Monday, November 9, 2015

Are Learning Styles Real?

Years ago, I posted an article here entitled Learning Styles that pointed to and summarized advice to A&P students that I gave at my blog The A&P Student. A recent article in a science magazine purporting to debunk the notion of learning styles prompts me to revisit this concept. There have been many, many articles claiming to debunk the concept of learning styles, but this most recent one concisely states the concern.

The myth-busting article claims that teaching strategies tailored to student learning styles do not improve learning, and implies that learning styles are thus useless. Perhaps I'm overstating that implication, but considering that readers are enticed with this headline 10 Lies About the Brain, on the magazine cover, I don't think so.

Many A&P study activities are
fun for visual and kinesthetic learners.
I think the article correctly interprets what we know from experimentation when it concludes that students, as a group, can learn just as well with strategies that do not match their learning styles. Perhaps we have a lot more experimentation to do before we get too comfortable with that idea, though. One issue is the variety of descriptions of what a "learning style" even is. Are we talking left-brain/right-brain? Or the VARK styles based on sensory preferences? Or perhaps big-picture/little-pieces learning preferences? Or is it active-passive, or maybe quiet-loud? Really, there are all kinds of learning style preferences that could be examined.

Another issue to consider is how experimental results apply to individuals—rather than giving us a group's average measure of performance impacts of teaching to specific learning styles. Have we sufficiently eliminated the possibility that some students are more style-dependent than others?

Questions that occur to me include how and when "learning" is measured for such experiments. Could learning be quicker when targeting teaching to learning styles? Could some kinds of learning benefit from a learning-style approach to teaching, but not other kinds of learning?

Regardless of the potential pitfalls of research that has failed to prove that teaching strategies keyed to specific learning strategies improves learning, there are some additional aspects to consider. One is that learning-style targeted teaching has not proven to do any harm. Perhaps there are other benefits to providing multiple types of learning experiences to our students besides the "ability to learn" the concepts. Do students enjoy learning more when it better fits their personal style?

Another issue not addressed by the recent article, nor any of the similar articles that I've seen, is that it doesn't seem to consider that most of us teachers don't much rely on style-specific teaching strategies, anyway.

What we most often do is suggest that students make their own choices about study strategies based on their learning style preferences. We do that because we know that each student has their own way of thinking and learning. Why not help them do a bit of metacognition and analyze which study strategies work best for them? Or at least help them figure out which strategies are more comfortable—or less painful?

A&P students can tailor
personal study to their learning styles
To use an analogy, let's compare learning styles to clothing styles. Students in my face-to-face classes can tell you my clothing "uniform" worn every day for teaching: sneakers, jeans or khakis, pocket-T shirt or mock turtleneck, and sport coat. Each of these items is worn mainly for comfort. It seems easier and more enjoyable for me to teach in this kind of outfit. But I've also presented information in suit-and-tie and even in academic regalia (believe it or not). And I think I've been no less effective as a teacher—even if I'm not at all comfortable in formal outfits. My point is that for me, clothing style does not affect my ability to teach—but it does affect my comfort and joy of teaching. And I think perhaps that can potentially affect the comfort and joy of learning among my students.

Likewise, I could learn all the features of the human skull by reading a narrative description—but it's a heck of a lot more fun to instead learn them by exploring an actual human skull held in my hands. Perhaps that's because I'm a kinesthetic learner and my comfort and joy of learning blossoms when I can play with specimens.

Doesn't comfort and joy of learning—perhaps enhanced by making personalized choices in study strategies—have some value alongside the value of learning outcomes measured on an exam?

Perhaps it's not very useful to have a black-and-white approach to learning research that implies that because we have not proven a link between learning-style teaching strategies and learning outcomes, such strategies are therefore useless. Let's consider a more shades-of-gray approach that allows the possibility that suggesting learning-style-specific study strategies to our students may make learning more enjoyable for them—and possibly more efficient.

What can we use from this in teaching undergraduate A&P?

  • Learning research has not confirmed a significant impact on learning when we provide learning activities matched to the learning styles of our students, so perhaps we should avoid focusing too much on trying to do that.

  • Consider the value of metacognition—thinking about how we think and learn—for our students when they are planning their own study strategies. Perhaps suggesting to them a personalized approach based on individual learning styles can be helpful.

  • Learning styles should not be seen as hard barriers to learning, but instead seen as areas where the process of learning can be adjusted for ease and comfort of learning.

