September 11th, 2017
Making the most of being a new instructor: Learning that collaborative learning is my silver bullet

When starting my first semester as an associate instructor in graduate school, I felt nervous and anxious, but also excited and privileged. I went to graduate school with the intention of not only performing experiments and learning about physiology and behavior, but also with the strong desire to learn how to teach and mentor students at all stages of their undergraduate careers. Many of my colleagues had very similar reactions to the first few weeks of teaching. I spoke to a few of them about these feelings recently. Here is what they had to say:

“The first week always felt a bit awkward. Students are still getting comfortable with your presence and getting to know you.”

“I felt curious about a new system, nervous about giving the students what they needed out of the class, and excited to lead a class for the first time.”

“I remember not feeling prepared and incredibly nervous! I wish I had known what I know about teaching now, but the nerves haven’t gone away either…I think I’m now able to better apply “what works” as far as classroom techniques.”

In thinking about all of these ideas, what particularly resonated with me was the notion that the nerves haven’t quite gone away, but I too have learned that there are techniques I can now implement in my classroom, helping to hide some of those feelings. I began my graduate career helping to teach an Integrative Human Physiology course, where I was able to teach teams of students in a case-based classroom. In this course, students engaged in collaborative learning (team-based learning) in every class period (something I had not witnessed myself during my education thus far). Collaborative learning is a technique in which students engage in problem solving with their peers, using the different skills and expertise of the group, as well as resources and tools that are available to them [1,2].  Students in this course were put into teams, and members of each team were responsible for their own learning and for assisting in the learning of their teammates. In this kind of classroom environment, the team’s culture and how they interacted with each other were key elements of their success. While a graduate student instructor for this course, I met with the teams regularly to facilitate a discussion, of not only the course material, but also their strategies for working collectively and how to approach their assignments as a team.

What I feel to be the most important part of teaching physiology is that we have to be able to adapt to the changing environment and have the courage to try new techniques. Students learn at their own pace, and each student learns in a slightly different way, therefore it is important to have flexibility in how we teach [1]. What I hadn’t realized until spending time using collaborative learning in my own classroom is that it can be adapted for so many disparate situations. I’ve found that it will work for a diverse range of students, and that with careful thought and planning (though sometimes on the fly), it can work well in a host of teaching situations and for a number of different types of learning styles.

 

A few examples for an introductory course:

  1. Taboo

    1. This game is similar to the actual game, “Taboo,” in which the goal is for students to get their teammates to guess the word at the top of the card. He or she can say any word to try to make the teammates guess, except for the words written below it on the card. The game can be played by a small team of about 3-5 students. It is important to emphasize that teams should discuss the cards after playing them, so they can master the connections.
    2. You can make these cards beforehand, so students can immediately start playing, or you can have the teams make their own cards, which will also help them think of the connections between the words before starting.
  2. Affinity Map

    1. This game has to do with making connections between key words. In many introductory classes, students must master lots of vocabulary, but “mastering” should mean more than just memorizing. This activity gives students the opportunity to discuss how these important terms create an understanding of a concept.
    2. This can be used for many different concepts, but here is an example for the properties of water: Each student in a group receives 3 or 4 post-it notes. Ask each student to write down one property of water. They might draw the molecular symbol, write a fact about the universal solvent, discuss how much of our body is composed of water, hydrogen bonds, etc. It doesn’t really matter what they write, and some will write similar things, but that’s okay. After they have all finished, students will go up to the board and place their post-it notes on the board where everyone can read them. Then the group, together (and out loud), will organize their statements about water, putting them into groups (affinities). They should categorize the affinities, noting what is the same and what is missing and can label the affinities. Some may feel like adding additional post-its to make more connections, and that is okay too.

 And one for the more advanced course:

  1. Case Study

    1. This can be used throughout a semester to help students synthesize many physiological concepts in a single activity with their team. It helps to stimulate discussions about many different concepts rather than a focused discussion on just one concept they may have learned.
    2. Provide a case study to each team of students (they can be all the same or different). Allow the students to work in their teams to analyze and synthesize their case. You can have them write important aspects of the case either on paper or on a large white board (if available). Once students have completed their case study, have teams share their analysis with the whole classroom, providing the opportunity for questions and discussion. You can also have teams make their own case studies for other teams in the class. When students take the time to create their own case studies, they often learn even more!

Throughout all of these activities, I always walk around to make sure students are both on task and making connections.

 

Moving Forward

As I continue in my graduate career and beyond, what is most important is that I try to be flexible enough to see the possibilities that there are in every new classroom. Each classroom that I am in is a little different than the next, so understanding that collaborative learning can help students with a range of concepts, and having the courage to adapt collaborative learning in a way that will work for my classroom has been very helpful (and will continue to be useful). It is almost as if each classroom has its own personality that might change from day to day, so knowing that I have a set of key techniques that I can fine-tune for each classroom is helpful as I continue in my teaching career and can hopefully be helpful in yours!

