It's difficult to change the way we teach: lessons from the Integrative Themes in Physiology curriculum module project

The Integrative Themes in Physiology (ITIP) project was a National Science Foundation-funded collaboration between the American Physiological Society (APS) and the Human Anatomy and Physiology Society (HAPS). The project goal was to create instructional resources that emphasized active learning in undergraduate anatomy and physiology classrooms. The resources (activity modules and professional development) addressed two factors thought to be limiting science education reform: instructors' knowledge of how to implement active learning instruction and time to design innovative curricula. Volunteer instructors with a strong interest in using active learning in their classrooms were recruited to use the ITIP modules and provide ease-of-use feedback and student assessment data. As the study unfolded, instructor attrition was higher than had been anticipated, with 17 of 36 instructors withdrawing. More surprisingly, instructors remaining with the project failed to use the modules and reported specific obstacles that precluded module use, including lack of support from academic leadership, unplanned class size increases and heavy teaching loads, a union strike, insufficient time to develop a mindset for change, inadequate technology/funding, an adverse human subjects ruling, incompatibility of modules with instructors' established content and expectations, and personal factors. Despite the lack of module use and obstacles, 8 of 19 site testers began independently to introduce new active learning instruction into their classrooms. In the larger picture, however, it is important to note that only 8 of the initial 36 volunteers (22%) actually ended up changing their instruction to include opportunities for student active learning. These findings underscore the difficulty of implementing instructional change in college classrooms.     

Interactive instruction of cellular physiology for remote learning.

The biomedical sciences are a rapidly changing discipline that have adapted to innovative technological advances. Despite these many advances, we face two major challenges: a) the number of experts in the field is vastly outnumbered by the number of students, many of whom are separated geographically or temporally and b) the teaching methods used to instruct students and learners have not changed. Today's students have adapted to technology--they use the web as a source of information and communicate via email and chat rooms. Teaching in the biomedical sciences should adopt these new information technologies (IT), but has thus far failed to capitalize on technological opportunity. Creating a "digital textbook" of the traditional learning material is not sufficient for dynamic processes such as cellular physiology. This paper describes innovative teaching techniques that incorporate familiar IT and high-quality interactive learning content with user-centric instruction design models. The Virtual Labs Project from Stanford University has created effective interactive online teaching modules in physiology (simPHYSIO) and delivered them over broadband networks to their undergraduate and medical students. Evaluation results of the modules are given as a measure of success of such innovative teaching method. This learning media strategically merges IT innovations with pedagogy to produce user-driven animations of processes and engaging interactive simulations.     

Endocrine physiology in a patient-centered learning curriculum

The medical curriculum at the University of North Dakota School of Medicine and Health Sciences has recently been redesigned into a problem-based/traditional hybrid model that utilizes an integrated organ systems-based approach to teach basic and clinical sciences. The number of lecture hours in general has been greatly reduced, and, in particular, lecture hours in physiology have been reduced by 65%. Students learn basic science in small groups led by a faculty facilitator, and students are responsible for a great deal of their own teaching and learning. The curriculum is centered around patient cases and is called patient-centered learning (PCL). The curriculum includes traditional lectures and laboratories supporting faculty-generated learning objectives. Endocrine physiology is taught in year one, utilizing four weeks of patient cases that emphasize normal structure and function of endocrine systems. Endocrine physiology is revisited in year two, which is primarily focused on pathobiology. The PCL curriculum, with emphasis on the endocrine component, is described in detail along with key portions of an endocrine case.     

Effects of different forms of physiology instruction on the development of students' conceptions of and approaches to science learning

The purpose of this study was to investigate students' conceptions of and approaches to learning science in two different forms: internet-assisted instruction and traditional (face-to-face only) instruction. The participants who took part in the study were 79 college students enrolled in a physiology class in north Taiwan. In all, 46 of the participants were from one class and 33 were from another class. Using a quasi-experimental research approach, the class of 46 students was assigned to be the "internet-assisted instruction group," whereas the class of 33 students was assigned to be the "traditional instruction group." The treatment consisted of a series of online inquiry activities. To explore the effects of different forms of instruction on students' conceptions of and approaches to learning science, two questionnaires were administered before and after the instruction: the Conceptions of Learning Science Questionnaire and the Approaches to Learning Science Questionnaire. Analysis of covariance results revealed that the students in the internet-assisted instruction group showed less agreement than the traditional instruction group in the less advanced conceptions of learning science (such as learning as memorizing and testing). In addition, the internet-assisted instruction group displayed significantly more agreement than the traditional instruction group in more sophisticated conceptions (such as learning as seeing in a new way). Moreover, the internet-assisted instruction group expressed more orientation toward the approaches of deep motive and deep strategy than the traditional instruction group. However, the students in the internet-assisted instruction group also showed more surface motive than the traditional instruction group did.     