  • When students insist that you must deliver content to match their learning styles, or "I can't learn," suggest to them the more reasonable assertion that they can still learn effectively no matter the style of presentation. Then consider helping them tailor their own study strategies to their preferred learning style.

  • Although a learning-style approach should never limit the strategies we can use in learning, adapting personal study strategies to learning-style preferences may enhance the experience of learning.

Want to know more?

Brain Myths Busted (10 Lies About the Brain)

  • M. Scudellari. Popular Science. November 2015. p.49-53.
  • One of many articles that in recent years claiming to debunk the entire concept of learning styles by refuting their value in designing lesson plans.

VARK: A Guide to Learning Styles

  • Accessed 8 November 2015.
  • Website explaining the VARK system of learning styles, including its origin and research related to VARK.

The VARK Questionnaire

  • VARK: A Guide to Learning Styles. Accessed 8 November 2015.
  • A self-quiz that helps any student determine their own learning style in the VARK system (see above).

Learning Styles Online

  • A website that outlines yet another system of learning styles.

Learning Styles

  • Kevin Patton. Lion Den. Last updated January 2015.
  • One of my A&P Study Tips & Tools pages from the Lion Den website. Your students can link to this page, get a brief intro to learning styles, then link to various tools to help them use them.

Survival Guide for Anatomy & Physiology

  • Kevin Patton. Elsevier Publishing. 2nd edition, 2014.
  • My compact study tool for all A&P students, includes information for students on using learning styles to improve their success in the A&P course.

The A&P Student

Top photo: melodi2
Bottom photo: picaland

Monday, October 5, 2015

Water Intoxication Case in Hiker

While emphasis is often placed on keeping athletes and outdoor enthusiasts properly hydrated, too much water can be just as dangerous. Exercise-associated hyponatremia (EAH), a form of water intoxication, results in an extreme, and potentially fatal, sodium imbalance.

In the latest issue of Wilderness & Environmental Medicine, investigators detail the case of a hiker who died as an illustration of the potential danger of endurance exercise and excessive water intake lowering serum sodium to a dangerous level. There have been several deaths from EAH associated with various sports. This is one of few reported fatalities due to EAH in a wilderness setting.

The study details the death of a 47-year-old female hiker who passed out after a 10 km hike on the South Kaibab Trail in Grand Canyon National Park in 2008. Over a five-hour period, the woman consumed a large amount of water but ate very little food. She collapsed approximately an hour after finishing the hike. Despite the efforts of emergency medical personnel, the patient was pronounced dead 19 hours later from cerebral edema brought on by water intoxication.

As outdoor endurance recreation grows in popularity, so does the risk of EAH. Early symptoms of EAH often mimic dehydration and include nausea, vomiting, malaise, and headache. If left untreated, the condition can lead to an altered mental status, seizures, and death. Unfortunately, many practitioners have difficulty recognizing the condition and treating it appropriately.

“EAH results from overhydration, and avoiding additional fluid overload is critically important in treatment,” explained co-investigator Martin D. Hoffman, MD. “Because dehydration is often a reflex diagnosis for a symptomatic exerciser in a hot environment, the usual treatment of oral or IV isotonic or hypotonic fluids needs to be resisted if there is a strong likelihood that the underlying condition is EAH.”

What can we use from this in teaching undergraduate A&P?

  • When discussing fluid/electrolyte balance, we can introduce the concepts of water intoxication and EAH

  • This particular case can be discussed as an example of water intoxication

  • This particular case could be adapted into a case-study activity in your course—or a case-study problem on a test.

  • The fact that early symptoms of EAH mimic dehydration, creates a clinical issue.  Class discussions regarding this—including suggested solutions from the research article—could be fruitful in increasing the understanding of basic principles of fluid/electrolyte balance in the body—as well as critical thinking skills.

  • This is a good example of practical applications of fluid/electrolyte balance, thus answering the common question, "why do we have to learn all this?!"

  • Everybody should know this, right?

Quick points about water intoxication (EAH)

EAH symptoms
  • Impaired exercise performance
  • Nausea and vomiting
  • Headache
  • Altered level of consciousness
  • Seizure (convulsion)
  • Muscle cell breakdown (rhabdomyolysis) with the development of acute kidney failure
NOT symptoms of neither EAH nor dehydration
  • Dizziness and fainting
  • Muscle cramping
  • Wheezy breathing
Risk factors of EAH
  • Overdrinking water, sports drinks, and other hypotonic beverages
  • Weight gain during exercise
  • Exercise duration of more than 4 hours
  • Event inexperience or inadequate training
  • Slow performance pace
  • High or low body mass index
  • Readily available fluids

Want to know more?

