Humanizing physiology education.

We teach medical and other health professional students “human physiology,” so one might wonder at the title of this editorial. One definition of humanize is “to make something friendlier to humans. Humanizing makes things more civilized, refined,andunderstandable”(https://www. vocabulary.com/dictionary/humanize). So, should we even attempt to humanize physiology education? And, if so, how might we do this? Given that every instructor would wish to make the subject friendlier and more understandable, it follows that we should attempt to humanize physiology education. So how can we work toward achieving this? We are actually in a unique situation in physiology, for in no other course is the student also the subject of the course. I used to say to my students, “Physiology is not out there; it’s not in books, it is all about you. And if you analyze how you respond in situations, then you already know a lot of physiology.” So the first simple thing we can do is just make sure that students relate what we are discussing to themselves. It really is extraordinary how much students can tell you in response to a series of questions. We can lecture at them about, say, the production of a concentrated urine, but it’s much better if they can begin by telling us under what circumstances they notice that their urine is more highly colored. They can then speculate about what this means and the physiological advantages of a concentrated urine in the morning or after exercise. Having thought about this, they are then curious to understand the detailed mechanisms of how this concentration of the urine is achieved and are perfectly capable of researching and finding the required information for themselves. It used to be that this “active learning” approach was best carried out with small groups interacting directly with an instructor. This is expensive in staff time, and for that reason many of us, although we would like to have used this approach, just could not do so. But modern technology is transforming learning, and it is now possible for students to study online either individually or in small groups and work their way through a series of questions and receive immediate feedback as they go. Their instructor can see what they have done, and how long they have taken, and can then meet with them to discuss any issues that have arisen during this self-study session. Note that this approach does not replace instructors. Instead, it allows much more meaningful interactions between students and instructors–an example of humanizing physiology by making the learning friendlier for humans! We can also humanize physiology education by appropriate use of laboratory time. There continues to be debate about the place of laboratory learning in courses for aspiring health professionals. If we run laboratories in isolation from the rest of the teaching program, perform the experiments largely using anesthetized animals or animal organs and tissues, and do not include assessment of the laboratory work in determining the final grades, then laboratory time can never be justified. However, it can be justified when the experiments are performed on the students themselves, with the laboratories integrated into the rest of a course that includes illustrative patient cases, and with due recognition of the laboratory learning in the assessment procedures. There is essential learning that occurs best in a laboratory setting. Laboratory work enables students to appreciate biological variability, it illustrates basic physiological principles including homeostasis, and it shows students the difficulties and pitfalls in making “simple” measurements of biological variables (e.g., blood pressure, pulse, ECGs, lung function tests, nerve conduction studies, measurements of blood glucose or body temperature, urine analysis). It provides experience in data analysis (e.g., interpretation of tables and graphs), including simple statistical analysis And, very importantly, laboratory work can provide an introduction to scientific method and experimental design. Modern technology has allowed us to transform the laboratory experience, making it possible to measure many important physiological variables on the students themselves. And nothing excites students more in a laboratory than seeing their own physiological data. It is also very easy to show students how to do a technique and then allow them to design and perform their own studies. So, for example, we can show them how to record their blood pressure and then let them generate questions that they can then answer with the equipment provided. For example, they might ask whether posture affects blood pressure or whether cuff size makes any difference to the measured pressure. We can also record data from patients with a particular condition using the same hardware and software that the students use in the laboratory. This allows students to make the same measurements on the patient’s data as they do on their own. Differences in the findings are immediately obvious and provide an ideal opportunity for discussion of the disturbances in physiology that result during illness. Also, comparison of student and patient results shows the students that what they are doing in the laboratory is directly related to how disturbances in function are assessed clinically. Through the online study and laboratory work, students feel a sense of ownership of their learning. They are learning the things that they have identified as important to know and understand. But it is also very important that students learn the context in which they will use the information in the future. To retrieve information from our memory when we need it, we must have associated this learning with its future use. Since our students intend to become health professionals, what better way is there for them to learn than to do so in clinical contexts. Many of us have used paper cases to provide a learning framework for basic physiological principles. For example: