Smartphoneassisted-experimentation-as-a-didactic-strategy-to-maintain-practical-lessons-in-remote-education-Alternatives-for-physiology-education-during-the-COVID19-pandemic2020Advances-in-Physiology-EducationOpe
Smartphoneassisted-experimentation-as-a-didactic-strategy-to-maintain-practical-lessons-in-remote-education-Alternatives-for-physiology-education-during-the-COVID19-pandemic2020Advances-in-Physiology-EducationOpe
doi:10.1152/advan.00066.2020.
STAYING CURRENT
Lellis-Santos C, Abdulkader F. Smartphone-assisted experi- for hands-on activities in physiology are not as common as
mentation as a didactic strategy to maintain practical lessons in those for activities in anatomy and histology. Virtual atlases
remote education: alternatives for physiology education during the and interactive videos for anatomy education are effective at
COVID-19 pandemic. Adv Physiol Educ 44: 579 –586, 2020; doi: promoting engagement and learning (12, 36). Similarly, the
10.1152/advan.00066.2020.—Online and distance education may be
dismissed by educators who argue that these methods are not equiv-
virtual microscopy and histology slide collection is an effective
alent to traditional face-to-face education due to the lack of laboratory tool for distance education and blended learning, where stu-
classes. However, smartphone-assisted experimentation is an innova- dents can achieve similar performances as their peers in the
tive and powerful didactic tool that helps educators in the teaching face-to-face (F2F) format (2). Interestingly, students seem to
process of physiology, particularly in situations with a lack of finan- prefer the online rather than the F2F format (42). Because
cial support for purchasing laboratory equipment, or lack of support anatomy and histology are morphological sciences, the use of
for homework and assignments, distance learning courses, and emer- augmented and virtual reality are additional didactic resources
gency remote education, such as during the COVID-19 pandemic. that facilitate the engagement of students in manipulating and
Therefore, we present the concept of the mobile learning laboratory understanding body structures (5). Contrary to anatomy and
(MobLeLab), which is a collection of smartphone applications that histology, physiology learning is concerned with understand-
allow scientific data collection, such as physiological variables, for
educational purposes. The three types of MobLeLabs (simulators,
ing the dynamics and mechanisms of variables of the human
built-in, and plug-in) are presented, as well as ideas on how to use body. Teaching such mechanisms only with static images may
smartphone sensors to collect physiological data. Additionally, we give the novice physiology student the impression that these
elaborate on the principles of the protocols for physiology education mechanisms are rather straightforward and simple rather than
with MobLeLabs and discuss their importance to fostering scientific complex and dynamic. Moreover, the experimentation in phys-
method reasoning by students. iology education is dependent on data collection, which re-
distance education; experimentation; physiology education; practical
quires expensive laboratory equipment. Thus, while students
lesson; smartphone can perform hands-on activities at home to learn anatomy and
histology by using virtual atlases and microscopy, respectively,
to learn physiology by practice, students would be necessarily
dependent in principle on institutional facilities. However, for
INTRODUCTION certain physiology contents, computer-based simulators can
assist in experiments at home.
Online and distance education are very popular, and the To inspire educators to develop assignments and apply
number of students taking a distance course is steadily growing experimental physiology activities in distance education,
(33). However, a critique we often hear from fellow university despite the lack of specific laboratory facilities in the homes
instructors toward online undergraduate courses in biology is of students, we present herein the rationale of mobile
that they are less effective due to the lack of laboratory classes. learning laboratories (MobLeLabs), a learning framework
Several didactic strategies can be applied to overcome this for smartphone-assisted experimentation. A short review of
obstacle, such as the following: virtual laboratories, laboratory the functionalities of smartphones, a classification of these
videos, kitchen laboratories using household items, and labo- MobLeLabs, and ideas for physiology laboratory protocols
ratory kit activities sent to students by regular postal service are shared herein.
(39). Despite these strategies, teaching through experiments
can be challenging for both students and instructors in the Rationale of MobLeLab
context of online and distance education.