 

References

[1]       J. Bransford, A. Brown, R. Cocking, How People Learn: Brain, Mind, Experience, and School, National Academy of Sciences, Washington, D.C., 2000.

[2]       D.B. Luckie, J.J. Maleszewski, S.D. Loznak, M. Krha, Infusion of collaborative inquiry throughout a biology curriculum increases student learning: a four-year study of “Teams and Streams”., Adv. Physiol. Educ. 28 (2004) 199–209. doi:10.1152/advan.00025.2004.

 

Kristyn Sylvia received her B.S. in Biology from Stonehill College, and is currently a PhD candidate in the Department of Biology at Indiana University (IU) and a NIH Common Themes in Reproductive Diversity fellow where she studies how the neuroendocrine system interacts with the reproductive and immune systems early in life in Siberian hamsters. She worked as a clinical research associate in Boston, MA, before coming to IU. She is also a graduate student instructor in Biology, where she has taught a number of courses, including Human Integrative Physiology, and she serves on the Animal Behavior Undergraduate Curriculum Committee, where she collects and analyzes data on the major and addresses potential changes to the curriculum as it grows. She also serves on the APS Teaching of Physiology Section Trainee Committee.
August 28th, 2017
Teaching Backwards

 

Generating new ideas and cool learning experiences has always been natural and fun for me. My moments of poignant clarity often came during a swim workout or a walk with my dog as I reflect on my classes. As I visualize this activity, my students are as enthusiastic as I am and are learning. Then, reality returns as I grade the next exam and see that less than half of the class answered the question related to that activity correctly. Accounting for the students who learn despite what I do, I quickly see that I only reached a quarter of my students with this great activity. Why did this happen? What can I do about this?

Well, my life as an instructor changed the day I walked into my first session of University Center for Innovation in Teaching and Education (UCITE) Learning Fellows at Case Western Reserve University.  This program is a semester long session on how learning works where the focus is on evidence-based learning practices and provides an opportunity to discuss successes and failures in teaching with peers.  It was here that I learned about “Backwards Design”1.

What is Backwards Design?

Essentially, it is designing your course with the end in mind. I think of it as “Teaching Backwards” – that is, I visualize my students 5-10 years from now in a conversation with a friend or colleague discussing what they learned from my class. I ask myself these questions:

  1. How do I want them to describe my class? Hansen refers to this as the “Big Idea” or broad objective. An example from one of my classes is provided in Table 1.
  2. What do I want them to be able to tell their friend or colleague that they learned from the class in 5 to 10 years? Hansen has termed this as “Enduring Understanding” (see Table 1).

The next phase is to write learning objectives for each of the enduring understandings (see Table 1). We continue the journey backwards into linking learning objectives to assessment methods and developing the details of each class session. During this process, we must always take into account the student’s prior knowledge (refer to How Learning Works2).

Table 1: Example of Backwards Design Concepts for “Exercise Physiology and Macronutrient Metabolism” class.

Class: Exercise Physiology and Macronutrient Metabolism
Big Idea Enduring Understanding Learning Objective
Exercise-Body Interaction Substrate utilization during exercise depends on type, intensity, and duration of exercise. Students will be able to describe substrate utilization during exercise.
Fatigue during exercise has been associated with low glycogen levels, but scientists are not in agreement as to the underlying cause of fatigue. Students will be able to debate the theories of fatigue.

What did backwards design do for me?

Backwards design provided me focus. It allowed me to step back and ask myself: What are the key take-aways? Does that cool, creative idea I have help to achieve my end game for the course? Is there a better way to do this? Overall, the framework has helped me develop a higher quality course. With that said, I still run into exam questions where I thought I did better at teaching the material than represented by the students’ responses.  So, while there is always room for improvement, this has definitely been a step in the right direction for better learning by my students.

References:

  1. Hansen EJ. Idea Based Learning: A Course Design Process to Promote Conceptual Understanding. Sterling VA: Stylus Publishing, LLC; 2011.
  2. Ambrose SA, Bridges MW, DiPietro M, Lovett M, Norman MK.How Learning Works: 7 Research Based Points for Teaching. San Francisco CA: Jossey-Bass, 2010.

 

Lynn Cialdella-Kam, PhD, MBA, MA, RDN, LD joined CWRU as an Assistant Professor in Nutrition in 2013. At CWRU, she is engaged in undergraduate and graduate teaching, advising, and research. Her research has focused on health complications associated with energy imbalances (i.e. obesity, disordered eating, and intense exercise training). Specifically, she is in interested in understanding how to alterations in dietary intake (i.e., amount, timing, and frequency of intake) and exercise training (i.e., intensity and duration) can attenuate the health consequences of energy imbalance such as inflammation, oxidative stress, insulin resistance, alterations in macronutrient metabolism, and menstrual dysfunction.  She received her PhD in Nutrition from Oregon State University, her Masters in Exercise Physiology from The University of Texas at Austin, and her Master in Business Administration from The University of Chicago Booth School of Business.  She completed her postdoctoral research in sports nutrition at Appalachian State University and is a licensed and registered dietitian nutritionist (RDN).
August 14th, 2017
Thinking Critically About Critical Thinking

 

A few mornings ago, I was listening to a television commercial as I got ready for work.  “What is critical thinking worth?” said a very important announcer.  “A whole lot” I thought to myself.

