How decades of scattered coverage became a new chapter in Anatomy & Physiology.
As I mentioned in my previous post, b the new 12th Edition of Anatomy & Physiology has a new chapter devoted entirely to the human microbiome. I also mentioned that we'd been covering the human microbiome for decades—but in small pieces placed strategically throughout the textbook.
Our explanation of essential concepts related to the human microbiome goes back at least to our 1993 edition, when we talked about the roles of microorganisms living on the surfaces of our skin, intestines, and other membranes—each in the chapter where it naturally belonged. We didn't call the concept the "human microbiome" because that term was not in common use back then.
Google Ngram Viewer Showing Book Usage of "Human Microbiome"The chart above suggests that use of the term “human microbiome” in published books rose sharply after 2012.
Something else happened during those years. In 2007, the National Institutes of Health launched the Human Microbiome Project. Its researchers began the ambitious task of characterizing the microbial communities associated with different regions of the healthy human body. A coordinated collection of major findings appeared in 2012, helping push the human microbiome into the scientific spotlight.
In our 2013 edition, we introduced the term as our discussion of the microbiome concept evolved and expanded to reflect its growing importance in anatomy and physiology (and its clinical applications).
The 2016 edition of Anatomy & Physiology saw the introduction of our Connect It! (formerly A&P Connect) library of online "special interest" articles, including one about the human microbiome.
As I've previously explained, many of these articles are intended to help students draw together core concepts that play roles in many different regions and processes of human biology. Because this approach helps our readers gradually build their conceptual frameworks, that microbiome article remains in our Connect It! library. Of course, we revised it to reflect the addition of our new Human Microbiome chapter.
After much research and discussion among the Patton Team of authors and editors, we recognized that the human microbiome deserves its own chapter. We saw how well giving homeostasis its own chapter worked for student understanding and we wanted to give similar emphasis and coherence to the increasingly important microbiome concept.
In 2022, the final year shown in the Google Ngram chart, with use of the term still climbing, we began our work for this new edition.
Behind the scenes: how did we do it?
It sounds simple. And it may even sound easy. But it wasn't, of course. Such things never are, right?
First, we asked for a volunteer from among our author team to be the designated wrangler of this new chapter. Author Terry Thompson stepped up and is largely responsible for what you see in the new chapter.
But hey, we're the Patton Team, so we all pitched in to help Terry. Anything you don't like in the new chapter? That's probably because we talked Terry out of something that we shouldn't have. We went back and forth on the new chapter for several years. Despite its brief length and straightforward storyline, there was a lot of research, debate, and hard work that went into producing the version you see.
As alluded to earlier, Terry scanned the entire previous edition to assess our existing microbiome content. Then, using her new research on current scientific thinking, she developed a storyline that we wanted to tell our readers.
From Patton (2027) Anatomy & Physiology 12e. Elsevier. Contents p. xxxv
Our goal was to give your students the basic concepts they need to build and expand their conceptual frameworks, improve their understanding of A&P, and prepare for later clinical courses and health careers.
Terry wove the previously scattered microbiome content into the new chapter, leaving brief mentions in its previous locations to help students map out where the microbiome applies in their studies. For example, the human microbiome is still mentioned when discussing the skin, the gut, the respiratory tract, and other body regions.
She moved content about what microorganisms are and their roles in the body from Chapter 2's Mechanisms of Disease section and adapted it to the new Chapter 49 on the microbiome. Throughout the process, she added current content based on what microbiome experts are telling us—and what we believe our students really ought to know about.
This is a good spot to give a shout-out to HAPS member Brian Elliott at Saint Louis University, who has been introducing his A&P students to the microbiome concept. He graciously gave us feedback that helped guide us in developing our new chapter. When I participated in the HAPS Book Club discussions of the book, I Contain Multitudes: The Microbes Within Us and a Grander View of Life, I gained greater insight into how microbiome concepts intersect with the mainstream A&P curriculum. Thanks, bookclub friends!
Where to put the new chapter?
One issue that we really wrestled with was this: "Where do we put this new chapter in the book?"
There are good arguments for putting it among the very earliest chapters. Microbial communities occupy many body sites, and the microbiome influences structures and functions throughout the body. We decided against that for at least two reasons.
One reason is practical. It's not a small thing to renumber all the subsequent chapters and each of their numbered figures, boxes, and tables—not only in the book itself, but also in all the many, many supporting resources organized by the numbering in the textbook's table of contents.
The other reason is pedagogical. We didn't want to overwhelm the beginning A&P learner, whose head is already spinning with all those anatomical, chemical, cellular, and metabolic terms by adding another new introductory topic with its own hard-to-pronounce terminology. So we mention it broadly, starting early in the book, but we put the microbiome chapter at the very end.
We could not find an ideal location later in the book, either. It really "goes with" nearly every chapter, so it wasn't clear to us where the "best" placement might be.
Setting all that aside, putting the new chapter at the end of the book gives both readers and instructors some real agency in deciding when they want to dive a bit more deeply into the human microbiome. Early on, we suggest that readers "peek ahead" to the last chapter. They have the option to do that, or to wait.
Instructors likewise have the option to assign it early or late in the course—or at any point in between.
Placing it at the end makes it easier to assign the chapter wherever it fits best—or to use only selected parts—without disrupting the book’s traditional sequence.
There's much more to this story.
I think this blog post is getting to be longer than the new chapter is! But now you know part of the story behind our new Chapter 49: Human Microbiome.
In my next post, I’ll get to the most important part of this story by explaining why we believe the human microbiome belongs in A&P—even when students may also encounter it in introductory biology, microbiology, pathophysiology, or other courses.
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