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An Application-Based, Experiential Learning Course in Clinical Cardiology: Faculty and Student Perspectives

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Title: An Application-Based, Experiential Learning Course in Clinical Cardiology: Faculty and Student Perspectives
Language: English
Authors: Jesse D. Moreira-Bouchard (ORCID 0000-0002-5644-2540), Evan J. Nessen, John McLaughlin, Liam J. Dwyer, Styliana Michaelidis, Kelly Pesanelli
Source: Advances in Physiology Education. 2026 50(1):112-119.
Availability: American Physiological Society. 9650 Rockville Pike, Bethesda, MD 20814-3991. Tel: 301-634-7164; Fax: 301-634-7241; e-mail: webmaster@the-aps.org; Web site: https://www.physiology.org/journal/advances
Peer Reviewed: Y
Page Count: 8
Publication Date: 2026
Document Type: Journal Articles
Reports - Research
Education Level: Higher Education
Postsecondary Education
Descriptors: Teacher Attitudes, Student Attitudes, Experiential Learning, Clinical Experience, Undergraduate Students, Graduate Students, Physiology, Medicine, Human Body, Skill Development, Exercise Physiology, Universities
Geographic Terms: Massachusetts (Boston)
DOI: 10.1152/advan.00200.2024
ISSN: 1043-4046
1522-1229
Abstract: Recent reports describe a cultural shift in the average American's perception of the value of higher education. Additionally, and possibly as a consequence of this shifting perception, college enrollments have decreased in recent years. One major element identified in students' perception of college education is whether or not they receive career preparation. In facilitating career preparedness, many instructors have turned to experiential learning opportunities in the form of internships, laboratory-based courses, and simulations. In this article, we describe an experiential learning course for undergraduate and graduate human physiology students in clinical cardiology skills, including electrocardiography, auscultation, manual blood pressure measurement, and cardiac ultrasonography. Student and instructor perspectives were solicited, and four student and one faculty perspectives are included from the author team as qualitative evidence of the efficacy of the described course in preparing students for a variety of jobs with tangible clinical measurement skills. We describe here our perspective that this course enhanced critical thinking, subjective knowledge in cardiology, and application of cardiac principles to measurement techniques and fostered confidence in translating classroom knowledge to the workforce.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1497515
Database: ERIC
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  Value: <anid>AN0192623325;apu01mar.26;2026Apr01.05:47;v2.2.500</anid> <title id="AN0192623325-1">An application-based, experiential learning course in clinical cardiology: faculty and student perspectives </title> <sbt id="AN0192623325-2">INTRODUCTION</sbt> <p>Recent reports describe a cultural shift in the average American's perception of the value of higher education. Additionally, and possibly as a consequence of this shifting perception, college enrollments have decreased in recent years. One major element identified in students' perception of college education is whether or not they receive career preparation. In facilitating career preparedness, many instructors have turned to experiential learning opportunities in the form of internships, laboratory-based courses, and simulations. In this article, we describe an experiential learning course for undergraduate and graduate human physiology students in clinical cardiology skills, including electrocardiography, auscultation, manual blood pressure measurement, and cardiac ultrasonography. Student and instructor perspectives were solicited, and four student and one faculty perspectives are included from the author team as qualitative evidence of the efficacy of the described course in preparing students for a variety of jobs with tangible clinical measurement skills. We describe here our perspective that this course enhanced critical thinking, subjective knowledge in cardiology, and application of cardiac principles to measurement techniques and fostered confidence in translating classroom knowledge to the workforce. NEW & NOTEWORTHY This article is a novel, highly descriptive interrogation of students' subjective perceptions of the value of clinically relevant experiences learning cardiovascular measurement techniques as a way to foster career preparedness. We demonstrate that experiential learning courses foster not only skill building but self-confidence in physiology students.</p> <p>A recent study in <emph>Inside Higher Ed</emph> provides evidence that modern college students in the United States desire career preparation in their curricula in the form of experiential learning ([<reflink idref="bib1" id="ref1">1</reflink>]). Moreover, educational frameworks exist to create experiential learning opportunities in a multitude of ways ([<reflink idref="bib2" id="ref2">2</reflink>]). As there have been national declines in college enrollment and surveys published indicating that there exists a public perception that college education is losing its value ([<reflink idref="bib3" id="ref3">3</reflink>]), it is imperative that we as educators identify ways to revise our courses and curricula to continue meeting the needs of students entering modern scientific workforce. At Boston University, the undergraduate Program in Human Physiology at Sargent College of Health and Rehabilitation Sciences has had a long-standing tradition of training future science and medical professionals, and as such we often look for new ways to build practical skills into our curriculum. In this article, we describe a new experiential learning course with a heavy clinical laboratory focus to teach students fundamental and intermediate skills in clinical cardiology and exercise science.