Institutional objectives for medical education that relates to the community.

The graduate of most medical schools in North America is described as an "undifferentiated physician", but there is no universally agreed upon definition of the term. With the proliferation of subspecialties during the past 30 years, each division or department has its own concept of the undifferentiated physician. The result is strong pressure on curriculum committees to increase curriculum content. The medical faculty of the University of Ottawa used an approach to developing institutional objectives for medical schools that was based on the premise that graduates should possess the knowledge, skills and attitudes of a primary care practitioner in the community, and they accepted an institutional goal and 10 institutional objectives after five revisions of the original proposal. An essential element in the development of the objectives was the use of a list of common medical problems, ranked in order of frequency, as guidelines. The resulting institutional objectives are relevant to current community needs and may be used to project the future needs of the community.     

Combination of didactic lecture with problem-based learning sessions in physiology teaching in a developing medical college in Nepal

Physiology teaching as an essential part of medical education faces tremendous criticism regarding curriculum design, methods of implementation, and application of knowledge in clinical practice. In the traditional method of medical education, physiology is taught in the first year and involves little interdisciplinary interaction. The Manipal College of Medical Sciences, Pokhara, Nepal (affiliated with the Kathmandu Univ.) started in 1994 and adopted an integrated curriculum drawn along the lines of the student-centered, problem-based, integrated, community-based, elective-oriented, and systematic (SPICES) medical curriculum. Here, physiology is taught for the first 2 yr of the 4.5-yr Bachelor of Medicine, Bachelor of Surgery course. Methodology adopted is as follows. For a particular topic, objectives are clearly defined and priority content areas are identified. An overview is given in a didactic lecture class to the entire batch of 100 students. Tutorial classes are conducted thereafter with smaller groups of students (25/batch) divided further into five subgroups of five students each. In these sessions, a problem is presented to the students as a focus for learning or as an example of what has just been taught. Each problem was accompanied with relevant questions to streamline the students' thought processes. A tutor is present throughout the session not as an instructor but as a facilitator of the learning process. A questionnaire sought students' opinion on the usefulness of this approach, relevance of the combination of problem-based learning (PBL) sessions and didactic lectures in understanding a particular topic and relating clinical conditions to basic mechanisms, and improvement of performance on the university final examination. The majority of the students opined that the combination of didactic lectures and PBL sessions was definitely beneficial regarding all the above-mentioned aspects of learning. The university results corroborated their opinion. Thus it may be considered that a judicious mixture of didactic lectures and PBL sessions is beneficial as a teaching module of physiology in medical schools.     

利用文献精读教学新模式优化遗传学教学

《遗传学》是生命科学相关专业本科阶段最重要的课程之一。近年来,随着生命科学领域研究的不断深入,新知识与新技术也在不断更新。但遗传学的教学模式目前仍以理论讲授为主,这使得抽象的原理难以被学生理解接受,直接影响了教学效果。因此探索新的教学模式尤为必要。2010年以来我校在生物技术专业《微生物遗传学》教学中开展了新教学模式——文献精读,文章从文献精读的前期课程基础,如何选择专业文献,怎样组织教学过程,开展文献精读对学生和教师的意义等方面全面分析了实施情况和应用价值,指出该教学模式体现了“前沿”和“经典”的结合,使书本的知识在实践中具体化,既提高学生的学习效果,激发学习兴趣,又开拓了学生的思路,锻炼其能力。这种教学模式为《遗传学》教学授课不断探索新的模式、在“精准医疗”时代下如何培养兼具临床与科研能力的医疗人才提供新思路。     

A structured decision making analysis to increase a Red-cockaded Woodpecker population and balance stakeholder objectives for a National Forest

