Dr. Bruce Wright, Ph. D.
About Dr. Bruce Wright, Ph. D.
Research Interests, Bruce Wright
Note: This Canvas page is updated, 3 April 2026).
Background: Dr. Bruce Wright received his Ph.D. in Physiology in 1993. He is Professor of Physiology at LECOM’s Seton Hill campus.
General Research Theme: Dr. Wright engages in educational research. He is particularly interested in creation and validation of new teaching tools for physiology and pathophysiology. He also is interested in other aspects of medical education, such as methodology for increasing interdisciplinary curricular integration both at the macro- and micro-scale. The first two projects listed below are the highest priority but two others are mentioned for those students who take an interest in them.
Research Projects:
- Research Project 1. The Wright Table of the Cardiac Cycle.
Background to current research: In 2006, Dr. Wright developed a teaching tool for the cardiac cycle (all the events that occur in one heartbeat) in a 4×4 table format which supplements the 100-year-old Wiggers diagram. In this format 4 virtual or actual compartments for one side of the heart (e.g., pulmonary veins, left atrium, left ventricle, and aorta are set up in vertical columns and four fluid-moving cardiac cycle phases (slow ventricular filling, atrial systole/active filling, ventricular systole/ejection, and rapid ventricular filling) are set up in rows from top to bottom. For each phase, pressures within each compartment demonstrate direction and speed of flow between compartments, showing the direct effect of changing pressures within the heart on changing flow patterns and ultimately moving blood from low-pressure veins into high-pressure arteries.
Following many years of use in teaching medical students, he copyrighted the concept in 2014, published his first abstract on it in 2017, and finally published an article in Advances in Physiology Education in September 2020 (1). As of this update (20 May 2024) has been downloaded 20,070 times. However, it has been cited only 3 times. One possible reason for the lack of citations is that this 4×4 table does not display isovolumic phases as separate phases, which are displayed in both anatomical models and in the Wiggers Diagram. To correct this, a new 5×7 “clinical” format for the Wright table has been created, which incorporates one new compartment, (jugular vein or the virtual “pulmonary capillaries), three new phases (two isovolumetric phases and a slow-ejection/protodiastole phase), and a reset such that all three filling phases come first. This has been published in abstract/poster form (2) but it warrants more refinement as indicated below.Research Project 1a. Qualitative validation of the 5×7 clinical Wright table as a teaching tool to undergraduate medical students. While one form of this was done face-to-face at one campus in 2020 for the original 4×4 variant, development of the particulars on how and when to carry out an introduction/validation for this 5×7 model on a multi-campus and/or multi-institution basis is not yet complete. This is an opportunity for a few students to come forward to help make this happen. Students working on this as a research project may possibly join others from Virginia Tech’s Carilion School of Medicine.
Status: Data collected, not yet formally analyzed. An animation of the Wright Table has been created but again not evaluated.Research Project 1b. Creation and validation of models of either or both the 4×4 and 5×7 variants of the Wright Table to demonstrate cardiac pathologies for use both in teaching and possibly in the clinic as well. For 4×4 tables, some of this was done in pilot form in 2020 and 2021 (2), but more needs to be done. For example, there are multiple ways using variants of the Wright table to illustrate how mild, moderate, or severe aortic stenosis might affect pressures and flows in these tables For the more detailed 5×7 format, no pathologies have yet been modeled. These pathophysiological models would have to be based on solid references, which have proved to be available (2). In this study, students would be creating and testing variants of Wright tables for different pathologies for the first time. These student-created tables would serve as a foundation for a larger work on application of the Wright table for use in clinic and beyond, not just in teaching. Project 1b is on a larger scope than is Project 1a, and will involve many more medical students in a coordinated effort, but its possible value in practice justifies the effort.
Projected student roles and numbers: Project 1a, validation: 1 or 2 students per campus to work with their respective research clubs to coordinate a session and work on both qualitative and quantitative validation methods. These projects could begin this summer between academic years. Project 1b, creation of pathophysiology variants of Wright Tables: Initially 1 or 2 students to work on creating new protocols or adapting prior protocols, to select appropriate pathologies for which other students will model, and to develop both qualitative and quantitative validation methods.
Status: Currently inactive but it could be revived if student researchers joined me this summer to lay the groundwork.
References:
1. Wright et al., 2020. The Wright Table of the Cardiac Cycle: A Stand-Alone Supplement to the Wiggers Diagram. The Wright table of the cardiac cycle: a stand-alone supplement to the Wiggers diagram | Advances in Physiology Education
2. Wright and Carvalho, 2022. Wright Table of the Cardiac Cycle: Expanding Applications to Clinical Settings. Wright table of the cardiac cycle: Expanding application to clinical settings | Physiology
—————- - Research Project 2: The Wright (OB) Variation of the Darrow-Yannet Diagram: A new tool to teach water homeostasis.