Hiker Fatality From Severe Hyponatremia in Grand Canyon National Park
  • Thomas M. Myers, MD, and Martin D. Hoffman, MD. Wilderness & Environmental Medicine, Volume 26, Issue 3 (September 2015) DOI:
  • Research article outlining the case, including causes, outcomes, and suggestions for successful diagnosis and treatment of EAH.

Seven clear symptoms of Exercise-Associated Hyponatremia
  • Timothy Noakes. Human Kinetics. Accessed 28 Sep 2015. 
  • Excerpt from the book Waterlogged: The Serious Problem of Overhydration in Endurance Sports (ISBN-13: 9781450424974) Source of the symptoms "quick points" listed above.

Guidelines Released for Exercise-Associated Hyponatremia
  • Diana Phillips. Medscape Medical News. July 03, 2015
  • Summary of recent guidelines published in a statement developed at this year's Third International Exercise-Associated Hyponatremia Consensus Development Conference. Source of the risk factors in the "quick points" listed above.

Some text adapted from an Elsevier press release
Top photo: Sanja Gjeero
Bottom photo: Sara Hammeraback

Thursday, September 24, 2015

Noisy A&P Classrooms and Labs

I'll never forget the feedback a dean gave me a few years ago when he visited my (then) new A&P supplement course. The feedback was memorable because it seemed to miss the whole point (learning outcomes) of the course!

Should A&P students always be quiet?
I was very happy with the way that day's class went. Meant to be an informal coaching and collaboration course to provide supplemental support for my human anatomy and physiology students, we had more fun than usual that day. Held in a teaching lab with about 22 students, we started with questions submitted on index cards as the students entered the room. They freely commented "Yeah!" to concerns about a topic being hard to understand. They piped up to give advice to the whole group about what worked for them.

Then we moved on to an active learning session with students working collaboratively in small groups. But not quietly. At all. Some occasionally "shouted" a remark to another group. Once or twice members of one group talked across the aisle to another group about their progress or to get "unstuck" on a concept. And few shouted, "Kevin! We need you over here!"

After that, we wrapped up with the usual "need for speed" activity where I'd put up slides of lab specimens—it was either bone markings or tissue types that day—and they'd have five or ten seconds to give the correct response with their clickers. A bit like a game show, my students are not shy about expressing their enthusiasm loudly. They groan when most of them get one wrong.  They cheer when most of them get it right. They sometimes, yell out a "No way that's hyaline cartilage!" and we have a chance to work out the "differential diagnosis" in a way that helps them all get better at identifying tissue types.

In fact, my students love the chaotic need-for-speed session so much that they complained that our class was just too short. So we eventually changed the schedule to give more time in class for this activity.

That classroom-visit day was particularly chaotic and raucous. And I walked out on cloud nine, as did my students. How often does such enthusiastic and effective learning take place?

So when I later met with my dean after the classroom visit, I was eager for his feedback. Being a fellow A&P teacher himself, known for his informal and playful approach to both teaching and college administration, I thought he'd have enjoyed the experience. And he did. But he expressed concern about the potential of the class being "so close" to getting "out of control."

Yikes. The aspect of the class that I had thought went particularly well, was seen by him as a cause for concern. And this guy is a bright, insightful educator who is usually very constructive in any criticism he gives. Being the self-analytical dude that I am, I spent many months thinking about this. I even discussed it with teaching colleagues and former students—was I doing it all wrong?

I (and others) eventually concluded that my dean wasn't fully appreciating the "big picture" of what was really going on that day—the way he usually does.

As a former lion tamer who presided over many raucous—but highly productive—training sessions, I can appreciate that anyone "outside the pride" may not understand what they are witnessing. It easily could seem more like a dangerous, chaotic, mess than a particularly wonderful day inside the lion den. They don't know the personalities of the animals (and people) involved, how their comfortable (and loud) relationship developed, and how the loudness was an indicator of enthusiasm rather than distraction (or menace).

So I was particularly heartened to read a blog post from the Center for Teaching Quality today on this very topic—learning is loud. Have a read yourself and see if there's anything you can glean from it that may fit your own teaching style—or that may want to make part of your teaching style.

There are some other related resources listed below, too!

Want to know more? 

