Historically the discipline of Physiology has had 70Kg “Physiologic” man as a foundational reference model representing an assumed average individual from which “normal” values could be derived (Phillips, 2023). While this may prove useful, the limitations of the concept of “average” man have become more apparent recently, especially in the context of medical education and research with a diverse and global cohort of students, subjects and patients. Students who do not see themselves in the curriculum do not learn as effectively, (Ahmet, 2010; Koens et al., 2005) and the reliance on the male standard promotes a gendered stereotype of physiologic knowledge (Cheng & Yang, 2015).
To challenge the “Physiologic Man” model, we have designed a “Busting the Myth of 70Kg Man” practical to illustrate the wide variability in physiologic data across populations and challenge the myth that a “typical” human exists. Students measure height, weight, body fat percentage, stretch, jump and endurance performance in a practical class. As well as gaining experience in measuring human variables, participants get the opportunity to interpret data and draw inferences from raw numbers. That way, the skills of interpolation are inculcated as well as physiologic principles. The remit of the practical also includes issues around professionalism, informed (and immediately withdrawable) consent, anonymising data, bodily autonomy of volunteers, and awareness that the measurement of some variables (weight and body fat percentage) can be triggering.
After gaining ethics committee approval, a mixed methods approach was used combining both electronic survey data and focus group discussions from 2nd Year Medicine (Exercise and Applied Physiology Student Selected Component (n=14) and Science (Human Biology Degree Programme (n=4) students. The survey assessed students’ knowledge of and opinions on the importance of inclusion in the physiology curriculum and their lived experience of completing the practical (both as investigator and subject). Changes in attitudes on undertaking the practical were evaluated with pre- and post- practical Likert questionnaires that calculated responses to statements about the classes from 1 (Strongly disagree) to 5 (Strongly agree). Differences between groups were tested for significance using a Wilcoxon signed rank test. In addition, open questions supplemented the Likert semi-quantitative data, allowing students to express opinions and relate experiences. Focus groups were also conducted to give further opportunity to students to relay their experiences. Thematic analysis of the focus group transcripts and answers to open questions allowed us to develop themes using the framework of Braun and Clarke (2006).
Students disagreed with the contention that 70Kg man was an appropriate reference point for teaching physiologic norms (Mean (±SEM) Likert scores: Female=1.7±0.83, Male=2.2±0.4, Non Binary (NB) =1±0), with slightly more men than women thinking the model was appropriate. Similarly, males felt themselves better represented in the physiology curriculum ((Mean (±SEM) Likert scores: Male=3.8±1.2, Female=2.1±0.4, NB=2±0). Students found the experience of the practical profoundly affecting, gaining a regard for the importance of communication, emotional safety and the primacy of consent when gathering these data. Students especially stressed the importance of the instructor’s language and the tone of respect thus set.