Background: The Darrow-Yannet (D-Y) diagram was first published in 1935 and later expanded into a general tool to teach water homeostasis, but its applicability to describe clinical conditions and consequences of therapy is very limited because it only has two compartments, intracellular fluid (ICF) and extracellular fluid (ECF). In 2021, Dr. Wright developed a three-compartment model incorporating both an out-of-body (OB) compartment, and a not-to-scale epithelial layer between ECF and OB to better show which proteins are involved in both physiology and pathology for each condition of altered water balance. Dr. Wright published an abstract/poster concept on this in 2021 (1), but validation of the concept as a teaching tool has not yet been done.
Research Project. Qualitative validation of the Wright variation of the D-Y diagram as a teaching tool to undergraduate medical students. Unlike that for the Wright table of the cardiac cycle, development of the particulars on how and when to carry out an introduction/validation for this model of water balance in health and disease on a multi-campus and multi-institution ) basis has not been performed at all. This is an opportunity for a few students to come forward to help make this happen. As in project 1a, students working on this as a research project might also work with those from another institution.
Projected student roles and numbers: 1 or 2 students per campus to work with their respective research clubs to coordinate a session and work on both qualitative and quantitative validation methods. This project could begin this summer between academic years.
Status: Pilot data collected from its inclusion in Boot Camp 2024, not yet analyzed. A more formal study involving volunteers to provide qualitative input has not been done.
REFERENCE: The Wright Variation of the Darrow‐Yannet Diagram: A New Tool to Teach Water Homeostasis – Wright – 2022 – The FASEB Journal – Wiley Online Library
——————— - Project 3: The Physician’s Statement.
The Physician’s Statement is a fifth-order evaluation-level NBME/NBOME-compatible format for multiple choice examination items. The abstract below highlights a two-item version but in the years that followed a one-item version became more standard and is the one we would be working on instead.
Projected student roles and numbers:
A. 1 second-year LECOM-Seton-Hill-campus student to help develop a few select Physician’s-Statement-format items for incorporation into student information sessions and to develop and implement qualitative student feedback on those items.
B: As an advanced project, 1 graduate level student to take control of this project and do one or more large-scale studies involving this and other formats for higher-order multiple choice item formats compatible with COMLEX-USA Level 1 and NBME Step 1, across different curricular programs. This would require approval by LECOM’s Department of Medical Education so it would not be immediately available as a project for this summer. For more information, contact me directly.
REFERENCE “The Physician’s Statement”: A novel test item strategy for medical education – Wright – 2010 – The FASEB Journal – Wiley Online Library
Abstract follows.
“The Physician’s Statement”: A novel test item strategy for medical education
Bruce E. Wright, David B. Averill, Herbert F. Janssen
We introduce a novel test item strategy that requires higher-order thought processes. In this format, students first receive a clinical vignette. Then a physician makes a higher-order statement presumably based on the data contained within a clinical vignette. This statement may propose a diagnosis, a treatment, the physiological basis for a clinical condition, etc. Students then analyze the vignette and this physician’s statement, in a two-question format. In the first question, students confirm whether the statement is: a) correct, b) incorrect, c) logical but requires more information to adequately support, d) illogical but requires more information to definitively refute, or e) unrelated to available data; only guessing. In the second question, students suggest how to support or refute the statement by choosing either: a) no additional information is required, b) or c) as two options that could provide support for the statement, or d) or e) as two options to refute the statement. Requiring students to analyze a physician’s third-order statement and then justify their decisions takes this assessment format a level beyond that of standard scenario style questions. This format also requires students to apply basic science information to a clinical case in a manner that does not appear contrived and which promotes classroom discussions. This format may be equally useful in clinical training.
Status: Inactive pending recruitment of student researchers.
——————— - Project 4: Cardiac Input-Output keys with a Clinical Key
This is a revision of the Venous Return-Cardiac Output or Venous function-cardiac function curve with a change in the standard layout and a clinical key.
Research could include obtaining qualitative data on student perception of this teaching tool.
A manuscript was sent but sent back with insightful reviews requiring extensive modification and follow-up with student input. A poster for late April is in preparation.
Status: Inactive pending recruitment of student researchers.
—————– - Project 5: The Internal Cuff: A New Way to Describe Lung Zones in Respiratory Physiology
This is a new project in which a comparison between lung zones’ pulmonary pressures (high-medium-low alveolar, arterial, venous) are correlated with standard blood pressure measurements (high-medium-low cuff pressures, arterial, venous). Plans have been made for a Seton Hill art student to take up the challenge of drawing and perhaps animating this comparison.
Research could include obtaining qualitative data on student perception of this teaching tool.
Status: Inactive pending recruitment of student researchers.
—————— - Project 6: At the races: Axonal Transmission and Neurotransmission.
This is an old laboratory exercise used in a very small manner during each January’s OPP session on reflexes within or just following hour 1 which describes neuronal function and motor end plates. It involves creating three tracks of 1) unmyelinated neuron, 2) small myelinated neuron, and 3) large myelinated neuron, with students “racing” along each one, first under normal conditions then under conditions of demyelination, remyelination, and/or neurotransmission defects.
