Pub Date : 2024-08-08DOI: 10.1152/advan.00086.2024
Jack A Rall
The expression excitation-contraction (EC) coupling in skeletal muscle was coined in 1952 (1). The term evolved narrowly to include only the processes at the triad that intervene between depolarization of the transverse tubular (T-tubular) membrane and Ca2+ release from the sarcoplasmic reticulum (SR). From 1970 to 1988, the foundation of EC coupling was elucidated. The channel through which Ca2+ was released during activation was located in the SR by its specific binding to the plant insecticide ryanodine. This channel was called the ryanodine receptor (RyR). The RyR contained four subunits that together constituted the "SR foot" structure that traversed the gap between the SR and the T-tubular membrane. Ca2+ channels, also called dihydropyridine receptors (DHPRs), were located in the T-tubular membrane at the triadic junction and shown to be essential for EC coupling. There was a precise relationship between the two channels. Four DHPRs, organized as tetrads, were superimposed on alternate RyRs. This structure was consistent with the proposal that EC coupling was mediated via a movement of intramembrane charge in the T-tubular system. The speculation was that the DHPR acted as a voltage sensor transferring information to the RyRs of the SR by protein-protein interaction causing the release of Ca2+ from the SR. A great deal of progress was made by 1988 toward understanding EC coupling. However, the ultimate question of how voltage-sensing is coupled to opening of the SR Ca2+ release channel remains unresolved.
骨骼肌中的兴奋-收缩(EC)耦合这一说法诞生于 1952 年(1)。该术语狭义地演变为只包括横小管(T-tubular)膜去极化和肌浆网(SR)释放 Ca2+ 之间的三联体过程。从 1970 年到 1988 年,EC 耦合的基础被阐明。激活过程中释放 Ca2+ 的通道通过与植物杀虫剂雷诺丁的特异性结合被定位在 SR 中。这一通道被称为雷诺丁受体(RyR)。RyR 包含四个亚基,共同构成 "SR 足 "结构,穿越 SR 和 T 管膜之间的间隙。Ca2+通道,也称为二氢吡啶受体(DHPRs),位于三联体交界处的T管膜上,对心肌耦合至关重要。这两种通道之间存在着精确的关系。四个 DHPRs 以四分体的形式叠加在交替的 RyRs 上。这种结构与 EC 耦合是通过 T 管系统中的膜内电荷移动介导的这一提议相一致。根据推测,DHPR 起着电压传感器的作用,通过蛋白质与蛋白质之间的相互作用将信息传递给 SR 的 RyR,从而导致从 SR 释放 Ca2+。到 1988 年,在理解 EC 耦合方面取得了很大进展。然而,电压感应如何与 SR Ca2+ 释放通道的开启相耦合这一终极问题仍未解决。
{"title":"The foundation of excitation-contraction coupling in skeletal muscle: Communication between the transverse tubules and sarcoplasmic reticulum.","authors":"Jack A Rall","doi":"10.1152/advan.00086.2024","DOIUrl":"https://doi.org/10.1152/advan.00086.2024","url":null,"abstract":"<p><p>The expression excitation-contraction (EC) coupling in skeletal muscle was coined in 1952 (1). The term evolved narrowly to include only the processes at the triad that intervene between depolarization of the transverse tubular (T-tubular) membrane and Ca<sup>2+</sup> release from the sarcoplasmic reticulum (SR). From 1970 to 1988, the foundation of EC coupling was elucidated. The channel through which Ca<sup>2+</sup> was released during activation was located in the SR by its specific binding to the plant insecticide ryanodine. This channel was called the ryanodine receptor (RyR). The RyR contained four subunits that together constituted the \"SR foot\" structure that traversed the gap between the SR and the T-tubular membrane. Ca<sup>2+</sup> channels, also called dihydropyridine receptors (DHPRs), were located in the T-tubular membrane at the triadic junction and shown to be essential for EC coupling. There was a precise relationship between the two channels. Four DHPRs, organized as tetrads, were superimposed on alternate RyRs. This structure was consistent with the proposal that EC coupling was mediated via a movement of intramembrane charge in the T-tubular system. The speculation was that the DHPR acted as a voltage sensor transferring information to the RyRs of the SR by protein-protein interaction causing the release of Ca<sup>2+</sup> from the SR. A great deal of progress was made by 1988 toward understanding EC coupling. However, the ultimate question of how voltage-sensing is coupled to opening of the SR Ca<sup>2+</sup> release channel remains unresolved.</p>","PeriodicalId":50852,"journal":{"name":"Advances in Physiology Education","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-25DOI: 10.1152/advan.00120.2024
Derek E Bowman, Heidi L Lujan, Stephen E DiCarlo