But what exactly is critical thinking?  A Google search brings up a dictionary definition.  Critical thinking is “the objective analysis and evaluation of an issue to form a judgement.”  The example sentence accompanying this definition is “professors often find it difficult to encourage critical thinking among their students.” WOW, took the words right out of my mouth!

Have any of you had the following conversation? “Dr. A, I studied and studied for this exam and I still got a bad grade.  I know the material, I just can’t take your tests!”  The student in question has worked hard. He or she has read the course notes over and over, an activity that has perhaps been rewarded with success in the past.  Unfortunately re-reading notes and textbooks over and over is the most common and least successful strategy for studying (4).

In my opinion, as someone who has been teaching physiology for over 20 years, physiology is not a discipline that can be memorized.  Instead, it is a way of thinking and a discipline that has to be understood.

Over the years, my teaching colleague of many years, Sue Keirstead, and I found ourselves during office hours trying repeatedly to explain to students what we meant by thinking critically about physiology.  We asked the same probing questions and drew the same diagrams over and over.  We had the opportunity to formalize our approach in a workbook called Cells to Systems Physiology: Critical Thinking Exercises in Physiology (2).  We took the tough concepts students brought to office hours and crafted questions to help the students work their way through these concepts.

Students who perform well in our courses make use of the workbook and report in student evaluations that they find the exercises helpful. But we still have students who struggle with the critical thinking exercises and the course exams.  According to the comments from student evaluations, students who struggled with the exercises report they found the questions too open ended.  Furthermore, many of the answers cannot be pulled directly from their textbook, or at least not in the format they expect the answer to be in, and students report finding this frustrating.  For example, the text may discuss renal absorption and renal secretion in general and then the critical thinking exercises asks the student to synthesize all the processes occurring in the proximal tubule.  The information is the same but the organization is different.  Turns out, this is a difficult process for our students to work through.

We use our critical thinking exercise as a type of formative assessment, a low stakes assignment that evaluates the learning process as it is occurring.  We also use multiple choice exams as summative assessments, high stakes assessments that evaluate learning after it has occurred.  We use this format because our physiology course enrollment averages about 300 students and multiple choice exams are the most efficient way to assess the class.  We allow students to keep the exam questions and we provide a key a couple of days after the exam is given.

When a student comes to see me after having “blown” an exam, I typically ask him or her to go through the exam, question by question.  I encourage them to try to identify how they were thinking when they worked through the question.  This can be a very useful diagnostic.  Ambrose and colleagues have formalized this process as a handout called an exam wrapper (1).  Hopefully, by analyzing their exam performance, the student may discover a pattern of errors that they can address before the next exam.  Consider some of the following scenarios:

Zach discovers that he was so worried about running out of time that he did not read the questions carefully.  Some of the questions reminded him of questions from the online quizzes.  He did know the material but he wasn’t clear on what the question was asking.

This is a testing issue. Zach, of course, should slow down.  He should underline key words in the question stem or draw a diagram to make sure he is clear on what the question is asking.

Sarah discovers that she didn’t know the material as well as she thought she did, a problem that is called the illusion of knowing (3). Sarah needs to re-evaluate the way she is studying.  If Sarah is cramming right before the exam, she should spread out her studying along with her other subjects, a strategy called interleaving (3).  If she is repeatedly reading her notes, she should put her notes away, get out a blank piece of paper and write down what she remembers to get a gauge of her knowledge, a process called retrieval (3).  If she is using flash cards for vocabulary, she should write out learning objectives in her own words, a process called elaboration (3).

Terry looks over the exam and says, “I don’t know what I was thinking.  I saw something about troponin and I picked it.  This really frustrates me. I study and study and don’t get the grade I want.  I come to lecture and do all the exercises. I don’t know what else to do.” It is a challenge to help this student.  She is not engaging in any metacognition and I don’t claim to have any magic answers to help this student.  I still want to try to help her.

I feel very strongly that students need to reflect on what they are learning in class, on what they read in their texts, and on the activities performed in lab (3).  I have been working on a project in one of my physiology courses in which I have students take quizzes and exams as a group and discuss the answers collaboratively.  Then I have them write about what they were thinking as they approached the question individually and what they discussed in their group.  I am hoping to learn some things about how students develop critical thinking skills.  I hope I can share what I learn in a future blog posting.