</p> <hd id="AN0192623325-3">THEORY</hd> <p>This new upper-level course, "Clinical Measurements in Cardiology," is designed to serve as a practical application of cardiovascular physiology to techniques often employed in health care and in research for understanding cardiovascular function and dysfunction. Experiential learning, as posited by Kolb ([<reflink idref="bib4" id="ref4">4</reflink>], [<reflink idref="bib5" id="ref5">5</reflink>]), is a learning process whereby students can apply theoretical frameworks through the act of doing to enhance retention and understanding. In experiential learning theory, there are four critical components to ensure that students work through. First, there is concrete experience. In concrete experience, a learner must have a new experience or interpret a prior experience in novel ways. Second, learners undergo reflective observation. The learner will engage in reflection on this new experience to find meaning or salience, as well as context. Third, there is abstract conceptualization. Here, the learner adapts their thinking or builds a new construct upon finalizing their reflection to better understand the experience and similar experiences in the future. Finally, in active experimentation, the learner applies their knowledge to real-world experiences to test their efficacy and identify any new challenges that must be accounted for. Through this cycle, students continuously improve upon their understanding of the theory and practical application of relevant skills. Notably, Kolb's experiential learning theory has been well documented to be effective in training practical clinical skills ([<reflink idref="bib6" id="ref6">6</reflink>], [<reflink idref="bib7" id="ref7">7</reflink>]). Ultimately, this course was designed with the intent of building useful practical skills in our student population such that their employability upon graduation is enhanced.</p> <hd id="AN0192623325-4">COURSE DESIGN</hd> <p>As a prerequisite to enrolling in the presently described course, students had to complete an intermediate course in cardiovascular physiology and pathophysiology with a grade of "A−" or better. The grade of "A−" was required for two reasons. First, as the presently described course requires prior knowledge in mechanistic cardiology (e.g., hemodynamics, electrophysiological principles, cellular pathology of heart failure), we wanted to ensure that students would be sufficiently prepared to enter without needing major revision of prerequisite content. Second, we were met with significant interest in the course, and in only being able to have one section run in our initial trial semester we needed a way to streamline the enrollment process. In future semesters it is likely we will decrease the requisite grade to "B" or better, supposing additional faculty and teaching assistants become available to teach more sections. Having the foundational knowledge would be imperative for building deeper understanding and new skills. In the present course, 13 students, 11 undergraduate seniors and 2 first-year masters students, were ultimately enrolled. The course cap was 15 to ensure sufficient hands-on, one-on-one time between each student and the instructor. The design revolved around the four tenets of experiential learning theory. The course was split up into four main units: <emph>1</emph>) patient interview skills and taking a personal and family cardiac history, <emph>2</emph>) cardiac auscultation and manual sphygmomanometry, <emph>3</emph>) taking and interpreting electrocardiograms (ECGs), and <emph>4</emph>) interpretation of cardiac ultrasound images. The course outline is included as Table 1. Of note, course time was split as one 1-h lecture once per week, one 4-h laboratory once per week, and 2–3 h of independent work per week.</p> <p>Table 1. Basic course outline</p> <p> <ephtml> <table><thead><tr><th>Week</th><th>Lecture Topic</th><th>Assignments</th><th>Lab Topic</th></tr></thead><tbody><tr><td><p><italic>1</italic></p></td><td><p>Welcome and Introduction, Professionalism</p></td><td><p>Reading: Professionalism in Healthcare and Basics of H&P (History and Physical); <italic>quiz 1</italic></p></td><td><p>Orientation to instrumentation, H&P basics, cardiac auscultation</p></td></tr><tr><td><p><italic>2</italic></p></td><td><p>Blood Pressure Review, Korotkoff Sounds</p></td><td><p>Reading: AHA Blood Pressure Guidelines; <italic>quiz 2</italic></p></td><td><p>Intro to manual BP taking at rest</p></td></tr><tr><td><p><italic>3</italic></p></td><td><p>Pathophysiology of Hypertension</p></td><td><p>Reading: Hypertension Diagnosis; <italic>quiz 3</italic></p></td><td><p>Continue manual BP taking at rest and add during exercise.</p></td></tr><tr><td><p><italic>4</italic></p></td><td><p>Noninvasive vs. Invasive BP Measurement</p></td><td><p>Reading: Blood Pressure and HTN in Marginalized Communities; <italic>quiz 4</italic></p></td><td><p>Open lab</p></td></tr><tr><td><p><italic>5</italic></p></td><td><p>Managing the Care of Hypertensive Individuals</p></td><td><p>None—prep for practical</p></td><td><p><italic>Practical 1</italic>: Cardiac auscultation, manual BP, and interpretation</p></td></tr><tr><td><p><italic>6</italic></p></td><td><p>Electrophysiology Review</p></td><td><p>Reading: Lead Placements and Interpretations; <italic>quiz 5</italic></p></td><td><p>ECG Basics—orientation and the leads</p></td></tr><tr><td><p><italic>7</italic></p></td><td><p>Determining axis</p></td><td><p><italic>Quiz 6</italic> on axis interpretation</p></td><td><p>ECG continued—axis determination</p></td></tr><tr><td><p><italic>8</italic></p></td><td><p>Myocardial infarction localization</p></td><td><p>Reading: Pathophysiology and Localization of MI</p></td><td><p>ECG continued—identifying MI virtual lab</p></td></tr><tr><td><p><italic>9</italic></p></td><td><p>Hypertrophy