Revisiting A&P Learning Outcomes

TAPP Radio Ep. 54 TRANSCRIPT

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Episode 54 Transcript

Revisiting A&P Learning Outcomes

Introduction

Kevin Patton: The physiologist Claude Bernard once wrote, “It is what we think we know already that often prevents us from learning.”

Aileen: Welcome to The A&P Professor, a few minutes to focus on teaching human anatomy and host Kevin Patton.

Kevin Patton: In this episode, I discuss the timing of vaccinations, neurons that seem to erase memories, vaping, and the HAPS Learning Outcomes.

Timing of Vaccinations

Kevin Patton: A couple of days before recording this episode, I went and had my annual flu shot. Now might be a good time to encourage all of you to get your flu shot, especially those of you dealing with students who are coughing and sneezing all over those papers before they turn them in. Oh, man, that’s a … Boy, what a great place to catch the flu is at a school or other crowded places like that.

Kevin Patton: But the reason I bring it up right now in this episode is to tell you about some research that I ran across recently that showed, apparently, that the biological clock that ticks inside of us all the time and has very many effects on various levels of human structure and function, one of those areas where we have cyclic activity is in our immune system. This recent research shows that the CD8 population of T cells, they become a lot more active during the middle of the day. Those are the cells that are particularly in responding to vaccinations, like my flu vaccine that a couple of days ago.

Kevin Patton: So when I went in and got the flu shot, guess when I went in? It was 12:09, because I still have the little receipt that says if I fill out the survey I’m eligible to win fabulous prizes or whatever. So it has the time stamped on there so when I fill out the little survey they can kind of track it down to who was on duty that day, I guess. So, I’m going to do that. I’m also glad that I got my vaccination right at noon because according to this research that’s the best time to get a vaccine. There’s your public service announcement for this episode.

Neurons That Erase Memory

Kevin Patton: My A&P students are fascinated with the idea that all of that memory work they’re doing to build a foundation for learning in our course is happening at the level of neurons and synapses. I think part of their fascination comes from the fact that after spending all that time and effort trying to understand the concepts of action potentials and all that involves and synaptic transmission and that all involves that there really is a useful application for all of that work. Course, there are many, many applications of understanding neurons and synapses beyond memory, but that’s one of the first ones that I give them.

Kevin Patton: I think memory is such an abstract thing. It’s kind of interesting to find out, well, there are little parts that have certain functions that is where memory occurs. I tell them that it’s hard to tell them the last best story because it probably would’ve changed over the course of the last week because it’s a very active area of research.

Kevin Patton: I just happened to run across another little piece of that story that has recently be relieved. This was in the journal Science, and it describes where some research in Japan were working with mice and they found a population of cells in the hypothalamus that actively removes old memories. Now, I always thought that when memories disappear it’s more of a passive process. We’re not accessing them frequently or at all, and therefore they just go away. They’re not being reinforced, and so that’s what causes the loss of memory. But, neuroscientists for a long time now have been proposing this idea that there are some active mechanisms involved where we’re actively getting rid of old memories.

Kevin Patton: One researcher used the analogy of stripping out old paint and getting rid of the flaking paint and so on, scraping it off and sanding it down and so on before adding new paint. If you want the new paint job to look okay, you have to do that active process of stripping the old paint. He likened that to having to strip out old memories so that new memories that form really are forming correctly and forming in a way that we’re going to be able to retrieve them later, or at least more likely to retrieve them later.

Kevin Patton: So this population of neurons that they found within the hypothalamus that are involved in actively getting rid of memories, they are called MCH neurons. MCH stands for melanin-concentrating hormone, so they are melanin-concentrating hormone neurons. When they are active, or one of the things they do when they’re active, is to get rid of older memories. They did a series of experiments that you can read about in the article in the accompanying summaries and so on which I have linked in the show notes or the episode page at theAPprofessor.org. You can look at all of that.