The number of online resources for teaching biomedical Mobile learning laboratories, or MobLeLabs, are learning
disciplines is extensive. However, the didactic tools available objects developed for portable devices, such as smartphones
and tablets, that work as mini-laboratories for hands-on activ-
ities (22). These learning objects are smartphone applications
Correspondence: C. Lellis-Santos ([email protected]). (apps) that must be operated by the user to collect physiolog-
1043-4046/20 Copyright © 2020 The American Physiological Society 579
Downloaded from journals.physiology.org/journal/advances (181.064.036.030) on April 17, 2021.
580 MobLeLabs FOR PRACTICAL LESSONS IN REMOTE EDUCATION
ical data through the smartphone sensors (23). To classify as a technology, physiology education based on experimentation
MobLeLab, the operational system of the smartphone has to mostly remains physically restricted to the laboratories of
perform all data acquisition, and thus it must be responsible for educational institutions, which own and maintain the comput-
generating a number, a value, a graph, or a nominal classifi- ers, interfaces, and plug-in sensors used in these practical
cation according to the variable collected. A simple manual lessons. In this sense, the concept of MobLeLabs frees the
entry of data typed by the user is not considered a MobLeLab physiology instructor and the student from the obligation to be
because, in that case, the experimentation was not dependent in the institution to perform experimental measurements in
on the device’s capacity to detect or simulate physical signals. human physiology, since smartphones combine the features of
Conversely, MobLeLabs are concerned with the use of smart- sensors, an interface, and an analysis computer that are found
phone-assisted experimentation for educational purposes, but in the laboratory, in a compact, accessible, and mobile format.
the idea of using smartphones as laboratory equipment is The origin and evolution of MobLeLabs follow the techno-
incorporated by mobile laboratories, pocket laboratories (29), logical evolution of computer-assisted learning (CAL) and the
and RExLab (8a), and can be found in commercial names such natural fusion of laboratory equipment and computer software.
as PocketLab and PhoneLab. In the 1970s, CAL, or computer-assisted instruction, was
One example of a MobLeLab is Google’s Science Journal already present in science teaching as a didactic tool (14). The
app, which is able to record data from the physical world, e.g., final path for the development of MobLeLabs was the advent
light, sound, pressure, and motion, and was developed for of e-learning (electronic learning), which is a consequence of
educational purposes. Similarly, the Phyphox app is a dedi- the development of CAL facilitated by the improvement of
cated MobLeLab developed for physics education that includes internet connections. E-learning was initially applied in ed-
experimental protocols by default (37). Regarding the target ucational institutions as a result of the increased accessibil-
variable detected by the application, MobLeLabs can be further ity to the internet by students, and it pertains to the learning
classified. Genuine MobLeLabs are applications that were processes developed on electronic platforms with no depen-
originally developed and used to specifically detect and ana- dency on the time and space of the educational institution
lyze the variable of interest. Other MobLeLabs can be thus (28). Following the evolution of personal digital assistants,
considered alternative MobLeLabs, or “off label,” where the microcomputers, and telephones, m-learning (mobile learn-
application was developed for a specific context but can be ing) emerged as the best solution for learning at any time and
used to collect data for the desired educational purpose. For
place (21). Finally, the increase in the capacity of processing
instance, in the protocol that Nadal and Lellis-Santos (27) used
information and the memory of smartphones and tablets pro-
for exercise physiology teaching, the authors employed an
pelled the creation of MILOs (mobile interactive learning
application designed for monitoring seismic activities to detect
objects), which are applications/software designed to boost the
muscular strength and resistance while performing up and
interactivity during learning by means of portability, sponta-
down movements after exposure to the exercise protocol.
neity, and personalization (17). Similarly, MobLeLabs thus
Thus the concept of MobLeLabs is based on the idea that
experimentation can be performed in any place and at any time emerged as MILOs designed for smartphone-assisted experi-
because learners are stimulated to collect data on themselves mentation following the rapid development of new features of
and learn, independent of a formal educational setting. smartphones, tablets, and their high-quality sensors. Figure 1
summarizes the origin of MobLeLabs and illustrates how the
experimental and education streams converged along with
Origin of MobLeLab
m-learning to lead to MobLeLabs. There are three types of
The use of laboratory experiments as tools for higher edu- MobLeLabs, depending on the manner that the data are col-
cation has a long history, particularly in physiology. For lected: simulators, built-in, and plug-in.
