Unpacking and validating the "cell-cell communication" core concept of physiology by an Australian team

An Australia-wide consensus was reached on seven core concepts of physiology, one of which was cell-cell communication. Three physiology educators from a "core concepts" Delphi task force "unpacked" this core concept into seven different themes and 60 subthemes. Cell-cell communication, previously unpacked and validated, was modified for an Australian audience to include emerging knowledge and adapted to increase student accessibility. The unpacked hierarchical framework for this core concept was rated by 24 physiology educators from separate Australian universities, using a five-point scale for level of importance for student understanding (ranging from 1 = Essential to 5 = Not Important) and level of difficulty (ranging from 1 = Very Difficult to 5 = Not Difficult). Data were analyzed with the Kruskal-Wallis test with Dunn's multiple comparison test. The seven themes were rated within a narrow range of importance (1.13-2.4), with ratings of Essential or Important, and statistically significant differences between the themes (P < 0.0001, n = 7). The variance for the difficulty rating was higher than for importance, ranging from 2.15 (Difficult) to 3.45 (between Moderately Difficult and Slightly Difficult). Qualitatively, it was suggested that some subthemes were similar and that these could be grouped. However, all themes and subthemes were ranked as Important, validating this framework. Once finalized and adopted across Australian universities, the unpacked core concept for cell-cell communication will enable the generation of tools and resources for physiology educators and improvements in consistency across curricula.NEW & NOTEWORTHY Seven core concepts, including cell-cell communication, were identified by an Australian Delphi task force of physiology educators. The previously "unpacked" concept was adapted for Australian educators and students to develop a framework with seven themes and 60 subthemes. The framework was successfully validated by the original Delphi panel of educators and will provide a valuable resource for teaching and learning in Australian universities.