A Multimedia Learning Object to Teach the Cardiac Cycle

Introduction: Interactive multimedia learning activities facilitate learning by engaging students through interactivity, sight, sound, and immediate feedback (1). The current study determined the effectiveness of a multimedia learning object (MMLO) activity to help students in a sophomore-level human physiology class to learn the sequence of events that occur during the cardiac cycle. We hypothesized that engaging with the MMLO would improve student perceptions of learning and learning outcomes assessed by multiple choice questions. Methods: We adapted a published pen and paper cardiac cycle puzzle into an accessible, freely available multimedia learning object (2). The Cardiac Cycle MMLO activity is in the form of a drag-and-drop puzzle that can be accessed using a computer, phone, or tablet. The puzzle can be completed in steps by considering one part of the heart at a time, or by considering one phase of the cardiac cycle at a time. Immediate feedback is provided at each step. It can also be done all at once (without guidance) as a more challenging activity. Students were provided with a link to the activity to practice their knowledge of the cardiac cycle outside of class. Student perceptions about whether the MMLO was useful were obtained using an anonymous Qualtrics survey. Student learning outcomes were assessed by comparing the percentage of correct answers to multiple choice quiz questions completed by students who used the MMLO (53 students who were quizzed in 2023) with those of an historical group of students who participated in the pen and paper activity on which the MMLO was based (80 students from 2021 and 2022). Results: BEFORE using the MMLO, 18% of students agreed or strongly agreed that they could accurately identify the correct sequence of events in one cardiac cycle. This percentage increased to 82% of students AFTER using the MMLO. When asked to what extent students thought that any differences in the ratings they gave for 'BEFORE' and 'AFTER' were the result of using the MMLO, 49% answered ‘mostly due to learning object’, 42% ‘partly due to learning object’, 4.5% ‘partly due to other factors’ and 4.5% were uncertain. The percentage of correct student responses to multiple choice questions was higher in the group that used the MMLO when asked about the state of the atrioventricular values during the phase of passive filling (92%), the state of the semilunar valves during ventricular isovolumetric contraction (74%), the state of the atria during ventricular isovolumetric contraction (79%), and the correct sequence of contraction of parts of the heart (89%) compared with historical data from students who used the pen and paper activity (80%, 69%, 68%, and 83%, respectively). Conclusion: The data suggest that the MMLO based on the cardiac cycle puzzle can complement lecture content to increase student confidence in their ability to correctly identify the correct sequence of events in one cardiac cycle and improve learning outcomes. 1. Mayer RE. Multimedia learning. Psychology of Learning and Motivation. Academic Press. 2002. Volume 41, p85-139. 2. Marcondes FK, Moura MJ, Sanches A, Costa R, de Lima PO, Groppo FC, Amaral ME, Zeni P, Gaviao KC, Montrezor LH. A puzzle used to teach the cardiac cycle. Adv Physiol Educ. 2015 Mar;39(1):27-31. This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.