Microbiology, Pharmacology, and Immunology for Pre-Clinical Students

Virginia Tech Publishing eBooks · 2025-04-15

<br><i><b>Microbiology, Pharmacology, and Immunology for Pre-Clinical Students</i></b> is a peer-reviewed open textbook designed to fill a gap in undergraduate medical education (UME) and support medical school pre-clerkship education. It covers the areas of immunology, microbiology, systems-based infections, and global mechanisms of treatment. It is aligned to USMLE® (United States Medical Licensing Examination) and modified from OpenStax Microbiology. The organization of this resource is driven by curricular structure to enhance integrated, multidisciplinary content delivery. This specific resource is intended to be used in various ways, mainly as a student quick-reference guide. The sections are not intended to be all-inclusive, but are primers for applied content delivery. The resource is organized into small chapters that can be used to support student preparation in any arrangement. Similarly, clinical context is only briefly discussed (or purposefully omitted) in order to allow the user to apply the basic content presented here in the clinical context used by their specific curricular structure. As cases and clinical correlates change regularly, it is beneficial to have flexible, short resources that can be applied to many scenarios. <b>Are you reviewing or adopting this book for a course?</b> <br>Please help us understand your use by filling out <b><a href="https://bit.ly/interest-preclinical">this form</a></b>. <b>How to access the book</b> <br>The main landing page for this book is <a href="https://doi.org/10.21061/micropharmimmuno">https://doi.org/10.21061/micropharmimmuno</a>. <br>The PDF and EPUB versions are available to download on the left-hand side of the screen. <br>An online, accessible version of the book is available in <b><a href="https://pressbooks.lib.vt.edu/micropharmimmuno/">Pressbooks</a></b>. <br>A paperback print version (in color) is <b><a href="https://www.amazon.com/dp/1962841022">available for order here</a></b>. <b>ISBNs</b> <br>ISBN (PDF): 978-1-962841-04-7 <br>ISBN (<a href="https://pressbooks.lib.vt.edu/micropharmimmuno/">Pressbooks</a>): 978-1-962841-05-4 <br>ISBN (<a href="https://www.amazon.com/dp/1962841022">Print</a>): 978-1-962841-02-3 <br>ISBN (EPUB): 978-1-962841-03-0 <b>Table of contents</b> 1. Host Defenses, Immunodeficiencies, and Autoimmune Disorders 2. Basic Microbiology 3. Systemic Infections of the Skin 4. Systemic Infections of the Oral Cavity and GI 5. Systemic Infections of the Respiratory Tract 6. Systemic Infections of the Circulatory and Lymphatic Systems 7. Systemic Infections of the Urinary System 8. Systemic Infections of the Nervous System 9. Foundations of Disease Management <b>Find, adapt, and share resources</b> <br>If you wish to share resources you build from this book or find those shared by other adopters of this book, please join the <b><a href="https://oercommons.org/groups/pre-clinical-resources/10133/">instructor portal</a></b>. <b>Attribution</b> <br>The base of the book is from OpenStax <a href="https://openstax.org/details/books/microbiology"><i>Microbiology</i></a> by Nina Parker et al, which is licensed with a <a href="https://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution 4.0 (CC BY 4.0) license</a>, much of which was reworded and reorganized. <b>About the adapters</b> <br><b>Jennifer L. Cleveland</b> is an assistant professor in the Department of Basic Science at Virginia Tech Carilion School of Medicine. She received a PharmD and MBA degree from Shenandoah University and has practiced in a variety of settings including hospitals, home healthcare, and independent pharmacy. She began her journey in clinical education at Jefferson College of Health Sciences, where she was instructor of clinical pharmacotherapeutics for physician assistant students for nine years. In 2017, she transitioned to Virginia Tech Carilion School of Medicine where her role includes teaching pharmacology to first- and second-year medical students, codirecting the problem-based learning curriculum, integrating pharmacology within clinical science, and facilitating small group sessions in the Health Systems Science and