Adaptation from a paper-based nephron manipulative to a hands-on electronic format to teach renal physiology,...

The complex processes of electrolyte transport across the nephron often pose learning challenges for medical students. Manipulatives are a means of providing an interactive learning experience that increases understanding and content retention. In this study, we updated our previous in-person, paper-based nephron manipulative into a digital, interactive PowerPoint format while also integrating clinical applications. Twenty-first-year medical students completed a premanipulative quiz (pretest) and then participated in the manipulative intervention, where they electronically dragged and positioned electrolytes/molecules onto corresponding transporters within each PowerPoint slide depicting specific nephron segments. Participants completed a postmanipulative quiz (posttest) and participated in a faculty-based discussion in that same session. A long-term knowledge assessment quiz (long-term test) was administered 9 mo later in their second year of medical school. A nonintervention group, consisting of 26 second-year medical students who did not participate in the nephron manipulative as first-year students, provided a comparison for the natural learning progression without the manipulative intervention. A statistically significant improvement was observed from pretest to posttest (P = 0.0093), confirming that the manipulative intervention produced a meaningful improvement in student learning in the short term. When comparing learning outcomes by question subject, Pharmacology questions showed a higher average gain (+0.13) compared to Physiology (+0.07), with less knowledge decay over time (-0.03 vs. -0.09). Student feedback was overwhelmingly positive. This electronic manipulative demonstrated success in interactive teaching of nephron physiology and pathophysiology concepts and is a valuable teaching tool due to its customizable design, available for free or at a low cost.NEW & NOTEWORTHY Our digital nephron manipulative offers an interactive teaching modality to nephron physiology, pathophysiology, and pharmacology education alongside clinical applications. Current attempts in the literature to provide engaging nephron physiology education do not offer students opportunities to electronically manipulate learning items in a hands-on manner. To the best of our knowledge, this updated digital nephron manipulative is the first of its kind to provide an electronic modality for a kinesthetic, hands-on manipulative integrated with clinical nephrology.