Category Archives: Teaching Strategies

Critical thinking or traditional teaching for Health Professions?

“Education is not the learning of facts but the training of the mind to think”- Albert Einstein”

A few years ago I moved from a research laboratory to the classroom. Until then, I had been accustomed to examine ideas and try to find solutions by experimenting and challenging the current knowledge in certain areas. However, in the classroom setting, the students seemed to only want to learn facts with no room for alternative explanations, or challenges. This is not the way a clinician should be trained- I thought, and I started looking in text books, teaching seminars and workshops for alternative teaching methods. I quickly learned that teaching critical thinking skills is the preferred method for higher education to develop highly-qualified professionals.

Why critical thinking? Critical thinking is one of the most important attributes we expect from students in postsecondary education, especially highly qualified professionals in Health Care, where critical thinking will provide the tools to solve unconventional problems that may result. I teach Pathophysiology in Optometry and as in other health professions, not all the clinical cases are identical, therefore the application and adaptation of the accumulated body of knowledge in different scenarios is crucial to develop clinical skills. Because critical thinking is considered essential for patient care, it is fostered in many health sciences educational programs and integrated in the Health Professions Standards for Accreditation.

But what is critical thinking? It is accepted that critical thinking is a process that encompasses conceptualization, application, analysis, synthesis, evaluation, and reflection. What we expect from a critical thinker is to:

  • Formulate clear and precise vital questions and problems;
  • Gather, assess, and interpret relevant information;
  • Reach relevant well-reasoned conclusions and solutions;
  • Think open-mindedly, recognizing their own assumptions;
  • Communicate effectively with others on solutions to complex problems.

However, some educators emphasize the reasoning process, while others focus on the outcomes of critical thinking. Thus, one of the biggest obstacles to proper teaching of critical thinking is the lack of a clear definition, as observed by Allen et al (1) when teaching clinical critical thinking skills. Faculty need to define first what they consider critical thinking to be before they attempt to teach it or evaluate student learning outcomes. But keep in mind that not all students will be good at critical thinking and not all teachers are able to teach students critical thinking skills.

The experts in the field have classically agreed that critical thinking includes not only cognitive skills but also an affective disposition (2). I consider that it mostly relies on the use of known facts in a way that enables analysis and reflection of conventional and unconventional cases for the future. I have recently experimented with reflection in pathophysiological concepts and I have come to realize that reflection is an integral part of the health professions.  We cannot convey just pieces of information based on accumulated experience, we have to reflect on it. Some studies have demonstrated that reflective thinking positively predicted achievement to a higher extent than habitual action. However, those may not be the key elements of critical thinking that you choose to focus on.

How do we achieve critical thinking in higher education and Health Professions? Once we have defined what critical thinking means to us, it must be present at all times when designing a course, from learning objectives to assignments. We cannot expect to contribute to development of critical thinking skills if the course is not designed to support it. According to the Delphi study conducted by the American Philosophical Association (3), the essential elements of lessons designed to promote critical thinking are the following:

  1. “Ill structured problems” are those that don’t have a single right answer they are based on reflective judgment and leave conclusions open to future information.
  2. “Criteria for assessment of thinking” include clarity, accuracy, precision, relevance, depth, breadth, logic, significance, and fairness (Paul & Elder, 2001).
  3. “Student meaningful and valid assessment of their own thinking”, as they are held accountable for it.
  4. “Improving the outcomes of thinking” such as in writing, speaking, reading, listening, and creating.

There are a variety of examples that serve as a model to know if the course contains critical thinking elements and to help design the learning objectives of a course. However, it can be summarized in the statement that “thinking is driven by questions”. We need to ask questions that generate further questions to develop the thinking process (4). By giving questions with thought-stopping answers we are not building a foundation for critical thinking. We can examine a subject by just asking students to generate a list of questions that they have regarding the subject provided, including questions generated by their first set of questions. Questions should be deep to foster dealing with complexity, to challenge assumptions, points of view and the sources of information. Those thought-stimulating types of questions should include questions of purpose, of information, of interpretation, of assumption, of implication, of point of view, of accuracy and precision, of consistency, of logic etc.

However, how many of you just get the question: “Is this going to be on the test?”. Students do not want to think. They want everything to be already thought-out for them and teachers may not be the best in generating thoughtful questions.

As an inexperienced research educator, trying to survive in this new environment, I fought against the urge of helping the students to be critical thinkers, and provided answers rather than promoting questions. I thought I just wanted to do traditional lectures. However, unconsciously I was including critical thinking during lectures by using clicker questions and asking about scenarios with more than one possible answer. Students were not very happy, but the fact that those questions were not graded but instead used as interactive tools minimized the resistance to these questions. The most competitive students would try to answer them right and generate additional questions, while the most traditional students would just answer, no questions asked. I implanted this method in all my courses, and I started to give critical thinking assignments. The students would have to address a topic and to promote critical thinking, a series of questions were included as a guide in the rubric. The answers were not easily found in textbooks and it generated plenty of additional questions. As always, it did not work for every student, and only a portion of the class probably benefited from them, but all students had exposure to it. Another critical thinking component was the presentation of a research article. Students had a limited time to present a portion of the article, thus requiring analysis, summary and reflection. This is still a work in progress and I keep inserting additional elements as I see the need.

How does critical thinking impact student performance? Assessment

Despite the push for critical thinking in Health Professions, there is no agreement on whether critical thinking positively impacts student performance. The curriculum design is focused on content rather than critical thinking, which makes it difficult to evaluate the learning outcomes (5). In addition, the type of assessment used for the evaluation of critical thinking may not reflect these outcomes.

There is a growing trend for measuring learning outcomes, and some tests are used to assess critical thinking, such as the Classroom Assessment Techniques (CAT), which evaluate information, creative thinking, learning and problem solving, and communication. However, the key elements in the assessment of student thinking are purpose, question at issue, assumptions, inferences, implications, points of view, concepts and evidence (6). Thus, without a clear understanding of this process and despite the available tests, the proper assessment becomes rather challenging.

Another issue that arises when evaluating students critical thinking performance is that they are very resistant to this unconventional model of learning and possibly the absence of clear positive results may be due to the short exposure to this learning approach in addition to the inappropriate assessment tools. Whether or not there is a long term beneficial effect of critical thinking on clinical reasoning skills remains to be elucidated.

I tried to implement critical thinking in alignment with my view of Physiology.  Since, I taught several courses to the same cohort of students within the curriculum, I decided to try different teaching techniques, assessments and approaches at different times during the curriculum.  This was ideal because I could do this without a large time commitment and without compromising large sections of the curriculum. However, after evaluating the benefits, proper implementation and assessment of critical thinking, I came to the conclusion that we sacrifice contact hours of traditional lecture content for a deeper analysis of a limited section of the subject matter. However, the board exams in health professions are mostly based on traditional teaching rather than critical thinking. Thus, I decided to only partly implement critical thinking in my courses to avoid a negative impact in board certification, but include it somehow as I still believe it is vital for their clinical skills.

 

References

  1. Allen GD, Rubenfeld MG, Scheffer BK. Reliability of assessment of critical thinking. J Prof Nurs. 2004 Jan-Feb;20(1):15-22.
  2. Facione PA. Critical thinking: A statement of expert consensus for purposes of educational assessment and instruction: Research findings and recommendations [Internet]. Newark: American Philosophical Association; 1990[cited 2016 Dec 27]. Available from: https://eric.ed.gov/?id=ED315423
  3. Facione NC, Facione PA. Critical thinking assessment in nursing education programs: An aggregate data analysis. Millbrae: California Academic Press; 1997[cited 2016 Dec 27].
  4. Paul WH, Elder L. Critical thinking handbook: Basic theory and instructional structures. 2nd Dillon Beach: Foundation for Critical Thinking; 2000[cited 2016 Dec 27].
  5. Not sure which one
  6. Facione PA. Critical thinking what it is and why it counts. San Jose: California Academic Press; 2011 [cited 2016 Dec 27]. Available from: https://blogs.city.ac.uk/cturkoglu/files/2015/03/Critical-Thinking-Articles-w6xywo.pdf

 

 

 

 

 

Lourdes Alarcon Fortepiani is an Associate professor at Rosenberg School of Optometry (RSO) at the University of the Incarnate Word in San Antonio, Texas. Lourdes received her M.D. and Ph.D. in Physiology at the University of Murcia, Spain. She is a renal physiologist by training, who has worked on hypertension, sexual dimorphism and aging. Following her postdoctoral fellowship, she joined RSO and has been teaching Physiology, Immunology, and Pathology amongst other courses. Her main professional interest is medical science education. She has been active in outreach programs including PhUn week activities for APS, career day, and summer research activities, where she enjoys reaching K-12 ad unraveling different aspects of science. Her recent area of interest includes improving student critical thinking.

