Creating the HAPS Physiology Learning Outcomes: terminology, eponyms, inclusive language, core concepts, and skills.

Learning outcomes are an essential element in curriculum development because they describe what students should be able to do by the end of a course or program and they provide a roadmap for designing assessments. This article describes the development of competency-based learning outcomes for a one-semester undergraduate introductory human physiology course. Key elements in the development process included decisions about terminology, eponyms, use of the word "normal," and similar considerations for inclusivity. The outcomes are keyed to related physiology core concepts and to process skills that can be taught along with the content. The learning outcomes have been published under a Creative Commons license by the Human Anatomy and Physiology Society (HAPS) and are available free of charge on the HAPS website.NEW & NOTEWORTHY This article describes the development of competency-based learning outcomes for introductory undergraduate human physiology courses that were published and made available free of charge by the Human Anatomy and Physiology Society (HAPS). These learning outcomes can be edited and are keyed to physiology core concepts and to process skills that can be taught along with the content.

Assessing Community College Biology Student Perceptions of Being Called on in Class.

Random call has been proposed as an inclusive and equitable practice that engages students in learning. However, this inclusion may come with a cost. In some contexts, students experience anxiety and distress when being called on. Recently, focus has shifted to critical components of random call that may mitigate this cost. We examined how community college (CC) students perceive being called on by addressing 1) benefits that help their learning and 2) characterizing the anxiety students experience through this practice. To do this, we surveyed students in six biology courses taught by six faculty members over six academic quarters. We analyzed survey responses from 383 unique students (520 total responses) using mixed methods. Qualitative responses were coded and consensus codes revealed that students saw benefits to being called on, including paying attention and coming prepared. Qualitative codes also revealed different types of anxiety, both distress and eustress. Analysis of Likert scale survey data revealed perceptions of increased student interaction with their peers in warm random call classes. Furthermore, warm random call may increase participation in class discussions, and it is not correlated with increased extreme anxiety. These data suggest warm random call used in smaller, community college classes, may contribute to students' positive perceptions of being called on.

Cultivating a Science, Technology, Engineering and Mathematics (STEM) community for two-year college student success and persistence.

Undergraduate students studying Science, Technology, Engineering and Mathematics (STEM) often fail to persist in critical "gateway" courses, resulting in students leaving the STEM pathway. Community college students leave STEM pathways at higher rates than students at universities. Implementation of a program designed to engage community college STEM students and faculty in a community of support was associated with increased persistence in STEM gateway courses and associate degree completion. Program elements included support staff, a STEM study room with peer tutors, faculty advisors, and transfer assistance. Over seven years, 415 students joined this opt-in support program. The majority of students in this program were economically disadvantaged and many were nontraditional college students. Using institutional data we tested the hypothesis that participation in this program was associated with increased student success and persistence in STEM courses and at the college. The mean GPA for students in the program in the ten courses with the highest STEM enrollments was higher (2.89) than that for other students (2.76). Quarter-to-quarter persistence was 87% for program students compared to 67% for non-program students in a matched student population. In STEM gateway courses, program students had between 1.2x to 3.5x greater likelihood than non-program students of progressing to precalculus-2 controlling for first-attempt GPA in precalculus-1. Similar persistence patterns were observed for other gateway STEM courses. Observed persistence for students in the program was higher than comparable groups of students, including persistence for those who experienced early failure in STEM courses. These data suggest students should be supported through early failure to enable persistence in critical STEM sequences, especially in gateway Math and Chemistry courses.

What a Difference in Pressure Makes! A Framework Describing Undergraduate Students' Reasoning about Bulk Flow Down Pressure Gradients.

Pressure gradients serve as the key driving force for the bulk flow of fluids in biology (e.g., blood, air, phloem sap). However, students often struggle to understand the mechanism that causes these fluids to flow. To investigate student reasoning about bulk flow, we collected students' written responses to assessment items and interviewed students about their bulk flow ideas. From these data, we constructed a bulk flow pressure gradient reasoning framework that describes the different patterns in reasoning that students express about what causes fluids to flow and ordered those patterns into sequential levels from more informal ways of reasoning to more scientific, mechanistic ways of reasoning. We obtained validity evidence for this bulk flow pressure gradient reasoning framework by collecting and analyzing written responses from a national sample of undergraduate biology and allied health majors from 11 courses at five institutions. Instructors can use the bulk flow pressure gradient reasoning framework and assessment items to inform their instruction of this topic and formatively assess their students' progress toward more scientific, mechanistic ways of reasoning about this important physiological concept.

Oaks to arteries: the Physiology Core Concept of flow down gradients supports transfer of student reasoning.