Learning is Loud
  • J. Keigan. Center for Teaching Quality-Teaching in the Present Tense. 20 Sep 2015.
  • Blog post that explores the value of loudness in pre-college classrooms has lessons for college teachers, too. It was this post that dredged up the memory described above.

When Is a Good Day Teaching a Bad Thing?
  • T. Slater. The Physics Teacher. 41, 437 (2003); doi: 10.1119/1.1616492
  • Brief article that contrasts the "hidden contract" of students keeping quiet may be at odds with successful teaching and learning.

How ‘Deprogramming’ Kids From How to ‘Do School’ Could Improve Learning
  • K. Schwartz. KQED News - Big Ideas 15 Dec 2014
  • Brief article that explores the idea the many classrooms do not resemble what we know about how people learn best.

Using Supplemental Courses to Reinforce Concepts and Promote Learning Skills
  • K. Patton. The A&P Professor. Accessed 24 Sep 2015.
  • Want to know more about the A&P Supplement course I referred to in this post? This online presentation explores a case study outline the use of supplemental courses to helps student prepare effectively for their first A&P course, and to improve their learning skills as they begin their first A&P course.

Photo credits: click image

Tuesday, July 14, 2015

Dissolving Microneedle Vaccinations

Researchers recently demonstrated that a flu vaccine delivered using microneedles that dissolve in the skin can protect people against infection even better than the standard needle-delivered vaccine.

The new microneedle patch is made of dissolvable material, eliminating needle-related risks. Not to mention the sea change it may mean for patients with severe needle anxiety!  I suspect this approach may also be more tolerable for many patients than oral and nasal vaccination methods. It is also easy to use without the need for trained medical personnel—making it ideal for use where healthcare resources are limited.

“Our novel transcutaneous vaccination using a dissolving microneedle patch is the only application vaccination system that is readily adaptable for widespread practical use,” said Professor Shinsaku Nakagawa, one of the authors of the study from Osaka University. “Because the new patch is so easy to use, we believe it will be particularly effective in supporting vaccination in developing countries.”

The new microneedle patch – MicroHyala – is dissolvable in water. The tiny needles are made of hyaluronic acid, a naturally occurring substance in tissue matrix and the synovial fluid that cushions the joints. When the patch is applied sort of like a Band-Aid, the needles pierce the epidermis of skin and dissolve into the body, taking the vaccine with them.

The researchers compared the new system to traditional needle delivery by vaccinating two groups of people against three strains of influenza: A/H1N1, A/H3N2 and B. None of the subjects had a bad reaction to the vaccine, showing that it is safe to use in humans. The patch was also effective: people given the vaccine using the microneedles had an immune reaction that was equal to or stronger than those given the vaccine by injection.

“We were excited to see that our new microneedle patch is just as effective as the needle-delivered flu vaccines, and in some cases even more effective,” said Professor Nakagawa.

Previous research has evaluated the use of microneedles made of silicon or metal, but they were not shown to be safe. Microneedles made from these materials also run the risk of breaking off in the skin, leaving tiny fragments behind. The new dissolvable patch eliminates this risk because the microneedles are designed to dissolve in the skin.

What can we use from this in teaching undergraduate A&P?

  • Consider mentioning this advance when discussing the layers of the skin, this giving a clinical application to pique student interest.

  • When discussing immunity and vaccination, consider mentioning this discovery.

  • If you discuss hyaluronic acid when covering histology, this information may help students realize the importance of knowing such details because of clinical applications of materials science.

Want to know more?

  • Clinical study and stability assessment of a novel transcutaneous influenza vaccination using a dissolving microneedle patch.
    • Sachiko Hirobe, et al. Biomaterials. Vol 57 (July 2015), Elsevier. doi: 10.1016/j.biomaterials.2015.04.007
    • The original research article.

Microneedle image courtesy of S. Nakagawa
Some content adapted from an Elsevier newsroom release

Friday, June 26, 2015

There May Not Be a Single Language Comprehension Center in the Brain

A recent paper in the journal Brain, a journal of neurology, challenges the long-held notion that the sensory speech area of the left temporal lobe of the cerebrum—often called the Wernicke area—acts as the center of language comprehension.

Wernicke area
The report describes research that leads one to the conclusion that although the Wernicke area (pictured) apparently has a role in understanding individual words, the task of sentence comprehension is accomplished by a complex network of diverse areas of the cerebrum. These include, "temporoparietal components of Wernicke’s area, Broca’s area, and [the] dorsal premotor cortex."