 

The Real World – A Philosophical Analysis?

Silhouette of coming businessman in doorway with shadow

“The world is too much with us; late and soon,

Getting and spending, we lay waste our powers”—thus, Wordsworth over two centuries ago, bemoaned man’s disconnect from the natural world and meaningful lives. Universities these days are exhorted to prepare students for the “real world”. But what that “reality” is, puzzles me.

 

In one sense, there is a depressing soul-numbing banality to our daily lives. As the Fool told Jacques, “From hour to hour, we ripe and ripe/And then, from hour to hour, we rot and rot;/And thereby hangs a tale.” Surely we do not need Universities to teach students to cope with that tedium—picking out the best buys from a selection of toilet paper or tooth pastes, parking cars, changing diapers, filing tax forms and other drearies (to coin a word). The ‘real world” is one where many trudge through their working days longing for the weekends when they can begin to live. We always ask people how their weekends went, not their week. Do we need courses in coping with tedium or preparing for the weekend?

 

We could of course, prepare them for other realities. Beyond death and taxes, there are other certainties, the “resonant lies” that Auden warned us about in his Ode to Terminus. That our students will find themselves in a thicket of lies in the real world is more than certain. We can prepare them well by giving them the right tools. In the sciences, much is made of critical appraisal where students are taught to assess peer-reviewed articles and analyze publications. That is all well and good, but the more dangerous lies have rarely been subject to peer review. They lie buried elsewhere in the minutes of Committee meetings, confidential reports etc. I think it was David Halberstam in his brilliant analysis of the Kennedy administration, who noted the significance of selective “minuting” in skewing decisions. Perhaps an interdisciplinary or trans-disciplinary mandatory course in “Institutional Lying” can be very useful.

 

Philip Larkin found himself in a church where he mused on what would become of such sacred spaces, “In whose blent air all our compulsions meet/ Are recognized, and robed as destinies.”  To me, the University much like a church, is a sacred space, where one melds the richness of the past with the exuberance of the future. It is that richness of the real world that we can pass on to our students, not just its banalities.

 

I am a basic biologist and most, though not all, of my courses deal with biological mechanisms that underly the very marrow of our existence, the stuff we are made of, so to speak. The words and concepts, I use, (receptors, inverse agonists, G-proteins, allosteric modulators, constitutive activities etc.), may seem a trifle arch but these can, and have, made their way from bench to boardroom and beyond. In addition, our daily lives, loves, behaviors, misbehaviors stem from responses to such molecules.

 

None of what I teach may help my students deal directly with their quotidian vicissitudes; in a deeper sense though, they may realize that underlying all their actions, their fears, hopes, loves and despairs are molecular interactions whose mysteries have been probed and defined by their own species adding to the rich tapestry of human expression and creativity. We are, ourselves, part of that wonderful world that Wordsworth wanted us to be in touch with.  Truly the unknown psalmist got it right when he said “Oh Lord, How manifold are Thy works! In Wisdom has thou made them all: the earth is full of thy riches”

What better way for a university to fulfill its role than opening the windows to their students to that wonderful world, the REAL one?

 

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P.K. Rangachari is currently Professor (Emeritus) of Medicine at McMaster University. Depending on the emphasis placed, that word emeritus could imply he has much merit, none whatsoever or only in cyberspace. He has a medical degree (M.B.B.S. 1966) from the All-India Institute of Medical Sciences, New Delhi, India and a Ph.D. (Pharmacology) from the U. of Alberta (1972). He drifted into medical school due to a bureaucratic blunder that derailed his efforts to become an organic chemist. However he was lucky. He had great teachers in the basic sciences and so after graduation, he left his stethoscope behind and began a peripatetic existence moving from lab to lab in several continents, finally landing up at McMaster University in Canada, some thirty plus years ago.
P.K. Rangachari’s experimental research focused on the effects of inflammatory mediators on ion transport in smooth muscles and epithelia. He has taught students in undergraduate science, liberal arts, nursing, medicine, physiotherapy and pharmacy. He has sought to bridge the two cultures (the sciences and the humanities) by designing interdisciplinary courses or encouraging students to express their learning through more creative outlets such as framing conversations, writing reviews and plays. He is blessed that he is blissfully ignorant so he can wake up each day convinced that there is so much more to learn. His students fortunately help him in that regard.

 

 

May I Cut In? – A Short Dance With Social Media

1 hour, 43 minutes.  Per day.  In the United States, ~10% of a person’s waking hours are spent on social media.  And, you’d be hard pressed to find a college student who doesn’t use social media as 90% of adults between 18-29 years old use some form of it.  It’s a tremendous online environment in which people spend considerable amounts of time – a promising place for educators to expand their repertoire for teaching.

Now, some may consider it “crazy” that social media influences the way people think (about politics, for example), but it certainly has the power to affect the way we feel (for good or ill).  It also seems to increase student interest in a subject near and dear to my heart – physiology.

So, earlier this year, I experimented with social media during my block of a large (~330 undergraduate students), upper-division course on integrative cellular physiology.  This class was principally lecture-based with the online portal for the course only used for distributing slides/notes, administering quizzes, and tracking grades.

Browsing through the science education literature, I found a number of articles evaluating the benefits and burdens of using social media in the classroom.  After some reading, I decided I needed to test the waters myself and get a better sense of how to use social media as a tool to improve learning.

But, why even bother with social media?

  1. Location, location, location. I wanted to go where the students were (digitally).
  2. Beyond the lecture hall. By extending the learning environment past the walls of the classroom, I hoped to get students thinking more about physiology outside the isolated microcosm of the lecture (whether they’re standing in line at Starbucks, checking status updates during lunch, or sneaking a peek to clear the notification bubble on their app).
  3. Build rapport. If I engaged students in an online locale they were familiar with, I could help erode some of the barriers (fear of speaking in class, an “intimidating” professor, etc.) that tend to inhibit communication between teacher and student.
  4. Cultivate a sense of community. I wanted to take advantage of a hub that would help foster the formation of friendships and study groups.  I also hoped to provide a curated online environment for students to help each other with the course material – a community of learners.
  5. “Go online,” they said. “It’ll be fun,” they said.  I saw an opportunity for myself to grow as an educator, and I wanted to challenge myself by wrestling with a tool I had yet to add to my teaching kit.

Which social media venue, though?  

A Facebook group.  Facebook has the largest active user base of social media platforms (192 million active users in the US), it’s in the top 3 most visited sites in the US, and it’s the social media site with which I have the most experience.

social media meme

 

Soon, I began to have feelings of self-doubt and trepidation as an onslaught of questions started rolling in.

Would students be willing to participate?  What about students who had chosen to avoid Facebook?  How many points would I need to assign to get them to buy in?  Would students have concerns about their instructor potentially seeing their Facebook profiles?  Would other privacy issues arise such as online student-to-student harassment?  How frequently would I need to post to keep students interested?  What kind of material would I post?  How would I compose posts to make them “effective”?  How would I evaluate participation and engagement?

Well, some of these questions can only be answered in execution, so I looked at this endeavor as an exploratory, two month “pilot study” and pressed on.