instance, a seminal book on practical laboratory lessons in
physiology was organized by Walter B. Cannon in the 1920s Classification of MobLeLabs
(6). However, education studies on the modalities and effec-
tiveness of laboratory work in curricula is a more recent, and To systematize the communication among educators and
often neglected, field of research (16). Even in Cannon’s time, facilitate the retrieval of MobLeLabs for specific pedagogical
some experiments (mostly demonstrations) involved human purposes, we created a classification for the different types of
subjects as testing models. Undoubtedly, experimentation as a MobLeLabs, depending on the manner through which the data
means to acquire knowledge about physiology and medicine, are collected: simulators, built-in, and plug-in.
especially experiments with living animals, was reinforced and Simulators. This type of MobLeLab is a classical simulator
disseminated by Claude Bernard (1813–1878) (3). With the that has been used worldwide in physiology courses but was
digital advance, computers became fundamental tools for the developed for a mobile device platform. It allows experimen-
overwhelming development of the physical and biological tation because the system is programmed with algorithms
sciences after the second half of the 20th century, especially based on physiological principles and laws. The learner does
following the development of the first A/D laboratory inter- not type in raw data to be analyzed, but has to manipulate the
faces with the primitive digital computers of the late 1950s for variables to observe the final result. An example is the appli-
the data collection and display of human biological parameters cation (available only for iPad) Respiratory–Craytonium Inter-
(9). One of the first studies to make use of computers as active Physiology, designed by Craytonium Ltd. This applica-
physiological experimental devices aimed to detect reaction tion allows the students to change the values of variables to
time responses in humans to identify the orientation of visual observe modulations in alveolar gas exchange, lung volume,
patterns (13). Despite the rapid advance of computational cell gas exchange, and respiratory equations (Fig. 2, A–C).
Lab Equipment
Equipment Lab Equipment
+ Computer
Built-in. This is the most typical MobLeLab because the app electrical activity detected through the scalp of the user (34)
per se is responsible for the collection and processing of the (Fig. 2, G–H).
data. There are several sensors built in the structure of modern
smartphones. These sensors allow the exploration of different Uses of MobLeLab in Physiology Education
variables of the physical world that can be used in physiology The use of MobLeLabs to promote learning physiology
education activities. Depending on the features of the student’s concepts is possible via the considerable number of variables
smartphone, it can include a camera, microphone, GPS (global of the human body that can be collected through noninvasive
positioning system), proximity sensor, temperature sensor, hu- methods. Similarly, the advanced development of mobile ap-
midity sensor, touch sensor, fingerprint sensor, pressure sensor, plications for health monitoring should encourage educators to
ambient light sensor, gyroscope, accelerometer, magnetometer, create, apply, and analyze protocols designed to teach physi-
and image sensor (Fig. 3). The last four sensors are not very ology for grades K–12 and higher education students. The
familiar to the majority of non-tech-savvy educators. They literature on MobLeLabs or smartphone-assisted experimenta-
detect, respectively, angular rotational velocity and accelera- tion for physiology education is still scarce. One example of
tion, linear acceleration, the Earth’s magnetic field, and infor- the use of MobLeLabs for physiology education was presented
mation to integrate an image based on metal-oxide-semicon- by Nadal and Lellis-Santos (27), who described a protocol for
ductor technology. An example of a built-in MobLeLab is the exercise physiology education using genuine and alternative
app Instant Heart Rate (available for Android and iOS) de- smartphone applications. Briefly, the volunteers engaged in a
signed by Azumio to detect one’s pulse when users place the jogging protocol, housekeeping activity, or smartphone-guided
tip of their index finger on the camera lens. In this case, the meditation to evaluate their heart rate, respiratory rate, forced
smartphone detects the desired signal and generates a value expiration, muscular tonus, and reaction time.
from automatically coordinating the camera and the LED light To demonstrate the applicability of MobLeLabs for remote
of the device. Several types of heart rate apps, such as Instant physiology experimental learning, Table 1 summarizes these
Heart Rate, were validated and tested for reliability (8, 25), and other simple smartphone applications for experiments
which provides more scientific accuracy for the creation of devised to illustrate each of the physiological systems around
protocols for cardiovascular lessons (Fig. 2, D–F). which most undergraduate courses are organized.