  1. Ambrose SA, Bridges MW, DiPietro M, Lovett M, Norman MK. How Learning Works: 7 Research Based Points for Teaching. San Francisco CA: Jossey-Bass, 2010.
  2. Anderson LC, Keirstead SA. Cells to Systems: Critical Thinking Exercises in Physiology (3rd ed). Dubuque, IA: Kendall Hunt Press, 2011.
  3. Brown PC, Roediger HL, McDaniel MA. Make it Stick: The Science of Successful Learning. Cambridge MA: The Belknap Press of Harvard University Press, 2014
  4. Callender AA, McDaniel, MA. The limited benefits of rereading educational text, Contemporary Educational Psychology 34:30-41, 2009. Retrieved from http://ac.els-cdn.com/S0361476X08000477/1-s2.0-S0361476X08000477-main.pdf?_tid=22610e88-61b4-11e7-8e86-00000aacb35e&acdnat=1499281376_e000fa54fe77e7d1a1d24715be4bbf50 , June 22, 2016.

 

 Lisa Carney Anderson, PhD is an Assistant Professor in the Department of Integrative Biology and Physiology at the University of Minnesota. She completed training in muscle physiology at the University of Minnesota. She collaborates with colleagues in the School of Nursing on clinical research projects such as the perioperative care of patients with Parkinson’s disease and assessment of patients with spasticity. She directs a large undergraduate physiology course for pre-allied health students.  She also teaches nurse anesthesia students, dental students and medical students.  She is the 2012 recipient of the Didactic Instructor of the Year Award from the American Association of Nurse Anesthesia.  She is a co-author of a physiology workbook called Cells to Systems: Critical thinking exercises in Physiology, Kendall Hunt Press. Dr. Anderson’s teaching interests include teaching with technology, encouraging active learning and assessment of student reflection.
August 1st, 2017
Report from the Inaugural Physiology Majors Interest Group Meeting

When I first heard about the Physiology Majors Interest Group at the APS Teaching Section Symposium entitled “What’s Your Major? The Rise of the Undergraduate Physiology Degree” by co-chairs Erica Wehrwein and John Halliwell at Experimental Biology in 2015, I was immediately excited.  I’m primarily an undergraduate educator and strongly identify as a ‘physiologist’ and hope some of my students do as well.  Yet, I wasn’t entirely sure.  As an assistant professor in a department of Health and Sport Science who primarily advises students in the Exercise Physiology major who want to be physician assistants and physical therapists, was I “enough” physiology?  After attending the first stand-alone conference for this group in East Lansing earlier this summer, I’m not only confident that I was right to be excited about this APS interest group but also that as Erica Wehrwein, organizer of the conference has previously reported, physiology really is alive and well at the undergraduate level.

 

What is a Physiology Major?

One of the overarching topics of discussion at the meeting, in formal sessions and during breaks revolved around this central question regarding physiology education at the undergraduate level.  From the first introductions onward, it was clear it wasn’t going to be a simple answer.  Of the 45 in attendance, a number of different departments and/or majors were represented: physiology, biology, health sciences, human biology, and kinesiology to name a few with 24 to 2274 students in these different majors.  When we talked about the students we teach, advise, and mentor, they are future physicians, nurses, physical therapists, researchers, physician assistants, and many other professions.  Still more diverse, when we compared curricula as reported in a pre-meeting survey, we saw ranges of required courses in basic sciences, anatomy, physiology, and associated laboratories.  Yet, among these differences, there were striking similarities as well.  Sessions sparked discussions of the core concepts (a topic discussed previously on this blog) of physiology we emphasize, required skills that we want our graduates to have and how we try to build these, and common employment trends when students leave our programs and the challenges this can pose for advising.  In regard to the original query of what is a physiology major, as can often be the case in our discipline, it was less about the answer itself, and more about the discussions we had along the way.

 

An integrative discipline, an integrated community

One of the most valuable aspects of the meeting was being able to spend two days with other passionate physiology professionals.  Just as I see integration of physiology and other scientific disciplines, similar to integrated body systems, I was making connections with others from large, research-intensive universities, to small, liberal arts colleges and still others that like myself, fit somewhere in the middle.  Everyone was extremely willing to share their thoughts and ideas on how to best push physiology forward and increase its value in the ever-competitive landscape of higher education.  Conversations ranged from curriculum design to specific teaching strategies and there was a free flow of information with both newer and more seasoned participants engaging in the learning process.  In a sense, the meeting modeled what we often strive to achieve in our programs and classrooms- critical thinking, grounded in evidence, with a creative application towards future improvements or development of new knowledge.

 

What does the future hold?

As the meeting ended, we went our separate ways, armed with new tools and ideas we can implement or consider in our own programs.  A sampling of the ideas I took home:

  • In teaching materials, identify the conceptual model or core principle that is being taught and ask students to do the same when completing assessments.
  • Include teaching about T-Shaped professionals in my Introduction to Health Professions course.
  • Use Khan academy YouTube videos to demonstrate to students how they can concept map while studying.
  • Help students identify transferable skills and knowledge from non-health related job (such as a cashier or server) through ONET.
  • Consider departmental membership in the American Kinesiology Association to further connect with similar programs.
  • Use and contribute to the resources I already knew about, such as Advances in Physiology Education, this LifeSciTRC, and other APS resources.

