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Successful learning of many aspects in physiology depends on a meaningful understanding of fundamental chemistry concepts. Two conceptual diagnostic questions measured student understanding of the chemical equilibrium underlying calcium and phosphate homeostasis. One question assessed the ability to predict the change in phosphate concentration when calcium ions were added to a saturated calcium phosphate solution. Fifty-two percent of the students correctly predicted that the phosphate concentration would decrease in accord with the common ion effect. Forty-two percent of the students predicted that the phosphate concentration would not change. Written explanations showed that most students failed to evoke the idea of competing chemical equilibria. A second question assessed the predicted change in calcium concentration after solid calcium phosphate was added to a saturated solution. Only 11% of the students correctly predicted no change in calcium concentration; 86% of the students predicted an increase, and many based their prediction on a mistaken application of Le Chatelier's principle to heterogeneous equilibria. These results indicate that many students possess misconceptions about chemical equilibrium that may hamper understanding of the processes of calcium and phosphate homeostasis. Instructors can help students gain greater understanding of these physiochemical phenomena by adopting strategies that enable students achieve more accurate conceptions of chemical equilibria.
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