Common student misconceptions in exercise physiology and biochemistry

James P. Morton, Dominic A. Doran and Don P. M. MacLaren

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Common student misconceptions in exercise physiology and biochemistry

James P. Morton, Dominic A. Doran, and Don P. M. MacLaren
Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
Submitted 24 October 2007; accepted in nal form 28 January 2008

Morton JP, Doran DA, MacLaren DP. Common student misconceptions in exercise physiology and biochemistry. Adv Physiol Educ 32: 142146, 2008; doi:10.1152/advan.00095.2007.The present study represents a preliminary investigation designed to identify common misconceptions in students understanding of physiological and biochemical topics within the academic domain of sport and exercise sciences. A specically designed misconception inventory (consisting of 10 multiple-choice questions) was administered to a cohort of level 1, 2, and 3 undergraduate students enrolled in physiology and biochemistry-related modules of the BSc Sport Science degree at the authors institute. Of the 10 misconceptions proposed by the authors, 9 misconceptions were conrmed. Of these nine misconceptions, only one misconception appeared to have been alleviated by the current teaching strategy employed during the progression from level 1 to 3 study. The remaining eight misconceptions prevailed throughout the course of the degree program, suggesting that students enter and leave university with the same misconceptions in certain areas of exercise physiology and biochemistry. The possible origins of these misconceptions are discussed, as are potential teaching strategies to prevent and/or remediate them for future years. prerequisite knowledge; metabolism; sport science
SPORT AND EXERCISE SCIENCE

(SES) is one of the fastest growing academic disciplines in the United Kingdom. By denition, SES is the application of scientic principles to the promotion, maintenance and enhancement of sport and exercise related behaviours (4). From a teaching and research perspective, SES is primarily concerned with the scientic study of sporting performance or that of how regular exercise can promote health and well-being. The subject further encompasses the subdisciplines of physiology, biochemistry, psychology, sociology, biomechanics, and motor learning, to which one of these students will typically direct their attention as their studies develop. Although SES is undergoing rapid growth as an academic discipline, available educational research directed toward improving the teaching of SES within the United Kingdom is limited (18, 19). Of all the subdisciplines of SES, students typically report they have greatest difculties when studying exercise physiology and biochemistry, despite these being the most popular areas of SES. This is perhaps not surprising given the factual and conceptual difculties of the topics and also the rate at which ongoing research is contributing to existing knowledge. For example, the introduction of molecular biology to exercise physiology and biochemistry has presented itself as another major challenge for both student and teacher. Students are now expected to understand whole body physiological responses to acute and chronic exercise

while also having an appreciation for the molecular mechanisms underpinning these adaptations. In teaching exercise physiology and biochemistry disciplines, many lecturers often assume that students are familiar with the basics because of they have already satised course prerequisites. We assume that because students have completed school or college qualications in biology, chemistry, or physical education that they will therefore be able to benet from the teaching of advanced content during higher education. On the basis of this assumption, we subsequently devise educational objectives and teaching strategies for the relevant course. We also assume that as students progress through their studies at university, what they learn in modules studied at level 1 will prepare them for level 2 and, nally, level 3. However, when collectively reecting on our teaching experience, we have frequently observed that merely satisfying course and module prerequisites does not ensure an understanding of basic physiological and biochemical concepts. The aims of the present preliminary study were to expand the misconception literature [readers of this journal will be well acquainted with such literature (see Refs. 13, 14, 16, 17, and 20)] by attempting to identify those common misconceptions experienced by SES students while studying exercise physiology and biochemistry components of their degree. By distributing multiple-choice questionnaires (and also requesting justication for chosen answers) to level 1, 2, and 3 students, we attempted to track the prevalence of these misconceptions throughout their degree progression.
METHODS

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Address for reprint requests and other correspondence: J. Morton, School of Sport and Exercise Sciences, Liverpool John Moores Univ., 15-21 Webster St., Liverpool L3 2ET, UK (e-mail: J.P.Morton@ljmu.ac.uk). 142