Longleaf pine (Pinus palustris) savanna is a biodiverse ecosystem native to the southeastern United States. Due to fire suppression and timber harvest, longleaf pine has declined to 3% of its original range. The extant forest provides habitat for many threatened and endangered species, including the endangered Red-cockaded Woodpecker (Picoides borealis; RCW), a cavity-nesting bird that co-evolved with fire-maintained forest, resulting in savanna-like old-growth forest as the bird’s preferred habitat. Our study site, the Oakmulgee Ranger District of the Talladega National Forest, harbors the largest RCW population in Alabama and is managed with an emphasis on RCW conservation. The United States Forest Service (USFS) also manages the Oakmulgee for uses such as wildlife conservation, recreation, and timber harvest. Despite efforts to restore RCW habitat and install artificial cavities in the Oakmulgee, the number of RCW groups has not exceeded 123, although the Recovery Plan objective is 394 groups. Our project was motivated by the USFS expressing interest in determining why the RCW population has not exceeded 123 groups. We proposed using structured decision making (SDM) with the USFS and other stakeholders to address this problem. Our goals were to explicitly define management objectives, build a Bayesian belief network with a model of how decision alternatives are believed to affect management objectives, and use a sensitivity analysis to determine the part of the model to which RCW population growth was most sensitive. Therefore, results from the analysis were expected to give insights into 1) ecological factors limiting RCW population growth, 2) how management can overcome these limits, plus 3) the relative expected ability of different decision alternatives to satisfy multiple objectives in addition to increasing RCW group number. We held four SDM workshops with representatives from the USFS, the Animal and Plant Health Inspection Service, the Longleaf Alliance, the Birmingham Audubon Society, and local residents. Stakeholder objectives consisted of maximizing the following: RCW group number, forest health, recreational enjoyment, community economic health, and aesthetics. Cavity insert installation had the greatest probability of increasing the number of RCW groups. The number of RCW groups was most affected by cavity availability, adult survival, reproductive output, food availability, and herbaceous understory. Prescribed burning was most likely to meet the combination of stakeholder objectives, followed by midstory removal. Our findings suggest that cavity installation efforts may need to be increased in the Oakmulgee to increase RCW group number. Also it could be beneficial to investigate how RCWs select cavity tree locations with the goal of increasing the chance that RCWs use artificial cavities to form new groups. The Bayesian belief network provided insights into factors limiting RCW population growth and how management can overcome these limits. The Bayesian belief network also can be used to prioritize management methods in the Oakmulgee given stakeholder objectives and time constraints.     

Peer instruction enhanced meaningful learning: ability to solve novel problems

Students must be able to interpret, relate, and incorporate new information with existing knowledge and apply the new information to solve novel problems. Peer instruction is a cooperative learning technique that promotes critical thinking, problem solving, and decision-making skills. Therefore, we tested the hypothesis that peer instruction enhances meaningful learning or transfer, defined as the student's ability to solve novel problems or the ability to extend what has been learned in one context to new contexts. To test this hypothesis, our undergraduate exercise physiology class of 38 students was randomly divided into two groups: group A (n = 19) and group B (n = 19). A randomized crossover design in which students either answered questions individually or during peer instruction was used to control for time and order effects. The first factor that influences meaningful learning is the degree of mastery of the original material. Importantly, peer instruction significantly enhanced mastery of the original material. Furthermore, the student's ability to solve novel problems was significantly enhanced following peer instruction. Thus pausing two to three times during a 50-min class to allow peer instruction enhanced the mastery of the original material and enhanced meaningful learning, i.e., the student's ability to solve novel problems.     

The Physiology undergraduate major in the University of Arizona College of Medicine: past, present, and future

The American Physiological Society (APS) and APS Council encourage the teaching of physiology at the undergraduate, graduate, and medical school levels to support the continued prominence of this area of science. One area identified by the APS Council that is of particular importance for the development of future physiologists (the "physiology pipeline") is the teaching of physiology and physiology-related topics at the undergraduate level. In this article, we describe the historical development and implementation of an undergraduate program offered through the Department of Physiology, a basic science department in the College of Medicine at the University of Arizona, culminating in a Bachelor of Science in Health Sciences degree with a major in Physiology. Moreover, we discuss the current Physiology curriculum offered at our institution and explain how this program prepares our students for successful entry into a variety of postbaccalaureate professional programs, including medical school and numerous other programs in health professions, and in graduate study in the Masters and Doctoral programs in biomedical sciences. Finally, we cover the considerable challenges that we have faced, and continue to face, in developing and sustaining a successful physiology undergraduate major in a college of medicine. We hope that the information provided on the Physiology major offered by the Department of Physiology in the College of Medicine at the University of Arizona will be helpful for individuals at other institutions who may be contemplating the development and implementation of an undergraduate program in Physiology.     

