A practical approach to illustrate the importance of the bodily energy and heat balances and of the associated regulatory loops to healthcare students.

backgroundTraining medical students is a demanding task, and some contents remain difficult to teach and understand. This also applies to topics that require increasing attention. For instance, obesity rates keep rising, while almost each year turns out to be hotter than the last. Consequently, it is inevitable that current healthcare students will one day be confronted with these challenges. But the underlying physiological principles are concepts that prove difficult to understand. To remedy this situation and improve students' awareness and understanding of impacted patients, we have developed an educational tool to illustrate the concepts of metabolic rate and thermoregulation.

methodsFollowing a 'learning by doing' approach, we designed practical courses covering these topics and comprising data production, collection and analysis. Students measure their heart rates, metabolism rates (indirect calorimetry) and body temperature, at rest and during moderate-intensity exercise. They then (i) quantify the amounts of energy expended as muscular work or heat, (ii) characterize heat dissipation mechanisms, and (iii) estimate theoretical core temperature rise in the absence of thermoregulatory control. Their data are ultimately integrated into a large cohort dataset (N = 89), enabling the study of confounding variables (e.g. sex, body size). This course is evaluated by the students via an anonymized web-based survey.

resultsExercise-induced changes in heart rate showed that the test subjects were primarily healthy and challenged at a moderate level only. The measurements and subsequent calculations illustrated that this moderate-intensity exercise induced a strong increase in metabolic rate, and that this additional energy is spent as heat rather than muscle work. A dramatic shift in the relative contributions of the heat dissipation pathways during physical activity were also observed. Finally, average increase rates of core temperature of 1.33 °C/h at rest and 4.4 °C/h during moderate-intensity exercise were estimated. Only minor differences between female and male subjects were observed. This course has received very positive evaluations in recent years.

conclusionsWe present a readily implementable approach that integrates education and science. It is designed to favor medical students' comprehension of metabolic balance and thermoregulation while fostering critical evaluation of data quality and analytical rigor.