I announced the Facebook group during the first lecture in my block of the course, explained that it was completely optional (no associated points), listed some of the benefits (that I perceived) of joining it, and told them that all supplementary materials posted to the group would also be posted on the course website (if they didn’t have/want Facebook).  The first prompt I gave them on the Facebook group was a question I had found on an 8th grade test from 1912:

“Why should we study physiology?”

Immediately after lecture ended, I whipped out my smartphone and checked on the group.  About 30 students had joined.  This was encouraging, but really… I was hoping for more.  With less than 10% of the class on board, I began to regret not offering more carrot.

Over the next week, the students trickled in.  It climbed to 40.  60.  80.  By the end of my block two months later, 108 students had joined the group.  Close to a third of the class, which (considering I made it optional) was a success.

Ah, but were students actually participating? 

In order to get an overview of this, I turned to marketing analytics for social media.  Likes, shares, and comments are the marketing currency for businesses in this realm.  I think it’s much the same for educational purposes, though the value you assign to each currency for their contribution to “engagement” rating may differ.

Regardless, I used the website sociograph.io to give me metrics for my Facebook group.  Sociograph.io is free and quite a nice tool (despite some bugs).  The image below shows the kind of data it provides, which includes:

kanady1

 

  1. Summary for number of unique contributors (post authors, commenters, and likers)
  2. Timeline showing activity for the group in graphical format (posts, likes, and comments).
  3. Breakdown of the types of posts that have been made (photos, videos, links, statuses, and events).

Sociograph.io also allows you to analyze posts to see which had the highest engagement ratings (which is done by summing data for likes/shares/comments for each post).

kanady2

 

Of my posts, those that included videos were the highest rated followed by ones containing photos.  The second highest rated post for the group was from a student who posted a photo that related to a topic we were covering in class.  Perhaps unsurprising, visual content is the best bet for engagement.  Pure text-based posts and links were not very popular.

Additionally, summary stats ranking each visitor can be viewed.  This is useful for finding students in the group who are the most active or who are generating the most engaging posts.  This “visitor rating” takes into account received likes, shares, comments, and comment likes and submitted likes, posts, and comments.  The comparison between the two (received versus submitted) is what sociograph.io measures as “karma”.

kanady3

 

On top of all this, each set of data can also be exported as CSV or XLS files for analysis.

That said… did this actually have a positive impact for learning physiology?

Yes, I believe so.  Based on comments from students (directly asking them or through course evaluations), using the Facebook group got them more engaged with the material.  Students seemed to like the online dynamic.  They felt that it showed that I cared about interacting with them and facilitating a different avenue for them to ask questions.

It also gave me a chance to share interesting tidbits about physiology with students without having to shoehorn them into lecture.  Social media is definitely well-designed for “hey, look at this cool thing” kind of communication.  Often, it’s those tidbits that tend to stick and motivate students to dig deeper on their own.

But, did using social media make an appreciable difference for their exam grades?

Given the way I carried out my “pilot study”, determining that with confidence is trickier.  However, students who simply joined the Facebook group scored a few percentage points higher on the block exam.  Since the group was optional, though, those who took part may represent students who usually take more initiative in their learning.

While my approach to trying out social media was a little messy, I thought it was an extremely valuable experience.  I’ve found that fumbling around is often the best way to learn.  I may still have two left feet, but I’m not going to find the rhythm without stepping onto the dance floor.

Sources for social media usage statistics:

  • Kemp, Simon. “Special Reports: Digital in 2016.” We Are Social, 27 Jan. 2016, http://wearesocial.com/uk/special-reports/digital-in-2016
  • Perrin, Andrew. “Social Media Usage: 2005-2015.” Pew Research Center – Internet, Science & Tech, 8 Oct. 2015, http://www.pewinternet.org/2015/10/08/social-networking-usage-2005-2015/

 

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Scientist, teacher, and all-round geek, John Kanady earned his PhD in Physiological Sciences from the University of Arizona.  He is currently a postdoctoral trainee in Dr. Janis Burt’s laboratory at the University of Arizona.  His research involves looking at how cells communicate with each other via proteins called connexins and what that communication means for cell function.  He serves as Postdoctoral Councillor for the Arizona Chapter  of the American Physiological Society where he strives to advance the three pillars of the organization: teaching, research, and outreach.  You can follow him on Twitter @JDKPhD

 

 

The Benefits of Having Nontraditional Age Students in Your Classes

If asked the traditional age of a college student, most people would answer between 18-22 years old. While for many colleges this is accurate, at our college we have some students that are above the age of 22, and designated nontraditional age students (Nontrads). These students are enrolling at an older age for several reasons. Some have had other careers, and finally mustered up the courage to start fulfilling their dream of getting a college degree. These students could also be the first in their family to go to college, and are designated First Generation students. Others started college at the traditional age, and then stopped attending (stopped out). The reasons for stopping out vary, and could be for academic reasons, financial instability, or family obligations. Some are transfer students that work full time, have been taking one or two courses a semester at a community college, and are now moving on to a four year college. A fourth group are military veterans. These students served in the military for several years and are now just beginning their college careers. A final group are students who earned a Bachelor’s degree at a traditional age, had a career, and are now back to take prerequisites for graduate or professional school.

The course where I see the greatest mix of all these students is in Principles of Biology I & II. These are the required courses for first year science majors on our campus. In a room full of students, the Nontrads can sometimes make up 20% of the class enrollment. This provides a unique environment that I really enjoy. While some of the Traditional age students might be intimidated at first to have an older student sit next to them, as the professor standing in the front of the room I have a different perspective. What I see when I look at the Nontrads is typically someone who is engaged from the first day of class, and ready to get to work. These students have had life experiences, and they know without a doubt that the college classroom is where they want to be at this point in their lives.  They are focused and want to get the most out of this experience. Usually a Nontrad is the first to answer my questions, or raise their hands on the very first day of class. For me that first day experience is very important for all the students and getting them past the barrier of participating in class is important. Having a Nontrad start off right away by participating is a joy and the beginning of forming a community that is open to discussions. I encourage their engagement and this leads to more positive interactions. These interactions benefit the Nontrad as they may be a bit uncertain about starting college at an older age and getting the reassurance from the professor early helps ease their minds while building their confidence. It is no surprise that the Nontrads are the students whose names I learn first and then call on them by name (Student A). One pitfall is that they will start answering every question I ask, and to gently discourage this I will say to the entire class “Now Student A cannot answer all the questions, come on folks who wants to answer this question?” This allows me to get different students involved in the class without discouraging others.

Another unique quality found in the Nontrad student population is that they are not concerned about the test. Everyone knows what I mean by this, students that only want to understand and perhaps memorize information that they will be tested on in a few weeks. The Nontrads want to understand what they are learning at a deeper level and they find connections to the material that most of the Traditional students would not initially make. They bring their life experiences into the classroom and it benefits everyone. Some of our students want to go on to careers in health care (PA, MD, OD), and I often have Nontrads in the class who are currently working part time (or full time) as paramedics, emergency medical technicians (EMTs), or they were a medic in the military. They bring in real life examples of some of the principles that we are going over in class. I love to hear these stories as they bring the concepts to life for the entire class. These stories benefit all of us as they capture the attention of the students, engage them, and also provide me with yet another example of the concept we are discussing.

For the Traditional age student, the Nontrads are often active mentors to them in the classroom. During a break in class I will see the Nontrad explaining concepts to the Traditional age student sitting next to them. If the Traditional age student is receptive to this mentoring it will continue to occur throughout the semester. Being mentored by a Nontrad benefits the Traditional age student as they will then understand the material at a deeper level and any misconceptions can be addressed during class time. Mentoring benefits the Nontrad as they gain confidence in their knowledge.  Because of this positive experience some of the Nontrads will become tutors in our tutoring center the following year.