Sudden Cardiac Death</p></td><td><p>Reading: HCM and SCD</p></td><td><p>Open lab</p></td></tr><tr><td><p><italic>10</italic></p></td><td><p>Managing MI</p></td><td><p>None—prepare for practical</p></td><td><p><italic>Practical 2</italic>: ECG taking and interpretation</p></td></tr><tr><td><p><italic>11</italic></p></td><td><p>Ultrasound: Physics and Basic Principles</p></td><td><p>Reading: Basics of Ultrasound Physics; <italic>quiz 7</italic></p></td><td><p>Basic views in cardiac ultrasound</p></td></tr><tr><td><p><italic>12</italic></p></td><td><p>M-Mode, B-Mode, Color Doppler and Diagnosis</p></td><td><p>At-home exercises on virtual echo lab; <italic>quiz 8</italic></p></td><td><p>Guest demonstration of cardiac echo in simulation center</p></td></tr><tr><td><p><italic>13</italic></p></td><td><p>Heart Failure and Measuring EF on Echocardiography</p></td><td><p>Reading: EF in the Diagnosis of HF; <italic>quiz 9</italic></p></td><td><p>Open lab</p></td></tr><tr><td><p><italic>14</italic></p></td><td><p><italic>Practical 3</italic> practice examples</p></td><td><p>Prep for practical</p></td><td><p><italic>Practical 3</italic>: Interpreting an echocardiogram</p></td></tr><tr><td><p><italic>15</italic></p></td><td><p>Lecture review period</p></td><td><p>Reading: Care for HF Patients; <italic>quiz 10</italic></p></td><td><p>No lab</p></td></tr></tbody></table> </ephtml> </p> <p>AHA, American Heart Association; BP, blood pressure; EF, ejection fraction; HCM, hypertrophic cardiomyopathy; HF, heart failure; HTN, hypertension; MI, myocardial infarction; SCD, sudden cardiac death.</p> <p>The course began with a unit on professionalism and patient respect, consent, and confidentiality. As this was many of our students' first exposure to working directly with another person in a clinical scenario, we intended to help them foster rapport and comfort with their patient and build interaction skills that included both professional data taking (verbal history and tests such as ECG) as well as humanistic interaction (identifying names and pronouns, building trust, obtaining consent for physical touch). We relied on references in the published literature ([<reflink idref="bib8" id="ref8">8</reflink>]).For each unit, we began with a laboratory session where students observed a demonstration of the set of techniques by the instructor. For example, the primary instructor (J.D.M.-B.) and a guest would role-play, and J.D.M.-B. would begin with a detailed patient interview, followed by an explanation of the procedure, obtaining consent, clearing of contraindications, technical setup (e.g., ECG lead placement), running the sample rhythm strip, and then interpreting out loud for students. Next, students would be given an opportunity to reflect through interactive virtual resources, such as practice pattern recognition on ECG tracings. These resources would be available in the laboratory in real time but also at home for further practice. Students were asked to engage with these practice resources for 2–3 h of outside work each week. Then, in the laboratory session, students were given live resources (e.g., ECG machines and computers) to attempt the technique on their own with a student partner, with the instructor present to answer questions about the technique, accurate performance, interpretation, and more. The in-person sessions would last on the initial day for 4 h of hands-on, guided practice. Third, students were given a reading pertinent to the learning experience that they would read and process over the course of the academic week before taking an online quiz via the learning management software at home to interrogate their understanding, with the ability to message the instructor with questions on concepts that remained unclear. Fourth, students received in-laboratory time to practice the technique over a period of 3 wk with the instructor present to guide their engagement for a total of 16 h minimum of practice per technique before assessment of skills on a practical-based exam using the clinical simulation laboratory, which simulates an inpatient hospital setting on a standardized patient. There were weekly opportunities to cycle through each unit's skill and access the instructor and equipment to perform the techniques. Our process is illustrated in Fig. 1.</p> <p></p> <p>PHOTO (COLOR): Figure 1. Schematic illustration adapting experiential learning theory by Kolb for the present described course.</p> <hd id="AN0192623325-5">PERSPECTIVES</hd> <p>To illustrate the effect of the experiential learning in this course, two graduate and two undergraduate students were asked to participate in this Teaching Innovations article and share their perspectives as coauthors on the ways they engaged with the course material in their research, jobs, or internships. Additionally, a guest lecturer who is a clinician by training, who contributed to the first unit on professionalism and the basics of a history and physical and is also the coordinator of the BU Human Physiology student internship course, gives her perspective on the value of this experiential learning course.