Understanding complex physiological processes is a cornerstone of medical education, and one such fundamental concept is the regulation of the glomerular filtration rate (GFR) by Starling forces. Therefore, developing a physiologically sound educational model to demonstrate these forces can significantly enhance the learning experience for students, providing them with a clear and comprehensive understanding of renal filtration. Starling forces include the glomerular capillary hydrostatic pressure, which drives plasma filtration; the plasma colloid osmotic pressure (also referred to as the oncotic pressure within the capillary), which opposes filtration; and the Bowman's capsule hydrostatic pressure, which resists fluid influx. Bowman's capsule oncotic pressure is typically considered negligible in healthy kidneys and, therefore, does not usually influence the glomerular filtration process. It is crucial for future clinicians to understand these Starling forces in order to monitor and manage kidney function effectively. To aid in understanding these concepts, we present a simple yet effective physical model of GFR. This model uses pressurized air and a serological pipette setup to simulate the filtration process, with a ping-pong ball's height representing GFR. Various perturbations demonstrate changes in Starling forces, allowing students to visualize the impact of different physiological and pathological conditions on GFR. This hands-on approach aims to simplify the complex interplay of factors affecting GFR, making it an invaluable educational tool for medical students.
理解复杂的生理过程是医学教育的基石,其中一个基本概念就是斯特林力对肾小球滤过率(GFR)的调节。因此,开发一个生理学上合理的教学模型来演示这些作用力,可以大大增强学生的学习体验,让他们对肾脏滤过有一个清晰而全面的了解。斯特林力包括推动血浆滤过的肾小球毛细血管静水压、反对滤过的血浆胶体渗透压(也称为毛细血管内的渗透压)以及阻止液体流入的鲍曼囊静水压。在健康肾脏中,鲍曼囊膜张压力通常可以忽略不计,因此通常不会影响肾小球滤过过程。对于未来的临床医生来说,了解这些斯特林力对于有效监测和管理肾功能至关重要。为了帮助理解这些概念,我们提出了一个简单而有效的 GFR 物理模型。该模型使用加压空气和血清学吸管装置来模拟过滤过程,乒乓球的高度代表 GFR。各种扰动会显示斯特林力的变化,让学生直观地了解不同生理和病理条件对 GFR 的影响。这种动手操作的方法旨在简化影响肾小球滤过率的各种因素之间复杂的相互作用,使其成为医科学生宝贵的教育工具。
{"title":"Visualizing Filtration: A Hands-On Model for Understanding Starling Forces in Glomerular Filtration Rate.","authors":"Derek E Bowman, Heidi L Lujan, Stephen E DiCarlo","doi":"10.1152/advan.00120.2024","DOIUrl":"https://doi.org/10.1152/advan.00120.2024","url":null,"abstract":"<p><p>Understanding complex physiological processes is a cornerstone of medical education, and one such fundamental concept is the regulation of the glomerular filtration rate (GFR) by Starling forces. Therefore, developing a physiologically sound educational model to demonstrate these forces can significantly enhance the learning experience for students, providing them with a clear and comprehensive understanding of renal filtration. Starling forces include the glomerular capillary hydrostatic pressure, which drives plasma filtration; the plasma colloid osmotic pressure (also referred to as the oncotic pressure within the capillary), which opposes filtration; and the Bowman's capsule hydrostatic pressure, which resists fluid influx. Bowman's capsule oncotic pressure is typically considered negligible in healthy kidneys and, therefore, does not usually influence the glomerular filtration process. It is crucial for future clinicians to understand these Starling forces in order to monitor and manage kidney function effectively. To aid in understanding these concepts, we present a simple yet effective physical model of GFR. This model uses pressurized air and a serological pipette setup to simulate the filtration process, with a ping-pong ball's height representing GFR. Various perturbations demonstrate changes in Starling forces, allowing students to visualize the impact of different physiological and pathological conditions on GFR. This hands-on approach aims to simplify the complex interplay of factors affecting GFR, making it an invaluable educational tool for medical students.</p>","PeriodicalId":50852,"journal":{"name":"Advances in Physiology Education","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-11DOI: 10.1152/advan.00181.2023
Christophe O Soulage, Fabien Van Coppenolle, Fitsum Guebre-Egziabher
Artificial intelligence (AI) has gained massive interest with the public release of the conversational AI "ChatGPT" but it also has become a matter of concern for academia as it can easily be misused. We performed a quantitative evaluation of the performance of ChatGPT on a medical physiology university examination. Forty-one answers were obtained with ChatGPT and compared to the results of 24 students. The results of ChatGPT were significantly better than those of the students; median (IQR) score was 75 (66-84) % for the AI compared to 56 (43-65) % for students (p<0.001). The exam success rate was 100% for ChatGPT, whereas 29% (n=7) of students failed. ChatGPT could promote plagiarism and intellectual laziness among students and could represent a new and easy way to cheat, especially when evaluations are performed online. Considering that these powerful AI tools are now freely available, scholars should take great care to construct assessments that really evaluate the student reflection skills and prevent AI-assisted cheating.