I enjoy sharing stories about the Nontrads who have had interesting lives before they came to our college and will share a few favorites with you. One was a diamond broker, and then a massage therapist, before majoring in science. She will earn her Ph.D. in Biochemistry next year. Our commencement speaker last year was a plumber, who became a member of Phi Beta Kappa and won the Beta Chapter award for the highest GPA at our university.  He is now in an MD-Ph.D. program. Our biology program award winner for the previous year was a diesel engine mechanic, who had attended every community college in the state before switching his focus to science. He is now in his first semester of a Ph.D. program in microbiology. The final example I will share is of our convocation speaker a few years ago. He told family and friends he did not need college, as he was going to be a rock star. After getting married, having two children, and realizing he did need college, he came to us after getting an Associate’s degree at a community college. He earned his Bachelor’s degree with a 4.0 GPA and is now in his second year of dental school. Having Nontrad students in the classroom benefits them, their classmates, and their professors. I am continually grateful they have decided to attend our college and look forward to having them in my classes in the future.

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Patricia A. Halpin is an Assistant Professor in the Life Sciences Department at the University of New Hampshire at Manchester (UNHM). Patricia received her MS and Ph.D. in Physiology at the University of Connecticut. She completed a postdoctoral fellowship at Dartmouth Medical School. After completion of her postdoc she started a family and taught as an adjunct at several NH colleges. She then became a Lecturer at UNHM before becoming an Assistant Professor. She teaches Principles of Biology, Endocrinology, Cell Biology, Animal Physiology, Global Science Explorations and Senior Seminar to undergraduates. She has been a member of APS since 1994 and is currently on the APS Education committee and is active in the Teaching Section. She has participated in Physiology Understanding (PhUn) week at the elementary school level in the US and Australia. She has presented her work on PhUn week, Using Twitter for Science Discussions, and Embedding Professional Skills into Science curriculum at the Experimental Biology meeting and the APS Institute on Teaching and Learning.

Closing the Circle: How being faculty at a liberal arts college made me a better medical physiologist

Happy Halloween!

As I look back upon my career as a faculty member at both a liberal arts college and several medical schools, I’ve come to the realization that this holiday is not a bad analogy for some things we all are familiar with—surprises both good and bad, sometimes a little scary… and at the journey’s end, a reflection of our perceived world and ourselves.pumpkinghosts

Example:  20 years ago last month, I started my first faculty position as an Assistant Professor of Biology at a small liberal arts college. Walking into that first classroom on the first day of classes was pretty frightening, because I did not know it all. As a graduate of a medical-level physiology Ph.D. program I had a solid background in the teaching of physiology, having taught it in lecture and/or lab to students in dental hygiene, nursing, dental, medical, and graduate programs. But I’d never taken gross anatomy or histology. So in that first Anatomy and Physiology class I was going to have to be an “expert” in both topics to students who had no reason to think I wasn’t.  The horror of it all to me.

I spent a good deal of my first semester staying one week ahead of the students in those weak areas.  In the next semester, it was Microbiology in which I was deficient. I had only taken one undergraduate microbiology course 14 years before, and unlike anatomy or histology there had been little cross-learning of this topic with physiology in graduate school, so I was on my own. I had help of course, including experienced faculty and excellent teaching resources that came with the textbooks. But it was a long way out of my comfort zone.  In fact, it was downright frightening!  As the years went by, I put on many other hats, some of which were better fits than others. I taught general biology, biochemistry, genetics, cell biology, and personal health, among other courses offered to a dozen biology majors and a few hundred non-majors.  From being trained as a Physiologist, I had become a Biologist.

So what were the lessons I learned at this liberal arts college? The first was this:  That it is possible to teach what many medical schools of the day would have been considered an insane teaching load of 16-20 contact hours with students per week instead of 16-20 contact hours per year. Second, it is not necessary to be THE expert on a topic in order to teach it well. Third, to achieve this adequacy required being very flexible and willing to learn new things. For example, while I couldn’t actually replace an ecologist in the planning and leading of field trips, I could teach enough of the basic principles to satisfy the needs of students in a Biology II class. This involved working with the ecologists on the staff, even following them into the field to see and experience how they looked at the biological sciences. The final lesson I learned, though I learned it late, was that there are always opportunities to be a scientist. That not all research takes place in the laboratory or the clinic. That being a teacher and being a scientist need not be an either-or career choice. That the principles of science could be applied to the science and art of teaching itself.

After several years at this liberal arts college, I made the life-changing decision to start medical school on a part-time-student-part-time-teacher basis, at a Caribbean location.  While I never did get an M.D., my faculty experience at this medical school led to other full time faculty positions at both allopathic and osteopathic medical schools. And out there, working up from smaller medical schools to larger ones, I learned still more.  For two years before I joined my current institution, I taught medical physiology from 8-10 a.m. five days a week, assisted in the anatomy lab another four hours, and lectured in a premedical prep course for another 8-10 hours per semester. Completely unlike anything I had done before, I had to teach a medical physiology course three times per year as the sole instructor.  By necessity I relearned physiology as an entire discipline to a level close to what I’d known as I was finishing up my first year as a graduate student. I became able to teach any physiology topic at the medical level with little to no advance prep, again adequately but not necessarily at the research specialist level. The flip side was that as the only physiologist, there was essentially no time off for anything else including travel, conferences, or research.

From this experience I learned that it is possible to be a sole medical physiologist with the same teaching load as that taught at the undergraduate level. If necessary, one can have at least 14 contact hours per week to medical students and an additional 1-2 hours over several weeks each semester to premedical students and still teach well. I firmly believe that had I not had seven years of teaching experience as a multidisciplinary biologist at the undergraduate level, I would have found it much harder be able to teach all aspects of physiology at the medical level at such an intense pace. Just as I had had to do at the liberal arts college, I worked 16-18 hour days that first semester to stay two weeks ahead of the students. Each semester after that I worked 12 hour days to try to keep up with the demand of keeping lecture content and other materials updated, write 75 new exam items every three weeks, and perform all the other duties required of an associate professor at a tiny school. Along the way I finally overcame the self-concept built in from graduate training that I was an “endocrine physiologist” or a “reproductive physiologist” or a “gastrointestinal physiologist” or any other specialist physiologist based on the research I was doing. And in so doing I did acquire a specialty after all… I became a specialist at being a “generalist” whole-body physiologist, as well as a specialist in physiology education!

It was these specialties, honed from the lessons in adaptability first learned at the liberal arts college, which I brought to both my current medical school and to an osteopathic medical college in the United States. But my lessons weren’t done. Both of these medical programs use an integrated curriculum, which was far different from anything I had experienced before.  Prior to helping design the integrated curricula of both schools, I had never had significant teaching-level interactions with either histologists, biochemists, pathologists, or clinical medicine faculty despite our having been colleagues for years.  Now not only was I going to interact with them, I was going to have to be able to discuss pathology with medical students with enough competency to help explain how the physiology dovetailed into it and both of them into clinical conditions/presentations.  I was going to have to do the same thing with microbiology, anatomy, histology, biochemistry, and pharmacology to appreciate the whole-system approach to medical education.

So once again, I dove into the new challenges of adapting to this integrated organ-system driven curriculum.  For the first time, I came to understand across several organ systems how the clinical medicine was driven by pathology and that driven by the four foundations of gross anatomy, microanatomy, physiology, and biochemistry. But the focus of any integrative approach would always be first and foremost the clinical aspect of these four foundations in disorders and compensations because that’s what our students were ultimately trying to master. Bringing the balance in teaching the appropriate level of physiology in such a systems-based curriculum while ultimately keeping the clinical focus was a challenge I had never before faced.

And this is what brings me back almost full circle to my days as a young assistant professor at a tiny liberal arts school.  Instead of having teaching resources located in a set of supplements to a textbook, I have access to several specialists in each discipline, all of whom are focused on the same tasks for their respective fields.  And yet, in a curious sort of way I have become a Biologist again, albeit a medical biologist.