Developing ecosystem objectives for the Great Lakes: policy,progress and public participation

Under the Great Lakes Water Quality Agreement of 1978 between the United States and Canada, as amended in 1987, an ecosystem objective with associated indicators for Lake Superior was adopted, and a commitment was made to develop ecosystem objectives and indicators for each of the other Great Lakes. Building upon a history of activities within the International Joint Commission related to the development of ecosystem indicators for Lake Superior and for mesotrophic waters, a binational Ecosystem Objectives Work Group (EOWG) has been established by the U.S. and Canada and charged with developing ecosystem objectives for the Great Lakes, beginning with Lake Ontario. These objectives are primarily biological in nature, in contrast to chemical objectives. The approach of the EOWG is to identify in sequence: (1) broad ecosystem goals, (2) a suite of objectives whose attainment would ensure achievement of the goals, and (3) one or more measurable indicators of progress toward meeting each objective. Societal values are reflected in the goals and objectives following consultation with competing users of ecosystem resources. Identification of appropriate indicators requires the assistance of technical experts. The experience of the EOWG in developing ecosystem objectives for Lake Ontario illustrates the application of this process.     

The STAR project: context, objectives and approaches

STAR is a European Commission Framework V project (EVK1-CT-2001-00089). The project aim is to provide practical advice and solutions with regard to many of the issues associated with the Water Framework Directive. This paper provides a context for the STAR research programme through a review of the requirements of the directive and the Common Implementation Strategy responsible for guiding its implementation. The scientific and strategic objectives of STAR are set out in the form of a series of research questions and the reader is referred to the papers in this volume that address those objectives, which include: (a) Which methods or biological quality elements are best able to indicate certain stressors? (b) Which method can be used on which scale? (c) Which method is suited for early and late warnings? (d) How are different assessment methods affected by errors and uncertainty? (e) How can data from different assessment methods be intercalibrated? (f) How can the cost-effectiveness of field and laboratory protocols be optimised? (g) How can boundaries of the five classes of Ecological Status be best set? (h) What contribution can STAR make to the development of European standards? The methodological approaches adopted to meet these objectives are described. These include the selection of the 22 stream-types and 263 sites sampled in 11 countries, the sampling protocols used to sample and survey phytobenthos, macrophytes, macroinvertebrates, fish and hydromorphology, the quality control and uncertainty analyses that were applied, including training, replicate sampling and audit of performance, the development of bespoke software and the project outputs. This paper provides the detailed background information to be referred to in conjunction with most of the other papers in this volume. These papers are divided into seven sections: (1) typology, (2) organism groups, (3) macrophytes and diatoms, (4) hydromorphology, (5) tools for assessing European streams with macroinvertebrates, (6) intercalibration and comparison and (7) errors and uncertainty. The principal findings of the papers in each section and their relevance to the Water Framework Directive are synthesised in short summary papers at the beginning of each section. Additional outputs, including all sampling and laboratory protocols and project deliverables, together with a range of freely downloadable software are available from the project website at www.eu_star.at.     

Lessons learned through listening to biology students during a transition to online learning in the wake of the COVID‐19 pandemic

During the Spring Semester of 2020, an outbreak of a novel coronavirus (SARS‐CoV‐2) and the illnesses it caused (COVID‐19) led to widespread cancelling of on‐campus instruction at colleges and universities in the United States and other countries around the world. Response to the pandemic in university settings included a rapid and unexpected shift to online learning for faculty and students. The transition to teaching and learning online posed many challenges, and the experiences of students during this crisis may inform future planning for distance learning experiences during the ongoing pandemic and beyond. Herein, we discuss the experiences of first‐ and second‐year university students enrolled in a biology seminar course as their classes migrated to online environments. Drawing on reported student experiences and prior research and resources, we discuss the ways we will adjust our own teaching for future iterations of the course while offering recommendations for instructors tasked with teaching in online environments.     

How do learning issues relate with content in a problem-based learning pathophysiology course?