{"title":"The conversational AI \"ChatGPT\" outperforms medical students on a physiology university examination.","authors":"Christophe O Soulage, Fabien Van Coppenolle, Fitsum Guebre-Egziabher","doi":"10.1152/advan.00181.2023","DOIUrl":"https://doi.org/10.1152/advan.00181.2023","url":null,"abstract":"<p><p>Artificial intelligence (AI) has gained massive interest with the public release of the conversational AI \"ChatGPT\" but it also has become a matter of concern for academia as it can easily be misused. We performed a quantitative evaluation of the performance of ChatGPT on a medical physiology university examination. Forty-one answers were obtained with ChatGPT and compared to the results of 24 students. The results of ChatGPT were significantly better than those of the students; median (IQR) score was 75 (66-84) % for the AI compared to 56 (43-65) % for students (p<0.001). The exam success rate was 100% for ChatGPT, whereas 29% (n=7) of students failed. ChatGPT could promote plagiarism and intellectual laziness among students and could represent a new and easy way to cheat, especially when evaluations are performed online. Considering that these powerful AI tools are now freely available, scholars should take great care to construct assessments that really evaluate the student reflection skills and prevent AI-assisted cheating.</p>","PeriodicalId":50852,"journal":{"name":"Advances in Physiology Education","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-11DOI: 10.1152/advan.00023.2024
Guilherme Brito-da-Silva, Gustavo Manzanares, Beatriz Beltrame Barone, Vanessa Silva Dos Santos, Sabrina Sturion Fillipini, Paulo Guimaraes Gandra
Carbohydrates and fats constitute our primary energy sources. The importance of each of these energy substrates varies across cell types and physiological conditions. For example, the brain normally relies almost exclusively on glucose oxidation, while skeletal muscle shifts from lipids towards higher carbohydrate oxidation rates as exercise intensity increases. Understanding how carbohydrate are stored in our cells and which tissues contain significant carbohydrate stores is crucial for health professionals, especially given the role of carbohydrate metabolism in various pathophysiological conditions. This laboratory activity uses a simple and low-cost iodine binding method to quantify glycogen in mouse skeletal muscle and liver samples. By integrating the results of this activity with literature data, students can determine overall glycogen storage in the human body. The primary goal of the activity is to enhance students understanding of the importance and limitations of glycogen stores in energy metabolism.