What can we use from this in teaching undergraduate A&P?

  • When discussing the sensory speech (Wernicke) area, one might bring up this discovery and how it may modify our description of its main function.

  • This discovery is a good example of how science works—how theories are formed and how they are modified as new information is discovered.  And how new research must be confirmed before it becomes widely established as fact.

  • When discussing cerebral localization of function, this story may be helpful in emphasizing that complex cerebral functions often involve integration of diverse cortical areas.

  • This story is a good example of our rapidly advancing knowledge of complex brain function.

  • You'll sound very "with it" when you can drop in casual asides about the latest brain research in your classroom discussions!

Want to know more?

New Human Brain Language Map | Researchers find that Wernicke’s area, thought to be the seat of language comprehension in the human brain for more than a century, is not.
  • Bob Grant. The Scientist  Published online June 26, 2015
  • Brief, plain-English article summarizing the recent findings.

The Wernicke conundrum and the anatomy of language comprehension in primary progressive aphasia 
  • M-Marsel Mesulam , et al. Brain. DOI: First published online: 25 June 2015
  • The original research article.

Scientists redraw traditional brain map of language comprehension
  • Northwestern University press release. Published online June 25, 2015

Cortical Areas Involved in Speech Processing

Image credits: Database Center for Life Science (Wernicke area)
Leuthardt, et al. (cortical speech areas)

Monday, June 15, 2015

Virtual Cardiology Lab

Looking for a supplemental hands-on activity with cardiology in your course?

Try the FREE online interactive Cardiology Virtual Lab from the Howard Hughes Medical Institute.

It covers these concepts:
  • Symptoms of a selection of heart diseases, to serve as examples of what kinds of things can go wrong with the heart. 
    • How are symptoms detected and why?
  • Tools and techniques used for diagnosis. 
    • What can the different techniques detect and how do they work?
  • Principles of pedigree analysis.

What can we use from this in teaching undergraduate A&P?

  • Link to this virtual lab activity from your online syllabus, course web page, or LMS (or in an email  or tweet to students)
  • If you want to give course points for the lab, consider an online quiz or lab report submitted through your learning management system (LMS) or emailed to you.
  • Gives students a "real life" clinical lab application for the concepts they are learning in A&P.
  • Provides a cardiology lab option for online/hybrid courses or wet labs that don't have funding for cardiology experiments.
  • Helps integrate principles of genetics with cardiology, so it can be used in your genetics unit.

Want to know more?

Cardiology Virtual Lab

  • BioInteractive. Howard Hughes Medical Institute. Accessed 16 Sep 2014.
  • This virtual lab will familiarize you with heritable diseases of the heart. Learn about the diagnostic tools used to examine and diagnose patients.

BioInteractive Virtual Labs

  • BioInteractive. Howard Hughes Medical Institute. Accessed 16 Sep 2014.
  • List of all the FREE virtual labs offered by HHMI's BioInteractive project.

Cardiovascular Topics

  • Kevin Patton. The A&P Professor. Various dates.
  • List of previous blog posts on cardiovascular topics

Wednesday, June 3, 2015

A Brain-Lymphatic Connection

Existing dogma in neuroscience states that the brain does not possess the classical lymphatic drainage system found in other parts of body. However, a recent letter in the journal Nature reports the discovery of lymphatic vessels lining the dural sinuses in mice. These were shown to drain immune cells and cerebrospinal fluid (CSF) into the deep cervical lymph nodes.

Although more work is yet to be done in humans, this discovery will cause neuroscientists to revisit a number of concepts related to CSF and lymphatic drainage, as well as immune functions in the brain.

For example, do these new data truly challenge the notion of immune privilege in the nervous tissue of the central nervous system—or do they apply to the brain as an organ and allow for lymphatic drainage of tissues outside the nervous tissue of the brain?

What can we use from this in teaching undergraduate A&P?

  • When discussing CSF drainage, consider mentioning the possibility that filtration of CSF directly into dural sinuses may be augmented by the newly discovered lymphatic drainage.

  • If you discuss the dogma of the "immune privilege" of the brain, consider mentioning this possible challenge to the concept. This may trigger a great discussion of whether these newly discovered lymphatic vessels are truly "in the brain."

  • If you discuss disorders involving altered immunity, such as multiple sclerosis, consider mentioning this discovery.

