AI-Assisted Development of an Open-Access Interactive Respiratory Physiology Textbook

I recently launched an open-access, interactive online textbook on respiratory physiology: Respiratory Physiology: A Clinical Approach. This post outlines some of the background and development process behind this project.

The primary objective, with the full support of my co-author Richard Schwartzstein, was to make this educational resource freely available to maximize its potential reach and impact. This guiding principle influenced many subsequent technical and strategic decisions.

Background: From Print to a New Digital Edition

With the copyright back from the publisher, we were free to reboot this project in a way well-suited for the modern web. The book’s original incarnation was a static print volume, which included access to a publisher website with approximately 40 interactive Flash-based diagrams I had developed to let people play with and visualize concepts from the book in a dynamic, data-driven, and highly visual, intuitive way. Flash was the right tool for the job at the time, but reached its end-of-life a number of years back. The interactives were highly integrated into the flow of the book, and so one goal was to recreate these to give people a unique understanding of the material, not achievable through text and static images alone.

Recreating and Rethinking for the Web

To create the new online version, the first step was content conversion and re-creation. There were numerous equations and other elements that were highly rooted in print design but that were not suitable for the web. Rather than try and recreate this all manually, I chose to lean into using AI tools to help with the process. Through my research work, I have developed skills in using different models (for example, from OpenAI, Anthropic, and Google, as well as open source models) and decided to incorporate those into custom workflows to accelerate the process. This included not only formatting and equations, but also coding assistance, transcription, and many other tasks. Beyond accelerating the process, there were other benefits to creating AI workflows: in a few cases, the models have gotten so capable that they spotted relatively subtle errors in the original version. This project has taken place gradually over a long period of time, and so one of the pleasures has been seeing AI models progress in both knowledge and capabilities such that things that were hard when I started the conversion became possible as it progressed.

For the interactive diagrams, the process involved developing a veritable tool chest of techniques to rebuild these from scratch. Tools like ObservableHQ Framework and d3 were important enablers (I’m a longtime fan of Mike Bostock’s work). I’ve even put new diagrams in there that were not in the original (for example, see the Henderson-Hasselbalch equation interactive). Just as was involved in the original creation of the diagrams, only part of the work was technical; it also involved other aspects like finding empirical models of key physiological processes that could be used to accurately provide the underlying data or mechanics for certain diagrams.

For other parts of the book, there were certain things that could have been just ported to the web but offered a great opportunity to rethink the possibilities (for example, see the interactive glossary concept map).

Concluding Remarks

As of this writing, all of the print aspects have been recreated in a more appealing and appropriate way that is easily used on the web. Approximately 70% of the interactives have been converted, but in the interest of getting the work out there in an already useful format, we chose to launch the book and to build the rest in public.

The redevelopment of this textbook aimed to transform a traditional print resource into a freely accessible, interactive online tool. The process involved overcoming challenges in content conversion, including rebuilding legacy interactive elements using modern web technologies, and leveraging AI to streamline parts of the workflow. The work spanned a considerable period, undertaken as time permitted.

The hope is that this resource will prove useful for students and educators in respiratory physiology and others with use cases we may not have even anticipated who want to explore this fascinating and useful subject.

The textbook is available at: Respiratory Physiology: A Clinical Approach.