The relation between learning process and content coverage is becoming increasingly important for the understanding of the effects of problem-based learning (PBL) on students' learning. In our medical school, PBL is used as a major educational strategy in the discipline of pathophysiology. A computer program was developed allowing students to register learning issues identified as needed during tutorial sessions and learning issues stated as covered during the individual study periods. In our study, we compared "planned" (learning issues identified during PBL sessions) and "accomplished" learning issues (covered after the independent study periods) identified by pathophysiology students from three consecutive years. We found that the planned learning issues raised during tutorial sessions related to the issues effectively accomplished during the independent study and that their number grew stepwise from basic to preclinical to clinical sciences. Pathophysiology was, globally, the most mentioned discipline. Moreover, the most mentioned disciplines from the basic, preclinical, and clinical areas were physiology, histopathology, and internal medicine, respectively. The single-discipline approach did not limit the student's capacity to identify and cover learning issues beyond the objectives of pathophysiology.     

Blending problem-based learning with Web technology positively impacts student learning outcomes in acid-base physiology

World Wide Web (Web)-based learning (WBL), problem-based learning (PBL), and collaborative learning are at present the most powerful educational options in higher education. A blended (hybrid) course combines traditional face-to-face and WBL approaches in an educational environment that is nonspecific as to time and place. To provide educational services for an undergraduate second-year elective course in acid-base physiology, a rich, student-centered educational Web-environment designed to support PBL was created by using Web Course Tools courseware. The course is designed to require students to work in small collaborative groups using problem solving activities to develop topic understanding. The aim of the study was to identify the impact of the blended WBL-PBL-collaborative learning environment on student learning outcomes. Student test scores and satisfaction survey results from a blended WBL-PBL-based test group (n = 37) were compared with a control group whose instructional opportunities were from a traditional in-class PBL model (n = 84). WBL students scored significantly (t = 3.3952; P = 0.0009) better on the final acid-base physiology examination and expressed a positive attitude to the new learning environment in the satisfaction survey. Expressed in terms of a difference effect, the mean of the treated group (WBL) is at the 76th percentile of the untreated (face-to-face) group, which stands for a "medium" effect size. Thus student progress in the blended WBL-PBL collaborative environment was positively affected by the use of technology.     

Gender differences in learning style preferences among undergraduate physiology students

Students have individual learning style preferences including visual (V; learning from graphs, charts, and flow diagrams), auditory (A; learning from speech), read-write (R; learning from reading and writing), and kinesthetic (K; learning from touch, hearing, smell, taste, and sight). These preferences can be assessed using the VARK questionnaire. We administered the VARK questionnaire to undergraduate physiology majors enrolled in a capstone physiology laboratory at Michigan State University; 48 of the 86 students (55.8%) who returned the completed questionnaire voluntarily offered gender information. The responses were tallied and assessed for gender difference in learning style preference; 54.2% of females and only 12.5% of males preferred a single mode of information presentation. Among the female students, 4.2% of the students preferred V, 0% of the students preferred A, 16.7% of the students preferred printed words (R), and 33.3% of the students preferred using all their senses (K). In contrast, male students were evenly distributed in preference, with 4.2% of the students preferring A, R, or K, respectively, while 0% of the students preferred V. Furthermore, 45.8% of female and 87.5% of male respondents preferred multiple modes [female: 2 modes (12.5%), 3 modes (12.5%), and 4 modes (20.8%); males: 2 modes (16.7%), 3 modes (12.5%), and 4 modes (58.3%)] of presentation. In summary, a majority of male students preferred multimodal instruction, specifically, four modes (VARK), whereas a majority of female students preferred single-mode instruction with a preference toward K. Thus, male and female students have significantly different learning styles. It is the responsibility of the instructor to address this diversity of learning styles and develop appropriate learning approaches.     

Factors influencing the emigration of physicians from Canada to the United States.