The Physiology Core Concept of flow down gradients is a major concept in physiology, as pressure gradients are the key driving force for the bulk flow of fluids in biology. However, students struggle to understand that this principle is foundational to the mechanisms governing bulk flow across diverse physiological systems (e.g., blood flow, phloem sap flow). Our objective was to investigate whether bulk flow items that differ in scenario context (i.e., taxa, amount of scientific terminology, living or nonliving system) or in which aspect of the pressure gradient is kept constant (i.e., starting pressure or pressure gradient) influence undergraduate students' reasoning. Item scenario context did not impact the type of reasoning students used. However, students were more likely to use the Physiology Core Concept of "flow down [pressure] gradients" when the pressure gradient was kept constant and less likely to use this concept when the starting pressure was kept constant. We also investigated whether item scenario context or which aspect of the pressure gradient is kept constant impacted how consistent students were in the type of reasoning they used across two bulk flow items on the same homework. Most students were consistent across item scenario contexts (76%) and aspects of the pressure gradient kept constant (70%). Students who reasoned using "flow down gradients" on the first item were the most consistent (86, 89%), whereas students using "pressures indicate (but don't cause) flow" were the least consistent (43, 34%). Students who are less consistent know that pressure is somehow involved or indicates fluid flow but do not have a firm grasp of the concept of a pressure gradient as the driving force for fluid flow. These findings are the first empirical evidence to support the claim that using Physiology Core Concept reasoning supports transfer of knowledge across different physiological systems.NEW & NOTEWORTHY These findings are the first empirical evidence to support the claim that using Physiology Core Concept reasoning supports transfer of knowledge across different physiological systems.

Empowering faculty to initiate STEM education transformation: Efficacy of a systems thinking approach.

Just a decade ago Vision and Change in Undergraduate Biology Education: A Call to Action was released, catalyzing several initiatives to transform undergraduate life sciences education. Among these was the Partnership for Undergraduate Life Sciences Education (PULSE), a national organization commissioned to increase the adoption of Vision and Change recommendations within academic life sciences departments. PULSE activities have been designed based on the recognition that life sciences departments and faculty are embedded within institutions of higher education which, similar to other large organizations, are complex systems composed of multiple, interconnected subsystems. The organizational change research suggests that effecting large-scale changes (e.g., undergraduate STEM education transformation) may be facilitated by applying systems thinking to change efforts. In this paper we introduce the approach of systems thinking as a professional development tool to empower individual STEM faculty to effect department-level transformation. We briefly describe a professional development experience designed to increase life sciences faculty members' understanding of systems thinking, present evidence that faculty applied a systems thinking approach to initiate department-level change, and discuss the degree to which transformation efforts were perceived to be successful. Though focused on faculty in the life sciences, our findings are broadly transferable to other efforts seeking to effect change in undergraduate STEM education.

Another look at the core concepts of physiology: revisions and resources.

In 2011, we published a description of 15 core concepts of physiology, and in 2017 we described how core concepts could be used to teach physiology. On the basis of publications and conference presentations, it is clear that the core concepts, conceptual frameworks, and the homeostasis concept inventory have been used by faculty in many ways to improve and assess student learning and align instruction and programs. A growing number of colleagues focus their teaching on physiology core concepts, and some core concepts have been used as explicit themes or organizing principles in physiology or anatomy and physiology textbooks. The core concepts published in 2011 were derived from inputs from a diverse group of physiology instructors and articulated what this group of instructors expressed a decade ago. On the basis of current feedback from the physiology teaching community as a consequence of the use of core concepts in teaching and learning, we have revisited these concepts and made revisions to address issues that have emerged. In this article, we offer revised definitions and explanations of the core concepts, propose an additional core concept ("physical properties of matter" which combines two previous concepts), and describe three broad categories for the revised core concepts. Finally, we catalog published resources for each of the core concepts that provide instructors tools to focus facilitation of student learning on goals (learning outcomes), activities and assessments to enable students to develop and apply their understanding of the core concepts of physiology.

The 2019 P-MIG Student Survey report and capturing the undergraduate perspective of physiology programming.

The aim of the 2019 Student Survey was to inform the Physiology Majors Interest Group (P-MIG) of characteristics of undergraduates enrolled in physiology courses or degree programs from across the United States, to be used as one input source for the development of program-level guidelines. There were 1,389 participants from seven universities who completed the 2019 P-MIG Student Survey. Thirty-seven percent reported enrollment in a physiology/human physiology major; allied health-related programs were the second most common (24%). Sixty-one percent of respondents reported attending a community college, the majority of whom enrolled in one or more courses at a community college while in high school (44%). Of participants who reported transferring coursework from one institution to another, 72% reported coursework transferred as expected. Homeostasis and structure/function were the two core concepts common to the top rankings for self-reported mastery, the expectation to be remembered in 5 yr, and deemed to be career relevant. Survey respondents indicated high engagement in co-curricular activities, with 72% participating or planning to participate in job shadowing opportunities, followed by volunteering (57%) and internships (50%). Over one-half of all survey participants indicated they "strongly agree" that their coursework and undergraduate programming has prepared them for success in their field of study. While the majority of respondents were satisfied with the academic advising received, additional guidance with regard to career choices and non-coursework professional development opportunities may be beneficial. Taken together, the collective data provides information from current physiology students that may inform development of consensus guidelines regarding curriculum, professional skills, and advising for undergraduate physiology degree programs.