Interprofessional Practice program. With her background in clinical pharmacy and board-certification as a pharmacotherapy specialist, she brings a unique blend of expertise in her role as a medical educator. <b>Andrew P. Binks</b> is a cardiopulmonary physiologist who gained his BSc (Hons) in Physiological Sciences at the University of Newcastle upon Tyne and a MSc in Human and Applied Physiology from King’s College, London. He returned to Newcastle to complete his PhD and study the underlying physiological mechanisms of dyspnea, the cardinal symptom of cardiopulmonary disease. He continued investigating dyspnea at Harvard School of Public Health as a postdoctoral fellow and then as a research scientist. After seven years at Harvard, Andrew took his first faculty position at the University of New England where he taught cardiovascular and pulmonary physiology to health professionals and medical students. He continued to teach heart and lung physiology after moving to the University of South Carolina’s Medical School in Greenville where he also directed the school’s heart and lung pathophysiology courses. Andrew currently teaches heart and lung physiology and pathophysiology at Virginia Tech Carilion School of Medicine, directs the heart and lung pathophysiology course, and has previously served as the departmental director of faculty development. <b>Renée J. LeClair</b> is an Associate Professor in the Department of Basic Science Education at the Virginia Tech Carilion School of Medicine. Her role is to engage activities that support the departmental mission of developing an integrated medical experience using evidence-based delivery grounded in the science of learning. She received a PhD at Rice University and completed a postdoctoral fellowship at the Maine Medical Center Research Institute in vascular biology. She became involved in medical education, curricular renovation, and implementation of innovative teaching methods during her first faculty appointment, at the University of New England, College of Osteopathic Medicine. In 2013, she moved to University of South Carolina, School of Medicine, Greenville. The opportunities afforded by joining a new program and serving as the Chair of the Curriculum committee provided a blank slate for creative curricular development and close involvement with the accreditation process. During her tenure she developed and directed a team-taught, student-centered undergraduate medical course that integrated the scientific and clinical sciences to assess the six-core competencies of medical education. <b>Suggested citation</b> <br>Cleveland, Jennifer L., Binks, Andrew P., and LeClair, Renée J. (2025). <i>Microbiology, Pharmacology, and Immunology for Pre-Clinical Students</i>. Roanoke: Virginia Tech Carilion School of Medicine. <a href="https://doi.org/10.21061/micropharmimmuno">https://doi.org/10.21061/micropharmimmuno</a>. Licensed with <a href="https://creativecommons.org/licenses/by/4.0/">CC BY 4.0</a>. <b><a href="https://bit.ly/feedback-preclinical">Report an error</a></b> | <b><a href="https://bit.ly/errata_micropharmimmuno">View errata</a></b> <b>Funding and project support</b> <br>This publication was made possible in part through funding and publishing support provided by the <a href="https://guides.lib.vt.edu/oer">Open Education Initiative</a> of the University Libraries at Virginia Tech. <b>Accessibility statement</b> <br>Virginia Tech is committed to making its publications accessible in accordance with the Americans with Disabilities Act of 1990. The text, images, and links in the PDF version of this text are tagged structurally and include alternative text, which allows for machine readability. We are continuously working to improve accessibility and welcome any feedback from readers. <b>Disclaimer</b> <br>This work may contain components (e.g., illustrations, or quotations) not covered by the license. Every effort has been made to clearly identify these components but ultimately it is your responsibility to independently evaluate the copyright status of any work or component part of a work you use, in light of your intended use. Please check the references at the end of each chapter or consult the source material from OpenStax before redistributing.