  • Bringing up this new information may be useful in discussions related to the process of science—how existing concepts are sometimes challenged by new information, for example. Perhaps a discussion of the need for more investigation would stimulate students to think about what future steps can be taken to map out a possible lymphatic network in or around the brain.
Current concept of lymphatic drainage (left) compared to updated version to reflect new data (right).

Want to know more?

Brain Drain | The brain contains lymphatic vessels similar to those found elsewhere in the body, a mouse study shows.
  • Ashley P. Taylor, The Scientist, June 1, 2015 (online)
  • Plain-English article summarizing the study and its significance.
Structural and functional features of central nervous system lymphatic vessels,
  • A. Louveau et al., Nature, June 1, 2015.doi:10.1038/nature14432, 
  • The original research article. Includes images and video.
Missing link found between brain, immune system; major disease implications
  • University of Virginia Health System, Science Daily, June 1, 2015
  • Illustrated press release describing the research.

Images: DBCLS (top)
Univ Va Health System (bottom)

Tuesday, May 19, 2015

Testing as a Learning Tool | UPDATE

I radically changed my approach to testing my A&P students about 13 years ago. It was was one of those experiments that had me questioning my sanity leading up to its roll-out. That's because in some fundamental ways, it challenged my experience of how I and others had always thought about the role of testing in the learning process.

But when it did finally roll out in the first set classes in which I tried it, my new method of using tests as learning tools was a phenomenal success. The class averages on my exams went up by a whole letter grade! Students were working harder—but grumbling less. And student attitudes, which I'm grateful have always been pretty positive anyway, suddenly became downright sunny!

About six years ago, I published an article about online testing as a method of teaching in my blog The Electronic Professor. In the article, I shared my experience in using frequent online tests in my anatomy & physiology courses as a way to get students engaged with the material on an ongoing basis. It outlines how they used testing as a way of learning—promoting construction of a cognitive framework of concepts that helped them prepare for their in-class exams.

Almost a year later, research published in Science further supported this idea. Not that I needed the support . . . my own experience over many years has confirmed for me that it works. In fact, it works VERY well in enhancing student learning. But as a scientist, a variety of independent confirmations of a topic is always valuable and appreciated.

Of course, the concept of frequent, online formative testing (as opposed to summative testing) is not at all new. But like a lot of breakthroughs in teaching and learning, it hasn't caught on with many professors "out in the trenches" yet. But it's really worth taking a look at--and trying it out yourself.

First, check out an updated version of a seminar that I've given on this topic several times over the years.
Seminar: Testing as Teaching
  • Kevin Patton The A&P Professor.
  • Narrated presentation outlining a method to produce randomzed formative tests for A&P.
Next, check out my article from 2009 to get my take on some reactions I've gotten from other professors.
Teaching as Testing
  • Kevin Patton. The Electronic Professor. 27 Feb 2009.
  • Article outlining my use of online, randomized formative tests in teaching A&P.
After that, take a look at the research published in Science a year ago.
To Really Learn, Quit Studying and Take a Test
  • Pam Belluck. The New York Times. 20 January 2011.
  • Brief summary of the research, including a graph of the results.
Retrieval Practice Produces More Learning than Elaborative Studying with Concept Mapping
  • J.D. Karpicke, J. R. Blunt. Science. Published Online January 20 2011. DOI: 10.1126/science.1199327
  • Original research mentioned above.
Next, read these brief articles on a few of the many adaptive learning tools that are now available to accompany many of the major A&P textbooks. Oh, if only I'd had something like this back then!
Students Have Fun and Learn Quickly with EAL Adaptive Learning
  • Kevin Patton. Anatomy & Physiology 18 March 2015
  • Article outlining a self-quizzing tool based on the popular Cerego system.
Adaptive Quizzing Helps Students Get Ready for Tests and Exams
  • Kevin Patton. Anatomy & Physiology 25 March 2015
  • Brief article outlining a quizzing system that helps students prepare for their exams.
Lastly, just take the plunge and try it. Come on—the water's fine and you'll have a blast!

Content updated from a
previous post in
The A&P Professor 
Photo: M. Bowden

Wednesday, April 15, 2015

Mechanism of Cracking Knuckles

It never fails—somebody always asks about what's going on when knuckles crack when we get to the topic of articulations.

Recently, researchers used modern MRI techniques to demonstrate exactly what is happening—a process first described in the 1940s.  As joint surfaces separate, the changing tension in the synovial fluid causes a vapor pocket or "air bubble" to form in a process called cavitation.

