Modifying BioInteractive Resources for an Anatomy and Physiology Course

HHMI BioInteractive offers a rich compilation of resources in the fields of molecular biology, genetics, and evolution. But if you teach anatomy and physiology courses as I do, you may think at first glance that these materials do not apply to your courses. The students in my courses are primarily nursing students who often do not see the direct relevance of learning basic biological concepts such as the central dogma, osmosis, diffusion, cell division, genetics, and natural selection.

As instructors, we know that these basic biological principles are essential to understanding physiological processes. However, students may not have learned basic biological principles within the appropriate context required to apply them to physiological concepts.

I have used a vetted concept inventory from the Genetics Society of America that provides insight into my students’ genetics literacy (www.genetics.org/content/178/1/15). Nursing students who have previously completed their entire sequence of required introductory biology courses struggle to appropriately use and apply genetics concepts in an upper level pathophysiology course. Students seem to have the most problems with the central dogma, meiosis, genetic inheritance and mutations, evolutionary principles of genetics, and genetic engineering.

Why emphasize these concepts if your students, like mine, are not going to major in biology? Interestingly, the standard nursing education curriculum does not have a required component in genetics. Based on my teaching experience and a review of the literature, most nursing students only receive a cursory introduction to these disciplines either in an introductory biology course or in some cases in their anatomy and physiology courses.

A basic understanding of genomic medicine is essential for 21^st century nursing practice because nurses will most likely work with patients who have had some type of genetic test for a disease, prenatal genetic testing, or pharmacogenomic therapy. In addition, nurses often have the most contact with patients when doing patient intakes and in providing health education materials for patients. Understanding genetics would also better equip nurses during patient intake to recognize a possible genetic disorder or to have the ability to answer patient questions related to their diagnosis.

This is where HHMI BioInteractive resources that cover basic biological principles can be used, with minor adaptations, to provide nursing students with an exciting opportunity to immerse themselves in genomics research. The following is one of my favorite activities which I use in the second semester of a two-semester anatomy and physiology course.

Lactase persistence module: I use this in the second semester of my anatomy and physiology course to introduce students to the digestive system and enzymatic digestion. Students apply previously learned knowledge of acid-base balance via blood and respiratory system to digestive system processes. These resources also allow students to apply osmotic principles to physiological processes and reinforce genetic inheritance and natural selection concepts. For this activity, I use the following BioInteractive resources:

Pre-class assignment completed individually:

1. http://www.hhmi.org/biointeractive/regulation-of-the-lactase-gene
2. In-class group activity using clickers or color-coded ABCD student response cards: https://www.hhmi.org/biointeractive/lactase-film-quiz
3. Students complete data analysis portion in class and then are assessed individually using several additional critical thinking questions that I have created in which students apply principles of osmosis, acid-base balance, and enzyme activity to the signs and symptoms of lactose intolerance as related to the digestive and respiratory systems: www.hhmi.org/biointeractive/lactase-film-quiz

For homework, I assign the following questions which are based on the illustration below, as part of the summative assessment for the unit. I also include versions of a few of these on their unit exam.

• Why does fermentation occur in the large intestine and not the small intestine?
• Explain the role of the brush border (microvilli) of the small intestine in digesting lactose in a person who is not lactose intolerant.
• Explain in your own words how the creation of hydrogen gas leads to bloating.
• Explain in a short paragraph, or diagram, how the hydrogen gas moves from the large intestine to the lungs so that it can be exhaled. Be sure to include the role of the blood.
• If lactose is consumed in large quantities, undigested lactose also builds up in the large intestine, leading to other recognizable side effects of lactase-deficient patients, such as diarrhea. In the space below, explain how the unabsorbed lactose pulls fluid into the large intestine. Be sure to include the following terms in your answer: osmosis and osmolality. (I instruct students to review these definitions in their textbooks.)

After completing this activity, students should have working knowledge of the following:

• Identify and explain the genetic basis of lactase persistence.
• Relate the role of the respiratory system in pH balance using the hydrogen breath test for lactose intolerance as an example.
• Explain the process of osmosis as it applies to fluid movement between body compartments using lactose-induced intestinal problems as a model.
• Analyze data and use it to create a graph.
• Understand that mutations are changes in an organism’s DNA that occur randomly.
• Understand the effect of a mutation on an organism’s traits based on the type of mutation and its location.
• Explain how a mutation can lead to a change in physiological processes.

I recommend that you peruse all of the HHMI BioInteractive resources to see how you could create a meaningful activity for your anatomy and physiology students!

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