{"title":"Carbohydrate storage in cells: a laboratory activity for the assessment of glycogen stores in biological tissues.","authors":"Guilherme Brito-da-Silva, Gustavo Manzanares, Beatriz Beltrame Barone, Vanessa Silva Dos Santos, Sabrina Sturion Fillipini, Paulo Guimaraes Gandra","doi":"10.1152/advan.00023.2024","DOIUrl":"https://doi.org/10.1152/advan.00023.2024","url":null,"abstract":"<p><p>Carbohydrates and fats constitute our primary energy sources. The importance of each of these energy substrates varies across cell types and physiological conditions. For example, the brain normally relies almost exclusively on glucose oxidation, while skeletal muscle shifts from lipids towards higher carbohydrate oxidation rates as exercise intensity increases. Understanding how carbohydrate are stored in our cells and which tissues contain significant carbohydrate stores is crucial for health professionals, especially given the role of carbohydrate metabolism in various pathophysiological conditions. This laboratory activity uses a simple and low-cost iodine binding method to quantify glycogen in mouse skeletal muscle and liver samples. By integrating the results of this activity with literature data, students can determine overall glycogen storage in the human body. The primary goal of the activity is to enhance students understanding of the importance and limitations of glycogen stores in energy metabolism.</p>","PeriodicalId":50852,"journal":{"name":"Advances in Physiology Education","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-03-07DOI: 10.1152/advan.00122.2023
Kristen L W Walton
Views of obesity as a consequence of "lack of willpower" or other behavioral choices, rather than a complex array of biological and other factors, are quite common among undergraduate students. Many undergraduates in prenursing or biology programs have little exposure to the physiology and pathophysiology of obesity, including learning about leptin and other hormones involved in appetite control. I developed materials for teaching about the pathophysiology of obesity in two different pathophysiology courses: one designed as a survey of pathophysiology topics for prenursing majors, and the other designed as an in-depth exploration of the molecular and cellular basis of selected diseases for upper-division biology majors. In the molecular basis of disease course, obesity is covered as part of a unit organized around metabolic syndrome. The discussion includes molecular and cellular mechanisms that link obesity to several other diseases, including type 2 diabetes and atherosclerosis. This article briefly describes the approaches I have taken for teaching obesity to two different undergraduate student populations and lists several resources that may be useful tools for teaching about obesity.NEW & NOTEWORTHY This article describes approaches for teaching obesity in an allied health major pathophysiology course, and, additionally, in an upper-division biology major course on the cellular and molecular basis of disease.
{"title":"Approaches to teaching about mechanisms of obesity in undergraduate pathophysiology courses.","authors":"Kristen L W Walton","doi":"10.1152/advan.00122.2023","DOIUrl":"10.1152/advan.00122.2023","url":null,"abstract":"<p><p>Views of obesity as a consequence of \"lack of willpower\" or other behavioral choices, rather than a complex array of biological and other factors, are quite common among undergraduate students. Many undergraduates in prenursing or biology programs have little exposure to the physiology and pathophysiology of obesity, including learning about leptin and other hormones involved in appetite control. I developed materials for teaching about the pathophysiology of obesity in two different pathophysiology courses: one designed as a survey of pathophysiology topics for prenursing majors, and the other designed as an in-depth exploration of the molecular and cellular basis of selected diseases for upper-division biology majors. In the molecular basis of disease course, obesity is covered as part of a unit organized around metabolic syndrome. The discussion includes molecular and cellular mechanisms that link obesity to several other diseases, including type 2 diabetes and atherosclerosis. This article briefly describes the approaches I have taken for teaching obesity to two different undergraduate student populations and lists several resources that may be useful tools for teaching about obesity.<b>NEW & NOTEWORTHY</b> This article describes approaches for teaching obesity in an allied health major pathophysiology course, and, additionally, in an upper-division biology major course on the cellular and molecular basis of disease.</p>","PeriodicalId":50852,"journal":{"name":"Advances in Physiology Education","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-01-04DOI: 10.1152/advan.00187.2023
Douglas R Seals
The ability to effectively host a guest speaker is an important but underemphasized aspect of career development in the physiological and broader biomedical sciences. Currently, there is scant information available to guide early-career scientists through this multifaceted, subtlety-filled process. In this Personal View on Training and Mentoring, I first describe the importance and benefits of hosting visiting speakers. I then discuss the many considerations involved in selecting an appropriate speaker and how to formulate the invitation to present. The key activities involved in planning and preparing for a speaker's visit are described next, including information that must be obtained from the speaker, the logistics of travel and lodging, constructing an effective itinerary, food/meals, and how the presentation will be advertised. I then delve into the essential components of host responsibilities during the visit: best practices for introducing speakers, other hosting duties associated with the presentation, tips for enhancing trainee interactions with the speaker, and keys to properly completing the visit on the right note. I next discuss events occurring after the visit, including speaker expenses, reimbursements, and honoraria. Last, the distinct aspects of virtual visits (i.e., remote presentations and meetings) compared with in-person visits are noted. Overall, this viewpoint is intended to provide a comprehensive guide to successfully hosting a guest speaker that should help advance the professional development of students, postdoctoral fellows, and other early-stage investigators.NEW & NOTEWORTHY This Personal View on Training and Mentoring provides a comprehensive guide to successfully hosting a guest speaker that should help inform and advance the professional development of students, postdoctoral fellows, and other early-stage investigators.