</p> <hd id="AN0192623325-6">E.N.: Perspective 1</hd> <p>As a graduate student taking the experiential learning course described in this article, I practiced hard and soft skills that strengthened my ability to conduct research, engage with physicians, and make decisions regarding my career. While taking this course I was simultaneously conducting participant intakes for my master's thesis work investigating the effects of psychosocial stress on blood pressure ([<reflink idref="bib11" id="ref9">11</reflink>]). Each visit with a participant involves a multitude of clinical skills, including taking manual blood pressure several times.Having previously completed my undergraduate degree in physiology, I was equipped with the theoretical knowledge relevant to my thesis work but lacked the technical and interpersonal skills required to conduct my research autonomously. The opportunity to take a skills-based clinical cardiology course positively affected every aspect of the participant intake process. Starting with the patient interview, I can interact with my participants in a professional and comfortable manner and diffuse much of the stress associated with coming in for a study visit. Having been formally taught how to take a patient history and given the opportunity to practice taking a history with feedback from our instructor has made my participant interviews efficient and effective at ascertaining all relevant information needed for my study, as was previously identified in medical students being formally instructed on how to take a history ([<reflink idref="bib12" id="ref10">12</reflink>]). These skills are also important when acquiring consent from the participant. Moreover, the questions I am asking participants investigate mental health and physical activity status, which are topics that not everyone is comfortable sharing.The crux of my thesis work is in the blood pressure readings I collect at each study visit. I am now able to properly position participants, obtain consent, clear of all relative and absolute contraindications, and collect readings with a high degree of certainty and accuracy, as directed in the American Heart Association Blood Pressure Guidelines ([<reflink idref="bib13" id="ref11">13</reflink>]). Before this course, I would not have had the opportunity to practice taking blood pressure to the degree that is required to truly hear the first Korotkoff sound and differentiate these from rubs that the stethoscope is picking up. Missing the first Korotkoff sound, for example, would significantly affect my data in that I would have missed the participant's true systolic blood pressure reading.A further strength of this experiential learning course was the instruction regarding abnormal findings upon cardiovascular exam. Much of my undergraduate, and even graduate-level, physiology curriculum discussed the normal function of major organ systems. This course builds upon that through hands-on skills pertaining to assessment of cardiovascular (CV) function as well as the identification and analysis of abnormal findings. For example, commonly discussed conditions in this course were myocardial infarction, mitral valve regurgitation, arrhythmias, and reduced ejection fraction (due to a myriad of pathologies). After this course, I shadowed a cardiologist who is also echocardiography faculty. Because of the instruction I had received concerning echo, I could identify the physiology on the echocardiograms the physician showed me. This allowed me to ask questions such as "It appears this patient has impaired systolic function, why is that the case and how do you go about treatment?". Because of this course, I could engage with the provider at a higher level instead of using the limited time between patients to have the doctor orient me to the echocardiogram. This significantly improved the utility of physician shadowing. The value of encountering abnormal exam findings in a classroom setting sent me into shadowing with a high baseline knowledge of cardiovascular disease (CVD). Upon graduation, I entered a clinical research role. Having an understanding of normal and abnormal cardiac exam findings allowed me to serve as the lead assistant on a trial that requires extensive ECG, echocardiogram, and cardiac MRI. For example, I could recognize abnormal QRS voltage on ECG that, as I have now learned, can indicate cardiac conduction issues in certain clinical encounters. Although the disease condition being interrogated on this trial was unfamiliar to me, being able to understand cardiovascular disease states from examination data set me up well for this role and put me ahead of other applicants.Career preparedness is a primary concern among myself and my peers ([<reflink idref="bib1" id="ref12">1</reflink>]). However, an even more common conflict is actually deciding what career to pursue in the first place, which can be related to significant stress for college students ([<reflink idref="bib14" id="ref13">14</reflink>]). A degree in human physiology prepares a student for a variety of careers including but not limited to physician associate, nurse practitioner, medical doctor, and research scientist at the masters or PhD level. A course such as the one outlined in this article is the first time students can see the juxtaposition of didactic instruction and practical application and implementation of skills. This educational format allows students to reflect on what sparks the most intellectual curiosity while also catering to many different learning styles. I have found the progression of concrete experience, reflective observation, abstract conceptualization, and active experimentation to be profoundly useful in guiding my research, learning in and outside the classroom, and career reflection.</p> <hd id="AN0192623325-7">J.M.: Perspective 2</hd> <p>The interpersonal and technical skills taught in the described experiential learning course are highly applicable in both of my current clinical roles. From the first day of the semester, we emphasized respectful and appropriate interaction with patients, including strategies for including patients in every aspect of their care. With this patient-centric mindset, it was straightforward to translate technical and diagnostic skills into solutions for what matters for a patient.In my initial training to work as an emergency medical technician (EMT), the emphasis of patient assessment was rapid determination of differential diagnoses using a chief complaint, brief history, set of vital signs, and basic examination. However, this experiential learning course encouraged taking more care during assessment for the sake of accuracy, without