Kevin Patton: But, the bottom line is that they found that if they activated those neurons, then the mice were able to erase memories of some objects that they had been exposed to. And when they inhibited those MCH neurons, the mice did not forget those objects that they had been exposed to, and it became … So obviously they could just glance at the mice and tell which population of mice they were, the ones where the MCH neurons were suppressed or the ones where they were active. This looks like it’s probably going to be part of the story.

Kevin Patton: Another thing that they found is that these MCH cells get very active during REM sleep, rapid eye movement phase of sleep. This may account in part for the fact that it’s very difficult to remember very many details from dreams because dreams happen during the REM state. But it also probably tells us why we do the REM state, or at least one of the reasons why we do the REM state, and that is to go in and strip out all of those memories that we don’t think are important. That, well, in a manner of speaking, makes room for new memories. It prepares the neurons, it prepares the brain for the next day. And of course that leads to the idea that sleep deprivation or sleep that is disrupted or dysfunctional in the sense that you’re not having REM dreaming states, at least in the cycle that you normally would, is destructive to our ability to form new memories in the following days. It makes it hard to concentrate. It makes it hard to process things. Maybe this part of this story that these MCH cells have to actively go in there on a regular basis and clean out the old memories is important.

Vaping

Kevin Patton: There’s always some amount of lag time between when I record any one segment in an episode and when you actually hear it. What that means is for things that are rapidly unfolding in real time you’re going to be hearing it some time after maybe some other developments in that story have occurred. But I can’t just not talk about some important things because they might have changed a little bit by the time you hear them. One of those stories is vaping. I think vaping is important to discuss and it’s important for A&P teachers to keep up with because we’re getting students asking us about that in class. And if they’re not asking about it in class, they’re asking about it outside of class. So it’s worth our while to be up on what the latest or what the last best story is about vaping. I think the bottom line of that is don’t do it until we’re got it figured out, and maybe even then don’t do it. So, there’s that.

Kevin Patton: But, we just recently, at least at the time of this recording, crossed over the 1,000 mark where we have now over 1,000 cases of illnesses and deaths that have been linked to vaping. We’re up to 18 deaths at the time of this recording. And why is that? People have been vaping for a little while. And have we just not been recognizing these things happen or is there something happening recently in the supply chain that have triggered this, or what is it? We don’t have it figured out. But, that’s one of the reasons why I think it is important to discuss it in our class to not only kind of bring people up to date and do our due diligence in telling students that this is a potential health risk, a possibly very severe health risk so they want to use that information to make their own personal choices. But beyond that, it’s a really good example of how our public health system works in trying to track down the nature of a disease and the source of a disease.

Kevin Patton: One of the recent bits of information that came out was a histological study of the lungs of some of the people who either have had this severe illness or have died. And in looking at a combination of both groups of people affected by these vaping illnesses, they determined, at least in their initial observations, that these histological specimens look like they came from people who had experienced some sort of toxic fume incident, like an industrial accident where toxic fumes were released and caused burning, chemical burning, of their airways, including the lungs themselves. Now, exactly what caused it and whether that’s the only mechanism involved in these cases is still debatable.

Kevin Patton: They still seem to be going back and forth a little bit about the role of vitamin E, which is an oil that is used to mix with other oils, often with THC, which is the active ingredient, the psychoactive ingredient, in marijuana. It’s used to mix with that to be kind of a filler or a diluter of that. So there was some early evidence that those lipids were building up inside the lungs and causing some of the problems. The more recent research shows that that’s probably not the mechanism that’s involved. So we’re still teasing that out to see, is it? Isn’t it? What’s going on here? And maybe possibly tracking it to a particular point source or patient zero or whatever.

Kevin Patton: This is a good example of how our public health system works, and I think it’s one of those stories that we can continue to follow in class over a semester or two semesters, depending on how long you have your students, and maybe keep bringing in the latest news so that students can see how that branch of human biology, that branch of applied human biology really works. It might add some interest to your class. Might add some motivation and learning the different kinds of things that go on in the human body, and it may even give a few of our students some alternate career ideas when they find out that, well, they always wanted to be a nurse and they got into the clinic and found out they never want to be a nurse. If they have some backups, some other options where they can use their A&P but in a different way, maybe in the public health sector, then that would be a useful thing to give our students as well.