To illustrate this, I’ll give a short example.  At my current institution we have a curriculum in which organ systems are split into a first-or-second semester component and a third-or-fourth semester component.  In one lecture I deliver in second semester Endocrine Systems, I deliver a significant portion of the basic science content for the hypothalamus and pituitary gland.  In the initial preparation for this lecture, I incorporate materials prepared by our module’s microanatomist (a neuroscientist by training) and from our module’s pathologist which mentions those pathologies most appropriate for students at this level to learn.  When I then stand before the class as the lecture presenter, I deliver not only physiology content but this other content as well.  As I do so, I am reminded of those times so many years ago now when I was just as far out of my field, delivering the details of dense connective tissue to biology majors, the presentation of viral gastrointestinal disorders to nursing students, or the principles of public health to non-majors.

The story is the same really.  We are all alike now, the physiologists of the undergraduate and the medical teaching world.  We have much to share with one another, and much to learn from one another.  And you know, that’s not really a scary thought at all.  Happy Halloween anyway.

 

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Bruce Wright is a professor in the Department of Physiology at Ross University School of Medicine in the Commonwealth of Dominica, West Indies.  Bruce received his doctorate in Physiology from Louisiana State University Health Sciences Center in New Orleans.  Following two postdoctoral fellowships he taught at Thomas University in Thomasville, GA.  He also taught at the Medical College of the Americas in St. Kitts and Nevis, West Indies, the University of Sint Eustatius School of Medicine in the Netherlands Antilles, West Indies, and the Alabama College of Osteopathic Medicine in Dothan, AL.  Bruce has been a regular member of the APS for 22 years, most of those with the Teaching section as his primary affiliation. Bruce has served as Treasurer/Events and Awards Coordinator of the APS Teaching of Physiology Section since 2015.  He has presented work at EB and the APS ITL on APS learning objectives, novel teaching strategies and item objective formats, integrated curriculum design and implementation, and challenges in preserving physiology content in integrated curricula.

 

 

More detail = More complex = Less clear

The question that I’m going to tip-toe around could be expressed thus:

“More detail does not clarity make. Discuss.”

37194627bI’m not going to write an essay but I am going to offer a few different perspectives on the question in the hope that you realise that there might be a problem hiding a little further down the path we’re all walking.  In doing so I’m going to scratch an itch that I’ve had for a while now.  I have entertained a rather ill-defined worry for some time and this post provides an opportunity to try pull my concerns into focus and articulate them as best I can.

One of the first things I remember reading that muddied the water for me was ‘Making Learning Whole’ by David Perkins (Perkins, 2009).  He argues that in education we have tended to break down something complex and teach it in parts with the expectation that having mastered the parts our students would have learned how to do the complex thing – playing baseball, in his example.  The problem is that baseball as a game is engaging but when broken down into little bits of theory and skill it becomes dull – a drudge.  So, do we teach science as the whole game of structured inquiry, or do we break it down into smaller chunks that are not always well connected (think lecture and practical)?  That was worry number one.

Let me broaden this out.  I see a direct link between the risks of breaking down a complex intellectual challenge into smaller activities that don’t appear to have intrinsic value and  ‘painting-by-numbers’ – as a process, it might create something that resembles art but the producer is not working as an artist.  If you indulge me a little, I’ll offer an example from education; learning outcomes.   In his 2012 article, The Unhappiness Principle’, in the UK’s Times Higher Education magazine, Frank Furedi argues that learning outcomes distort the education process in a number of ways.  He worries that learning outcomes provide a structure that learners would otherwise construct for themselves and the adopted construct is rarely as robust as a fully-owned one.  He also worries that learning outcomes by their nature attempt to reduce a complex system in a series of statements that are both simple and precise.  Their seeming simplicity of expression gives students no insight into the true nature of the problems to be tackled.  I don’t imagine that Socrates would have set out learning outcomes for his students.

I see similar issues in the specification of the assessment process; the detailed mark scheme.  Sue Bloxham and colleagues recently published the findings of a study of the use of marking scheme, entitling it ‘Let’s stop the pretence of consistent marking: exploring the multiple limitations of assessment criteria’.  The article is scholarly and it contains some uncomfortable truths for those who feel it should be possible to make the grading of assessments ‘transparent’.  In their recommendations they say, ‘The real challenge emerging from this paper is that, even with more effective community processes, assessment decisions are so complex, intuitive and tacit that variability is inevitable. Short of turning our assessment methods into standardised tests, we have to live with a large element of unreliability and a recognition that grading is judgement and not measurement [my emphasis] (Bloxham et al., 2016).

The idea that outcomes can be assured by instructions that are sufficiently detailed (complex) is flawed but it appears to have been adopted outside education as much as within.  The political historian, Niall Fergusson, makes this point well in one of his BBC Reith Lectures of 2012. In relation to the Dodd-Frank Act, he says, ‘Today, it seems to me, the balance of opinion favours complexity over simplicity; rules over discretion; codes of compliance over individual and corporate responsibility. I believe this approach is based on a flawed understanding of how financial markets work. It puts me in mind of the great Viennese satirist Karl Kraus’s famous quip about psychoanalysis, that it was “the disease of which it purported to be the cure” I believe excessively complex regulation is the disease of which it purports to be the cure.”  Niall Ferguson: The Darwinian Economy (BBC Reith lecture, 2012).

One of the problems is that detail looks so helpful.  It’s hard to imagine how too much detail could be bad.  There is are examples of where increasing detail led to adverse and unintended outcomes.  I have two examples, one from university management and another from education and training.  A colleague recently retold a story of a Dean who was shocked that, should a situation arise in an examination room, staff would themselves often decide on an effective course of action.  It turned out that the Dean had thought it more proper for the staff to be poring through university regulations.  He was also shocked to discover that the regulations did not contain solutions to all possible problems.  The example from education and training can be found in article by Barry Scwartz, published in 2011.   The article, called ‘Practical wisdom and organizations’, describes what happened when the training of wildland firefighters was augmented from just four ‘survival guidelines’ to a mental manual of very nearly 50 items.  He writes. ‘….teaching the firefighters these detailed lists was a factor in decreasing the survival rates. The original short list was a general guide. The firefighters could easily remember it, but they knew it needed to be interpreted, modified, and embellished based on circumstance. And they knew that experience would teach them how to do the modifying and embellishing. As a result, they were open to being taught by experience. The very shortness of the list gave the firefighters tacit permission—even encouragement—to improvise in the face of unexpected events. Weick found that the longer the checklists for the wildland firefighters became, the more improvisation was shut down.’  (Schwartz, 2011).  Detail in the wrong place or at the wrong level flatters to deceive.

By writing this piece I hoped to pull together my own thoughts and, speaking personally, it worked.  I now have a much clearer view of what concerns me about how we’ve been pushing education but that clarity has made my worries all the more acute.  Nevertheless, in order to round on a positive note I’ve tried to think of some positive movements.  I have always found John Dewey’s writing on education and reasoning to be full of promise (Findlay, 1910).  Active learning, authentic inquiry,  mastery learning and peer-learning seem to me to be close cousins and a sound approach for growing a real capacity to conceive of science as a way of looking to understand the unknown (Freeman et al., 2014) seem to me to have Dewey’s unspoken blessing.  I also think that Dewey would approve of Edgar Morin and his Seven complex lessons in education for the future (Morin, 2002). There is a video of Morin explaining some aspects of the seven complex lessons that I would recommend.

I’m off to share an hour with a glass of whisky in a dark room.

References

Bloxham S, den-Outer B, Hudson J & Price M. (2016). Let’s stop the pretence of consistent marking: exploring the multiple limitations of assessment criteria. Assess Eval High Edu 41, 466-481.

Findlay JJ, ed. (1910). Educational Essays By John Dewey. Blackie & Sons, London.

Freeman S, Eddy SL, McDonough M, Smith MK, Okoroafor N, Jordt H & Wenderoth MP. (2014). Active learning increases student performance in science, engineering, and mathematics. Proceedings of the National Academy of Sciences 111, 8410-8415.

Morin E. (2002). Seven complex lessons in education for the future. Unesco.

Perkins DN. (2009). Making learning whole : how seven principles of teaching can transform education. Jossey-Bass ; Chichester : John Wiley [distributor], San Francisco, CA.

Schwartz B. (2011). Practical wisdom and organizations. Research in Organizational Behavior 31, 3-23.