sacrificing efficiency. The blood pressure unit enabled deeper understanding of the physiology of normal and abnormal blood pressure. We also learned proper measurement technique and several factors that can influence a blood pressure measurement ([<reflink idref="bib13" id="ref14">13</reflink>]). For example, patient positioning and recent intake of substances such as caffeine and nicotine can temporarily elevate blood pressure ([<reflink idref="bib15" id="ref15">15</reflink>], [<reflink idref="bib16" id="ref16">16</reflink>]). Furthermore, the cardiac electrophysiology unit transformed my understanding of when, how, and why an "electrical picture of the heart" would be useful. Here, too, studying electrocardiograms (ECGs) afforded us a theoretical framework that made it almost intuitive to apply lead placement, tracing interpretation, and the concept of electrical axis to real patient scenarios. Having taken this course, I feel comfortable looking at a 12-lead recording and assessing fundamental intervals and wave morphologies, estimating axis, and examining for signs of ischemia. In the course we reinforced these skills through hands-on practice setting up and interpreting ECGs with healthy volunteers and through both supervised and independent interpretation of example tracings. This experience has made me more comfortable and capable when working with higher-level practitioners. I became faster and more accurate when setting up ECGs in the field and began to recognize patterns that could indicate pathology. I became a more effective member of the prehospital care team by applying the knowledge and skills I learned in this course.While applying for clinical positions after graduation, I drew significantly on this course material to emphasize my strengths in the clinical setting. In the position I accepted, working in a family and primary care practice, knowledge of blood pressure was once again pertinent. I now know how to prepare patients for the most accurate possible measurement of blood pressure, enabling the provider to make informed decisions about whether to recommend lifestyle changes or prescribe medical therapy. The ECG and echocardiography units have also enabled me to take a more active role in understanding cardiac components of my patients' health. While reviewing charts or notes from specialist visits, I can discern meaning from ECG readings or cardiac echo images, enabling a more holistic picture of the health problems each person deals with. In addition, I am able to discuss and understand treatment decisions made by the providers, gaining insight into their thought processes. I believe that the skills learned in this course prepared me extraordinarily well for clinical work and represent a valuable clinical and academic experience as I prepare to apply to medical school.</p> <hd id="AN0192623325-8">S.M.: Perspective 3</hd> <p>Over the past several months, I have been participating in a clinical physiology internship as a requirement for the Boston University human physiology major at Beth Israel Deaconess Medical Center's Cardiology Division while simultaneously enrolled in the experiential learning course described in this article. During this time, I not only advanced my knowledge of cardiology but also acquired, practiced, and refined clinical skills essential for a health care career, achieving a level of proficiency beyond what classroom settings had previously offered. With guidance from the instructors, in both laboratory and lecture settings, I not only mastered the technical aspects of each clinical skill and grasped the complexities of clinical cardiology but also learned to practice compassion and inclusivity in the health care environment.Beginning with the first clinical skill presented in the laboratory, taking a history and basic physical exam, I learned the importance of collecting a detailed and complete patient and family history, including what information is vital toward providing patient-centered care, whether it be cardiology specific, regarding overall mental and physical health, or about socioeconomic barriers to receiving health care. Additionally, I developed skills that foster inclusivity and create an environment where patients feel supported and comfortable, where they are able to share the information health care providers request. Furthermore, with the next clinical skill introduced in the laboratory, cardiac auscultation and manual sphygmomanometry, I learned both how to precisely auscultate at all five points of the heart and how to efficiently collect accurate blood pressure readings, including the nuances behind these examinations and when contraindications may be present. Next, during the unit on taking and interpreting electrocardiograms, I developed the skills to confidently take, read, and interpret ECGs, noting the rate and rhythm of the heart, whether arrhythmias were present, and whether the patient was at risk of or having a myocardial infarction through various ECG markers. The last clinical skill introduced in the laboratory included the interpretation of cardiac ultrasound images. During this unit, I learned how to interpret cardiac pathologies using the various views and modes of an echocardiogram, including assessing hypertrophy, valve stenosis, and valve regurgitation.Throughout each unit covered in this course, I acquired knowledge and skill in executing a cardiovascular exam. Thus, when beginning my internship as a technician in the Cardiology Stress Test Lab, I immediately applied my knowledge and skills toward patients in real clinical scenarios. Having prior familiarity with the skills I was expected to perform facilitated exponential progress, optimizing the time available for the practice of these clinical skills and interactions. Furthermore, through witnessing various health care professionals perform the skills I had learned previously in the laboratory, I was able to broaden both my knowledge and my skill set, understanding first hand the importance of adapting toward patient-specific needs. Ultimately, I was able to deepen my understanding of the nuances and intricacies of cardiology and patient care, building the confidence necessary to apply the knowledge and skills I learned in the classroom and laboratory.