These last eighteen months or so have made us rethink how we teach environmental physiology here at the University of Brighton as we have had to navigate the impact the pandemic was having on delivery. A previous blog post reinforced that we were still going strong, but had to move outside to investigate rewarming techniques post accidental hypothermia experimentally, as part of our Expedition Physiology 3rd year module. Fortunately, the weather was cold and allowed for students to experience what it is like to try and re-warm in the field! However, it was not always easy with multiple lockdowns and restrictions, we had to get creative! This blog post shares and reflects on some of our experiences so that it might help others in the future should you be prevented from teaching and your students learning in the way you/they are used to.

We are fortunate to have three choice modules allied to environmental extremes at the University of Brighton and with the introduction of environmental physiology to our 1st year sport and exercise science students alongside our PhD students, it amounts to ~150 students each year engaging with the subject. For our first years, we take them through a whistle-stop tour of the subject, covering everything from temperature (hot and cold) to pressure (hypobaric and hyperbaric environments, even microgravity), with a bit of sleep deprivation thrown in for good measure. At second year, we focus environmental extremes just towards sports performance, whereas at third year we direct learning towards expedition physiology. By masters level we have introduced how environmental extremes has relevance to clinical and occupational settings as well as sport and take a more problem-based approach to student learning. Across all years, we try and excite them towards the subject through engaging lecture material and with the prevalence of injuries at the extremes, this can be quite compelling. Nevertheless, it is from the lab practicals that students really learn, where they can experience some of the stressors first hand. With multiple lockdowns and remote delivery alongside our environmental physiology lab and chamber being recommissioned as a decontamination lab to service all our other labs, it meant we needed to move to Plan B. Actually, I think between Dr Mark Hayes, Dr Alan Richardson and myself, we went through Plan A, B, C, D, E and F!

It was our 2nd year – SI521 – Performance at Environmental Extremes and 3rd year – SI627 – Expedition Physiology modules that kicked off the academic year in September 2020. In SI521, we began with using the psychological tool of performance profiling to help students prepare for different challenges in environmental extremes. This was a great way for students to appreciate the importance of profiling the client as well as the event and students were able to deliberate over what were the key considerations, whether the challenge was at altitude, in the cold or hot environments.

Mark was still able to deliver our dive reflex (breath-holding) lab with the necessary, added safety measures, as this lab could be delivered out of any space. Both Alan and myself for the 3rd year and 2nd year modules respectively, used our portable elevation training masks as a surrogate for hypoxia (acknowledging there is plenty debate on whether they simulate altitude at all) to provide further environmental extremes-focused labs. Alan directed his towards COVID. During the COVID-19 pandemic there have been a wide variety of guidelines to attenuate the spread of the virus. One such requirement as we know has been the wearing of face masks. Many articles in the media suggested these masks cause individuals to suffer with hypoxaemia, demonstrating a subsequent decline in peripheral arterial saturation. This could have been potentially dangerous, especially for those with poor cardiovascular or respiratory function. It was our students’ job to find out whether this decline in oxygen saturation occured, what masks (Type IIr vs elevation training masks) could cause this and whether it was dependent upon exercise intensity? Alan took a really nice PBL approach to learning, with the students having to come up with the design to test these questions themselves, which at 3rd year really worked well.

For our 2nd year students, in smaller groups they had to decide on the research question they wanted to investigate around the efficacy of elevation training masks to create a hypoxic environment. It led to some great creativity with some innovative designs given a little thought and showed the students, there are many different ways,  each have merit, to answer the same question. It also showed, that you can engage with environmental physiology without the need of a chamber. I was reminded of many years ago a good friend, Dr Philippe Lopes, asked me to help him set up an environmental physiology module at the University of East London, but he had no chamber and next to no bespoke equipment – we still did it and he said it was one of the most enjoyable modules the students had experienced!

As part of our SE709 – Personal and Professional Development module, our students struggled to secure placements early on in the academic year. Consequently, I put on seven additional placements, four internal (in bold below). To make it more realistic to what the students would experience on graduating, students had to apply through a video pitch and one of our MSc students, Lewis MacDonald, showed great initiative in his application for the Marathon des Sables Placement Project!

• trainSharp Cycling Online Physiology Consensus Statements
• International Paralympic Committee Online Heat Mitigation Resources for Tokyo 2021
• Lands’ End to John O’Groats Challenge
• Ski the 7 Summits Project
• Marathon des Sables Heat Acclimation Support
• Para-Monte Altitude Awareness
• Heat Wave Health Plan for University of Brighton

In the Heat Wave Health Plan for the University of Brighton Placement Project, some great work was carried out by our students (Charlotte Avery, Matthew Cheeseman, Harriet Dodd and Dayna Kingshott), including a survey of 107 staff that resulted in them presenting to a sub-committee of our University Executive Board about the need for a heatwave health plan in the university. I presented about the value of placement projects like this at our recent Education and Student Experience Conference. With resources already being produced to help Brighton’s staff and students, their legacy will be when this plan develops into university policy…so watch this space.