{"title":"The complete guide to hosting a guest speaker.","authors":"Douglas R Seals","doi":"10.1152/advan.00187.2023","DOIUrl":"10.1152/advan.00187.2023","url":null,"abstract":"<p><p>The ability to effectively host a guest speaker is an important but underemphasized aspect of career development in the physiological and broader biomedical sciences. Currently, there is scant information available to guide early-career scientists through this multifaceted, subtlety-filled process. In this Personal View on Training and Mentoring, I first describe the importance and benefits of hosting visiting speakers. I then discuss the many considerations involved in selecting an appropriate speaker and how to formulate the invitation to present. The key activities involved in planning and preparing for a speaker's visit are described next, including information that must be obtained from the speaker, the logistics of travel and lodging, constructing an effective itinerary, food/meals, and how the presentation will be advertised. I then delve into the essential components of host responsibilities during the visit: best practices for introducing speakers, other hosting duties associated with the presentation, tips for enhancing trainee interactions with the speaker, and keys to properly completing the visit on the right note. I next discuss events occurring after the visit, including speaker expenses, reimbursements, and honoraria. Last, the distinct aspects of virtual visits (i.e., remote presentations and meetings) compared with in-person visits are noted. Overall, this viewpoint is intended to provide a comprehensive guide to successfully hosting a guest speaker that should help advance the professional development of students, postdoctoral fellows, and other early-stage investigators.<b>NEW & NOTEWORTHY</b> This Personal View on Training and Mentoring provides a comprehensive guide to successfully hosting a guest speaker that should help inform and advance the professional development of students, postdoctoral fellows, and other early-stage investigators.</p>","PeriodicalId":50852,"journal":{"name":"Advances in Physiology Education","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-01-11DOI: 10.1152/advan.00253.2023
Helbert Rondon-Berrios
This article introduces an innovative teaching and learning tool called "Edelman Gamblegrams" that aims to help medical learners better understand disorders related to water/plasma tonicity homeostasis, i.e., hyponatremia and hypernatremia. Gamblegrams, named after physician James L. Gamble, are bar diagrams displaying the relative abundance of extracellular anions and cations and are commonly used in the analysis of acid-base disorders. The Edelman equation represents the physiological variables that determine plasma sodium concentration, namely, total body sodium mass, total body potassium mass, and total body water volume. Edelman Gamblegrams inspired by traditional Gamblegrams but using the components of the Edelman equation, visually demonstrate how sodium, potassium, and water contribute to plasma sodium concentration under normal and pathological conditions. Scenarios that lead to hypotonic hyponatremia and hypernatremia in Edelman Gamblegrams are also discussed. Furthermore, examples of how these visual aids can enhance understanding of the pathogenesis of dysnatremias are also presented. Overall, the use of Edelman Gamblegrams has the potential to improve comprehension and retention of concepts related to water/plasma tonicity homeostasis.NEW & NOTEWORTHY This article introduces a new teaching tool called "Edelman Gamblegrams," modeled after the conventional Gamblegrams used in acid-base disorder analysis and using the independent physiological variables that determine the plasma sodium concentration (Edelman equation), that aims to help medical learners understand disorders related to water/plasma tonicity homeostasis.