Gaining Empathy for the Learner: A Way to Identify Unique Themes and Patterns in Medical Student Experiences

Medical Science Educator · 2025-10-28

A variety of program evaluation tools are used in medical education, including grade-based, narrative, and quantitative methods. While providing valuable feedback, they may not fully capture the lived experiences of the learner. To enhance understanding and empathy for the medical school experience, we conducted ethnographic interviews of learners across all years of training. Emergent themes were compared with feedback from traditional instruments. Our empathetic methods not only confirmed themes identified through conventional evaluations but also revealed additional factors that heavily impacted learners. This highlights the need for empathic, human-centered approaches to generate a holistic picture that better informs programmatic change. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-025-02547-w.

The Impact of Changing Step 1 to Pass/Fail Reporting on Anxiety, Learning Approaches, and Curiosity

Medical Science Educator · 2023-09-18 · 9 citations

An integrated pre-clerkship curriculum to build cognitive medical schema: It’s not just about the content

Frontiers in Physiology · 2023 · 4 citations

• Computer Science
• Computer Science
• Psychology

Both physiology and pathophysiology are essential disciplines in health professional education however, clinicians do not use this knowledge in isolation. Instead, physicians use inter-disciplinary concepts embedded within integrated cognitive schema (illness scripts) established through experience/knowledge that manifest as expert-level thinking. Our goal was to develop a pre-clerkship curriculum devoid of disciplinary boundaries (akin to the physician's illness script) and enhance learners' clerkship and early clinical performance. As well as developing curricular content, the model considered non-content design elements such as learner characteristics and values, faculty and resources and the impact of curricular and pedagogical changes. The goals of the trans-disciplinary integration were to develop deep learning behaviors through, 1) developing of integrated, cognitive schema to support the transition to expert-level thinking, 2) authentic, contextualization to promote knowledge transfer to the clinical realm 3) allowing autonomous, independent learning, and 4) harnessing the benefits of social learning. The final curricular model was a case-based approach with independent learning of basic concepts, differential diagnosis and illness scripting writing, and concept mapping. Small-group classroom sessions were team-taught with basic scientists and physicians facilitating learners' self-reflection and development of clinical reasoning. Specifications grading was used to assess the products (written illness scripts and concept maps) as well as process (group dynamics) while allowing a greater degree of learner autonomy. Although the model we adopted could be transferred to other program settings, we suggest it is critical to consider both content and non-content elements that are specific to the environment and learner.

Cardiovascular Pathophysiology for Pre-Clinical Students

Virginia Tech Publishing eBooks · 2022-03-22 · 1 citations

preclinical. This assists the Open Education Initiative at Virginia Tech in assessing the impact of the book and allows us to more easily alert instructors of additional resources, features and opportunities.