The interest group will continue, and future meetings are already being planned.  The next meeting will be held in June 2018 at the University of Arizona.  To stay in the loop, join the listserv by contacting Erica Wehrwein (wehrwei7@msu.edu).  To keep physiology education a priority, we will continue to meet, discuss, and inspire the next generation of those who identify with physiology, just as I have and will continue to.  I’m grateful to Erica and the work of the planning committee for putting together an event that focused on this important aspect of the work I do as a physiology educator.

Anne Crecelius is an Assistant Professor in the Department of Health and Sport Science at the University of Dayton.  She teaches Human Physiology and a Capstone Research course.  She returned to her undergraduate alma mater to join the faculty after completing her M.S. and Ph.D. studying Cardiovascular Physiology at Colorado State University.  Her research interest is in the integrative control of muscle blood flow.  She is a member of the American Physiological Society (APS), serving on the Teaching Section Steering Committee and the Communications Committee.
July 24th, 2017
Who’s Teaching Tomorrow’s Teachers?

Have you ever had a colleague say to you:

 “They want me to teach in this new integrated physiology course, but no one has ever taught me how to be an effective teacher!  I’ll be so nervous and probably make embarrassing mistakes, like saying the “love hormone”, oxytocin, is synthesized from cholesterol in the adrenal medulla.”

Being asked to teach first year medical students can certainly be intimidating, but that assignment is not actually akin to being thrown to the wolves. It is true that medical students are often over-achievers, but it’s been my experience over many years that these students are respectful and anxious to learn.

 

Maybe I can offer you a few tips that will help you avoid or prevent these first time  ‘teaching jitters’:

  • Know your subject and relevant scientific facts inside and out
  • Take advantage of teaching skills, workshops, and faculty development programs at your institution or through professional organizations
  • Ask your colleagues for constructive criticism of your first presentations
  • Remember that practice makes perfect, at least most of the time
  • Remember that a good sense of humor goes a long way, but bad jokes rarely help the situation
  • Don’t be afraid that you will make a couple of mistakes- we all make them but not all of us learn from them
  • Work to create effective visuals which may include human interest stories, physiology in the news, and even masterpieces by your favorite artist

Another more proactive approach is to offer programs that will encourage students to pursue their interests in teaching and help them develop the communication skills and understanding of different learning styles and pedagogies that are so essential to becoming an enthusiastic and dedicated educator. Many medical students want to ultimately incorporate teaching into their future careers as clinicians, either by formally teaching in an academic medical center or more informally through their communication with patients and with the community at large.

Here at the Carver College of Medicine at The University of Iowa we encourage our students to pursue one of our specific distinction tracks, which include research, teaching, global health, service, humanities and healthcare delivery science and management, while they are pursuing their medical degree. Although the whole concept of “teaching medical students to teach” is certainly not unique to my institution (ref 1), I do believe that our Teaching Distinction track is unique and has succeeded in terms of achieving the desired outcomes.  I’ve been very fortunate, not to mention honored, to serve as the faculty mentor for several of our previous and current students who have selected to pursue their MD with a Distinction in Teaching. It has been very exciting for me to have the opportunity to impact a student’s learning, not only in the classroom, but also in terms of their own experiences and development as educators. It has also been very gratifying when a former mentee tells me that they learned so much from me- not just endocrinology and cell biology, but also how to convey passion and enthusiasm as a teacher.  Certainly this has been a win-win experience because I’ve learned so much from these students!  Maybe Henry Adams was right when he concluded that “A teacher affects eternity; he/she can never tell where his/her influence stops.”

In order to graduate with a Distinction in Teaching our students must meet a number of requirements that include a minimum of 60 hours of relevant teaching experiences that may include: tutoring and didactic teaching; creating new educational materials; serving as a small-group facilitator; and participation on medical education committees (ref 2).  These students are also required to develop a teaching portfolio and to successfully complete a 4-week teaching elective with a capstone project (ref 2).  Since this distinction track was fully implemented in 2010, approximately 60 students, or 7-8% of all graduates, have graduated with a Distinction in Teaching.  We’ve also heard anecdotally that some students have decided to attend medical school here at the University of Iowa because they specifically wanted to pursue this track, and that having this distinction track on their resume gave them a competitive advantage during their interviews for residency positions.

Great teachers are not always born with that potential, but frequently discover their passion at some point in their careers.   I hope that through this Teaching Distinction track we’ve trained and inspired some excellent teachers who will have major impacts on all of their future students.