Revisiting the HAPS Learning Outcomes for A&P

Kevin Patton: I want to spend a few minutes talking about learning outcomes. You know what learning outcomes are, right? These are the things that we want our students walking away from our course to have, things that we want them to have mastered as they move in to their next course and the course after that and eventually into their careers. If you’re a member of HAPS, the Human Anatomy & Physiology Society, you may have noticed the recent communication that says that the new A&P Learning Outcomes are now available. They’re available on the website. You can get there by going to theAPprofessor.org/haps. You go to the tab that says HAPS Comprehensive Exam, and you look in the submenu, and way at the bottom it’ll say Learning Outcomes. That’s how you get to them. I recommend you get to them, and I’ll tell you why over the next couple of minutes.

Kevin Patton: First of all, I want to explain sort of how they rose. The idea of HAPS Learning Outcomes came way in the early days of the organization, back in the early 1990s. So that’s right around the time that HAPS gelled as an organization, officially became an organization. We were all noticing the sort of the same behavior in each other, and that is we were coming to HAPS meetings and spending a lot of our time asking each other, “Do you cover this topic? Do you cover that topic? If you cover that topic, well, how do you cover it? How much detail do you get into? What do you do as a learning activity?” And you know what? I’m coming up on my 31st consecutive HAPS annual conference this next spring and I still do that and everybody that I run into still does that. I’m asking that question. People are asking those questions of me.

Kevin Patton: So that led to the idea, should we have some sort of master document, sort of a starting point for everyone? And people, all of us said, “Well, yeah.” Of course we had little bit of trepidation because any time you publish something, then it can be interpreted by some people that this is the must-do list. Everyone must do it and must do it this way. And all along, that has never been the goal. That’s even stated in almost exactly the same way in the documents that come along with the HAPS Learning Outcomes. They are meant to be suggestions, a starting point. They’re not meant to be a mandate, so keep that in mind.

Kevin Patton: And starting from the beginning, or at least the early days, these learning outcomes have been tied to the HAPS comprehensive exam, which, again, is not something we would expect our students to ace, that is to get 100% perfect score on. It’s something that’s offered all around the United States, and Canada, and beyond with a lot of different kinds of programs and a lot of different kinds of A&P courses. It’s just meant to compare the performance of our students within the universe of A&P students who are taking the exam. So it’s a standardized-type thing that, again, is used as a tool not to necessarily aspire to 100%. We have to keep in mind that there’s some topics that are in the learning outcomes, and therefore in the exam, that we just don’t cover in our course.

Kevin Patton: Now, the A&P outcomes are … The kind of course that they have in mind in a general sense is a two-semester combined A&P course. There is also a set of learning outcomes for the anatomy-only course, undergraduate anatomy-only course. Coming soon will be a set of learning outcomes for the physiology course. So whatever flavor of A&P, the format of A&P at your institution, there will be a list of learning outcomes that you can use as a tool.

Kevin Patton: I’m going to focus on the two-semester combined A&P Learning Outcomes. That’s the kind of course I’m probably most recently familiar with. I’ve done the straight ARP format as well. But what I’m thinking of mostly is the combined anatomy/physiology course. And one of the things I realize is that there’s certain topics I don’t cover in my course because at my institution there’s certain concepts that are covered in a different course so we move it over there. So there’s that.

Kevin Patton: Also at my institution, we have a one-semester version of A&P. So the persons who teach that course, they can still use these two-semester sequence outcomes just realizing the fact that they’re not going to be able to cover all of those topics, probably. Or if they do, they’re not necessarily going to cover all the concepts within each of those topics. So no matter what flavor, format, whatever that you’re teaching A&P, this is still a useful tool. Because remember, they’re not a mandate. They’re not a list of must-do things. They’re a place to start thinking about it.

Kevin Patton: We still at our conferences are still going to want to ask each other, “Hey, these learning outcomes here, do you cover those? Cover those? If you do, how do you get there? What changes have you made to it?” And so on. So in a minute, I’m going to get in to a few of the changes that have been made, but I strongly recommend that you download these yourself. Now, you have to be a member to get them, so make sure you’re current in your membership and log in and download those learning outcomes and take a look at them. It’s going to take a while to go over it.

