Balancing act: enhancing student comprehension of acid-base physiology through interactive, system-based teaching

Acid-base physiology is widely recognized as one of the most conceptually challenging topics in undergraduate education due to its interdisciplinary nature and the necessity for both mechanistic and integrative understanding. This article presents a structured, system-based teaching framework designed to enhance student comprehension of acid-base balance by promoting active learning and conceptual integration across organ systems. The instructional model is organized around four core modules: mastering terminology, identifying acid sources, exploring regulatory mechanisms, and understanding acid-base disorders. Notably, the approach introduces a specific sequence for concept delivery, supported by interactive in-class activities such as multiple-choice questions, open-ended prompts, pattern recognition tasks, physiological reflex analysis, and the construction of concept maps. This format encourages students to link molecular mechanisms with systemic outcomes and fosters the application of knowledge to clinical and everyday life scenarios.NEW & NOTEWORTHY This teaching strategy not only enhances understanding of acid-base regulation but also exemplifies how system-based integration, interactive learning, and scaffolded concept development can transform the delivery of complex physiological content. The integration of teleological reasoning with mechanistic analysis and the explicit teaching of homeostatic patterns improves higher order thinking. Implementation of this framework significantly improved student performance on acid-base physiology exam questions and reduced the proportion of students identifying acid-base balance as one of the most difficult topics.