Reflections on core concepts for undergraduate physiology programs.

Undergraduate education should help students build a deep, conceptual understanding of their discipline, not merely compel them to acquire factual knowledge. The core concepts for physiology (described in 2011), conceptual frameworks, and conceptual assessments are available to focus undergraduate physiology education on helping students understand and apply principles that govern and describe physiological processes. We review the context in which physiology core concepts were identified by a community of physiology educators. We explain the structure of conceptual frameworks and concept inventories and their benefit. We describe how core concepts have been used in physiology courses and departments, as communicated in publications, through presentations at physiology and biology education meetings, and within the Physiology Majors Interest Group (P-MIG). Finally, we share our recommendations and hopes for the next decade.

Development and Validation of the Homeostasis Concept Inventory.

We present the Homeostasis Concept Inventory (HCI), a 20-item multiple-choice instrument that assesses how well undergraduates understand this critical physiological concept. We used an iterative process to develop a set of questions based on elements in the Homeostasis Concept Framework. This process involved faculty experts and undergraduate students from associate's colleges, primarily undergraduate institutions, regional and research-intensive universities, and professional schools. Statistical results provided strong evidence for the validity and reliability of the HCI. We found that graduate students performed better than undergraduates, biology majors performed better than nonmajors, and students performed better after receiving instruction about homeostasis. We used differential item analysis to assess whether students from different genders, races/ethnicities, and English language status performed differently on individual items of the HCI. We found no evidence of differential item functioning, suggesting that the items do not incorporate cultural or gender biases that would impact students' performance on the test. Instructors can use the HCI to guide their teaching and student learning of homeostasis, a core concept of physiology.

Checking Equity: Why Differential Item Functioning Analysis Should Be a Routine Part of Developing Conceptual Assessments.

We provide a tutorial on differential item functioning (DIF) analysis, an analytic method useful for identifying potentially biased items in assessments. After explaining a number of methodological approaches, we test for gender bias in two scenarios that demonstrate why DIF analysis is crucial for developing assessments, particularly because simply comparing two groups' total scores can lead to incorrect conclusions about test fairness. First, a significant difference between groups on total scores can exist even when items are not biased, as we illustrate with data collected during the validation of the Homeostasis Concept Inventory. Second, item bias can exist even when the two groups have exactly the same distribution of total scores, as we illustrate with a simulated data set. We also present a brief overview of how DIF analysis has been used in the biology education literature to illustrate the way DIF items need to be reevaluated by content experts to determine whether they should be revised or removed from the assessment. Finally, we conclude by arguing that DIF analysis should be used routinely to evaluate items in developing conceptual assessments. These steps will ensure more equitable-and therefore more valid-scores from conceptual assessments.

Validating a conceptual framework for the core concept of "cell-cell communication".

We have created and validated a conceptual framework for the core physiology concept of "cell-cell communication." The conceptual framework is composed of 51 items arranged in a hierarchy that is, in some instances, four levels deep. We have validated it with input from faculty who teach at a wide variety of institutional types. All items making up the framework were deemed essential to moderately important. However, some of the main ideas were clearly judged to be more important than others. Furthermore, the lower in the hierarchy an item is, the less important it is thought to be. Finally, there was no significant difference in the ratings given by faculty at different types of institutions.

Broadening Participation in Biology Education Research: Engaging Community College Students and Faculty.

Nearly half of all undergraduates are enrolled at community colleges (CCs), including the majority of U.S. students who represent groups underserved in the sciences. Yet only a small minority of studies published in discipline-based education research journals address CC biology students, faculty, courses, or authors. This marked underrepresentation of CC biology education research (BER) limits the availability of evidence that could be used to increase CC student success in biology programs. To address this issue, a diverse group of stakeholders convened at the Building Capacity for Biology Education Research at Community Colleges meeting to discuss how to increase the prevalence of CC BER and foster participation of CC faculty as BER collaborators and authors. The group identified characteristics of CCs that make them excellent environments for studying biology teaching and learning, including student diversity and institutional cultures that prioritize teaching, learning, and assessment. The group also identified constraints likely to impede BER at CCs: limited time, resources, support, and incentives, as well as misalignment between doing research and CC faculty identities as teachers. The meeting culminated with proposing strategies for faculty, administrators, journal editors, scientific societies, and funding agencies to better support CC BER.