Kevin Patton: I was just talking to some other A&P colleagues recently and they said, “Well, golly, we just started our course, and now these come out. I would’ve liked to have seen them before the course started.” And I’m thinking to myself, “Oh my gosh. This is going to take me months to really sort of meditate on, and sleep on, and have a snack on and think about and then go through my course bit, by bit, by bit.” So this is going to take me probably a good year, even though I’m probably not going to make many changes in my course. It’s going to take a while for me to think about what’s here in this newly revised document and what am I actually doing in the courses I teach and see how they align and make some decisions. Because when it comes down to it, it’s up to me, again, a principle emphasized in the documents that accompany the learning outcomes.

Kevin Patton: So what are some of the changes that have been made? One of them is that a new module has been added, a module on embryology, because a lot of us weave the story of embryology into the overall story of human anatomy and physiology. Some people do embryology as its own topic. I think most of us, in the combined A&P course at least, weave it in there bits and pieces. That’s what I do. I don’t frankly cover a lot of embryology in my course. But what embryology I do, I sort of weave that. I sort of set the stage at the beginning and weave it in here and there and so on and come back to it occasionally. Either way you do it, now there’s some learning outcomes that I can compare my coverage against what is sort of a recommended central core idea.

Kevin Patton: So I’m anxious to … I haven’t looked at … It’s module T that they added on. I’m anxious to look through module T and see what they have to say there and see how that compares to what I’m actually doing in my course. So I might use that as a starting point to think about what I’m going to do with embryology. Am I going to continue to do it the same way? Am I going to alter the way I do it? I don’t know yet. I haven’t gotten that far yet.

Kevin Patton: Another thing that is a little bit different, or at least a guiding principle that they used in this most recent revision, which was 10 years in coming … And that’s the plan, is to look at them again every 10 years to see if they need to be revised. One of the guiding principles this time around was to align the anatomical terms with the Terminologia Anatomica, which I have mentioned a number of times in previous episodes. This is an international list that was developed in the anatomy community so that we could maybe try to be a little more uniform in our use of terminology.

Kevin Patton: One of the principles of the Terminologia Anatomica, or TA for short, is to remove eponyms. So the eponyms have been removed. Eponyms, remember, are anatomical terms that are named after someone. Islets of Langerhans, for example, that’s an eponym. If we call it pancreatic islet, that’s a little more descriptive and probably more helpful for learning.

Kevin Patton: So what I do in my course, and I mentioned this in previous episodes … You know what I do. You know what my attitude about this is, is yes, eponyms should be secondary. I think they still need to be exposed to them because they’re going to run into them in clinical situations, but the primary term should not be the eponym but instead the descriptive term. It’s going to increase accuracy, precision, and, best of all, students are going to find it easier to learn. Not just easier to learn the term, but easier to learn the characteristics or location of what that term is naming, what part of the body it is that they’re naming.

Kevin Patton: Another thing they did when they revised is they tried to make the language more consistent and as clear and concise as possible. That’s always an issue when you have something created by a committee, is that you get some difference in the voice and the language. Everything now uses active verbs to describe behaviors that can be assessed, so that’s uniformly done.

Kevin Patton: And speaking of redundancy, there were a number of concepts that showed up in more than one module. And of course, that’s the way we teach A&P, right? I know I do. For example, the core metabolic pathways that I discuss in my course, I introduce that very early on, and then I bring it up again later and add a little content. Then I bring it up again later and add a little content. It’s sort of like a character in a mini series. In the first episode, you learn a little bit about that character. Then, the next episode you learn a little bit more. By time you’re finished with that mini series, well by golly, then you know everything there is to know about that character but it’s been introduced bit, by bit, by bit all the way along.