Misconceptions inventory. At a meeting of the authors, a list of common misconceptions on various aspects of exercise physiology and biochemistry was compiled. This list was drawn from the authors previous experiences of interacting with students in the classroom and ofce and from formal marking of coursework tasks and examinations. Statements of these misconceptions are shown in Table 1. These misconceptions were subsequently incorporated into a questionnaire that presented 10 multiple-choice questions detailing those misconceptions outlined in Table 1. Students were also provided with space to justify their reasoning for their answers so as to provide the authors with a further understanding of any misconceptions identied. The Misconceptions Inventory questionnaire is shown in Table 2 together with a full breakdown of student responses. Populations surveyed. A sample of students enrolled in physiologyand biochemistry-related modules in the BSc (Hons) Sports Science degree at Liverpool John Moores University participated in the investigation. Students from levels 1 to 3 participated in the study so as to gain an understanding of the prevalence of any misconceptions throughout the course of the degree program. Students were not asked to volunteer, and the exercise was presented as a compulsory part of the course, which served to act as a catalyst for promoting revision for end of year examinations. Demographic information of

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Table 1. Potential student misconceptions on aspects of exercise physiology and biochemistry as recognized by the authors experiences of teaching these topics
Potential Student Misconceptions

1. Lactate is only produced when muscle contracts under anaerobic conditions. 2. Lactate causes fatigue. 3. Fat is only used as an energy source during exercise when carbohydrate sources run out. 4. To maximize fat loss during exercise, exercise intensity should be high. 5. The process of muscle contraction consists solely of peripheral processes. 6. When a muscle shortens in length during contraction, the A-band also shortens. O2max is the most important determinant of endurance performance. 7. V 8. Oxidation reactions only involve oxygen molecules. 9. Blood pressure is higher during prolonged exercise in hot conditions compared with normal conditions. 10. Brain blood ow increases during exercise. O2max, maximal oxygen uptake. V

the students studied is shown in Table 3, along with their educational background.
RESULTS

Of the 10 misconceptions proposed by the authors, 9 misconceptions appeared to be prevalent among the populations studied (there was no evidence of any misconceptions regarding brain blood ow during exercise; data not shown). The percentage of the student population at each level of study who displayed misconceptions is shown in Table 4. A comprehensive analysis of student answers is also shown in Table 2. Lactate misconceptions. The data demonstrated that 85%, 80%, and 60% of the population studied at levels 1, 2, and 3, respectively, responded with a misconception concerning the understanding of cellular conditions that result in lactate production during muscle contraction (question 1). In relation to the function of increased lactate production (question 2), there was a linear decrease in the prevalence of misconceptions from levels 1 to 3. In general, students at levels 1 and 2 misconceived lactate to be a dead-end waste product that causes fatigue or will produce hydrogen ions that cause fatigue. In level 3, only 19% of the population responded with a misconception, whereas 81% of students correctly understood lactate to be an important energy-yielding substrate. These data demonstrate that as lactate metabolism is studied in more detail as the degree program progresses, students successfully appreciate lactate as a metabolite as opposed to a possible fatiguing agent. Nevertheless, students do not appear to appreciate or become aware that lactate can also be produced during oxygenated conditions. Fat metabolism misconceptions. Misconceptions concerning the optimal exercise intensity to oxidize lipids during exercise (question 3) were made by 44% (level 1), 43% (level 2), and 72% (level 3) of the population studied. Greater than 95% of the population at levels 13 showed misconceptions regarding the interaction of fat and carbohydrate metabolism during exercise (question 4). In this situation, all students clearly misconceived that skeletal muscle will only utilize fat as a fuel source during exercise when carbohydrate stores have been

