Physiology is hard: a replication study of students' perceived learning difficulties.

Human Anatomy and Physiology (HAP) has long been recognized as a difficult course. A 2007 study (Michael J. Adv Physiol Educ 31: 34-40, 2007) sought to better understand this difficulty by asking faculty for their perceptions of why students struggle to learn in HAP. Later research built on these findings by investigating why students find physiology difficult (Sturges D, Maurer T. Internet J Allied Health Sci Pract 11: 1-10, 2013). However, without replication, these claims are limited in their generalizability. There is a need in physiology education research to replicate studies like these across different institutions to support generalizations. We, therefore, replicated both of these studies by collecting survey responses from 466 students at 4 different institutions and 17 instructors at 15 different institutions. We found that students in our study identified similar factors as the students surveyed in the original study. Students most strongly agreed with items that attributed the difficulty of HAP to the nature of the discipline, as opposed to the way physiology is taught or the way students approach learning it. Faculty in our sample, like those in the original study by Michael, agreed most strongly with items that attributed physiology's difficulty to discipline specific factors. Our data reinforce the results of Sturges and Maurer and Michael. We can more confidently claim that HAP students and faculty believe the difficulty in learning physiology is the result of inherent features of the discipline itself and not factors related to instruction or the students themselves.