</p> <hd id="AN0192623325-9">L.J.D.: Perspective 4</hd> <p>While enrolled in the experiential learning course described in this article, I simultaneously had the opportunity to shadow a cardiothoracic surgeon at Beth Israel Deaconess Medical Center while also volunteering as an EMT. The confluence of these experiences provided me with a unique opportunity to apply the technical classroom knowledge gained in this course toward my real-world clinical experiences.In the high-pressure environment of the operating room during the cardiac cases that I observed, including coronary artery bypass graft, valve replacement, aortic aneurysm repairs, and transcatheter mitral valve repairs, having technical and practical knowledge of clinical cardiology was tremendously helpful in being able to maximize the experience. I felt uniquely able to understand not only what I was seeing as far as the cardiac anatomy but also why the surgeon was performing each step. Furthermore, I felt that I was able to demonstrate to the surgeon my technical knowledge, which he considered beyond someone of my academic level. I found our class unit on how to interpret echocardiographic imaging to be able to diagnose valve regurgitations and stenoses, myocardial hypertrophy, and coronary artery occlusions particularly valuable in this experience.In taking this class, I also was able to apply the evidence-based concepts learned in the classroom toward my other clinical role as an EMT. Having volunteered as an EMT for several years, I had become accustomed to taking both manual and automated blood pressure measurements on patients. However, even with extensive experience with this procedure, I gained new appreciation for the clinical significance of blood pressure measurement and how slight differences in systolic and diastolic pressure can equate to large differences in cardiac prognosis in patients. For example, a meta-analysis in <emph>The Lancet</emph> found that lowering blood pressure by 5 mmHg reduced cardiovascular mortality risk by 10% ([<reflink idref="bib17" id="ref17">17</reflink>]), suggesting that accurate assessment of patient blood pressure can help facilitate interventions and even small inaccuracies can lead to worse outcomes. This knowledge, along with enhanced technical skill in auscultating blood pressure, has allowed me to become a more proficient EMT for my patients. Additionally, although not a basic life support level skill, our time learning about electrocardiography interpretation has given me the ability to understand more advanced interventions done by paramedics in the field, ultimately allowing me to operate at a higher level in my EMT role.</p> <hd id="AN0192623325-10">K.P.: Perspective 5</hd> <p>Students in Boston University's Sargent College of Health and Rehabilitation Sciences Human Physiology program are required to complete an internship for credit during their senior year. This experiential learning opportunity allows students to reinforce concepts learned in the classroom and develop practical skills in a health care setting. For students who have completed Clinical Measurements in Cardiology, another hands-on experiential learning course, the internship provides students an opportunity to translate the knowledge/skills they have learned in the classroom into clinical practice. As one of the Internship Coordinators, I have seen the positive effects of classroom experiential learning on student internship outcomes.Students who have taken Clinical Measurements in Cardiology who then complete their internship in a health care environment are able to generalize the skills learned in a real-world clinical setting. Students gain exposure to patients of diverse backgrounds in a fast-paced setting. The value for students is that they are now afforded an opportunity to observe and participate in the diagnostic and treatment process. They collaborate with an interdisciplinary team and build confidence in their ability to interpret test results and clinical decision-making. The environment is no longer controlled as it is in the classroom; instead, they face the unpredictability and complexity of patients, including assessing abnormal test results and comprehensive histories.The Clinical Measurements in Cardiology course plays a critical preparatory role in this transition from the classroom to a clinical setting. Although both the course and the internship are forms of experiential learning, the course offers a more structured and guided environment where students can begin applying clinical reasoning, technical skills, and communication strategies without the full pressure of a live clinical setting. Through supervised practice, reflection, and feedback, students develop foundational competencies that ease their adjustment to the demands of a clinical internship. As a result, students enter their internship with greater readiness and confidence, enabling them to engage more fully and productively from the outset.While in the clinic, students are tasked with applying what they have learned in Clinical Measurements in Cardiology in real time. As students are deemed competent in a specific clinical skill (e.g., ECG lead placement), they can perform this skill in the clinic if allowed by their clinical supervisor. This allows the student to spend more of their time becoming adept at communicating with patients of various backgrounds and improving their ability to interact with them.The combination of taking an experiential learning course and completing an internship contributes greatly to students' career preparedness. Students are provided with real-world experience that reinforces the knowledge they have gained in the classroom and equips them with the competence and confidence to thrive in a clinical setting. This combined approach to teaching ensures that students are well prepared for the demands of a career in health care.