References

  1. Soriano RP, Blatt B, Coplit L, CichoskiKelly E, Kosowicz L, Newman L, Pasquale SJ, Pretorius R, Rosen JM, Saks NS and Greenberg L. Teaching medical students to teach: a national survey of students-as-teachers programs in U.S. medical schools. Acad Med. 2010;85:1725-31.
  2. Schmidt TJ, Ferguson KJ, Hansen HB and Pettit JE. Teaching distinction track for future medical educators. Med. Sci. Educ. 2015;25:303-06.
Thomas Schmidt is a Professor in the Department of Molecular Physiology and Biophysics at the Carver College of Medicine, The University of Iowa. He is a Fellow of the American Physiological Society and has served on the Education Committee and the Career Opportunities in Physiology Committee.  He has been the recipient of numerous teaching awards including: The President and Provost Award for Teaching Excellence (The University of Iowa); Master Teacher Award (International Association of Medical Science Educators); and most recently the Arthur C. Guyton Educator of the Year Award (American Physiological Society).  He has served as a mentor for a number of medical students who have graduated with a Teaching Distinction.
July 19th, 2017
Teaching Physiology in an Integrated Curriculum

Culmination of the 2016-17 academic year allows time for reflection and planning for the next year.   This past academic year, I was involved in the delivery of a new medical curriculum to an inaugural class of osteopathic medical students.   In keeping with current medical education trends, physiology and all other basic sciences were integrated throughout the year in individual systems based courses.  It is against this backdrop that I have decided to share a few observations and offer a few suggestions on delivering physiology content in a completely integrated teaching environment.

 

  • Delivery of an integrated curriculum is very time intensive for faculty. The idea of incorporating the teaching of anatomy, biochemistry, cell biology, physiology and microbiology/immunology of an organ system in a single course is conceptually attractive and to many medical practitioners the best way to educate the next generation of physicians.   Curricular challenges center on time limitations and the blurring of boundaries between the basic science disciplines.  Successful courses result when faculty are able to connect relevant information.   For example, my preparation for classroom discussions involved gaining an awareness of what was being taught in other disciplines and to incorporate appropriate synergies with the teaching materials developed by my colleagues in other disciplines.   The challenge was not to re-teach material.
  • Learning for the majority of students is not integrative. The development and delivery of an interdisciplinary integrated curriculum does not instantly result in students who are higher order problem solvers.   Learning is sequential, iterative, and cumulative.   Integration of concepts takes time and a firm foundation.   Guiding students along towards higher learning dimensions requires careful planning on behalf of the educator and can be accomplished through various pedagogical approaches.  Central to any approach should be basic questions for the educator to consider such as: 1) What is/are the basic fact(s) that the student should know? 2) Why does the student need to know this particular material?  and 3) How will the particular material be used in the problem solving process?   The answers to these and similar questions should then be used to introduce material in the classroom environment that keeps study groups discussing content after the session ends.
  • The true effectiveness of an integrated systems based curriculum should be measured by assessments that include questions designed specifically to high levels of integration. Data from both multidisciplinary and comprehensive formative as well as summative assessment instruments will provide a basis for future curricular decisions.

In the preceding discourse I have attempted to share a few views based on a year long teaching experience in a systems based medical curriculum.   My overall impression is that an integrated curriculum is a great way to teach physiology.   I also have learned that I am at the beginning of a new teaching journey that is sequential, iterative, and cumulative.   Sound familiar?  In preparation for next year, I know what I will be doing this summer to refine my previous year’s work in ways that facilitate student learning next year.    I am sure that I am not alone and wish you the best for a productive summer.

Joseph N. Benoit, PhD is Professor of Physiology and Director of Research & Sponsored Programs at the Burrell College of Osteopathic Medicine.   He has served in various higher education positions over the past 30 years including faculty, graduate school dean, college president and most recently founding faculty at a new medical school.   His current scholarly interests center on student learning, curriculum development, and regulatory compliance.  He lives and works in Las Cruces, NM.
June 5th, 2017
Diary of an Adventure Junkie – Part Deux:  The Path Diverges

As many scientists within our group look back over their training paths, they see a straight, hard-packed trail, with a few stumbling rocks, that led from graduate school, to a postdoc, to a bench-based, classroom-based or combination faculty position.  This relatively scripted path is one which many have traveled before us and many more will traverse in the future.  Without this path, science as we know it would cease to exist.  We require scientists in the laboratory and in the classroom, educating, influencing, inspiring and guiding the next generation; but what happens when some of those newly-minted scientists want to educate and train and motivate others in new ways?  Meet the proverbial fork in the road…

Over the past year, my road forked and I took the other path…twice.  So, what happens to a bench-trained educator who leaves the classroom for life in the society lane? Semi-adventure takes over and they drive on the shoulder and decide to direct a medical society while staying in the same comfortable location.  Being an executive director for a small society forces you to see education from a whole new perspective.  Questions arise, what are the hot topics, what is interesting, what is required…and who will teach it?  In this paradigm, the teacher becomes the student again, but also shifts into a motivational role, instilling an enthusiasm for teaching, fulfilling that ever-present need to educate.