A conceptual framework for homeostasis: development and validation.

We have developed and validated a conceptual framework for understanding and teaching organismal homeostasis at the undergraduate level. The resulting homeostasis conceptual framework details critical components and constituent ideas underlying the concept of homeostasis. It has been validated by a broad range of physiology faculty members from community colleges, primarily undergraduate institutions, research universities, and medical schools. In online surveys, faculty members confirmed the relevance of each item in the framework for undergraduate physiology and rated the importance and difficulty of each. The homeostasis conceptual framework was constructed as a guide for teaching and learning of this critical core concept in physiology, and it also paves the way for the development of a concept inventory for homeostasis.

The pipeline of physiology courses in community colleges: to university, medical school, and beyond.

Community colleges are significant in the landscape of undergraduate STEM (science technology, engineering, and mathematics) education (9), including biology, premedical, and other preprofessional education. Thirty percent of first-year medical school students in 2012 attended a community college. Students attend at different times in high school, their first 2 yr of college, and postbaccalaureate. The community college pathway is particularly important for traditionally underrepresented groups. Premedical students who first attend community college are more likely to practice in underserved communities (2). For many students, community colleges have significant advantages over 4-yr institutions. Pragmatically, they are local, affordable, and flexible, which accommodates students' work and family commitments. Academically, community colleges offer teaching faculty, smaller class sizes, and accessible learning support systems. Community colleges are fertile ground for universities and medical schools to recruit diverse students and support faculty. Community college students and faculty face several challenges (6, 8). There are limited interactions between 2- and 4-yr institutions, and the ease of transfer processes varies. In addition, faculty who study and work to improve the physiology education experience often encounter obstacles. Here, we describe barriers and detail existing resources and opportunities useful in navigating challenges. We invite physiology educators from 2- and 4-yr institutions to engage in sharing resources and facilitating physiology education improvement across institutions. Given the need for STEM majors and health care professionals, 4-yr colleges and universities will continue to benefit from students who take introductory biology, physiology, and anatomy and physiology courses at community colleges.

A physiologist's view of homeostasis.

Homeostasis is a core concept necessary for understanding the many regulatory mechanisms in physiology. Claude Bernard originally proposed the concept of the constancy of the "milieu interieur," but his discussion was rather abstract. Walter Cannon introduced the term "homeostasis" and expanded Bernard's notion of "constancy" of the internal environment in an explicit and concrete way. In the 1960s, homeostatic regulatory mechanisms in physiology began to be described as discrete processes following the application of engineering control system analysis to physiological systems. Unfortunately, many undergraduate texts continue to highlight abstract aspects of the concept rather than emphasizing a general model that can be specifically and comprehensively applied to all homeostatic mechanisms. As a result, students and instructors alike often fail to develop a clear, concise model with which to think about such systems. In this article, we present a standard model for homeostatic mechanisms to be used at the undergraduate level. We discuss common sources of confusion ("sticky points") that arise from inconsistencies in vocabulary and illustrations found in popular undergraduate texts. Finally, we propose a simplified model and vocabulary set for helping undergraduate students build effective mental models of homeostatic regulation in physiological systems.

The core principles ("big ideas") of physiology: results of faculty surveys.

Physiology faculty members at a wide range of institutions (2-yr colleges to medical schools) were surveyed to determine what core principles of physiology they want their students to understand. From the results of the first survey, 15 core principles were described. In a second survey, respondents were asked to rank order these 15 core principles and, independently, to identify the three most important for their students to understand. The five most important core principles were "cell membrane," "homeostasis," "cell-to-cell communications," "interdependence," and "flow down gradients." We then "unpacked" the flow down gradients core principle into the component ideas of which it is comprised. This unpacking was sent to respondents who were asked to identify the importance of each of the component ideas. Respondents strongly agreed with the importance of the component ideas we had identified. We will be using the responses to our surveys as we begin the development of a conceptual assessment of physiology instrument (i.e., a concept inventory).

The "core principles" of physiology: what should students understand?

The explosion of knowledge in all of the biological sciences, and specifically in physiology, has created a growing problem for educators. There is more to know than students can possibly learn. Thus, difficult choices have to be made about what we expect students to master. One approach to making the needed decisions is to consider those "core principles" that provide the thinking tools for understanding all biological phenomena. We identified a list of "core principles" that appear to apply to all aspects of physiology and unpacked them into their constituent component ideas. While such a list does not define the content for a physiology course, it does provide a guideline for selecting the topics on which to focus student attention. This list of "core principles" also offers a starting point for developing an assessment instrument to be used in determining if students have mastered the important unifying ideas of physiology.