Contributors

Elsevier eBooks · 2022-01-01 · 1 citations

Pulmonary Pathophysiology for Pre-Clinical Students

Virginia Tech Publishing eBooks · 2022-05-26 · 2 citations

<br><b><i>Pulmonary Pathophysiology for Pre-Clinical Students</i></b> is an undergraduate medical-level resource for foundational knowledge of pulmonary pathophysiology. This text is designed for a pre-clinical undergraduate medical curriculum and is aligned to USMLE(r) (United States Medical Licensing Examination) content guidelines. The text is meant to provide the essential information in a concise format that would allow learner preparation to engage in an active classroom. Clinical correlates and additional application of content is intended to be provided in the classroom experience. The text assumes that the students will have an understanding of basic pulmonary physiology that will be helpful to understand the content presented here. This resource should be assistive to the learner later in medical school and for exam preparation given the material is presented in a succinct manner, with a focus on high-yield concepts. The 82-page text was created specifically for use by pre-clinical students at Virginia Tech Carilion School of Medicine and was based on faculty experience and peer review to guide development and hone important topics. <b>Available formats</b> <br>ISBN (PDF): 978-1-957213-08-8 <br>ISBN (EPUB): 978-1-957213-11-8 <br>ISBN (print): 978-1-957213-09-5 <br><a href="https://www.amazon.com/Pulmonary-Pathophysiology-Pre-Clinical-Students-Andrew/dp/1957213094">Order a print copy here</a> <br>ISBN (Pressbooks): 978-1-957213-10-1 <br><a href="https://pressbooks.lib.vt.edu/pulmonarypathophysiology">Pressbooks</a> <br><a href="https://med.libretexts.org/@go/page/34444">Also available via LibreTexts</a> <b><a href="https://bit.ly/feedback-preclinical">Report errors</a></b> <b>How to adopt this book</b> <br>Instructors reviewing, adopting, or adapting parts or the whole of the text are requested to register their interest by filling out <b><a href="https://bit.ly/interest-preclinical">this form</a></b>. Instructors and subject matter experts interested in and sharing their original course materials relevant to pre-clinical education are requested to join the <b><a href="https://www.oercommons.org/groups/pre-clinical-resources/10133">instructor portal</a></b>. <b>Features of this book</b> - Detailed learning objectives are provided at the beginning of each chapter; - High resolution, color contrasting figures illustrate concepts, relationships, and processes throughout; - Subsection summary tables - End of chapter lists provide additional sources of information; and - Accessibility features including structured heads and alternative-text provide access for readers accessing the work via a screen-reader. <b>Table of contents</b> 1. The Obstructive Lung Diseases 2. Upper Airway Infections 3. Lower Airway Infections 4. The Restrictive Lung Diseases 5. Acute Respiratory Distress Syndrome 6. Lung Cancer 7. Pulmonary Embolism 8. Immunological Diseases of the Lung 9. Pleural Disease <b>Suggested citation</b> <br>Binks, Andrew., (2022). <i>Pulmonary Pathophysiology for Pre-Clinical Students</i>, Roanoke: Virginia Tech Carilion School of Medicine. <a href="https://doi.org/10.21061/pulmonarypathophysiology">https://doi.org/10.21061/pulmonarypathophysiology</a>. Licensed with <a href="https://creativecommons.org/licenses/by-nc-sa/4.0">CC BY NC-SA 4.0.</a> <b>Other titles in this series</b> - LeClair, R., (2021) <a href="https://doi.org/10.21061/cellbio">Cell Biology, Genetics, and Biochemistry for Pre-Clinical Students</a> - LeClair, R., (2022) <a href="https://doi.org/10.21061/neuroscience">Neuroscience for Pre-Clinical Students</a> - Binks, A., (2022) <a href="https://doi.org/10.21061/cardiovascularpathophysiology">Cardiovascular Pathophysiology for Pre-Clinical Students </a> - Binks, A., (2022) <a href="https://doi.org/10.21061/pulmonaryphysiology">Pulmonary Physiology for Pre-Clinical Students</a>  <b>About the author</b> <br>Dr. Andrew Binks is a cardiopulmonary physiologist who gained his BSc (Hons) in Physiological Sciences at the University of Newcastle upon Tyne, then a MSc in Human and Applied Physiology from King’s College, London. He returned to Newcastle to do his PhD and study the underlying physiological mechanisms of dyspnea, the cardinal symptom of cardiopulmonary disease. He continued investigating dyspnea at Harvard School of Public Health as a postdoctoral fellow and then as a research scientist. After seven years at Harvard, Andrew took his first faculty position at the University of New England where he taught cardiovascular and pulmonary physiology to health profession and medical students. He continued to teach medical students their heart and lung physiology after moving to the University of South Carolina’s Medical School in Greenville where he also directed the school’s heart and lung pathophysiology courses. Andrew currently teaches heart and lung physiology and pathophysiology at Virginia Tech Carilion School of Medicine, directs the heart and lung pathophysiology course and has also served as the departmental director of faculty development. In his two decades of teaching medical physiology, Andrew has regularly drawn upon his dyspnea research experience to generate an active, clinically focused approach to medical education. This book is part of that approach and supports students preparing for class with the basic information with the intention to apply and contextualize that information in a guided case-based classroom experience. Andrew has published numerous peer-reviewed research papers and book chapters about dyspnea and about contemporary medical education. He has also given keynote presentations, faculty workshops and international webinars to promote effective medical education for the modern adult learner. <b>Accessibility note</b> <br>The University Libraries at Virginia Tech and Virginia Tech Publishing are committed to making its publications accessible in accordance with the Americans with Disabilities Act of 1990. The HTML (Pressbooks) and ePub versions of this book utilize header structures and include alternative text which allow for machine-readability.

