Peer instruction is a cooperative-learning technique that promotes critical thinking, problem solving, and decision-making skills. Benson's think-pair-share and Mazur's peer-instruction techniques are simple cooperative exercises that promote student's participation in class and increase student's interaction with each other and with the instructor in a large classroom. We borrowed concepts from Benson and Mazur and applied these concepts to enhance student involvement during the respiratory component of the medical physiology class. The medical physiology class consisted of 256 first-year medical students. The peer-instruction technique was used for 10 classes. Each class of 50 min was divided into three or four short presentations of 12-20 min. Each presentation was followed by a one-question, multiple-choice quiz on the subject discussed. Questions ranged from simple recall to those testing complex intellectual activities. Students were given 1 min to think and to record their first answer. Subsequently, students were allowed 1 min to discuss their answers with their classmates and possibly correct their first response. The percentage of correct answers increased significantly (P < 0.05) after discussion for both recall and intellectual questions. These data demonstrate that pausing three to four times during a 50-min class to allow discussion of concepts enhanced the students level of understanding and ability to synthesize and integrate material.

Active involvement in the learning process has been suggested to enhance creative thinking, judgement, interpretation, and problem-solving skills. Therefore, educators are encouraged to create an active-learning environment by incorporating active-learning strategies into the class. However, there is very little documentation of the effectiveness of active-learning strategies. Furthermore, faculty are often reluctant to incorporate new strategies without documentation of the effectiveness of these strategies. To address this concern, we compared the performance of two individual classes on an identical respiratory physiology examination. One class was taught respiratory physiology using active-learning strategies. The other class was taught respiratory physiology using the traditional lecture format. The results document that students who learned using active-learning strategies did significantly better ( P < 0.05) on the respiratory physiology examination than students who learned by the traditional lecture format (61 ± 2.2 vs. 86 ± 1.0). Thus, by actively involving students in the learning process, academic performance is enhanced.

Examinations and quizzes should be used as learning as well as assessment tools. To achieve this goal, an assessment procedure was developed to enhance as well as assess student learning. Students were tested on four different topics of cardiovascular physiology. Each topic was tested by a different type of quiz (fill in the blanks, single best response multiple choice, short essay, or true/false). The students first completed a quiz individually. Once the quiz was completed individually, the students completed the same quiz in groups. Eighty percent of the score on the quiz was based on the individual results, and 20% of the score on the quiz was based on the group results. The performance on the quizzes was significantly higher (P < 0.001) when students completed the quizzes in groups than when they completed the quizzes individually. Results document that completing the quizzes in groups enhances the understanding of the material. In addition, students rated this format superior to the traditional method.

.-We tested the hypothesis that a single bout of dynamic exercise produces a postexercise hypotension (PEH) and ␣ 1-adrenergic receptor hyporesponsiveness in spontaneously hypertensive rats (SHR). The postexercise ␣1-adrenergic receptor hyporesponsiveness is due to an enhanced buffering of vasoconstriction by nitric oxide. Male (n ϭ 8) and female (n ϭ 5) SHR were instrumented with a Doppler ultrasonic flow probe around the femoral artery. Distal to the flow probe, a microrenathane catheter was inserted into a branch of the femoral artery for the infusion of the ␣ 1-adrenergic receptor agonist phenylephrine (PE). A microrenathane catheter was inserted into the descending aorta via the left common carotid artery for measurements of arterial pressure (AP) and heart rate. Dose-response curves to PE (3.8 ϫ 10 Ϫ3 Ϫ 1.98 ϫ 10 Ϫ2 g/kHz) were generated before and after a single bout of dynamic exercise. Postexercise AP was reduced in male (13 Ϯ 3 mmHg) and female SHR (18 Ϯ 7 mmHg). Postexercise vasoconstrictor responses to PE were reduced in males due to an enhanced influence of nitric oxide. However, in females, postexercise vasoconstrictor responses to PE were not altered. Results suggest that nitric oxidemediated ␣1-adrenergic receptor hyporesponsiveness contributes to PEH in male but not female SHR. vascular function; gender; arterial pressure; adrenergic receptors FIFTY MILLION AMERICANS HAVE hypertension or are taking antihypertensive medications (30). The morbidity and mortality associated with cardiovascular disease increase exponentially with increasing levels of arterial pressure (AP) (18). Thus interventions designed to lower AP are being vigorously investigated (13, 51). It is well documented that a single bout of dynamic exercise reduces postexercise AP for several hours (11,20,31). Thus acute exercise may be a safe therapeutic approach for lowering AP in hypertensive individuals.The mechanisms mediating postexercise hypotension (PEH) remain the focus of numerous investigative efforts (7,22,35,55). It is generally accepted that PEH is most often associated with elevations in cardiac output (CO) as well as reductions in peripheral vascular resistance (22,24,35) and sympathetic nerve activity (SNA) (16,22,24,35). The postexercise reduction in peripheral vascular resistance may be due to the reduction in SNA as well as a decreased vascular responsiveness to ␣-adrenergic receptor activation. This is suggested because recent evidence has shown that a single bout of dynamic exercise significantly attenuates the vasoconstrictor response to phenylephrine (PE) in an isolated aortic ring preparation (29) and in the intact conscious normotensive rabbit (28) and rat (45). Furthermore, Halliwill and colleagues (22) reported that sympathetic activity is reduced and the transduction of sympathetic activity into vascular resistance is attenuated after dynamic exercise. These data suggest that the ability of the vasculature to respond to a change in SNA or a sustained catecholamine increase after exercise is significantly re...

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