Kevin Patton: I think all of us tell our A&P story that way. The HAPS outcomes do not repeat things that way. And it’s not to discourage repeating it, it’s to discourage redundancy within the document because that can get, and has been, a little bit confusing for at least some users. So there are particular topics that have all been moved into just one module. So what that means is when you’re comparing it to your course, you have to keep that in mind so that you know if you’re talking about metabolism early on and then again here, and then again there …

Kevin Patton: For example, I’ll discuss when we discuss muscles because we’re talking about how muscles use energy and where they get the energy from. So we want to look at some of the major catabolic pathways that are generating ATPs. Is that going to be in the muscle module of the learning outcomes? No. It’s going to be in the metabolism module. But, that’s still appropriate to teach it, at least some of it, or review it, or introduce it, or whatever it is you’re doing depending on how you tell the story within the muscle chapter or muscle module in your course.

Kevin Patton: Another thing that you need to keep in mind is this one, even more so than the last edition of these learning outcomes, they really focused on getting to the core educational concepts. So when I start just flipping through the new ones, I thought, “Oh my gosh. This is like briefer than the other.” And I started to read more closely and I realized it’s way less detailed. In other words, it’s listing major kinds of things the students need to know, and it’s not telling you how much detail there needs to be for this core concept or that core concept, and certainly not how to teach it. Those are all things that you need to decide yourself, not in a vacuum, because hopefully you’re a member of HAPS, you’re a listener of this podcast. You might be a member of other organizations that are going to be helpful, such as AAA, the American Association for Anatomy. Oh my gosh. I got their new name right without even having to stop and think about it. So it’s now kind of ingrained in my brain somewhere. So I guess repeating it often enough really works, right? I’ve formed the synapses I need to form.

Kevin Patton: But, my point is we’re not going to do that in a vacuum. We’re going to get help from our colleagues. There’s lots of resources that we can use, but here’s a starting point. It’s giving us just the core concepts. And how we fill it in, well, we’re going to do that on our own with help from colleagues.

Kevin Patton: Now, keep in mind that another thing that they were thinking of when they put this together is that there’s wide variation in use. Some of the things you’re not going to do. Some of the things you’re going to do differently. You know what? That’s okay.

Kevin Patton: Another thing to remember is, yes, this was done by a committee. And each time they’ve revised it, I’ve noticed that how they put the committee together and how the committee work has changed a little bit, and I think that’s good. Because I think every time we look at it a little bit differently using different methodology, it’s going to become a cleaner, more usable tool. That’s certainly that’s been my experience of this edition of it so far.

Kevin Patton: But, one of my first reactions to anything produced by a committee is, “Oh, if I was on the committee, I wouldn’t have done that,” or, “I wouldn’t have done this.” I always have to sort of bring myself back from that and realize that if I was on that committee then it still may have turned out the way it turned out. It probably would have still turned out the way it turned out. I would’ve walked in with my perspective on things, and I would’ve argued for that and maybe debated that with other members of the committee. Then, we would’ve either gone with my way or we would’ve gone with someone else’s suggestions. Or more likely, we would’ve come out somewhere in the middle and it would’ve been better than either of the two positions, maybe, that were being debated. Or maybe three or four positions were being debated.

Kevin Patton: So when I second-guess committee work, that’s kind of a cheap shot, I think, because we don’t know how it would’ve worked out if we had been on the committee. And we didn’t do all of the leg work that the committee members did in terms of doing research and debating things back and forth and logically going through how they thought things should be in the learning outcomes.

Kevin Patton: So does that mean this is a perfect document? No. I’m sure that there’s something in there that I’m not going to agree with. And you know what? That’s okay. The documents themselves give me permission to go my own way if I want to. But I’m going to think about it. And I’m going to think, well, maybe this is not right. And I’ll be honest with you. There are a couple things so far that I’ve looked at and said, “No. No. I don’t think that’s a good idea.” Then I slept on it, and we know that’s important. Have a snack on it, as I mentioned before, that’s good. Now I’m kind of coming around to it. So I can honestly say, as of this moment that I’m recording this, that there’s nothing so far, none of the changes, that I can’t agree with. I can agree with them. Some of them kind of threw me for a loop. But now that I think about them, well, I think, yeah, okay. I get that.