Dyspnea

Handbook of clinical neurology · 2022-01-01 · 10 citations

Localizing the expression of Piezo2 in healthy and diseased lung tissue

The FASEB Journal · 2022-05-01

Intractable air hunger remains one of the most impactful symptoms of chronic cardiopulmonary disease and current pharmacological management remains limited. However, an endogenous mechanism for air hunger relief exists. Pulmonary stretch receptors (PSRs) responding to lung inflation reduce the brainstem drive to breathe and mitigate air hunger. Harnessing this mechanism could form the basis of a novel therapy. Recent animal studies suggest Piezo2, a mechanically‐gated cation channel, causes PSR depolarization when airway smooth muscle is stretched during inflation. We have assessed whether Piezo2 is associated with PSRs in healthy and diseased human airways to determine whether Piezo2 is a potential pharmaceutical target. Methods Human lung biopsies from NIH Lung Tissue Research Consortium were used for identification of Piezo2 receptors in emphysema, fibrosis, bronchiolitis, and normal lung tissue. Localization of Piezo2 was determined with immunofluorescent staining and imaged with confocal microscopy (Zeiss LSM880). As PSR fiber endings are associated with airway smooth muscle, co‐staining for Smooth Muscle Antibody (SMA) and Calcitonin Gene‐Related Peptide (CGRP) was performed to determine whether Piezo2 is associated with PSR. Summary of results Piezo2 is associated with airway smooth muscle (as evidenced by SMA, figure 1) and neuroepithelial bodies in normal human lung tissue (evidenced by cGRP, figure 2) and expression persisted in all disease states tested. Conclusions Piezo2 location is consistent with that of PSR in human lungs, making it a candidate for the mechanoreceptive transducer of human PSRs as has been demonstrated in animal studies. Expression persists in disease, making Piezo2 a potential therapeutic target, but it is still yet to be determined if Piezo2 is more significantly associated with airway or vascular smooth muscle in different disease states.

A Simple and Sustainable Exercise to Enhance Student Self-Reflection on Error-Making, Focus Support, and Guide Curricular Design

Teaching and Learning in Medicine · 2022-02-23 · 6 citations

Problem: Self-reflection is a critical component of professional development and clinical practice, but medical students’ ability to self-reflect is typically limited. While inadequate self-reflection impacts future clinical decision-making, it may also adversely impact current learning through an inability to identify learning-behavior deficits. This may be exacerbated by common use of multiple-choice questions (MCQ) where incorrect responses provide less insight than other measures for students, faculty, or academic support. To address this, an Error Reflection Method (ERM) was developed to help students focus on ‘why’ they got an MCQ wrong rather than ‘what’ they got wrong, thereby promoting self-reflection and a learning-focus on assessment. Understanding students’ learning-behavior deficits could also enrich engagement with academic support services and guide curricular design. Intervention: The ERM is a list of 10 common types of exam errors that were either ‘test-taking’ (unwitting) errors or ‘learning-behavior’ errors that reflected learning deficits. The ERM is simple, transferable, and sustainable, allowing longitudinal and regular monitoring of individual and collective error-making to focus support and guide curricular development. Context: Undergraduate medical students at the Virginia Tech Carilion School of Medicine, USA, used the ERM in formative assessment review sessions in pre-clinical years to select an error type that best described the cause of each incorrect response. Impact: Initial findings suggest the ERM is robust and associated with improved student performance and curricular development. Analysis of 3,775 student-identified errors showed the error types in the ERM described 96% of errors students made. Learning-behavior errors were more common (76%), but surprisingly, 19% were test-taking errors, allowing academic support to focus on test-taking skills in a population previously thought of as consummate test-takers. The most common error type reported was ‘the content looked familiar but I couldn’t answer the question’ (32%); which we suggest is consistent with shallow learning. This finding has helped steer recent curricular development toward active and applied learning techniques. Lessons Learned: By formally and regularly identifying learning deficits, students may be more capable of addressing them and improve summative exam performance. As well as focusing academic support, understanding common student errors has been useful in guiding curricular design and content delivery. Further potential of the ERM may be realized in faculty development and directing assessment culture toward a learning focus.