Plug-in. For the operation of this type of MobLeLab, an Clearly, Table 1 is not an exhaustive list of applications of
external device is required that contains a sensor to detect the MobLeLabs for human physiology teaching, but it is interest-
variable. The external device is connected to the operational ing to note that one can think of and find simple and useful
system of the smartphone or tablet through a cable to be alternatives to experimental and quantitative thinking for all
plugged in or a Bluetooth connection. Obviously, the use of major systems around which physiology courses are structured.
plug-in MobLeLabs for widespread remote education is limited However, the way in which MobLeLabs could be employed by
due to financial restrictions and affordability. The app Mind students should be carefully considered by instructors when
Monitor (available for Android and iOS) was designed by developing the protocols that guide them in MobLeLab use to
James Clutterbuck and provides values and patterns for brain guarantee learning effectiveness and safety, since the experi-
waves. However, it requires an electroencephalogram head- ments will be conducted without on-site supervision. In this
band called MUSE, which contains sensors that record the context, the search for validated applications is a sensible
A D G
Respiratory
B E H
C F I
Fig. 2. Classification of mobile learning laboratories (MobLeLabs). Examples of a simulator MobLeLab, in which the user manipulates virtual variables to
perform experiments, are as follows: icon of the application Physiology–Respiratory (Craytonium Ltd.; A); screenshot of cell gas exchange 464 simulation (B);
screenshot of lung volumes simulation (C). Examples of a built-in MobLeLab, with which the user can collect data of variables through sensors built into the
smartphone system are as follows: icon of the application Instant Heart Rate (Azumio Inc.; D); screenshot of finger positioning instruction (E); screenshot of
collected data showing results and waveforms (F). Examples of a plug-in MobLeLab, whose use is dependent on an external device to collect data of variables
are as follows: icon of the application Mind Monitor (James Clutterbuck; G); the MUSE headband that is necessary for electroencephalography (H); screenshot
of brainwaves register using Mind Monitor connected to MUSE through Bluetooth (I).
recommendation to achieve more reliable data (8, 30). Some methodology. We have observed and rejected the experimental
suggested smartphone applications are available in the Apple approaches of students who planned to analyze variables after
Store or Google Play, but others can be found only with the exposing themselves to unsafe conditions, such as marijuana
authorization of developers or the authors of the study. use, alcohol use, intercourse activities, or exhaustive and ex-
treme physical activities. For project-based learning, it is im-
Elaboration of Protocols Using MobLeLabs portant that each project be reviewed either by the educator or
through a guided peer-review activity.
The use of MobLeLabs can be stimulated through two To guarantee a reliable analysis of the experimentation, the
learning methods: project-based learning or science class pro-
protocol needs to provide scientific and precise guidelines. It is
tocols. In both types of methods, some concerns must receive
highly recommended to include drawings or videos in the
more attention, such as the ethics of experimentation, the
standardization of the protocol and instructions, orientations protocols to illustrate the step-by-step orientations of the ma-
and tools for data analysis, awareness of prank apps, and the nipulation of the smartphone. For example, a protocol can
accessibility of applications. include YouTube videos with instructions for dance move-
Before starting any smartphone-assisted experimentation us- ments to use MobLeLab to collect heart rate data (26). Several
ing MobLeLabs, educators should discuss with faculty the variables must be collected after specific movements (27), and
ethical policies that are required by the educational institution. any unforeseen misunderstanding of the instructions can create
Some institutions do not allow educators to develop practical abnormal results. The identification of these outliers and the
lessons without permission and approval by the institutional discussion of their possible causes can, however, be yet another
review board. Additionally, possible risks for human health opportunity for the instructor to promote learning by the
associated with the experimental protocol should be either students, particularly on the scientific method. Likewise, the
completely avoided or emphatically discussed with the stu- collection of data for the control groups must be precisely
dents, especially if one is adopting a project-based learning described in the protocol. As such, we believe that the use of
Accelerometer
7; 8; 15;
Gyroscope
GPS 2; 7;
Microphone
Ambient light sensor 13; 14;
16;
Bluetooth Plug-Ins
6; 19-22;
MobLeLabs as didactic tools is a fruitful opportunity to discuss effects based on light intensity. The category in which the apps are
scientific methodology and rigor in experimental biology. A classified in the store indicates the putative validity and reliability
strategy that we used was to ask high school students to devise of MobLeLabs for physiology education. Applications in the
hypotheses that could be tested through the use of an array of medical, health, fitness, and education categories are likely to
MobLeLabs and then submit their experimental design to fellow work better as MobLeLabs than apps classified as entertainment
students so that they act as peer reviewers to judge whether the and games.
