Active teaching and learning for a deeper understanding of physiology.

THIS LETTER is intended to contribute to the discussion of active versus passive learning in physiology. Here are some thoughts for consideration: are we, as teachers, making a difference in the learning process? How do we ensure that we emphasize the acquisition of knowledge rather than short-term memorization? Considering the pertinent discussion regarding the quality of learning in physiology by undergraduate students, a short survey with cardiorespiratory questions was distributed at the end of a physiology course (Table 1). Students were informed that the survey was voluntary. It was emphasized that students did not have to answer questions if they did not know the answer. Of 50 students, 40 students returned the questionnaire. The outcome shows results similar to surveys conducted in several different educational institutions across the country (1, 2, 4). The first part of the survey asked questions about physiological parameters familiar from everyday experiences. Students were asked what would happen to the strength of the heart beat after exercise. While most students (88%) responded that it would increase, only 15% of them were able to explain the action of the sympathetic nervous system (4 correct answers among 26 that attempted to respond). This result is in agreement with those of Michael et al. (2), who concluded that many students memorize facts but do not develop a deeper understanding of how physiological phenomena occur. Another important point brought out by this survey was the presence of misconceptions. When students were asked about the respiratory changes after quickly climbing a set of stairs, the majority of them (85%) knew that the respiratory rate would increase, but only 40% of them correctly responded that the depth of respiration would increase as well. Among these students, only 24% of them could explain the role of chemoreceptors. Similar findings have been described in a previously published survey including seven United States institutions (1). There are many possible interpretations for the results of the survey, but it is clear that despite our efforts to provide high-quality lectures and computerized laboratory exercises, only a small proportion of the material taught is effectively learned, and student performance does not meet our expectations. In our survey, student performance on questions that aimed to test the application of understanding of the material was significantly lower than questions testing for the assimilation of information. How do we then prepare our students so that they assimilate facts but are able to integrated them and apply them into new situations that they have not previously encountered? This issue of students not accomplishing a deeper understanding of physiology is also a reflection of teacher’s ineffectiveness. In reality, what has been repeated for generations is preparing the student for the exam. This invariably results in a low level of deep understanding at the end of a course. We seem to focus more on the “teaching facts” than on the “learning concepts.” We as teachers are preoccupied in making sure that we expose the students to as much of the information Address for reprint requests and other correspondence: H. Carvalho, Dept. of Physiology and Biophysics, School of Medicine, Virginia Commonwealth Univ., 1101 E. Marshall St., PO Box 980551, Richmond, VA 23298 (e-mail: [email protected]).