The recent research proved that the popping sound typical of cracking a knuckle is produced as the vapor pocket forms. It also disproved the theory that the popping occurs when the bubble collapses.

What can we use from this in teaching undergraduate A&P?

  • You'll now always be ready for that inevitable "what causes knuckles to crack?" question when discussing joints in your A&P course.

    • Consider having a slide containing the media offered below to show students.

  • Discussing joint-cracking mechanisms engages students in a subject that may not immediately interest them.

  • Joint-cracking allows us to reinforce concepts of fluid dynamics in the context of synovial joints.

  • Consider stimulating some critical thinking by asking "what could cause a cracking sound in a cartilaginous or fibrous joint?"   (Hint: think "fracture" as cavitation would not occur where there are no fluids)
  • Do a demonstration by hitting a glass bottle full of water with a rubber mallet (see the embedded video below)
    • I've done this with an unopened glass bottle of ketchup by upturning it and hitting the base with my palm

Want to know more?

  • Real-Time Visualization of Joint Cavitation
    • GN Kawchuk, et al. PLoS|ONE. April 15, 2015 DOI: 10.1371/journal.pone.0119470
    • The original journal article. Includes downloadable images and PowerPoint slides, plus a link to a video showing the MRI results.
  • Researchers pull fingers to solve why knuckles crack | Finding bursts bubble of popular theory
    • Tina Hesman Saey Science News April 15, 2015
    • A plain-English summary of the new work on knuckle cracking with an embedded video (see below)
Check out this video from the research article

Here's a video of the glass bottle demo of cavitation

Photo credit: Kawchuk et al.

Monday, February 9, 2015

Cytotoxic T Cell Horror Flick

Liven up your A&P class with a great video showing a gruesome attack by a killer T cell on a cancer cell. It's a fantastic bit of video microscopy produced by Cambridge University.

Okay, with the oddly soothing music score instead of a more appropriate score for the graphic violence shown in this video, it's not much of a horror flick.  Especially when you consider that it's the "bad guy" cell getting whacked.  But it is graphic and dramatic and impressive.

Just the thing to liven up a discussion of adaptive immunity, which (let's face it) can often cause a catatonic state in many students.

It's a free resource available on YouTube.

Monday, February 2, 2015

Virtual Immunology Lab

Looking for a supplemental hands-on activity with the immune system in your course?

Try the FREE online interactive Immunology Virtual Lab from the Howard Hughes Medical Institute.

It covers these concepts:

  • The basis of humoral immunity 
  • The foundation for ELISA (enzyme-linked immunosorbent assay)
  • Potential errors in conducting an ELISA
  • Sensitivity and specificity of a diagnostic test

What can we use from this in teaching undergraduate A&P?

  • Link to this virtual lab activity from your online syllabus, course web page, or LMS (or in an email  or tweet to students)
  • If you want to give course points for the lab, consider an online quiz or lab report submitted through your learning management system (LMS) or emailed to you.
  • Gives students a "real life" clinical lab application for the concepts they are learning in A&P.
  • Provides an immunology lab option for online/hybrid courses or wet labs that don't have funding for immunology experiments.

Want to know more?

Immunology Virtual Lab

  • BioInteractive. Howard Hughes Medical Institute. Accessed 16 Sep 2014.
  • This virtual lab teaches the procedures of performing an ELISA test to determine whether a particular antibody is present in a patient's blood sample.
  • MedlinePlus. National Library of Medicine. Accessed 16 Sep 2014
  • Brief overview of what ELISA is.  You can link your students to this as a brief intro to the virtual lab.

BioInteractive Virtual Labs

  • BioInteractive. Howard Hughes Medical Institute. Accessed 16 Sep 2014.
  • List of all the FREE virtual labs offered by HHMI's BioInteractive project.

Immunity Topics

  • Kevin Patton. The A&P Professor. Various dates.
  • List of previous blog posts on the topic of immunity.

Tuesday, January 6, 2015

Rhinovirus Replicates Best in the Nasal Cavity

It's that time of year, eh?  Cold and flu season.  And this week we have news from researchers giving us a bit more insight into the rhinoviruses that cause the common cold.

The unsurprising new discovery is that rhinoviruses replicate more efficiently—and therefore cause colds more effectively—in the nasal cavity than in the lungs because of a temperature difference.  In mice, the animals used in the recent study, the immune mechanisms that fight off rhinoviruses work better in the warmer environment of the lung than in the cooler environment of the nasal cavity.