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Phil Langton is a senior teaching fellow in the School of Physiology, Pharmacology and Neuroscience, University of Bristol, UK.  A biologist turned physiologist, he worked with Kent Sanders in Reno (NV) and then with Nick Standen in Leicester (UK) before moving to Bristol in 1995.  Phil has been teaching GI physiology for vets, nerve and muscle physiology for medics and cardiovascular physiology for physiologists. He also runs a series of units in the second and third (final) years that are focused on the development of soft (but not easy) skills.  He has been interested for years in the development of new approaches to old problems in education and is currently chasing his tail around trying to work out how fewer staff can mentor and educate more students.

 

Aligning the Stars: Reflections on Integrating Research into the Teaching Lab

reaching-for-the-starsThis summer and fall has been a tumultuous season: I moved halfway across the country to start my first tenure-track job, and promptly embarked on the challenges of unpacking my house while setting up my research lab and preparing to teach two brand-new classes to a brand-new group of students I’d never met before. It’s been a period of happy chaos.

One of the biggest adjustments from my visiting-faculty life to my tenure-track life has been the new need for me to balance teaching and research. For the past two years, I’ve been focusing almost exclusively on building my teaching skills, conducting research only during the summer. In my new position at a small liberal-arts college, teaching remains at the heart of my job, but it’s again important for me to build and maintain an active research profile. Because I work with cell culture and neonatal rodents, and because I want to offer research experiences to students during the academic year, I’m now running my lab year-round while teaching three lab sections per semester. I’d already learned over the past few years that my research can inform my teaching, giving me plenty of interesting examples and anecdotes to share with my classes. Now I’m working on the next step of learning to successfully function as a teacher/scholar: developing strategies to merge my research life with my teaching life. Here’s what I’d suggest based on my experiences so far:

  • Do the crucial groundwork yourself. I’m incorporating an ongoing research project on neuronal differentiation into a neurobiology course this fall. However, my research students and I are plating the cells, and making and sterilizing the proliferation and differentiation media, ourselves. This lets the lab students get valuable experience working with cultured cells (on the first lab day of this project, they replace the proliferation medium with the differentiation medium and harvest a plate of control cells), but is relatively low-risk.
  • Simplify the experiments. Many of my experiments require multiple expensive growth factors to be administered at precise time points. I’m paring down my teaching lab differentiation protocol to a single-step protocol, using inexpensive reagents and only one media change. This still gives the students an authentic experience, but saves time, trouble, and money.
  • Focus on different aspects of your research in different classes. In my neurobiology class, students will be spending a great deal of time examining the morphology of their differentiated and undifferentiated cells using fluorescence microscopy. However, for a developmental class next semester, I’m planning on using the same cell line but running an inquiry-based lab, asking students to predict the outcome of various differentiation protocols based on their knowledge of developmental signaling pathways. This means that the students and I can continue to benefit from the interplay between research and teaching, but students who take multiple classes with me won’t be doing the same project (or even similar projects!) for each class. This strategy might also help students draw links between material presented in different courses, but connected by labs using the same model system.
  • Fit the research-based project to the class. My upper-level students generally know how to pipet, how to use a microscope, and how to comport themselves around scientific equipment. Students in classes at the 100- and 200-level can’t really be expected to work with cells in culture, or to pipet accurately enough to perform qPCR. However, examples drawn from your research can still be used even at the introductory levels. Fixed and stained slides of my neuron-like cells can show introductory students some key differences between mitotic cells and cells in Go Genomic DNA and cDNA from my cell lines could form the basis of a lab teaching budding molecular biologists about the differences between PCR and RT-PCR.

Incorporating your scientific research into your teaching isn’t necessarily a question of waiting for the stars to align until you’re offered the opportunity to teach an upper-level class in your exact area of research with only 6 enrolled students. Instead, you may very well have the potential to pull the stars into alignment yourself, designing labs that draw on the science that excites you the most, and connecting that passion to diverse sub-disciplines within physiology and biology.

 

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Kat Bartlow received her Ph.D. in Neurobiology from the University of Pittsburgh. Currently, she is an assistant professor in the Biology department at Lycoming College, in Williamsport, PA. Her current courses include Human Anatomy for majors and non-majors, Neurobiology, and Developmental Biology; she’s looking forward to developing an upper-level neurophysiology course so she can rejoin the world of physiology education. Her research focuses on dopaminergic neuronal development and neurotransmission within the dorsal striatum. She is also interested in using undergraduate-led physiology and neuroscience outreach as a teaching tool.

 

Grading student lab reports (while keeping your sanity)

I love teaching undergraduate labs and watching students grow as scientists. However, I’m not at all excited by the prospect of grading student writing. There are three strategies I wish I had known about before giving my first lab report assignment.

  • Full-rubrics should be written for each writing assignment before the term starts
  • Students need practice and feedback. This can be achieved with short, low-stakes writing assignments, peer-review and scaffolded assignments, which require minimal grading on my part.
  • The biggest sanity and time saver of all was telling students that I am not their editor or proofreader.

Each of those is probably worthy of its own blog post, so this is a brief overview of strategies I’ve adopted to save my sanity while grading lab reports (and other student writing assignments).

 

1) Full-rubrics

A lab report is usually a long, high-stakes assignment, that is worth a substantial portion of the final grade. A full-rubric is invaluable for streamlining the grading process and communicating expectations to students. A full rubric is not just a check-list of presence or absence of criteria needed to complete the assignment. Instead, for each criteria there is a detailed description of different levels of mastery or quality. Rubrics can be used to give formative or summative feedback, analytical or holistic assessments, or a combination. Another advantage of rubrics is that they help standardize grading across multiple sections of a course that are taught by graduate teaching assistants.

A good rubric is very time-consuming to create, but it has potential to save you many hours when it comes time to assess student writing. [This is especially true if you use an online course management system that has a built-in grading tool (e.g. Canvas Speed Grader). You can link your rubric to the assignment, and give comments and numerical scores for each criterion on the rubric. The tool will add the scores and put them directly into the online grade book. Hooray!]

Here is an example of a summative grading rubric from the methods section of a lab report.

Excellent Average Inadequate No Effort
Contains sufficient detail for the audience to validate the experiments Contains clear descriptions of all necessary steps for the reader to be able to validate the experiments without having to contact the author for more explanations. Descriptions of the experimental methods are provided, but some minor steps are missing so the reader will not be able to validate the experiments without further assistance. Descriptions of the experimental methods are provided, but one or more key steps are missing so the reader will not be able to validate the experiments without major further assistance. Descriptions of methods are so poor that the reader cannot grasp what experiments were done OR no description included at all.
Includes brief description of how data were analyzed (equations, statistics etc.) A clear description of how data were analyzed, including all relevant steps and calculations. A description of how data were analyzed but is missing some steps or calculations. A poor description of how data were analyzed and is missing substantial steps or calculations. Reader is unable to understand how data were analyzed OR no description is given at all.

 Resources to help you get started on your own rubrics

 

2) Practice and feedback

Students sometimes tell me that they are “not very good at writing”. My reply is that writing is a skill and as a skill, it requires practice, practice, practice. To this end, I use a mix of short, low-stakes writing assignments and scaffolding.

Low-stakes writing assignments are short, informal assignments that are designed to help students reflect on what they have been learning or doing, but don’t require much grading effort from the instructor. It’s important to give students the rationale for the assignment and present it as equally important as larger assignments, even though it’s worth fewer points. One popular example is a “minute paper.” These are brief in-class written responses to an instructor-posed question. Some sample prompts that align with writing a lab report:

  • What was the most surprising result from your experiment?
  • In your opinion, what would be a good follow-up experiment to yours?
  • What relationship did you see between ____ and ____?
  • Would you agree or disagree with this statement __________?
  • List the keywords, phrases and databases that you are going to use to search for references for your lab report.

Examples of other low-stakes, minimal grading assignments are timed “free-write” (write everything that comes to mind about the topic from memory for 5-10min), journals (separate from lab notebooks), outlines, or concept maps.

