Keywords

1 Introduction

Human anatomy and physiology is a key element in any biomedical engineering (BME) higher education program curriculum. While BME is multidisciplinary by nature, the understanding the human body is always the cornerstone of BME, i.e. the application of engineering principles to solve problems related to the human body. Ideally, human anatomy and physiology learning in BME programs should be tailored to the specific needs of BME students, bridging engineering and medical fields and thinking frameworks. However, this is not always the case.

The historical diversity of BME departments, often stemming out from various engineering disciplines with their associated staff and resources, may result on the lack of anatomy and physiology courses tailored for BME students. This is especially true for newer BME programs in developing countries such as Indonesia. While each program may have a group of faculty members with a strong specific expertise related to BME, individual programs often has gaps in their set of expertise configuration vital for a comprehensive BME education, such as anatomy and physiology education. To solve this issue, programs may have students follow courses from other programs (e.g. taking human physiology courses from biology or medical programs). However, this arrangement is not optimal, as these courses are designed for students with different educational backgrounds and learning outcomes requirements. For example, engineering-based BME students following a medical program’s anatomy course may find it too detailed and memorization based. More importantly, it may be difficult to connect the physiological concepts learned in the course to their potential engineering applications and frameworks.

To contribute in addressing this issue, this paper describes the development and implementation of a series of Anatomy and Physiology courses for engineers that has been implemented both in blended and pure eLearning mode in two universities in Indonesia. The course adjusts traditional medical-school based course on human physiology by approaching the topic using analogies of the human physiological systems as engineering systems, including tie-in of physiological systems to engineering based quantitative models, as well as BME applications of anatomy and physiology principles.

2 Course Design

2.1 Context in the Curriculum and Institution

The authors in Institut Teknologi Bandung’s (ITB) BME program has developed a series of anatomy and physiology courses for engineers, each tailored for a specific target audience. There is (i) a condensed one semester course covering the basic principles of anatomy and physiology aimed for general engineering students, (ii) a more detailed two-courses sequence specifically for BME students, who needs more in depth knowledge of human anatomy and physiology, and finally (iii) a graduate course of anatomy and physiology.

The three series of courses have similar approaches to teaching and learning, but differ in the depth of knowledge and focus. The condensed one semester course is intended to be a brief introduction for non BME engineering students who may have an interest in BME or projects involving the human body. The course is designed to be taken as an elective for third or fourth year engineering undergraduate student, wit a solid background in basic engineering. In addition to implementation at ITB, the condensed one semester course has also been implemented three times with blended learning methodology at Udayana university, an Indonesian state university in Bali as an elective course in their Electrical Engineering Program [1,2,3,4]. The two-course series is part of the ITB’s core BME undergraduate curriculum, intended to be taken through two semesters in the second year of BME program. The course are taught concurrently with other basic core BME courses such as Fundamentals of Biomedical Engineering, Biomedical Electronics, and Biochemistry. In addition, BME students in the second year stage follows a series of BME lab courses that integrates lab modules from the different courses, including anatomy and physiology. Finally, the graduate course goes into more depth to the integration between body systems and engineering applications in anatomy and physiology.

The development and implementation of these courses has been supported by multiple academic grants, including the SPADA grant from the Indonesian government office for higher education (DIKTI), the INHERENT K-1 grant and the GDLN grant [1,2,3,4]. The course has been implemented and improved over time since 1999, and is also part of an initiative to develop a more comprehensive course repository on BME for Indonesia [5].

2.2 Course Content

The course opens with an introduction to living systems, homeostasis, and basics of physiological modeling, emphasizing the connection between biology and engineering frameworks. While not the core of the course, a short introduction of ethics in BME is also given, and reinforced throughout the course in topic relevant cases. It then follows the system based approach in teaching anatomy and physiology, proceeding with the major systems of the human body, including the nervous, musculoskeletal, cardiovascular, respiratory, respiratory and urinary system. Each chapter is accompanied by a module discussing BME applications of anatomy and physiology principles. The course is capped with a major assignment to integrate their anatomy physiology knowledge with an engineering application.