This phenomenon may be why a cold generally doesn't wreak the same havoc in lungs as do other respiratory viruses like influenza viruses.  Rhinoviruses, as their name implies, generally remain limited to the nose.

What can we use from this in teaching undergraduate A&P?

  • When discussing the nasal cavity's vascularity and air-warming functions, we may want to point out that understanding the temperature gradient between the nose and lower respiratory tract has practical clinical applications.  Such as why some pathogens are limited to the nose. And why cold weather may contribute to rhinvirus infection.

  • When discussing immunology, we may want to mention that body temperature—and sometimes organ temperature—can have an impact on how efficiently our immune mechanisms fight infection.

  • One could consider steering a conversation about "there is still no cure for the common cold" to a conversation about the fact that scientists are still working on understanding rhinoviruses—"and, oh, did you hear the latest .....?"

Want to know more?

Where Rhinovirus Replicates Best
  • Tracy Vence,  The Scientist.  Online. January 6, 2015.
  • Plain-English summary of the discovery.

Temperature-dependent innate defense against the common cold virus limits viral replication at warm temperature in mouse airway cells
  • Ellen F. Foxman, et al.  Proceedings of the National Academy of Science. Online. January 5, 2015. doi: 10.1073/pnas.1411030112 
  • Original research paper.
Photo credit: mcfarlandmo

Friday, January 2, 2015

Fat Cells in Skin Kill Bacteria

Scientists reported today that adipocytes in mouse and human skin produce an antimicrobial peptide (AMP) called cathelicidin is response to Staph aureus infections, including MRSA. Experimental animals that were deficient in the AMP were more susceptible to skin infections.

Adipocytes may recognize S. aureus by detecting bacterial peptides with toll-like receptors (TLRs), but more work is needed to fully understand the mechanisms.

This finding adds more to our understanding of human skin as a vital part of our body's defenses against infection. It also opens the door to understanding how diabetes, metabolic syndrome, and other conditions can reduce resistance to skin infections by altering the availability of AMPs in the fat associated with skin.

All of this may eventually lead to additional—perhaps more effective—strategies in preventing or curing serious skin infections such as MRSA.

I realize that we generally think of fat cells as belonging to the hypodermis, not the dermis, as described in the research. However, recent evidence shows the presence of adipocytes in the dermis that are distinct from those in the hypodermis. These adipocytes derive from a common precursor cell that produces both dermal fibroblasts and intradermal adipocytes. These dermal adipocytes have been shown to have a role in wound healing and the regeneration of hair follicles. And the research summarized here suggests that they also have a role in immunity.

What can we use from this in teaching undergraduate A&P?

  • Mention this discovery when discussing the roles of adipose tissue and adipocytes in your coverage of tissues of the body.

    • Consider clarifying that dermal adipocytes are distinct from fat cells in the hypdermis. And perhaps mention that it's a detail often left out of introductory discussions of skin.

  • This is a good point to mention when discussing the protective functions of the skin when covering the integumentary system.

  • When discussing the immune system, this concept helps illustrate several important principles:

    • The role of the skin as the first line of defense against infection

      • The variety of mechanisms available in the skin to act defensively

    • The role of TLRs and pattern recognition in immunity

    • The fact that immunity is a role for many tissues—not just lymphocytes and other WBCs

  • Take a moment NOW to add this to your course notes!

Want to know more?

Killer Fat
  • J. Alcorn and J. Kolls. Science 2 January 2015: Science Vol. 347 no. 6217 pp. 26-27 DOI: 10.1126/science.aaa4567
  • Editorial summary of the research in plain English. Includes a really nice, simple illustration of the concept (includes FREE teaching slide)

Dermal adipocytes protect against invasive Staphylococcus aureus skin infection
  • L. Zhang1, et al. Science 2 January 2015: Vol. 347 no. 6217 pp. 67-71 DOI: 10.1126/science.126097
  • Original research article. Additional images available here, including some nice micrographs showing increase in adipocytes in response to S. aureus infection

Defining dermal adipose tissue.
  • Driskell RR, et al. Exp Dermatol. 2014. Exp Dermatol. 2014 Sep;23(9):629-31. doi: 10.1111/exd.12450.
  • Review article describing dermal adipocytes.

FREE teaching slide
Click the image
to download a

Adipose image credit:
This post was updated 6 OCT 2015