Scaffolding refers to taking a larger assignment and breaking it into smaller parts. I have my students write their lab reports in stages over five weeks. Each stage they receive formative feedback from me and/or go through peer-review. At each stage they are also required to explain how they incorporated feedback from the previous stage. By breaking a large assignment into stages, I can provide more detailed feedback so that their final lab report is more polished and easier to read.

Resources to help you with low-stakes assignments and scaffolding:

 

3) You are not the editor or the proofreader

Fixing spelling, punctuation and grammar are the student’s responsibility, not yours. Yes, students need to know when they have made technical errors, but it shouldn’t consume all of your time. One strategy is to simply make an X or other mark at the end of each line that contains an error. It is then the student’s job to analyze their writing and find the error. Another is to edit one paragraph and then instruct the student to look for similar errors throughout their writing.

Focus your time on making meaningful comments about content, especially on early drafts. Some of the most helpful comments are actually questions. For example, rather than tell a student to delete a sentence, ask the student how that sentence helps their argument. It is easy to overwhelm students with too many comments, so prioritize which comments to give. Don’t forget to give students positive feedback about the strengths of their writing! We tend to focus too much on the weaknesses.

Finally, plan ahead for how much time you realistically have for grading, and how much time you’ll need to grade each submission. Set a timer to keep yourself on track. If you find that one submission is taking too long, set it aside and take a break.

Resources to help responding effectively to student writing

 

AguilarRoca

 

 

Nancy Aguilar-Roca is an assistant teaching professor at the University of California, Irvine in the Department of Ecology and Evolutionary Biology. She studied respiratory and cardiovascular physiology of air-breathing fishes for her PhD at Scripps Institution of Oceanography and did a postdoc in evolutionary genomics of E. coli at UCI. She currently runs the high-enrollment upper division human physiology labs and is in the process of revamping the course with flipped lab protocols and more inquiry based activity (instead of “cookbook”). She also teaches freshman level ecology and evolutionary biology and is interested in using online ecology databases for creating inquiry-based computer activities for this large lecture course. Her other courses include Comparative Vertebrate Anatomy, Marine Biology, Physiology of Extreme Environments and non-majors physiology. At the graduate level, she co-organizes a seminar series for graduate students  and postdocs who are interested in learning evidence-based teaching techniques.  She was recently appointed Director of the Undergraduate Exercise Sciences Major and welcomes any advice about developing curriculum for this major.

Acknowledging race in the science classroom

thinkingAs a science educator, it is easy to say, “I don’t teach about diversity. That isn’t my field. Leave it to the social scientists.” I know because I’ve been there. Even if I wasn’t saying it out loud, I was thinking it.

With every institutional equity or diversity initiative, I convinced myself I contributed in other ways, supporting other aspects of the college’s mission. “Leave diversity to the experts,” I said to myself.

Back to teaching science. Diabetes is a topic I know something about. My training, my research, and my teaching, focus on how the body uses hormones as a form of communication, and diabetes provides a useful framework for teaching and learning about human physiology.

I teach my entire introductory biology course through the lens of diabetes. Students become totally hooked! The active teaching, the activities with clay and pipe cleaners (regular classroom supplies in my department), and the engaging research projects all are student favorites. Students succeed, with very low drop or fail rates (<5%), and at the conclusion of the course, they are enthusiastic about taking more biology courses (Johnson & Lownik, 2013). Things seem to be going well. Why worry?

During the introductory biology course, we spend days going over CDC data about the trends and risk factors for diabetes (CDC, 2015). Are the relationships correlations or causations? How can we use population data to think about the biological mechanism of diabetes? These are great questions for introductory students, and they totally buy in.

However, something funny happens when we start looking at these data. Diabetes is a disease that affects Black and Hispanic populations at a vastly higher rate than White populations (CDC, 2015).  Why would I talk about that?  Let’s talk about the science.  I know the science. I have spent years studying how the hormones regulate glucose (i.e., “the science”).

Quite frankly, I am scared to stray from my training. The students of color become very engaged around the topic of diabetes, and they are really intrigued by the data about the racial differences.  Many students of color speak of their beloved grandparents’ struggle with diabetes.  What if these students start asking me questions about race? As a White professor, how can I answer their questions? I know about how hormones act to change glucose levels; I don’t know why certain racial and ethnic groups are more susceptible. These students want answers about their own risk, and I feel I don’t know how to help them.

In response to my fear, I deliberately avoid the topic of race disparities around diabetes rate among different races. I ask students to spend a day researching different populations, both domestic and abroad, that are at higher risks for diabetes. We talk about socioeconomic factors, cultural factors, obesity, and food availability, but in vague and general terms. I might put up a graph to demonstrate disparities, but we never “have time” to go into an in-depth discussion. We never really talk about why these disparities exist.

As a researcher, I would never intentionally ignore a major contributing factor to a disease. Would we ever ignore smoking as a risk factor for heart attacks or lung cancer? No. Why am I completely avoiding an aspect of diabetes that makes individuals almost twice as likely to develop the disease (CDC, 2015)?

 

In the process of teaching to my comfort level, by ignoring race and ethnicity as risk factors for diabetes in my course, I have been:

  1. Teaching students that only certain traditional aspects of disease should be investigated and emerging or relatively newly identified risk factors do not deserve attention.

Potential long-term impact: By focusing exclusively on the role of hormones in diabetes and obesity, I ignored other mechanisms that may be connected to other evidence-based risk factors of disease, limiting the scope and creativity of questions investigated in my classroom. What if the next great discovery comes from conducting a statistical correlation on an established dataset that no one has ever thought to run? While asking students to be scientists, I reinforced old practices at the expense of new findings and approaches.

  1. Reinforcing that scientists don’t “do” diversity.

Potential long-term impact: While national science education initiatives have a strong emphasis on encouraging diversity and equity, these movements have struggled to develop at the grassroots level. Almost all White science majors struggle to articulate the importance of diversity in science. Their typical answer will be that their fields do not address these differences, when in fact, everyone has different experiences, training, and assumptions, and everyone draws different conclusions based on their previous experience. If the importance of diversity is ignored, current and future scientists will continue to surround themselves with individuals that think and act like them, instead of those with new ideas and interpretations that will challenge their thinking.

  1. Ignoring the concerns of students of color, and possibly persuading them that their questions are not important.

Potential long-term impact: By glossing over the details of racial health disparities, or simply not taking the time to understand them myself, I silenced my students, specifically those of color. Looking back, no wonder my Black and Hispanic students switched their majors to public health and sociology. I was ignoring their queries and interests.  They went to disciplines that would address their questions. Mass exodus of individuals of color represents a deletion of perspectives from the scientific community. The result is a limited set of experiences that determine the scope of future research agendas; therefore, severely limiting the ability to solve large and complex scientific problems (Page, 2007).

Over the past couple of years, I have changed the way I think about diversity in my science classroom.  The potential harm listed above was a factor in these changes; however, my greatest influence was students of color at my institution stating saying they did not feel safe or welcome on campus or in the sciences. My institution accepted the challenge, and I needed to follow suit.

Here are a few things I have done to change the atmosphere in my classroom:

  1. We now talk about racial health disparities and investigate mechanisms in my courses, using CDC data or peer-reviewed scientific articles (ex. Herman, et al., 2016).
  2. I continue to educate myself about the interdisciplinary research investigating these disparities.
  3. I acknowledged publicly to students that when it comes to talking about race and diversity, I might not get it right, might not have all the facts, and might have different personal experiences than theirs.
  4. I avoid telling students that their experiences with racism are wrong or overblown.
  5. I use an assets-based approach to teaching science. All students develop strategies to become successful, and I ask students to identify those strategies and discuss how their strategies align with a list of skills needed to become a good scientist.
  6. I avoid shutting down communication. I do everything I can to facilitate productive participation, but even this can go wrong. In the past, on the first day of class, I would ask students to introduce themselves and talk about a summer experience. This exercise is very intimidating for students that worked as day labors all summer, compared to other students that went on wonderful European vacations. Now I ask students to describe their favorite food or dessert.

