Gotter 2018). Heart disease in younger individuals is appearing more frequently due to obesity, tobacco and alcohol usage, stress, and race (Napoli 2019). In this article, the authors describe how blood flow is important to the cardiovascular system by considering the harmful effects of smoking on the body using the Hewson and Hewson Learning Cycle Instructional Strategy (Keeley and Konicek-Moran 2015).

Italy opened the doors of its universities to female students in 1875. The general view was that very few women were clever enough to obtain a degree, so they would not threaten social stability. Female professors would be even rarer -- a few exceptional "male" women. Access to the professions was impossible in the case of the legal profession, or limited in terms of medicine. In this context, where both Catholics and Positivists opposed women's careers, seeing them as incompatible with motherhood and marriage, five women managed to enter the academic world as unsalaried lecturers: Giuseppina Cattani (1887, Pathology), Paolina Schiff (1891/1893, German literature and language), Rina Monti (1899, Anatomy and Comparative Physiology), Teresa Labriola (1901, Philosophy of Law) and Maria Montessori (1904, Anthropology). With archival documents and other contemporary texts, this paper reconstructs who these women were and the many difficulties they faced in academic life. Four of them were emancipationists and did not marry. These choices debarred them from pursuing a full academic career. Only Monti, who had a family and took no active part in female propaganda, managed to become a full professor in 1911, the first woman in Italy to do so.

Promoting student engagement and academic achievement in first-year anatomy and physiology courses. "Adv Physiol Educ" 43: 443-450, 2019; doi:10.1152/advan.00205.2018. Students from three undergraduate programs at James Cook University, Queensland, Australia, studying combined first-year anatomy and physiology courses, showed different academic achievement in physiology. Physiotherapy students were more active and social when completing learning tasks and achieved significantly higher grades in physiology compared with students enrolled in Sport and Exercise Science and Occupational Therapy programs. To promote academic engagement and achievement by all three groups, discussion questions, case studies, and study guides were included. The aim of this study was to investigate the effectiveness of using these modified resources to promote active learning, enhance academic social interactions, and provide a supportive learning environment. The occupational therapy students showed increased academic achievement (from 57.9 to 66.5%) following implementation of the new resources, but there was no change in the already high-performing physiotherapy students (73.1%) and, more concerningly, the sport and exercise science students (from 54.6 to 56.7%). Fewer sport and exercise science students had prior learning in chemistry (30.4% of participants) and also spent little time outside class studying (8 h/wk), compared with the physiotherapy cohort (70.0% chemistry; 13 h/wk studying). Findings of this research demonstrate that creating a supportive and active learning environment are important factors in promoting the learning of physiology for some cohorts. Background knowledge, academic self-regulatory skills, and the experience of teaching staff are factors that must be considered when endeavoring to increase student academic achievement. Future studies should examine the effect of students' academic self-regulation and the use of remedial chemistry classes when learning physiology.

The study of hemodynamic physiology utilizing traditional methods presents many challenges and limitations to educators. The goal of the educator is to provide the student with an adequate understanding of the basic hemodynamic anatomy and physiology governing blood flow, cardiac cycle and associated Korotkoff sounds, and the pathophysiology of vessel-related diseases. Several teachable moments reinforcing hemodynamic concepts are often overlooked when using traditional methods. The incorporation of arterial tonometry seeks to improve these shortcomings by offering a broader perspective of vascular physiology and introducing unique pathologies of the vasculature such as arterial stiffness and endothelial disorders.

Engaging students in discussion and creating high impact teaching and learning practices are a challenge in every classroom. Small group discussion and poster presentations were used to solve case-based problems to highlight issues for the learner and to allow each student to demonstrate understanding and application of theory to real life examples through open-ended, focused questions. This study consisted of students enrolled in an Anatomy and Physiology course sequence. Assessment was based on group goal and individual accountability. Rubrics for evaluation were developed for self and peer assessment of each groups' dynamics. A poster session provided our students with an opportunity to explain their work to an audience, as well as generate active discussion and peer evaluations. This study showed a significant positive effect (p = 0.0001-0.0025) on students' knowledge, attitude and psychomotor skills.

Rats can be used as a model organism to teach physiological concepts in a laboratory setting. This article describes a two-part laboratory that introduces students to hypothesis testing, experimental design, the appropriate use of controls and surgical techniques. Students perform both a castration and sham-control surgery on male rats and test the effects of reduced testosterone due to castration on the weight and histology of seminal vesicles. After performing the surgeries and collecting the data, students learn histological techniques, as well as empirical data collection, analysis and interpretation. Demonstrating the effects of testosterone through castration surgery bridges concepts learned in a traditional physiology class setting with data gleaned from research in a laboratory. Overall, the male castration surgery provides students with hands-on skills and an understanding of the work done by scientific researchers and health care professionals.

Intrinsic and extrinsic motivations of undergraduate students enrolled in human anatomy and physiology, physics, and nutrition courses were explored with course discipline-specific adapted versions of the Academic Motivation Scale. Information on students' study habits and efforts, and final course grades were also collected. Results revealed the adapted versions of the Academic Motivation Scale had comparable reliabilities to previous investigations, significant differences in motivations across the students enrolled in the three courses and significant influences of motivation on academic behaviors and course performance.