</p> <hd id="AN0192623325-11">DISCUSSION</hd> <p>Here, we have presented perspectives from students who enrolled in, and faculty who taught in, our new experiential learning course in clinical cardiology. Largely, perceptions across different individuals were that the course <emph>1</emph>) provides an approachable format for building highly useful skills for those in the medical field and science and pursuing careers in science and health care, <emph>2</emph>) represents added value to the educational experience of the students in the form of better career preparedness compared to peers who have not had this experience, and <emph>3</emph>) helped students with career decision-making by reinforcing their interest in cardiology and then setting them up for success with critical skills.First, it is critical in undergraduate programs to build tangible skills that students will have post graduation, making them marketable for employment or equipped to head to graduate/professional school. With respect to building these skills, there are traditional didactic approaches that introduce concepts such as electrocardiogram interpretation. In our experience, didactic approaches to technical skills can fail because of the highly conceptual nature of the technique and the resultant high cognitive load it imposes on a student to explain these techniques from a theoretical perspective. We propose here, and our students have described, that hands-on experience in simulated patient encounters reduces cognitive load by transforming a theoretical/cognitive skill into a hands-on, tactile skill in context; that is, hands-on practice with a technique reduces cognitive load and enhances understanding, as previously described ([<reflink idref="bib18" id="ref18">18</reflink>]).Second, as stated in introduction, there exists a shifting socio-political climate in the United States surrounding the perceived value of college education ([<reflink idref="bib3" id="ref19">3</reflink>]), and one way to combat skepticism is to ensure that students are prepared for a career after they graduate ([<reflink idref="bib1" id="ref20">1</reflink>]). Experiential learning has been demonstrated in the literature to provide career preparedness in the biomedical field across a multitude of career phases, including readiness for medical residency ([<reflink idref="bib19" id="ref21">19</reflink>]), preparedness for scientific research careers among medical undergraduates ([<reflink idref="bib20" id="ref22">20</reflink>]), and in general undergraduate education ([<reflink idref="bib21" id="ref23">21</reflink>]). Our course, too, appears to support the sense of preparedness experienced by those who enrolled. We, the instructors, additionally find that career-relevant skills for those in the medical field were enhanced in our students upon completion of the described course.Third, career exploration is important for undergraduate students, and often they can attend career fairs or, if fortunate enough, shadow individuals in their desired career path. Nonetheless, it is infrequent that undergraduate students get hands-on practice performing job-related functions from their desired career, and with the costly and time-consuming training that comes with careers in medicine it is important that students get to experience some facets of practical skills in their desired career field. Our students here described that they felt more prepared to make informed career choices about medicine having had simulated patient encounters in this course, as previously demonstrated in the literature on experiential learning and career choice confidence ([<reflink idref="bib22" id="ref24">22</reflink>]).This study has several limitations. First, this is an informal study with a small sample of perspectives from students who were in the course, as opposed to a formal, structured, hypothesis-driven study. In the future, we would like to pair assessments of career preparedness in enrolled students before and after taking this course and formally assess which elements of the course significantly affected student experience and self-perceptions. We are additionally limited in that our present data are perspectives and contain no formal outcome data on career success or placements. Future studies will collect longitudinal career outcome data. Additionally, this course sits among others in our curriculum with a clinical focus, and although this course may have enhanced student skills and understanding of application of techniques to cardiology, career choice cannot be fully informed in the absence of real-world clinical encounters, devoid of the objectively less consequential nature of clinical simulation.</p> <hd id="AN0192623325-12">Conclusions</hd> <p>Limitations aside, we feel confident that the described experiential learning course benefited students' career preparedness, enhanced their employability, and supported their ability to engage in career choice decision-making. We feel that, in a modernized physiology curriculum, we are in need of additional experiential learning opportunities that provide substance and tangible products for students to graduate with. Additional university resources should be dedicated in United States undergraduate physiology programs to supporting experiential learning opportunities in classrooms.</p> <hd id="AN0192623325-13">DATA AVAILABILITY</hd> <p>Data will be made available upon reasonable request.</p> <hd id="AN0192623325-14">GRANTS</hd> <p>J.D.M.