The teaching faculty of the Department of Physiology and Biophysics at the University of Louisville School of Medicine have designed and implemented various “active learning” approaches within three different courses that teach physiology to medical and graduate students. The courses are: 1) medical physiology, 2) advanced physiology, and 3) integrated physiology. The unique aspect incorporated within these courses is that students prepare answers to pre-assigned questions or topics and then “teach” that topic to their peers. This pedagogical exercise encourages students to learn the material at a more comprehensive level and to speak the language of physiology. This paper presents the rationale and design for this type of approach within each course and provides feedback comments from both student and faculty participants. We also provide a list of some of the questions and topics used in two of these courses as a practical guide to readers who may want to implement similar approaches.