The Para-Monte team (Ellie Noble, Harriet Dodd and Abbie McConnell) were also productive in their placement as they conceived ideas to further improve the reach of Para-Monte’s new web site to raise altitude awareness. After meeting and pitching their ideas to Chris and Jeannet Savory who set up the charity, they are now working on some simple, but effective infographics to add to the web site.

I needed to be innovative myself at the beginning of the MSc SI710 – Applied Environmental Physiology module with us still delivering remotely at that time and so I designed a home-based laboratory practical that allowed the students to investigate the effect of heating and cooling on muscle function and dexterity with the intention of applying learning to solve problems in the world of sport, occupation and health. Students completed the lab practical whilst on MS Teams in breakout groups across three weeks of labs, allowing them to feel engaged and part of something while still being at home. A common, live Excel spreadsheet allowed data to be collected and shared with all students. We would all have preferred to be in the labs, but when this was not possible it did show that a home-based lab practical enabled the students to engage with the subject.

 When our MSc students did return to the labs, we only had 2 weeks left of tutor-led lab practicals, so I decided to throw the kitchen sink at the lab and try and leave a memorable experience for our students!

There were five objectives we set out to try and achieve:

1. To experience a range of measurement tools allied to environmental extremes.
2. To compare a running heat tolerance for sport with a passive heat tolerance test for health settings, using a new, portable sauna and coretemp device.
3. To undertake a hypoxic tolerance test and demonstrate the measurement of haematocrit and haemoglobin concentration [HB] for the estimation of plasma volume and [HB] to estimate peripheral blood oxygen content.
4. To demonstrate the measurement of arterial velocity in the foot as an indicator of arterial stiffness and determine pre and post cold water/ice submersion.
5. To demonstrate the measurement of muscle temperature pre and post passive or exercise heat stress.

In order, Flyn Hutchinson, Ollie Coe and Andrew Price (and Greg Wright also took up the challenge) completing the running heat tolerance test.

One of our technicians, Bill Norton, kindly testing out our new portable sauna tents!

MSc students, Greg Wright (in Ken) and Harriet Dodd (in Barbie) – our new portable sauna tents!

To raise awareness of Motor Neuron Disease we asked those students who were willing to take part in the 92 second ice foot challenge as was so vividly displayed on Good Morning Britain by Ben Shepherd and Charlotte Hawkins. I think for future use, I need to get more ice as MSc students Charlotte Avery and Lucy Shephard looked far too comfortable!

We finished off the MSc module with an MS Teams-delivered Conversation with the experts, where we were fortunate that our students could ask questions allied to environmental extremes to Professor Nick Webborn (OBE, International Paralympic Committee), Dr Gareth Turner (EIS, GB Rowing), Dr Carl James (Malaysian Institute of Sport) and Dr Kirsty Waldock (British Army). Themes for the questions were:

• Working with Real Clients – Considerations
• Olympic and Paralympic Cycles
• Occupational Environmental Physiology
• Research vs. Applied Practice
• Managing misinformation amongst your clients
• Wearable Technology – how might it help or hinder
• Day in the Life of a Practitioner
• Advice for New Practitioners

We had to set the rules of engagement so to speak, with respect to use the chat function to air more thoughts and use the MS Teams hand to ask or answer questions, not to mention acknowledge a verbal non disclosure agreement to ensure examples offered by the experts could not be shared willy-nilly! There were considerably more questions by students than we had time for, but it resulted in a such a rich learning environment for the students as they benefitted from the collective wisdom of our expert panel and one that I would keep in place, even after the pandemic.

So, the module did not run as normal, but the students were still very encouraging and positive in their feedback, recognising the challenges and constraints we were under and reported to having had a very good student experience overall.

We are now mid-July and thankfully our MSc students are finally back into our labs being able to use all the equipment in the way they should for their respective research projects. We still have restrictions and guidance in place to minimise the transmission of COVID as best we can. As off writing this post, no COVID cases have emerged from within our labs which I think reflects the efforts we put in place to try to ensure a COVID safe environment. Thanks needs to be extended to our technicians, James, Ann and Bill for the hard work they put in to support us to this end. Of the ten environmental physiology-based MSc research projects, some students have plumped for research proposals rather than collecting data, especially if they really wanted to investigate clinical and/or vulnerable populations who would be unlikely to visit the labs to be a participant. However, it is great to see a bit of life back in the labs as students once again collect environmental physiology data.

So, looking back at what we have accomplished despite not having our environmental chamber or hypoxic chamber for a large part of the academic year, it certainly feels like we have been on a roller-coaster for way too long. One thing was for sure, as we encourage our students to follow the principles set out by Martin Buchheit in becoming better practitioners, of thinking outside the box, we had to take a leaf out of our own teachings!

Neil Maxwell