2.3 Delivery Methodology and Learning Approaches

The delivery method for the course is in general blended learning, with a combination of in-class instruction, discussion, and online learning and interaction. Online learning materials are designed to prepare students for active classroom discussions and activities, including video, picture, and textual materials. Students study online materials, submit assignments and conduct short quizzes online. This is aimed to provide students with a more efficient, flexible learning environment that also allows them to better track their progress [6,7,8]. This approach is supplemented with face-to-face or synchronized online meetings for distance learning implementations.

In terms of learning approach, the course approaches anatomy and physiology learning through the lenses of engineering student learning styles, using flowcharts and block diagrams to illustrate physiological processes and the connections between physiological elements, focusing on quantitative models of physiological systems, and when possible using analogies of the human physiological systems as engineering systems. In addition, each chapter is accompanied by a module discussing BME applications of anatomy and physiology principles. This can range from a discussion of windkessel models in cardiovascular system, to practical lab sessions with EMG. Figure 1 gives an example of engineering analogy used to describe physiological systems, in this case the electrical circuit equivalent to a human cell membrane.

Fig. 1
figure 1

Example of engineering analogy for physiological system: electrical circuit model for human cell membrane

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Matching the teaching approach, student performance was assessed by a balance of examinations, problem sets and design assignment. The written examinations are a combination of online, multiple choice knowledge based questions and more open ended problem-solving or critical-thinking based essay materials done on class in an open book manner. To complement the traditional exams, as a final class project, students are required to conduct a simple design exercise applying engineering principles to solve a medical problem. This allows them to start integrating engineering and medical knowledge, which is a key part of BME education.

3 Results and Future Developments

In general, throughout the iterations of their implementation, the courses have satisfied its learning objectives and general objective of improving BME anatomy and physiology education in their implementation sites. Student enrollment are generally to maximum capacity of the class for elective courses, and full attendance for compulsory courses. This generally amounts to between 25 and 32 student enrollment per course for undergraduate courses and between 5 and 10 student enrollments for the graduate course.

Student performance is generally high in problem solving and design based assessments. They are somewhat more varied in the knowledge based assessments (e.g. quiz and written examinations), but this is within normal pedagogical parameters, with 100% of the students passing the course. Moreover, the primary objective of the courses is to give basic grounding for engineering students to understand the basic principles of human anatomy and physiology, to be able to use them as a framework to use engineering skills and knowledge in solving medical based issues. Detail knowledge was not the main objective, and can be acquired over time as needed. Table 1 shows student assessment results from the 2016 iteration of the course.

Table 1 Example grade distribution for undergraduate courses on semester 1 2016/2017
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In terms of student based course assessments, a student questionnaire on a 5 level Likert scale was distributed at the end of each course iteration [9, 10]. Results showed that in 2016, the blended learning mode of teaching is new to slightly more than half the students, and 100% of the students recommends that this method of pedagogy should be repeated for the next semester. In terms of class activity, students primarily uses the online learning management system (LMS) to view class materials and submit assignments, with forums being the least used online tool in the LMS (average score 1.4).

In general, students agree that the blended learning method increases learning effectiveness, flexibility, and aids in controlling study progress (average scores >3.8), but think less that online learning can replace face to face interactions completely (average score 2.8). In terms of presentation of content and study method, students agree that learning media (pictures, animations, models) help course understanding (average score 4.1), the course was well structured (average score 3.8) and that the course motivates them to explore the field in more depth (average score 3.8).

Having said that, there are still some hurdles that merits improvement, notably technical issues related to ICT infrastructure and some pedagogical issues related to higher level learning outcomes in pure eLearning modes. Multi-university/distance learning implementation was particularly affected by this issue. It is hoped that this course and the lessons learned from its development and implementation will contribute to the growth of BME education in Indonesia and beyond.