Research could include development of the project here which is a worthy effort in itself particularly if combined with obtaining qualitative data on student perceptions of its effectiveness.
Status: Inactive pending recruitment of student researchers.
—————- - Project 7: The muscle tug-of war: A laboratory testing preload, afterload, sensing active and passive stretch, recruitment, tetany, and eccentric isotonic, concentric isotonic, and isometric contractions.
This is an approximately 1 hour laboratory-type exercise in which a set of ropes are fitted into a device to simulate a skeletal muscle. The device is anchored on one side to a door or other object and the other to a metal pole. Students in appropriate clothing (e.g. sneakers) take up roles as preload/afteroad setters at the pole, sensors along one rope. Students take positions at the pole setting preload and afterload, along one rope as Golgi tendon organs and nuclear chain or bag fibers, or as representations of sarcomeres within three motor units.
Status: Inactive pending recruitment of students to help rebuild the testing equipment, creating the laboratory protocol, and other tasks culminating in running the exercise and collecting qualitative data on student perceptions of the laboratory’s effectiveness.
—————— - Project 8: Micro-Integration
Presented in oral and poster form in April 2024 at the American Physiology Summit, currently In Press.
Projected student roles and numbers: 1 or 2 advanced students from LECOM-Seton Hill to help develop surveys for LECOM students to assess current transmission of integrated content in their respective curricula and to solicit student feedback as to whether and how more integrated content could be presented to them. To prevent student survey overload this would have to be coordinated with other parties. Expansion of this type of survey to other programs and other campuses is not anticipated until LECOM-Seton Hill programs are assessed.
Abstract follows.
Micro-Integration: A Process for Integrating Multiple Discipline-Specific Learning Objectives for Enhanced Co-Teaching of Medical Education Sessions
Bruce Wright1, Elisabeth Schlegel2
1Seton Hill, Lake Erie College of Osteopathic Medicine, 2Medical Education, Western Atlantic University School of Medicine
Text:
Introduction:
Integrating subject matter in organ-systems-based courses is now the norm in medical education. This is valuable at the course level and organ-system level. However, at the session level, many basic scientists have observed essential content from their disciplines being discarded when solo-taught by faculty from other disciplines. This has had the effect of content experts re-siloing their content in sessions that were intended to cover integrative content. Such siloing forces students to integrate the separated components themselves. Even when designated for co-teaching, many sessions created by only one faculty member effectively sideline the other instructors attending the sessions.
Hypothesis:
A deliberative process for improving the incorporation of discipline-based learning objectives and content into the material for multidisciplinary co-taught sessions improves both co-teaching opportunities and student learning.
Methodology:
The authors offer the term “micro-integration” as a deliberative, 4-step process for converting an individually created session into an effective multidisciplinary session. (1) Once a session on a topic is identified for co-teaching as part of a larger curricular plan, a session lead is identified. This person often teaches most of the session’s content. (2) In creating a multidisciplinary, integrated session, topics from other disciplines (in both basic and clinical sciences) that complement or complete the integration are identified. Each content expert creates learning objectives that correspond best to their discipline. (3) Each expert creates discipline-specific content that covers their individual learning objectives for that session. (4) The group collaboratively creates the final product. As an example, in one first-semester session on “Action Potentials and the Neuromuscular Junction,” most of the material—learning objectives and the content of the session—was prepared by a physiologist. Two learning objectives on the microbiology of botulism and tetanus were also incorporated. Finally, another learning objective and related content on the clinical presentation of these two disorders was included. Together, these highlighted the importance and relevance of physiology, microbiology, and clinical medicine on the same topic, presenting medical students with an integrated, clinically relevant understanding of action potentials and synaptic transmission.
Data and summary of results:
At a medical school that has an integrated pre-clinical curriculum, micro-integration was the norm for many sessions. Reaction from students to these micro-integrated sessions has been generally positive. Faculty also reported feeling empowered by micro-integration. An unexpected but welcome result of this process involved item writing. Because each content expert was aware of specific knowledge each of their peers were contributing, they were better able to write integrated formative and summative examination items that prioritized their learning objectives while also tying into others’ learning objectives. These learning objectives and related examination items were tracked all the way up to the course level to match content taught with overall learning objectives for each organ system. In general, micro-integration was used in three types of sessions: (1) Basic scientists from different disciplines (e.g., anatomy and physiology) coordinating their learning objectives and content across a common topic; (2) Basic science sessions incorporating clinical relevance to the original material (e.g., biochemistry and clinical medicine); and (3) Clinical sessions incorporating basic science material (e.g., clinical medicine and pharmacology).
Conclusion:
Micro-integration is a new, deliberate approach to creating contextualized, just-in-time educational materials at the session level that may improve the content and quality of co-teaching to undergraduate medical students. This process of session-specific curriculum development could be helpful, both for overcoming faculty resistance to integration of their learning objectives and content in undergraduate medical education, and for improving the quality of examination items.
Support or Funding Information:
None