While I still have much to learn, I am now a scientist that “does” diversity.

References

CDC (2015). Diabetes Public Health Resource. Available at: http://www.cdc.gov/diabetes/statistics/incidence/fig6.htm, accessed August 2, 2016.

Herman, et al. (2007). Differences in A1c by race and ethnicity among patients with impaired glucose tolerance in the diabetes prevention program. Diabetes Care, 30 (10): pp. 2453-7.

Johnson, K.M.S. and Lownik, J.C. (2013). Workshop Format Increases Scientific Knowledge, Skills, and Interest when Implemented in an Introductory Biology Course that Attracts and Retains Underrepresented Minorities.  Poster.  Experimental Biology, Boston, MA, April 20-24, 2013.  Published Abstract: FASEB J. 27:739.7

Page, S.E. (2007). The difference: how the power of diversity creates better groups, firms, schools, and societies. Princeton University Press (Princeton, New Jersey).

 

KatieJohnson

 

 

 

 

 

 

 

Katie Johnson, Associate Professor of Biology at Beloit College, evaluates the effects of active teaching practices on learning attitudes and outcomes in different student populations. She has been recognized by the American Physiological Society for her work. Her laboratory research assesses the connection between obesity and hormones that regulate glucose levels in animals. She mentors a diverse group of trainees and has numerous physiology and pedagogy publications and presentations co-authored by undergraduate researchers.

 

 

Establishing rapport with your class BEFORE they are your class

shutterstock_124813237Think back to some of the best courses/semesters you’ve ever had teaching (or as a student). I can almost guarantee that you fondly remember several of the students who were in the class. You would recognize them today even if you have had thousands of students since they last sat in your classroom. You probably remember specific interactions that you had. Maybe (after they were out of your class and preferably graduated, you even accepted their Facebook friend requests) Why? What made those students so memorable? Maybe it was a common academic interest or passion, some sort of unique personality trait, or maybe some unexplainable, unseen force that developed organically that you can’t pinpoint and think you can never purposefully recreate in future courses. Well, I’m here to tell you that you just might be able to recreate it. In fact, you can actually manufacture it for your future courses. While it does sound like cheating, it will help make your class successful for all of the other students as well.

With the beginning of the fall semester approaching, the first few days of your course will set the stage for the next 16 weeks. Obviously being well-prepared with the syllabus, course objectives, and course schedule well organized and outlined for the students is necessary as Angelina eloquently outlined in the previous article. Further outlining the expectations of yourself as the instructor and the students as the learners will help to start your course on the right trajectory. But a classroom success strategy that is easy to overlook, especially in the hectic first days of the semester, is building an early rapport between yourself and the students. While building rapport with the students comes more easily for some than for others (we all have that colleague who seems to naturally have the right combination of wit, charm, and caring and who never seems to have a problem engaging students), numerous factors contribute to its development, and nearly all of them can be planned for and controlled, manufactured if you will. I did not realize to what extent this was true until very recently though.

Generally, I have a good rapport with most of my classes and my Individual Development and Educational Assessment (IDEA) evaluation scores seem to indicate that is the case. However, the impetus for this article came after I struggled through my recent summer session course. I was left questioning my teaching abilities after every one of the 20, 2-hour-long class meeting times. Since I had taught the course multiple times, in the same time slot, and used all of the same strategies and more in attempts to connect and engage with the students like I successfully had in previous courses, I was baffled as to what the difference might be. Why was this one section so much less engaged, less likely to ask questions, less enthusiastic about the various activities, less likely to stop by my office, and less likely to e-mail with non-course related physiology questions? I had done everything that the literature recommends to develop rapport with students, but after my own post-hoc course evaluation and some serious introspection, I have an idea of what went wrong. I had not laid the ground work to build rapport with even one single student BEFORE the class began. While great articles do exist on building rapport in the classroom (see Meyers 2009 and Buskist & Saville 2001), few of them discuss how to build rapport before you’re in the classroom. It’s easier than you realize.

Thinking back to some of the best classes I’ve ever taught, I realized that I have always had at least one “go-to” student from the very first day of class, a student who I knew was reasonably comfortable speaking up in front of the whole class. I would use this student as a bellwether for the whole class in the first couple of days, posing questions directly to him or her and asking for comments and feedback. Inevitably, this would show other students that it was okay to speak up, make comments, and ask questions. Usually this student is pretty outgoing, but not always. Usually this student is good academically, but not always. Sometimes this student could be defined as the “class clown,” but not always. Almost always, however, I have known or at least communicated with this student before the semester has begun. Sometimes the student was in a previous class I taught or was my advisee, but often it is just a student who had trouble registering or had a question that required coming to my office before the first day of class. How did these students become my go-to students? What did I do to make these my go-to students? What makes them different? I have no idea honestly, but something about that first interaction, however innocuous, enables it to occur. Considering my past go-to students, I’ve come up with the three main ways that you can make sure that this interaction occurs in your class.

  1. During the advising and registration period (often the semester before), encourage students that you know to enroll in your class.
    • If you’re an advisor for students who might take your course this is actually pretty easy. Identify several students who might be able to fit your course into their schedules. Encourage them. “I really would enjoy it if you were able to take my course.” I have found this to be a very effective way to get students who are already comfortable speaking with me into my class. Not an advisor? E-mail students you’ve had in other courses or you’ve worked with in some other capacity.
  2. Prior to the semester start, someone is bound to e-mail or stop by your office to ask about your course, tell you he/she is having trouble registering, ask about a textbook, etc. Use this as an opportunity.
    • Obviously in these situations learn the student’s name, but also ask a couple other questions. “How’s your semester going?” “How was your summer?” “What makes you interested in this class?” “Is that shirt from that local 5k? You like running?” These interactions might seem like meaningless chit-chat, but they can really lay the foundations for classroom rapport later on. Latch on to anything the student says that you might be able to use later in class. Now you know you have a runner that went to the beach over summer. Great! You teach a physiology class and now you have a wealth of information that can make your lecture relevant to that student…and likely many more. Mention the student by name when you bring up the topic.
  3. Once you receive your class roster, look at it! E-mail the students even if it is weeks before the course starts.
    • Scan through your roster looking for students you’ve had previously or otherwise know. Send them individual e-mails and tell them you’re glad they’ll be in your class. Look at each student’s major, minor, even club affiliations if you have access. Take note of anything you can use later. Craft an e-mail to all the students to introduce yourself. “Hi! I’m Ed Merritt and I’ll be your professor for exercise physiology. I’m really looking forward to meeting everyone. Looking at the roster I see we have several nutrition majors in this class. Remind me to tell you a story about the time I ate a doughnut right before a hard workout. I also see we have a British literature major. Don’t worry. I’ll find a good story for you too! Let me know if you have any questions or concerns before the first day, otherwise I’ll see you soon!”

These three strategies alone will almost always insure that you have a go-to student for the first day of class. Use this connection. Call on him or her by name and show the class that you care about that student. The class won’t know that this is your go-to student, but once you have your go-to student engaged the rest of the class is much more likely to engage. Rapport is contagious, and once you have it with the class, teaching the material is much more enjoyable, and the student outcomes are much better. And hopefully you won’t have to suffer through a semester questioning your teaching abilities after every class.

Good luck with the upcoming semester!

 

References

Meyers SA. Do Your Students Care Whether You Care about Them? College Teaching, v57 n4 p205-210. 2009.

Buskist W, Saville BK. Creating positive emotional contexts for enhancing teaching and learning. APS Observer. p12-13. 2001.

 

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Ed Merritt is an assistant professor in the Department of Health and Exercise Science at Appalachian State University in Boone, North Carolina. Ed received his doctorate in Kinesiology from the University of Texas at Austin and completed a postdoctoral fellowship in Cellular and Integrative Biology at the University of Alabama at Birmingham. Ed’s research focuses on the molecular underpinnings of skeletal muscle atrophy after trauma and with aging, but he is also equally involved in the scholarship of teaching and learning and melding educational outreach activities with service learning.