proposed experimental approach is sound. Since 2017, we have One limitation that the instructor should consider is the
observed a myriad of hypotheses being tested by the students in availability of apps for different operating systems, territories,
their projects, such as testing the effect of caffeine on heart rate, and language barriers while developing MobLeLab-based pro-
the variability of balance before and after bedtime, and the impact tocols. Thus the instructor has to survey students to map their
of food consumption on sleep quality. access to the desired app and search for solutions that accom-
It is important to provide tables and charts to facilitate the modate all students. For instance, the app Neuro Physiology,
organization of the data collected while also encouraging developed by Craytonium Interactive Physiology, is only avail-
students to present their results in any type of data visualiza- able for iOS (iPad only) in certain countries, but it can be
tion. Experimentation for physiology education encompasses replaced by the app The Nernst/Goldman equation simulator,
the analysis of values and quantitative methods, which can be developed by BioCommunications (available for iOS on the
quite confusing when performed during remote education. iPhone), or Action Potentials, developed by Nervi-AP (avail-
Educators can teach the students how to use statistics software
able for Android), as alternative apps for activities aiming to
and explain the importance of analyzing the dispersion of a
use MobLeLabs simulators. Moreover, some countries have
variable rather than only using the final data.
restrictions on the availability of certain apps due to local
Although some apps were purposely developed to operate as
health monitors, the majority of them have not been validated. In policies. Furthermore, the majority of the apps are available
these cases, the data collected will not be able to represent the only in English, which creates a barrier for non-English speak-
precise value of the physiological variable of interest since its ers. The dissemination of the use of MobLeLabs is likely to
dimensions will be inferred by proxy from the actual parameter support actions to overcome these limitations and barriers.
the app was devised to measure; however, it still can be used for Additionally, faculty should be aware of and guarantee that
educational activities with adequate disclosure. It is prudent for all the students have access to smartphones and stable internet
the instructor to verify the reliability and replicability of the connections at least to download the MobLeLabs to be used
measurements provided by an app by searching for studies that before implementing this strategy in their courses. This re-
compare the app with conventional laboratory equipment. It is quirement could be met through a simple and anonymous
very important to advise the students of the existence of prank survey sent to students via email and could be even more
apps, which persuade the users with convincing graphical images crucial in developing countries where, despite the huge expan-
and design but provide fake or random results for entertainment sion of access to mobile phones in remote and poor areas,
purposes. For example, some X-ray apps available in online stores which has been a factor of lower inequality, a social and gender
induce users to think they are scanning body parts by matching the digital divide still remains (32). Indeed, both students (41) and
scan process with realistic radiographic images. Likewise, other instructors (19) from developing countries express concerns
so-called thermal camera apps promise to work without a con- regarding the overall effectiveness of m-learning strategies due
nection to a thermal camera device, but they only provide image to poor internet access.
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founded with regular online or distance learning (15), MobLe- patterns in a matrix of dots. Am J Psychol 72: 503–520, 1959. doi:10.2307/
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C.L.-S. and F.A. conceived and designed research; C.L.-S. and F.A. 19. Ishtaiwa F, Khaled A, Dukmak S. Faculty members’ perceptions of the
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