reduced due to depletion of muscle glycogen, blood glucose, or a combination of both. Muscle contraction misconceptions. In relation to the process of muscle contraction (question 5), 84% (level 1), 75% (level 2), and 90% (level 3) of the student population responded with answers AD, which focused solely on peripheral processes. This question, however, may have been misunderstood by students, as only 6% (level 1), 25% (level 2), and 10% (level 3) of the population correctly chose answer E (other), where all of these students correctly explained that muscle contraction begins with an impulse from the brain. It is acknowledged that if this option had been explicitly available for selection (as opposed to other), more students may have chosen this answer. Nevertheless, these data demonstrate that only 6 25% of the students appreciated the importance of the central nervous system in voluntary muscle contraction. In answering question 6, 56% (level 1), 50% (level 2), and 57% (level 3) of students responded with a misconception concerning what happens to components of the sarcomere during a shortening contraction. In these instances, the majority of misconceived responses assumed that the A-band will also shorten during a contraction. Approximately 50% of all students, therefore, do not appear to understand the mechanics of muscle contraction. Determinant of endurance performance misconceptions. Misconceptions concerning the most important predictor of endurance running performance (question 7) were made by 63%, 84%, and 68% of level 1, 2, and 3 students, respectively. The most prevalent misconception was that maximal oxygen uptake O2 max) is the most important determinant. Only 37% (level (V 1), 16% (level 2), and 32% (level 3) of the population correctly cited the lactate threshold as the most important determinant of endurance performance. Oxidation reaction misconceptions. Misconceptions concerning the nature of an oxidation reaction (question 8) were made by 81%, 61%, and 67% of level 1, 2, and 3 students, respectively. The most prevalent misconception was that oxidation reactions involve the loss (or gain) of an electron solely from (or by) an oxygen molecule. Students therefore appeared to misconceive that any biological substance can be oxidized or that oxidation reactions are the loss of an electron (as opposed to gain) from the particular substance. Blood pressure regulation misconceptions. Misconceptions concerning blood pressure responses during exercise in hot ambient conditions that induce dehydration (question 9) were made by 78%, 54%, and 80% of level 1, 2, and 3 students, respectively. These data demonstrate that students do not appear to understand how blood pressure is regulated and responds to exercise.
DISCUSSION

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The aim of the present preliminary study was to identify common misconceptions in students understanding of physiological and biochemical concepts of SES. Using a specically designed multiple-choice questionnaire, the present data identied nine misconceptions in understanding. Of these nine misconceptions, only one misconception appeared to have been alleviated by the present teaching strategy. Potential sources of misconceptions. Potential sources of misconceptions are often quoted as having arisen in the classroom, from textbooks or from an experience in the real world
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Table 2. Summary of student responses

Question Level 1 Level 2 Level 3

1. Lactate is produced during muscle contraction: A. when the cell contracts under oxygenated conditions. B. when there is a shortage of oxygen supply. C. during anoxic conditions. D. all of the above.* E. other. 2. Lactate produced during muscle contraction: A. is a dead end waste product. B. is a dead end waste product that causes fatigue. C. is an important energy-yielding substrate.* D. will produce lactate ions, which cause fatigue. E. does none of the above. 3. To maximize fat loss during exercise, it is necessary to exercise at the intensity at which fat oxidation will be highest. For a sedentary individual, this typically occurs at: O2max. A. 45% V O2max. B. 4654% V O2max.* C. 5565% V O2max. D. 6675% V O2max. 75% V 4. During prolonged exercise, skeletal muscle will predominantly use fat as an energy source when: A. there is reduced carbohydrate availablity due to depletion of muscle glycogen stores. B. there is reduced carbohydrate availability due to depletion of blood glucose stores. C. there is reduced carbohydrate availability due to both of the above. D. there is an increased availability of fatty acids within the muscle.* E. all of the above. 5. The process of muscle contraction begins with: A. propagation of an action potential along the sarcolemma. B. acetylcholine transport across the synaptic cleft. C. calcium release from the sarcoplasmic reticulum. D. calcium binding to troponin C. E. other.* 6. During muscle contration, when the muscle is shortining in length, the A-band will: A. shorten. B. lengthen. C. remain unchanged.* 7. The most important predictor of endurance running performance is: O2max. A. V B. lactate threshold.* C. maximal cardiac output. D. muscle size. E. other. 8. An oxidation reaction consists of: A. loss of an electron from an oxygen molecule. B. gain of an electron by an oxygen molecule. C. loss of an electron from any biological substance.* D. gain of an electron from any biological substance. E. other. 9. During prolonged continous exercise, blood pressure will initially increase (within the rst 10 min) above resting levels and should remain constant at the exercise pressure thereafter. When a subject is nearing the end of his run on a hot afternoon (30C), which induces signicant dehydration, his blood pressure will therefore: A. remain constant at the initially acquired exercise pressure. B. decrease to below the initially acquired exercsie pressure but remain above resting levels.* C. increase to above the initially acquired exercise pressure. Values are percentages of the student population. *Correct answer.