But then…

The phone rings and it’s my dream job calling.  This job is perfect and halfway across the country, where housing and new schools must be found, in space-limited high-priced high-rises.  Cue the Indiana Jones theme music.  Giddy with the prospect of yet another fork, I swerve back onto the road; ducks in a row I apply, interview, accept the offer and then panic!  The onslaught of changes has thrown me into the ditch, wheels spinning without gaining traction.  Late sleepless nights looking for apartments, reading about schools and worrying about downsizing by half.  This is feeling less like an adventure and more like a nightmare.  And then it happened, my junior adventure junkie said, “I’m ready for this adventure, it’s going to be fun.”  That’s when I re-committed to my belief that adventures are scary, but without them we don’t challenge ourselves, we don’t grow and we don’t change.  So, I said yes we will move and downsize and take on this adventure.  The adventure starts this summer, but the prelude has been fantastic. So, what is the lesson here?  Challenge yourself, jump out of the airplane, take the unpaved path or the unnumbered exit and be confident that you will land in the best possible place.

Jessica C. Taylor is a physiologist, medical educator and adventure seeker.  Previously, a classroom educator, she spent a brief stint as the executive director of the Mississippi Osteopathic Medical Association and is now the Sr. Manager of Higher Education Programs for APS.

 

 

 

May 5th, 2017
Embracing Online Education: A Brief Personal Reflection

I would like to state upfront to all the loyal PECOP readers that I am not a blogger, nor am I an active participant in many social media venues and I do not Tweet! So when I was trying to decide what to write about I made a list of concerns that I face as a faculty member at a regional state university in the Midwest. My ideas included topics like life-work balance, burn-out, anti-science/academic sentiments, student retention, academic standards and institutional budget concerns. The list of possibilities was great, but this list seemed too negative for a career I truly do enjoy. I would like to instead speak briefly of a place that I have found refuge from many of the topics mentioned above. That refuge is the administration of an online Principles of Biology course.

I find it strange myself to consider how a person who may seemingly possess the characteristics of a social media Luddite, would want to get involved with and indeed embrace the world of online education. So I will list and briefly reflect on three areas that drew me to online education: love of learning; love of teaching; and accessibility.

Love of learning

I derive deep pleasure from learning new things and even reviewing those things that I already know.  After all, who would ever tire of learning and teaching about the structure and function of the mitotic spindle, the sarcomere, or how an action potential occurs or how a whole embryo forms from a single cell!  These cellular structures and their functions are so beautiful and amazing, that I really enjoy revisiting them again and again, each time adding a few new details to my lecture notes.  I also appreciate hearing others talk about subjects outside of biology, such as history and philosophy. One important venue I use for learning new things takes place in my car, during my daily commutes.  I listen to courses from The Great Courses series produced by the Teaching Company, lectures and talks from iBiology, hhmi/BioInteractive, various Ted talks, and individual posted lectures that can be found through a quick search on Google. Some of my favorites are bookmarked for easy retrieval or in the case of the Teaching Company courses, I actually own.  So what keeps me going as a faculty member through the periods of burn-out and meeting the daily requirements of academic life is the joy of learning and putting together a package of information and materials that students can use to learn about the subject as well or even just tweaking that material so students may learn it better.

Love of teaching

How can this love of learning get transferred from faculty to students in a way that also encourages students to become lifelong self-learners?  Can students really be taught to be lifelong self-learners? And, if so, what pedagogical methods are best suited to reach this goal? I have already discussed how I enjoy listening to educational lectures, but I would argue that the enjoyment of listening is not sufficient enough to learn the material.  In preparing for a lecture or to oversee meaningful active learning experiences, one is not simply able to listen to a great lecture and then be able to teach the material to students, expecting them to walk away and be able to apply that content in a meaningful way.

How then do faculty prepare to teach? Even if you are a fan of lecturing, most faculty members would agree that a fabulously well-delivered lecture, even a short one, is the result of hours of reading, reflection, writing, and repeating each of these!  I see this as the elephant in the room: that a great lecturer is really a great learner.  Thus, while it is quite enjoyable to hear a great lecture, it does not mean that the attending students are learning in a manner that creates lasting behavioral changes. This is in contrast to someone who has already engaged with the material. Even before I started teaching online, I had started assigning more readings, reflective writing assignments, and oral presentations from students in all my classes. When students now ask me every semester,” Do I really need to buy/rent the textbook?”  I say yes AND you must also read it and bring it with you to every class, as if your life …I mean your grade depends on it!

Accessibility

I have briefly reflected above on my love of learning and my love of teaching. And I try to model for my students, the skills I use to learn new material, such as reading the text, reflecting and writing on the material, as well as presenting the material to others during class through presentation and in accessing learning through quizzes and examinations. But do you have to be in the same classroom to teach this way? I have found the answer to be no. I have had the enlightening experience to see that I can assign the same readings, provide many of the same online resources for reflection and practice, and have regular meaningful interactions and quality controlled proctored assessments online through webcasting software such as Zoom with my online students as I have had with my face to face students. Online education at its best is more than simply posting content and assessments over a learning management system.  Depending on software and internet availability, I can be anywhere, the student can be anywhere, and we can still have a scheduled, meaningful face-to-face interaction. In fact, I am often finding the interactions with my online students to be more meaningful and memorable than the ones in my face to face classes. As I continue this adventure in online education, I hope to continue to be able to take my classroom on the road so to speak. Maybe the car in my daily commutes (especially with the advent of self-driving vehicles) will become “my classroom”, instead of where I merely arrive.