本文介绍了一种名为 "埃德尔曼甘布尔图 "的创新教学工具,旨在帮助医学学习者更好地理解与水/血浆补养平衡相关的疾病,即低钠血症和高钠血症。甘布尔图以医生詹姆斯-L-甘布尔(James L. Gamble)的名字命名,是显示细胞外阴离子和阳离子相对丰度的条形图,常用于分析酸碱失调。埃德尔曼方程表示决定血浆钠浓度的生理变量,即体内钠总量、体内钾总量和体内水总量。受传统甘布尔图的启发,爱德曼甘布尔图使用了爱德曼方程的各个组成部分,直观地展示了钠、钾和水在正常和病理情况下对血浆钠浓度的影响。还讨论了使用埃德尔曼甘布尔图导致低渗性低钠血症和高钠血症的情况。此外,还举例说明了这些可视化辅助工具如何加深对失调症发病机制的理解。总之,使用埃德尔曼甘布尔图有可能提高对水/血浆补养平衡相关概念的理解和记忆。
{"title":"Edelman Gamblegrams: a tool to teach and learn disorders of water/plasma tonicity homeostasis.","authors":"Helbert Rondon-Berrios","doi":"10.1152/advan.00253.2023","DOIUrl":"10.1152/advan.00253.2023","url":null,"abstract":"<p><p>This article introduces an innovative teaching and learning tool called \"Edelman Gamblegrams\" that aims to help medical learners better understand disorders related to water/plasma tonicity homeostasis, i.e., hyponatremia and hypernatremia. Gamblegrams, named after physician James L. Gamble, are bar diagrams displaying the relative abundance of extracellular anions and cations and are commonly used in the analysis of acid-base disorders. The Edelman equation represents the physiological variables that determine plasma sodium concentration, namely, total body sodium mass, total body potassium mass, and total body water volume. Edelman Gamblegrams inspired by traditional Gamblegrams but using the components of the Edelman equation, visually demonstrate how sodium, potassium, and water contribute to plasma sodium concentration under normal and pathological conditions. Scenarios that lead to hypotonic hyponatremia and hypernatremia in Edelman Gamblegrams are also discussed. Furthermore, examples of how these visual aids can enhance understanding of the pathogenesis of dysnatremias are also presented. Overall, the use of Edelman Gamblegrams has the potential to improve comprehension and retention of concepts related to water/plasma tonicity homeostasis.<b>NEW & NOTEWORTHY</b> This article introduces a new teaching tool called \"Edelman Gamblegrams,\" modeled after the conventional Gamblegrams used in acid-base disorder analysis and using the independent physiological variables that determine the plasma sodium concentration (Edelman equation), that aims to help medical learners understand disorders related to water/plasma tonicity homeostasis.</p>","PeriodicalId":50852,"journal":{"name":"Advances in Physiology Education","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-01-25DOI: 10.1152/advan.00028.2023
Ben-Hur Souto Das Neves, Victória Ávila Martini, Mayúme de Freitas Fantti, Pâmela Billig Mello-Carpes
Neuroeducation is characterized as a subarea of neuroscience that involves comprehending the teaching and learning processes and relating them to neuroanatomy, neurophysiology, and neuropsychology. The inclusion of some aspects of the neuroscience of learning in teachers' and students' formation, applying them in teaching-learning environments, contributes to the quality of education and impacts students' quality of life and health. Thus, the POPNEURO outreach program performs interventions with students and teachers of low-income schools to disseminate neuroscience concepts, relating them to the students' daily lives. This study reports the impact of these actions, assessed 1 yr after their conclusion. The results showed that the long-term impact of the activities carried out is, in general, positive. Even 1 yr after the activities end, students demonstrate knowledge about the neuroscience themes and satisfaction with participating.NEW & NOTEWORTHY This article reports on neuroscience disclosure activities performed with school students and describes their short- and long-term positive impact. Even 1 yr after the activities, students demonstrate knowledge about the themes worked on and satisfaction with the activities.
{"title":"Long-term impact of neuroscience outreach interventions on elementary students' knowledge.","authors":"Ben-Hur Souto Das Neves, Victória Ávila Martini, Mayúme de Freitas Fantti, Pâmela Billig Mello-Carpes","doi":"10.1152/advan.00028.2023","DOIUrl":"10.1152/advan.00028.2023","url":null,"abstract":"<p><p>Neuroeducation is characterized as a subarea of neuroscience that involves comprehending the teaching and learning processes and relating them to neuroanatomy, neurophysiology, and neuropsychology. The inclusion of some aspects of the neuroscience of learning in teachers' and students' formation, applying them in teaching-learning environments, contributes to the quality of education and impacts students' quality of life and health. Thus, the POPNEURO outreach program performs interventions with students and teachers of low-income schools to disseminate neuroscience concepts, relating them to the students' daily lives. This study reports the impact of these actions, assessed 1 yr after their conclusion. The results showed that the long-term impact of the activities carried out is, in general, positive. Even 1 yr after the activities end, students demonstrate knowledge about the neuroscience themes and satisfaction with participating.