3 80 2 15 0 3 37 13 46 1 9 8 56 23 4 20 11 64 0 5 54 24 13 3 6 43 13 44 41 37 17 3 2 34 39 19 6 2

3 74 3 20 0 0 23 50 27 0 5 19 57 19 0 11 3 54 5 27 46 19 5 5 25 25 25 50 74 16 10 0 0 29 11 39 13 8

0 60 0 40 0 0 0 81 13 6 25 34 28 7 6 10 3 32 3 52 48 23 16 3 10 43 14 43 58 32 7 0 3 30 20 33 13 4

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40 22 38

33 46 21

42 20 38

(13, 16). It is difcult to precisely state the origins of the misconceptions identied here, and it is also possible that sources may be different between the level 13 populations sampled. For example, the level 1 students studied here had not been exposed to any exercise science during their rst year of study but rather were exposed to those physiological foundations deemed necessary before embarking upon exercise physiology in level 2 study. In this regard, it is tempting to speculate that misconceptions identied in level 1 students may be simply due to no previous knowledge (or exposure) of exercise science. Misconceptions in these students may have

therefore arisen from experiences outside of the classroom. However, considering that 50% and 70% of this population had completed school or college study in biology and physical education, respectively, it is somewhat concerning that students entered university with large misconceptions in areas such as mechanics of muscle contraction, lactate metabolism, and integration of lipid and carbohydrate metabolism. Furthermore, it is even more worrying that misconceptions were still prevalent in level 2 and 3 study, despite the increased emphasis on exercise science as the curriculum developed. Misconceptions in lactate metabolism appeared to have been somewhat
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Table 3. Description of the student population surveyed

Level 1 Level 2 Level 3

Number of students 80 64 42 Gender, %male/%female 70/30 81/19 70/30 Age, yr 20 4 20 1 21 1 Title of module in which Physiological Exercise Muscle subjects were studied Foundations Physiology Metabolism Prior biology, % 52 56 83 Prior chemistry, % 11 12 13 Prior physical education, % 73 75 73 Prior Natural Diploma in Sports Science/Studies, % 22 2 13

alleviated from the present teaching approach, although there is still denite room for improvement. Nevertheless, the prevalence of misconceptions from level 1 to 3 study indicates that the present classroom and laboratory teaching strategies do not appear to be achieving the the desired outcomes. In agreement with Michael et al. (16), it is clear that something we do or say in the classroom or include in our written materials will contribute to students developing a misconception. One such activity has been suggested to be the imprecise use of language by teachers and students (22). Jacobs (8) also noted that every science discipline uses terms from everyday (lay) language that have special meanings within the discipline, e.g., elasticity. Incorrect use of such terms may therefore lead to the formation of a misconception. Visual representations in the classroom (22) and oversimplied analogies (6) have also been proposed as origins of misconceptions in science. With this in mind, it is apparent that we must strive for precision and clarity in our words (or visual aids) so that what we seek to communicate is actually what is communicated. In addition to classroom practices, it is also possible that many misconceptions may be due to conicting research literature or ill-informed and vaguely written textbooks. This may be particularly the case with some of those misconceptions identied here, such as lactate metabolism and determinants of endurance performance. For example, the function of lactate was the subject of a Point-Counterpoint debate between established researchers in recent editions of the Journal of Applied Physiology in 2006 (1, 9 11). Furthermore, some O2 max as the most important determinant of authors still cite V endurance performance (12) despite the wealth of research evidence supporting the lactate threshold as the most important predictor (2). In a similar manner to teachers in the classroom, textbook authors should also strive for precision and clarity in their words when drafting texts. Having an awareness of common misconceptions and an appreciation of students understanding would appear to be a good starting point when undertaking the writing process. Experiences outside of the classroom have also been postulated as possible sources of misconceptions (16). This could potentially be the case with the present study with areas such as lactate and fatigue or with integration of lipid and carbohydrate metabolism. For example, many sports commentators and members of the general public frequently report buildup of lactic acid as a cause of fatigue during competition. The wealth of advertisement campaigns promoting the importance of carbohydrate sport drinks for optimal performance also create the perception that lipids are not an important fuel source during