Kevin Patton: Now, I’m not sure how that’s going to play out in my course yet. I haven’t had enough time to get that far. But, keep that in mind, that we need to be careful with this stuff. We need to make sure it’s going to work in our course. And we also need to be careful to respect the work that our colleagues have done in the committee, even if we end up disagreeing with them. Let’s not try to shoot them down right away. Let’s give it a chance to percolate in our brains a little bit and figure out what’s going on.

Kevin Patton: So I’m going to through a few more of the changes, the more specific changes, but not all of them, because I haven’t even seen all of them yet. But, this gives you kind of a flavor for the kinds of things that have been changed.

Kevin Patton: One of them is … Well, several of these have to do with changes in terminology, what they’re recommending for terminology. Again, sort of in the spirit of the Terminologia Anatomica in that if we’re all using the same phrasing for certain concepts, then maybe it’ll be better for our students. Since these were well thought out and research and so on, I’m going to take them to heart and I’m not going to dismiss them very easily.

Kevin Patton: One of them is action potential conduction. A lot of us have used or have heard the term action potential propagation, when the action potential propagates along an axon, for example. What they’re recommending is that we don’t call it propagation because action potential propagation could actually occur along a whole series of neurons, right? Could go from one to the next and next. The signal is propagating throughout a whole network where the signal is spread. So in order to avoid confusion, if we call it action potential conduction, then that might avoid some of that potential confusion. So take a look at it. I don’t want spend a lot of time discussing any of these, but I’m just kind of giving you a hint as the kinds of changes that were made.

Kevin Patton: Another thing sort of related to that is they omitted the term continuous conduction to describe what happens when an action potential is moving along an unmyelinated neuron. Because when we use continuous conduction, we’re sort of contrasting that to what happens in a myelinated axon where the action potential seems to jump from one node to the next to the next. And if you really look at what’s going on there, the electrical activity really isn’t jumping. It just appears to jump. It really is continuously conducted. It’s just that it’s sort of moving along long stretches under that myelin sheath very quickly rather than moving from spot to spot to spot along that axon. There’s some spots that it just sort of flies over, but it’s still being continuously conducted. So in order to avoid that sort of confusion, they just got rid of the term continuous conduction and are just calling it action potential conduction in an unmyelinated neuron.

Kevin Patton: Another example of a change in terminology would be when we’re talking about the production of blood cells. You’ve probably seen the term hematopoiesis and the term hemopoiesis. And you may wonder, “Well, which is bests to use?” And it turns out they mean something slight different. They’re not exactly equivalent to each other.

Kevin Patton: In the literature, hematopoiesis is usually used to talk about blood cell production in general, whereas hemopoiesis, so one less syllable, hemopoiesis is more often used to talk about how the cellular components of blood in myeloid and lymphoid tissue are produced. Hemopoiesis is a subset of hematopoiesis. So when we’re talking about blood tissue formation in general, blood cell formation I should say in general, then let’s call it hematopoiesis, at least that’s the approach, the strategy taken in the learning outcomes.

Kevin Patton: Another terminology difference is when we start talking about isovolumetric ventricular contraction, isovolumetric relaxation as part of the cardiac cycle. Those are commonly used terms that describe different phases of the cardiac cycle. They’re suggesting instead of using the term isovolumetric that we call it isovolumic, that is take out the metra part. Because that metra part can imply that there’s changes in the length of the ventricle, for example, if we’re talking we’re talking about ventricular contraction. And it’s not really about length, it’s about volume. So let’s call it isovolumic ventricular contraction so that we’re precise and we mean just the volume. That does reflect a lot of usage in the current literature, so there’s another example of a change.

Kevin Patton: Another one that they have suggested … And honestly, I kind of wrestled around with this, but I’ve come to see the wisdom in this, and that is moving away from the terms external respiration and internal respiration because it probably introduces more confusion than it clarifies things. You can read through some of the rationale, but they’re talking about just use the specific names of the specific components within this global idea of respiration. So let’s just talk about pulmonary gas exchange and tissue gas exchange. And if we’re talking about cellular respiration, let’s call it cellular respiration. How that might fit in the discussion varies with the story you’re telling. I do talk about cellular respiration when I’m talking about the respiratory system because that’s kind of the point of why we need oxygen and why we’re getting rid of CO2. So it can be part of the story, but maybe the way we label the different parts of the story that cause some confusion that doesn’t need to. So I’m going to certainly take a look at how I tell that part of the story.