<b>NEW & NOTEWORTHY</b> This article reports on neuroscience disclosure activities performed with school students and describes their short- and long-term positive impact. Even 1 yr after the activities, students demonstrate knowledge about the themes worked on and satisfaction with the activities.</p>","PeriodicalId":50852,"journal":{"name":"Advances in Physiology Education","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Effective communication skills are pivotal in health care, particularly when conveying distressing information to patients and their families. However, medical education still lacks the adoption of a universal model that can be incorporated into the curricula to train and assess students in effectively communicating with patients. This study aims to assess the impact of training undergraduate medical students to deliver bad news effectively using the Empowering Medical students' skills in BReaking bAd news with Compassion and Empathy (EMBRACE) module. This randomized case-control study involved medical students from the first, second, and third professional years (study group, n = 75; control group, n = 75). For the study group, the EMBRACE modules were distributed. Then, a 1-hour training session on effectively delivering bad news was followed by a multiple-choice question test and objective structured clinical examination with response, interpretation, and communication skills stations. Participants' feedback was obtained on a five-point Likert scale. There was a highly significant improvement in knowledge and skills among the study group compared to controls with a P value less than 0.0001. Of the participants, 98.76% perceived that the training equipped them with practical skills, and 98.77% felt that the facilitator had demonstrated the steps of delivering bad news clearly and effectively. Only 4.44% of participants were confident in effectively interacting with patients before the session, and an overwhelming 81.11% gained confidence in their communication skills after the training. With demonstrated significant improvement in knowledge and skills, this study supports the adoption of EMBRACE modules in undergraduate medical education, ultimately improving patient experiences, doctor-patient relationships, and health outcomes.NEW & NOTEWORTHY The Empowering Medical students' skills in BReaking bAd news with Compassion and Empathy (EMBRACE) module is noteworthy for its holistic approach to training medical students in the delicate art of delivering distressing news to patients. It not only incorporates the evidence-based setting, perception, invitation, knowledge, emotions, and strategy (SPIKES) method but also distinguishes itself by providing real-life conversation examples and self-assessment cases, which make the training highly relatable and practical for students to actively engage in their learning and personal development.
有效的沟通技巧在医疗保健中至关重要,尤其是在向患者及其家属传达痛苦信息时。然而,医学教育仍然缺乏一个可纳入课程的通用模式,以培训和评估学生与病人有效沟通的能力。本研究旨在评估使用 "EMBRACE"(Empowering Medical Students' skills in BReaking bAd news with Compassion and Empathy)模块培训本科医学生有效传达坏消息的影响。这项随机病例对照研究涉及第一、第二和第三专业年级的医学生(研究组 75 人,对照组 75 人)。研究组分发了 "EMBRACE "模块,然后进行了 1 小时的培训,内容是如何有效传递坏消息,随后进行了 MCQ 测试和 OSCE(包括反应、解释和沟通技巧)测试。参与者的反馈采用 5 分李克特量表。与对照组相比,研究组在知识和技能方面有了非常明显的提高,P 值小于 0.0001。98.76% 的参与者认为培训让他们掌握了实用技能,98.77% 的参与者认为培训师演示了清晰有效地传递坏消息的步骤。虽然只有 4.44% 的参与者在培训前对与病人有效互动有信心,但绝大多数 81.11% 的参与者在培训后对自己的沟通技巧有了信心。这项研究表明,学员在知识和技能方面都有了明显提高,因此支持在本科医学教育中采用 "EMBRACE "模块,最终改善患者体验、医患关系和健康结果。
{"title":"EMBRACE (Empowering Medical students' skills in BReaking bAd news with Compassion and Empathy) module improves the skills of undergraduate medical students in effectively breaking the bad news: a case-control study.","authors":"Kaviya Arumugam, Harshavardhini Nandagopal, Joseline Joseph, Jyotsna Needamangalam Balaji, Krishna Mohan Surapaneni","doi":"10.1152/advan.00224.2023","DOIUrl":"10.1152/advan.00224.2023","url":null,"abstract":"<p><p>Effective communication skills are pivotal in health care, particularly when conveying distressing information to patients and their families. However, medical education still lacks the adoption of a universal model that can be incorporated into the curricula to train and assess students in effectively communicating with patients. This study aims to assess the impact of training undergraduate medical students to deliver bad news effectively using the Empowering Medical students' skills in BReaking bAd news with Compassion and Empathy (EMBRACE) module. This randomized case-control study involved medical students from the first, second, and third professional years (study group, <i>n</i> = 75; control group, <i>n</i> = 75). For the study group, the EMBRACE modules were distributed. Then, a 1-hour training session on effectively delivering bad news was followed by a multiple-choice question test and objective structured clinical examination with response, interpretation, and