sport and exercise. It is, of course, difcult to say whether reasons such as these are the origin of those misconceptions identied here. Nevertheless, as teachers and scientists, we have the responsibility to correctly inform the general public and media of relevant research ndings. It should also be noted that many of the students studied here exhibited correct answers to the multiple-choice questioning but upon justifying their reasoning were unable to provide evidence of understanding behind the topic in question. In such circumstances, the extent of the misconception identied therefore appears underestimated. In agreement with Michael et al. (17), we also observed that students may understand less than they appear to know. These data suggest that students may have been able to memorize a particular fact they have read in a textbook or heard in the lecture theater but have not developed an understanding of how the fact has arisen. Regardless of the precise source of the misconception, it is essential that we are aware of the existence of the misconception in the rst instance. Indeed, it is possible that many of the current teaching staff involved in delivering those modules in question in the present study may have been unaware of the presence of the misconception. Furthermore, if not aware of such basic misconceptions, it is likely that such staff therefore pitch the lecture at a level that is beyond the current level of student understanding. Formal identication of misconceptions would therefore seem an appropriate and invaluable introductory activity for which to implement to understand the learners needs and current level of understanding while also promoting an aligned curriculum. Potential teaching strategies. Once a misconception has been identied, the logical progression is to formulate teaching strategies to remediate and/or prevent a reoccurrence for future years. Suggested teaching approaches include active laboratory experience to provide an understanding of the particular phenomena and also an interactive learning environment in the classroom (3, 15, 21). Where students do not have access to appropriate laboratory instrumentation, it has also been suggested that teaching with classic papers can lend itself to the exercise physiology and biochemistry discipline. For example, Brown (5) reported how teaching with the classic paper of Gollnick et al. (7) was especially useful for illuminating the exercise-specic differences in bioenergetic enzymes, muscle ber type, and tness characteristics that exist between untrained and trained individuals. Given the nature (and also the interrelationships) of the misconceptions identied here, all of the above approaches appear suitable. Table 4. Percentages of students at each level of study who displayed a misconception in understanding to questions 19
Student Population Misconception Question Level 1 Level 2 Level 3

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Question 1 Question 2 Question 3 Question 4 Question 5 Question 6 Question 7 Question 8 Question 9

