Newly developed practicals for physiology education and research

THE ROLE OF AIIMS, NEW DELHI, IN DEVELOPING NEWER REPLACEMENTS

The Department of Physiology of AIIMS, New Delhi, has been performing amphibian experiments for undergraduate students since inception. These practicals included the study of various aspects of cardiac muscles, capillary circulation, nerve-muscle physiology and certain aspects of neural reflexes among others. In the past 3 years, the matter was discussed and deliberated in our departmental meeting of teaching staff, to explore alternative options of frog nerve muscle preparation for demonstrating the concepts of nerve muscle physiology. The challenge was actively taken up by all the teaching staff of the department. After concept presentation in the weekly departmental meeting of teaching staff, a systemic brain storming was done to find replacement for each of the lost practical. Then for each replacement suggested, a go ahead signal for pilot study was given. Small teams of faculty led resident-volunteers were made. After obtaining appropriate clearances from the Institute Ethics and Animal Ethics committees, the experiments were performed. I supervised the progress of the individual groups continuously on a regular basis. With persistent efforts, the experimental setup and observations were standardised to be consistent and reproducible. The observations and the graphs were subsequently discussed with me and presented and validated by the faculty and teaching staff of the department. Based on these innovations, a full cycle of undergraduate practical demonstrations was performed. Feedbacks were received and incorporated. As and when I saw an opportunity to innovate, I encouraged the young residents and researchers to file a patent. Our departmental efforts nearly lasting for 2 years yielded fruitful results.

For the benefit of the medical teaching community world over, we have carefully documented and published these innovations in Indian Journal of Physiology and Pharmacology (2019, 1^st issue) [Table 1]. These were essentially intended for undergraduate medical education, however, now they find their value in Postgraduate Physiology education as well.

The advantages of these new experiments are manifold. Students can correlate their theoretical knowledge with the findings in practical experiments and discuss among themselves about the conceptual aspects of associated physiology. Assessment of student’s learning of this demonstration practical can also be done using objectively structured practical examination with question stations based on the graphs obtained during the demonstrations. These experimental protocols may be used for research as well.^[3]

THE GROWTH OF CLINICAL PHYSIOLOGY AND REVERSE ENGINEERING

The growth in the field of clinical physiology is remarkable during the last many decades. The country has seen the steady growth in the field of Autonomic Physiology for three decades,^[4] emergence of Human Sleep Physiology and Polysomnography over two decades and Clinical Neurophysiology (especially intraoperative neuromonitoring, IONM) during the last decade. The field of Applied Physiology too is expanding. Cognitive neuroscience has made its dent as it was taken as a thrust area in the country. Apart from this, non-invasive interventions of pain and other functional disorders, exercise physiology and wellness clinics are finding their deserved places. The research in yoga remains as low-hanging fruit for physiologists, albeit more fundamental research is needed to explore the basic mechanisms. The Interventional Physiology is, thus, getting the required momentum where physiologists can play a leading role. I am sure the lost fields of clinical physiology such as respiratory function testing, routine clinical neurophysiology and other newer fields such as cognitive function testing, and several other domains of physiology will also witness the headway in the departments of Physiology. Some of these practicals have already been included in physiology teaching and many more may be included.

Now, there is greater need to develop animal models for current practices in Clinical and Applied physiology services. In the absence of such animal models and experimentation, the physiology will reduce to ‘services’ with least component of research. I would consider this a reverse engineering in Clinical Physiology.

The newer Physiology should be pursued in this direction.

RECENT DEVELOPMENTS IN PHYSIOLOGY

There are several areas where both animal research and human research need to be done hand-in-hand to explore physiological basis such as gastrointestinal physiology, research in the field of special senses, sensory physiology, vascular research and many more.^[2,3] Furthermore, there is a need to create a “physiology skill map” of India, which may serve as roadmap for skill development programme for physiologists.

The recent activities in the field of space exploration have opened the new arena of Space Physiology. There are several analogue experiments that may be pursued on earth at molecular and cellular level, in small organisms, animals and humans. This covers a large number of organ/system areas. Therefore, the field of Space Physiology and Medicine is a new versatile area which has lots of potential to explore.

CONCLUSION

The purpose of physiology practical is to develop research skills and reinforce theoretical construct for physiology education. To reinforce and replace this, the Department of Physiology, AIIMS, New Delhi, has innovated and documented seven new experiments for undergraduate and postgraduate practicals. Since our department has been providing clinical services for over three decades, we have been successful in bringing practical elements of clinical physiology into teaching. Now, we are trying to explore the newer animal experiments for Clinical Physiology research and teaching.