Kevin Patton: Another thing they did was module O. Used to be called Metabolism. Now they’re calling it Nutrients and Metabolism. They’re going to focus on nutrients, not diet really, but the nutrients that are used in some of the metabolic pathways. That module, like several others, was completely reorganized and rewritten, so I can’t really summarize that for you easily, and I don’t want to. That’s not the point. The point is to just give you a little bitty taste, sort of like they do at the grocery store where there’s somebody there with some product they want to sell you. They’ll give you a little taste of it, here’s a little cracker, these are new crackers, hoping you’ll buy the whole thing. So I’m hoping you’ll buy the whole thing once you’ve gotten a taste of it.

Kevin Patton: Oh, another change, speaking of … I mentioned that diet isn’t involved in the nutrients and metabolism chapter. But when they talk about some of the things that are related to the metabolic pathways while we’re eating these nutrients or maybe in between times we’re eating the nutrients, they’re recommending getting away from using the terms absorptive state and postabsorptive state and instead using fed and fasted. They go through some of the reasons why that might be import. In the white paper, they explain the changes.

Kevin Patton: Oh, another thing that I was very happy to see … I think I might’ve done my little happy dance when I saw this, and that is they removed the learning outcomes that went through the details of the countercurrent mechanisms in the story of urinary physiology, what goes on in the kidney in terms of urine formation. Wow! That’s great. Because number one, it seems like that story changes a little bit over time, so which version of story. You know, when I say I tell the last best story, well, what is the last story? Maybe it’s different this week as of last week.

Kevin Patton: Not only that, our understanding of what’s going on in these countercurrent mechanisms, that gets more refined and therefore more detailed as time goes by. So again, which details are important for the beginning story, the story that someone going on into a health profession? What do they need to know in order to understand the kidney well enough to be able to apply it? I’ve come to the conclusion that they don’t need to know much. I think they need to know what a countercurrent mechanism is and what the result is, but many of the details that are in there, not necessarily all the details, but many of the details that are in there are not really essential for that understanding. So again, it’s leaving us to us work out which details to put in there, which details not to put in there, how to tell that part of the story. So yippee. I don’t really feel the peer pressure to get into a lot of detail there.

Kevin Patton: There were several other learning modules that were completely reorganized and rewritten, for example module Q, which is on fluid, and electrolytes, and acid-base balance. By the way, in that module, they took out any mention of those topics from the urinary module so that there was no redundancy. So does that mean you shouldn’t talk about acid-base balance or fluid and electrolyte balance when you’re talking about the kidney and what goes on in the kidney? No. I’m going to keep some of that in there, of course. But if I’m looking for the learning outcomes in this document, I’m not going to find them in the kidney module. I’m going to find them in this fluid, electrolyte, acid-base module.

Kevin Patton: So, okay, that’s more than enough preview. I strongly suggest you take a look at it, make some use out of it. I’m finding this revision to really be a very good one. I already liked the learning outcomes. Now I like them even more.

Staying Connected

Kevin Patton: Hey, don’t forget that I always put links in the show notes and at the episode at theAPprofessor.org in case you want to further explore any ideas mentioned in this podcast or if you want to visit our sponsors. And you’re always encouraged to call in with your questions, comments, book club recommendations, and other ideas. Just go to the podcast hotline. That’s 1-833-LION-DEN. That’s 1-833-546-6336. Or send a recording or written message to podcast@theAPprofessor.org. I’ll see you down the road.

Aileen: The A&P Professor is hosted by Kevin Patton, professor, blogger, and text book author in human anatomy and physiology.

Kevin Patton: The driver of this episode does not carry cash. Oh, wait. Here’s a quarter. Where’d that come from?

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