OBJECTIVE: To determine whether location of postgraduate medical training and other factors are associated with the emigration of physicians from Canada to the United States. DESIGN: Case-control study, physicians were surveyed with the use of a questionnaire mailed in May 1994 (with a reminder sent in September 1994), responses to which were accepted until Dec. 31, 1994. PARTICIPANTS: Physicians randomly selected from the CMA database, 4000 with addresses in Canada and 4000 with current addresses in the United States and previous addresses in Canada. OUTCOME MEASURES: Sex, age, location of undergraduate and postgraduate medical training, qualifications, practice location, opinions concerning residence decisions, current satisfaction and plans. RESULTS: The overall response rate was 49.6% (50.0% among physicians in the United States and 49.2% among those in Canada). Age and sex distributions were similar among the 8000 questionnaire recipients and the nearly 4000 respondents. Physicians living in the United States were more likely to be older (mean 53.2 v. 49.6 years of age), male (87% v. 75%) and specialists (79% v. 52%) than those practising in Canada. Postgraduate training in the United States was associated with subsequent emigration (odds ratio 9.2, 95% confidence interval 7.8 to 10.7). However, in rating the importance of nine factors in the decision to emigrate or remain in Canada, there was no significant difference between the two groups in the rating assigned to location of postgraduate training. Professional factors rated most important by most physicians in both groups were professional/clinical autonomy, availability of medical facilities and job availability. Remuneration was considered an equally important factor by those in Canada and in the United States. Six of seven personal/family factors were rated as more important to their choice of practice location by respondents in Canada than by those in the United States. Current satisfaction was significantly higher among respondents in the United States. Most physicians in each group planned to continue practising at their current location. Of Canadian respondents, 22% indicated that they were more likely to move to the United States than they were a year beforehand, whereas 4% of US respondents indicated that they were more likely to return to Canada. CONCLUSIONS: Factors affecting the decision to move to the United States or remain in Canada can be categorized as "push" factors (e.g., government involvement) and "pull" factors (e.g., better geographic climate in the US). Factors can also be categorized by whether they are amenable to change (e.g., availability of medical facilities) or cannot be managed (e.g., proximity of relatives). An understanding of the reasons why physicians immigrate to the United States or remain in Canada is essential to planning physician resources nationally.     

Monitoring in the Context of Structured Decision-Making and Adaptive Management

Abstract: In a natural resource management setting, monitoring is a crucial component of an informed process for making decisions, and monitoring design should be driven by the decision context and associated uncertainties. Monitoring itself can play ≥3 roles. First, it is important for state-dependent decision-making, as when managers need to know the system state before deciding on the appropriate course of action during the ensuing management cycle. Second, monitoring is critical for evaluating the effectiveness of management actions relative to objectives. Third, in an adaptive management setting, monitoring provides the feedback loop for learning about the system; learning is sought not for its own sake but primarily to better achieve management objectives. In this case, monitoring should be designed to reduce the critical uncertainties in models of the managed system. The United States Geological Survey and United States Fish and Wildlife Service are conducting a large-scale management experiment on 23 National Wildlife Refuges across the Northeast and Midwest Regions. The primary management objective is to provide habitat for migratory waterbirds, particularly during migration, using water-level manipulations in managed wetlands. Key uncertainties are related to the potential trade-offs created by management for a specific waterbird guild (e.g., migratory shorebirds) and the response of waterbirds, plant communities, and invertebrates to specific experimental hydroperiods. We reviewed the monitoring program associated with this study, and the ways that specific observations fill ≥1 of the roles identified above. We used observations from our monitoring to improve state-dependent decisions to control undesired plants, to evaluate management performance relative to shallow-water habitat objectives, and to evaluate potential trade-offs between waterfowl and shorebird habitat management. With limited staff and budgets, management agencies need efficient monitoring programs that are used for decision-making, not comprehensive studies that elucidate all manner of ecological relationships.     

Can learning style predict student satisfaction with different instruction methods and academic achievement in medical education?

The curriculum of our medical school has a hybrid structure including both traditional training (lectures) and problem-based learning (PBL) applications. The purpose of this study was to determine the learning styles of our medical students and investigate the relation of learning styles with each of satisfaction with different instruction methods and academic achievement in them. This study was carried out with the participation of 170 first-year medical students (the participation rate was 91.4%). The researchers prepared sociodemographic and satisfaction questionnaires to determine the characteristics of the participants and their satisfaction levels with traditional training and PBL. The Kolb learning styles inventory was used to explore the learning styles of the study group. The participants completed all forms at the end of the first year of medical education. Indicators of academic achievement were scores of five theoretical block exams and five PBL exams performed throughout the academic year of 2008-2009. The majority of the participants took part in the "diverging" (n = 84, 47.7%) and "assimilating" (n = 73, 41.5%) groups. Numbers of students in the "converging" and "accommodating" groups were 11 (6.3%) and 8 (4.5%), respectively. In all learning style groups, PBL satisfaction scores were significantly higher than those of traditional training. Exam scores for "PBL and traditional training" did not differ among the four learning styles. In logistic regression analysis, learning style (assimilating) predicted student satisfaction with traditional training and success in theoretical block exams. Nothing predicted PBL satisfaction and success. This is the first study conducted among medical students evaluating the relation of learning style with student satisfaction and academic achievement. More research with larger groups is needed to generalize our results. Some learning styles may relate to satisfaction with and achievement in some instruction methods.