85 87 44 100 84 56 63 81 78

80 50 43 95 75 50 84 61 54

60 19 72 97 90 57 68 67 80

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146 COMMON STUDENT MISCONCEPTIONS IN EXERCISE PHYSIOLOGY AND BIOCHEMISTRY 3. Biggs J. Teaching for Quality Learning at University. Buckinghamshire, UK: SRHE/OU, 2003. 4. British Association of Sport and Exercise Sciences. What Is BASES? (online). http://www.bases.org.uk/newsite/aboutbases.asp [17 October 2007]. 5. Brown GA. Teaching skeletal muscle adaptations to aerobic exercise using an American Physiological Society classic paper by Dr. Philip Gollnick and colleagues. Adv Physiol Educ 30: 113118, 2006. 6. Glynn SM. Explaining science concepts: a teaching with analogies model. In: The Physiology of Learning Science, edited by Glynn SM, Yeany RH, Briton BK. Hillsdale, NY: Erlbaum, 1991, p. 219 240. 7. Gollnick PD, Armstrong RB, Saubert CW, Piehl K, Saltin B. Enzyme activity and bre type composition in skeletal muscle of trained and untrained men. J Appl Physiol 33: 312319, 1972. 8. Jacobs G. Word usage misconceptions among rst year university physics students. Int J Sci Educ 11: 1056 1065, 1989. 9. Lamb GD, Stephenson DG. The Last Word: Point:Counterpoint authors respond to commentaries on Lactic acid accumulation is an advantage/ disadvantage during muscle activity. J Appl Physiol 101: 369 369, 2006. 10. Lamb GD, Stephenson G, Bangsbo J, Juel C. Point:Counterpoint: Lactic acid accumulation is an advantage/disadvantage during muscle activity. J Appl Physiol 100: 1410 1412, 2006. 11. Lindinger MI, Brooks GA, Henderson GC, Hashimoto T, Mau T, Fattor JA, Horning MA, Hussien R, Cho H-S, Faghihnia N, Zarins Z, Gladden LB, Hogan MC, Vissing J, Tupling R. Lactic acid accumulation is an advantage/disadvantage during muscle activity. J Appl Physiol 100: 2100 2102, 2006. 12. MacMillan K, Helgerud J, MacDonald R, Hoff J. Physiological adaptations to soccer specic endurance training in professional youth soccer players. Brit J Sports Med 39: 273277, 2007. 13. Michael JA. Students misconceptions about perceived physiological responses. Adv Physiol Educ 19: 90 98, 1998. 14. Michael JA. Misconceptionswhat students think they know. Adv Physiol Educ 26: 5 6, 2002. 15. Michael JA. Wheres the evidence that active learning works. Adv Physiol Educ 30: 159 167, 2006. 16. Michael JA, Richardson D, Rovick A, Modell H, Bruce D, Horwitz B, Hudson M, Silverthorn D, Whitescarver S, Williams S. Undergraduate students misconceptions about respiratory physiology. Adv Physiol Educ 22: 127135, 1999. 17. Michael JA, Wenderoth MP, Modell HI, Cliff W, Horwitz B, McHale P, Richardson D, Silverthorn D, Williams S, Whitescarver S. Undergraduates understanding of cardiovascular phenomena. Adv Physiol Educ 26: 72 84, 2002. 18. Morton JP. Teaching the sport sciences: is it time for us to teach in the way that we do research. Sport Exerc Scient 11: 10 11, 2007. 19. Morton JP. The active review: one nal task to end the lecture. Adv Physiol Educ 31: 236 237, 2007. 20. Oliveira GA, Sousa CR, Da Poian AT, Luz MRM. Students misconception about energy yielding metabolism: glucose as the sole metabolic fuel. Adv Physiol Educ 27: 97101, 2003. 21. Silverthorn DU. The Claude Benard distinguished lectureship: teaching and learning in the interactive classroom. Adv Physiol Educ 30: 135140, 2006. 22. Veiga MD, Costa Pereira D, Maskill R. Teachers language and pupils ideas in science lessons: can teachers avoid reinforcing wrong ideas? Int J Sci Educ 11: 465 479, 1989.

Limitations of the study design. The present study may be limited in terms of the wording of questions in our Misconceptions Inventory. For example, we have previously discussed how the wording of the question relating to contractile processes may have confused the student. It is also possible that the question testing students understanding of when lactate was made was misleading given that students may have interpreted this to mean predominantly made. Clearly, we should strive for precision and clarity in our wording and also design questions that more directly test the misconception being targeted. For example, in this instance, it would have been more benecial if such a question had graphs depicting what happens to the lactate concentration under conditions of hypoxia, normoxia, anoxia, and exercise so as to more robustly test students understanding of lactate production. Summary. This study represents the rst known attempt to undercover some of the misconceptions that SES students may have when studying physiology- and biochemistry-related areas of the progression of their degree. It is only when we can understand our students current levels of understanding can we begin to formulate teaching strategies to facilitate meaningful and successful learning. Formative assessment of relevant topics via online multiple-choice questioning (delivered at the beginning of a particular module or at appropriate points of study) may be one potential user-friendly avenue of how to obtain such information. These data also demonstrated that students may appear to understand less than they know, and, in this regard, it is essential that we focus on implementing teaching learning activities that develop thought and understanding rather than making students remain as passive recipients of facts. An interactive classroom environment, active laboratory experience, carefully chosen assessment tasks, and a well-aligned curriculum would appear to be essential activities for such higher-order learning to take place. Finally, once we understand the level of understanding of our students, it should be our duty as educators to provide comprehensible, easy-tofollow, integrative, and affordable texts to serve the undergraduate student population. Given the current direction of exercise physiology and biochemistry research, such texts should be drawn from a variety of scientic disciplines (e.g., molecular biology, biochemistry, and physiology) and deal with various levels of chemical organization (molecular to organism).
REFERENCES 1. Bangsbo J, Juel C. Reply: The Last Word: Point:Counterpoint authors respond to commentaries on Lactic acid accumulation is an advantage/ disadvantage during muscle activity. J Appl Physiol 101: 369 370, 2006. 2. Bassett DR, Howley ET. Limiting factors for maximal oxygen uptake and determiants of endurance performance. Med Sci Sport Exer 32: 70 84, 2000.

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