-B. reports support from the Boston University Sargent College Summer Teaching and Learning Innovation Grant.</p> <hd id="AN0192623325-15">DISCLAIMERS</hd> <p>The content of the article is the sole responsibility of the authors and does not necessarily represent the views of any institution.</p> <hd id="AN0192623325-16">DISCLOSURES</hd> <p>No conflicts of interest, financial or otherwise, are declared by the authors.</p> <hd id="AN0192623325-17">AUTHOR CONTRIBUTIONS</hd> <p>J.D.M.-B. and K.P. conceived and designed research; J.D.M.-B. performed experiments; J.D.M.-B. analyzed data; J.D.M.-B. prepared figure; J.D.M.-B., E.J.N., J.M., L.J.D., S.M., and K.P. drafted manuscript; J.D.M.-B., E.J.N., J.M., L.J.D., S.M., and K.P. edited and revised manuscript; J.D.M.-B., E.J.N., J.M., L.J.D., S.M., and K.P. approved final version of manuscript.</p> <ref id="AN0192623325-18"> <title> REFERENCES </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> Flaherty C. 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Dwyer; Styliana Michaelidis and Kelly Pesanelli</p> <p>Reported by Author; Author; Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib11" firstref="ref9"></nolink> <nolink nlid="nl2" bibid="bib12" firstref="ref10"></nolink> <nolink nlid="nl3" bibid="bib13" firstref="ref11"></nolink> <nolink nlid="nl4" bibid="bib14" firstref="ref13"></nolink> <nolink nlid="nl5" bibid="bib15" firstref="ref15"></nolink> <nolink nlid="nl6" bibid="bib16" firstref="ref16"></nolink> <nolink nlid="nl7" bibid="bib17" firstref="ref17"></nolink> <nolink nlid="nl8" bibid="bib18" firstref="ref18"></nolink> <nolink nlid="nl9" bibid="bib19" firstref="ref21"></nolink> <nolink nlid="nl10" bibid="bib20" firstref="ref22"></nolink> <nolink nlid="nl11" bibid="bib21" firstref="ref23"></nolink> <nolink nlid="nl12" bibid="bib22" firstref="ref24"></nolink>
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  Data: An Application-Based, Experiential Learning Course in Clinical Cardiology: Faculty and Student Perspectives
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  Data: <searchLink fieldCode="AR" term="%22Jesse+D%2E+Moreira-Bouchard%22">Jesse D. Moreira-Bouchard</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-5644-2540">0000-0002-5644-2540</externalLink>)<br /><searchLink fieldCode="AR" term="%22Evan+J%2E+Nessen%22">Evan J. Nessen</searchLink><br /><searchLink fieldCode="AR" term="%22John+McLaughlin%22">John McLaughlin</searchLink><br /><searchLink fieldCode="AR" term="%22Liam+J%2E+Dwyer%22">Liam J. Dwyer</searchLink><br /><searchLink fieldCode="AR" term="%22Styliana+Michaelidis%22">Styliana Michaelidis</searchLink><br /><searchLink fieldCode="AR" term="%22Kelly+Pesanelli%22">Kelly Pesanelli</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Advances+in+Physiology+Education%22"><i>Advances in Physiology Education</i></searchLink>. 2026 50(1):112-119.
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  Data: American Physiological Society. 9650 Rockville Pike, Bethesda, MD 20814-3991. Tel: 301-634-7164; Fax: 301-634-7241; e-mail: webmaster@the-aps.org; Web site: https://www.physiology.org/journal/advances
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  Data: <searchLink fieldCode="DE" term="%22Teacher+Attitudes%22">Teacher Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Attitudes%22">Student Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Experiential+Learning%22">Experiential Learning</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+Experience%22">Clinical Experience</searchLink><br /><searchLink fieldCode="DE" term="%22Undergraduate+Students%22">Undergraduate Students</searchLink><br /><searchLink fieldCode="DE" term="%22Graduate+Students%22">Graduate Students</searchLink><br /><searchLink fieldCode="DE" term="%22Physiology%22">Physiology</searchLink><br /><searchLink fieldCode="DE" term="%22Medicine%22">Medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Human+Body%22">Human Body</searchLink><br /><searchLink fieldCode="DE" term="%22Skill+Development%22">Skill Development</searchLink><br /><searchLink fieldCode="DE" term="%22Exercise+Physiology%22">Exercise Physiology</searchLink><br /><searchLink fieldCode="DE" term="%22Universities%22">Universities</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Massachusetts+%28Boston%29%22">Massachusetts (Boston)</searchLink>
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  Data: 10.1152/advan.00200.2024
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  Data: 1043-4046<br />1522-1229
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  Data: Recent reports describe a cultural shift in the average American's perception of the value of higher education. Additionally, and possibly as a consequence of this shifting perception, college enrollments have decreased in recent years. One major element identified in students' perception of college education is whether or not they receive career preparation. In facilitating career preparedness, many instructors have turned to experiential learning opportunities in the form of internships, laboratory-based courses, and simulations. In this article, we describe an experiential learning course for undergraduate and graduate human physiology students in clinical cardiology skills, including electrocardiography, auscultation, manual blood pressure measurement, and cardiac ultrasonography. Student and instructor perspectives were solicited, and four student and one faculty perspectives are included from the author team as qualitative evidence of the efficacy of the described course in preparing students for a variety of jobs with tangible clinical measurement skills. We describe here our perspective that this course enhanced critical thinking, subjective knowledge in cardiology, and application of cardiac principles to measurement techniques and fostered confidence in translating classroom knowledge to the workforce.
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