More than a module of autonomic function tests: student perceptions of a skill-based physiology elective

Autonomic function testing (AFT) is crucial for assessing autonomic nervous system integrity and diagnosing dysautonomia. However, AFT remains underrepresented in undergraduate physiology curricula worldwide. Limited evidence exists on how structured, skill-based AFT modules influence medical students' perceptions of learning within a competency-based framework. This study evaluated third-year medical students' perceptions of a structured AFT elective emphasizing experiential learning and faculty-guided skill acquisition and designed to bridge theoretical knowledge with clinical application. Ten third-year medical students participated in a 2-wk AFT elective combining lectures, hands-on testing, student presentations, and clinical case discussions. We employed a mixed-methods approach using structured questionnaires with 5-point Likert-scale items and open-ended questions. Quantitative data were analyzed descriptively, whereas qualitative responses underwent thematic analysis. Students reported uniformly high satisfaction across domains, including clarity of objectives (4.83 ± 0.22), clinical relevance (4.93 ± 0.10), and hands-on sessions (4.81 ± 0.18). The pretest-posttest analysis following the first lecture showed significant improvement (mean difference = 2.75, <i>P</i> = 0.0017). Thematic analysis revealed seven major themes: experiential learning, theory-practice integration, faculty engagement, student seminars, Objective Structured Clinical Examination (OSCE) assessment, curriculum expansion, and clinical preparedness. We conclude that integrating AFT electives within competency-based medical education (CBME) frameworks can enhance engagement, reinforce physiology-clinic integration, and stimulate student interest in underrepresented domains such as autonomic testing. This pilot provides a replicable model for embedding experiential learning into undergraduate physiology education.<b>NEW & NOTEWORTHY</b> This study presents a holistic systematic evaluation of an autonomic function testing (AFT) elective integrated into undergraduate medical education. We demonstrated that hands-on AFT training achieves high student satisfaction and enhances clinical confidence in the diagnosis of dysautonomia. The AFT teaching and assessment framework offers a replicable model for other institutions seeking to implement skill-based AFT electives. The findings of the study address a critical gap in medical education, where AFT remains underrepresented despite its growing clinical importance.