communication skills stations. Participants' feedback was obtained on a five-point Likert scale. There was a highly significant improvement in knowledge and skills among the study group compared to controls with a <i>P</i> value less than 0.0001. Of the participants, 98.76% perceived that the training equipped them with practical skills, and 98.77% felt that the facilitator had demonstrated the steps of delivering bad news clearly and effectively. Only 4.44% of participants were confident in effectively interacting with patients before the session, and an overwhelming 81.11% gained confidence in their communication skills after the training. With demonstrated significant improvement in knowledge and skills, this study supports the adoption of EMBRACE modules in undergraduate medical education, ultimately improving patient experiences, doctor-patient relationships, and health outcomes.<b>NEW & NOTEWORTHY</b> The Empowering Medical students' skills in BReaking bAd news with Compassion and Empathy (EMBRACE) module is noteworthy for its holistic approach to training medical students in the delicate art of delivering distressing news to patients. It not only incorporates the evidence-based setting, perception, invitation, knowledge, emotions, and strategy (SPIKES) method but also distinguishes itself by providing real-life conversation examples and self-assessment cases, which make the training highly relatable and practical for students to actively engage in their learning and personal development.</p>","PeriodicalId":50852,"journal":{"name":"Advances in Physiology Education","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-01-11DOI: 10.1152/advan.00067.2023
Paolo B Dominelli, A William Sheel
The pulmonary system is the first and last "line of defense" in terms of maintaining blood gas homeostasis during exercise. Our review provides the reader with an overview of how the pulmonary system responds to acute exercise. We undertook this endeavor to provide a companion article to "Cardiovascular Response to Exercise," which was published in Advances in Physiological Education. Together, these articles provide the readers with a solid foundation of the cardiopulmonary response to acute exercise in healthy individuals. The intended audience of this review is level undergraduate or graduate students and/or instructors for such classes. By intention, we intend this to be used as an educational resource and seek to provide illustrative examples to reinforce topics as well as highlight uncertainty to encourage the reader to think "beyond the textbook." Our treatment of the topic presents "classic" concepts along with new information on the pulmonary physiology of healthy aging.NEW & NOTEWORTHY Our narrative review is written with the student of the pulmonary physiology of exercise in mind, be it a senior undergraduate or graduate student or those simply refreshing their knowledge. We also aim to provide examples where the reader can incorporate real scenarios.
肺系统是运动时维持血气平衡的第一道也是最后一道 "防线"。我们的综述向读者概述了肺系统如何对急性运动做出反应。我们撰写这篇文章的目的是为了与发表在《生理学教育进展》(Advances in Physiological Education)上的《心血管对运动的反应》("Cardiovascular Response to Exercise")相呼应。这些文章共同为读者提供了健康人急性运动时心肺反应的坚实基础。本综述的读者对象是高年级本科生或研究生和/或此类课程的教师。根据我们的意图,我们希望将这篇文章用作教育资源,并力求提供例证以强化主题,同时强调不确定性以鼓励读者 "跳出教科书 "进行思考。我们对这一主题的论述在介绍 "经典 "概念的同时,还提供了有关健康老龄化肺生理学的新信息。
{"title":"The pulmonary physiology of exercise.","authors":"Paolo B Dominelli, A William Sheel","doi":"10.1152/advan.00067.2023","DOIUrl":"10.1152/advan.00067.2023","url":null,"abstract":"<p><p>The pulmonary system is the first and last \"line of defense\" in terms of maintaining blood gas homeostasis during exercise. Our review provides the reader with an overview of how the pulmonary system responds to acute exercise. We undertook this endeavor to provide a companion article to \"Cardiovascular Response to Exercise,\" which was published in <i>Advances in Physiological Education</i>. Together, these articles provide the readers with a solid foundation of the cardiopulmonary response to acute exercise in healthy individuals. The intended audience of this review is level undergraduate or graduate students and/or instructors for such classes. By intention, we intend this to be used as an educational resource and seek to provide illustrative examples to reinforce topics as well as highlight uncertainty to encourage the reader to think \"beyond the textbook.\" Our treatment of the topic presents \"classic\" concepts along with new information on the pulmonary physiology of healthy aging.<b>NEW & NOTEWORTHY</b> Our narrative review is written with the student of the pulmonary physiology of exercise in mind, be it a senior undergraduate or graduate student or those simply refreshing their knowledge. We also aim to provide examples where the reader can incorporate real scenarios.</p>","PeriodicalId":50852,"journal":{"name":"Advances in Physiology Education","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}