Using Role‐Playing Simulations to Teach Endocrine and Respiratory Physiology in Large Classes

Role‐playing simulations can help students master complex physiological processes, but may be less effective in larger classes if most students are observers instead of participants. The current study addressed this issue by evaluating the effectiveness of dividing the class into support groups for each role‐playing student. Depending on the situation, support groups provided advice verbally or via clickers. The simulations emphasized higher‐order thinking by asking students to predict how the simulation would change under different conditions. The first role‐playing exercise addressed negative feedback in the hypothalamic ‐pituitary‐target gland axis, using instrument noises to represent the hormonal output of the hypothalamus (drum), anterior pituitary (clapper), and target gland (clanger). After practicing the simulation under normal conditions, students worked with their support groups to predict how the simulation would change in response to perturbations such as an altered steady state, dysfunction of the target organ, or a tumor (an audience member playing an additional instrument). The second exercise examined the mechanics of ventilation by asking concentric circles of students to represent the chest wall/diaphragm, pleural membranes, and lungs. Students predicted how the circles would move during normal inspiration and expiration and under disease conditions (pneumothorax, emphysema, pulmonary fibrosis). Mastery of relevant concepts was examined both in the short term, by pre‐ and post‐testing, and in the long term, by examining exam performance, and student perceptions were studied using anonymous surveys. In summary, adding elements of “predict and test” and support groups to role‐playing simulations may increase their utility in larger classes.