In summary, when the daily grind of academic duties and responsibilities gets me down and feeling negative, I have a place I can go and do what I enjoy most about academia, prepare and deliver material for students anytime and anyplace.

A short list of my favorite online lecture resources for the lifelong self-learner in us all

Melissa A. F. Daggett is an Associate Professor of Biology at Missouri Western State University, St. Joseph, MO. Melissa received her Ph.D. in Physiology and Cell Biology at The University of Kansas, Lawrence, KS and completed post-doctoral work in gene regulation and sex determination at The University of Kansas Medical Center, Kansas City, KS. Melissa currently teaches Principles of Biology (both face to face and online), plus two senior undergraduate/graduate level courses in Developmental Biology and Molecular Cell Biology. She has also taught courses in Animal Physiology, Microbiology and Environmental Science. She is currently interested in expanding opportunities for course based undergraduate research experiences in all her courses; especially those projects related to environmental toxicology and development.
April 5th, 2017
What makes a good teacher?

I was intrigued to read this PECOP blog post on what makes a good teacher from December 2016. The post recommends that we reflect on our teaching at the end of the semester, and begin the process of understanding our teaching perspectives through the Teaching Perspectives Inventory. What makes a good instructor is something that is extremely relevant to me, because teaching happens to be my job and my passion.

I was recently prompted to think about this very question as I made contact with my former secondary school in Liverpool, U.K about being featured as a former pupil of theirs (I feel more than slightly uneasy about being featured together with John Lennon however!). I was stimulated to think about my former teachers and what I had learned from their teaching. I left the school over 20 years ago but can to this day recall specific teachers, moments in class, and things I learned inside and outside the classroom. Certainly, that’s the kind of learning I’d like my students to have 20 years after I’ve taught them!

As I reflect on the teaching that I had, several aspects popped out to me.

A love of teaching: My best teachers clearly loved teaching students. They enjoyed interacting with students, creating a rapport with us, which made the subject matter come to life and facilitated our engagement with the material. I have come to the realization that perhaps the most important aspect of teaching is to enjoy connecting with your students in order to create an effective learning environment. The saying of “they won’t care what you know until they know that you care” is somewhat cliché but it has a lot of truth to it. As a soccer coach in my spare time, I frequently reflect on the fact that if you don’t like kids, you shouldn’t coach youth soccer. In the same way, our teaching is unlikely to be as effective as it could be if we don’t like interacting with our students and enjoy teaching them.

Meeting students at their level: My English literature teacher taught us Pride & Prejudice, a text that many in my class found somewhat boring. My teacher perceived the boredom, and attempted to understand why it could be perceived as boring to my classmates. He then adapted his teaching to this in order to emphasize why the text was important. He attempted to bring the text to his students and make it relevant to them, rather than merely expecting students to engage, understand and enjoy the text automatically.

Adaptable: The best lesson I ever had was a history lesson. My teacher was a few minutes late, and as we all sat inside the classroom waiting for him, a dispute arose amongst two students in the class. The teacher came into the classroom and upon encountering the dispute, proceeded to set up a court to judge the basis of the evidence of the ‘crime’, as an example of the history of trials and determining justice. I have no idea if that was his intended lesson, but I was in awe of how the teacher adapted his lesson so perfectly to something that had just happened in the class. It is a reminder to me to be observant and adapt to issues that our students may be experiencing.

Practical: One of the most salient things I learned came from a teacher who was supervising me as I visited potential colleges. We were looking for somewhere to eat dinner one evening, and as we walked past various eating establishments, he gave me the advice of “never eat in an empty restaurant”. This has stuck with me ever since and I apply it frequently when deciding where to eat. It was practical advice on something that I had never before considered, and the ‘light bulb’ lit up for me. Reflecting on this, I see our role as teachers to help our students see beyond the immediate – to analyze and think critically about what we see with our eyes, and to help them consider what things mean. Finally, what we teach them must also be practical and relevant.

From these reflections, I have come to the realization that a good teacher is someone who is able to adapt to where our students are in terms of the knowledge that they come with, and take them to higher levels of learning that they cannot get to on their own.

What is your definition of a good teacher?

 Hugh Clements-Jewery PhD is currently Visiting Research Associate Professor and M1 Course Director in Physiology at the University of Illinois College of Medicine in Rockford, IL, starting in November 2016. Prior to moving to the University of Illinois, he taught medical physiology at the West Virginia School of Osteopathic Medicine from 2007 to 2016. He is a certified trainer-consultant in Team-Based Learning.

March 31st, 2017
The Surprising Advantages Retrieval Practice

Retrieval practice,  retrieval __________,    _________ practice,  testing effect……wuh?!?!

Retrieval practice simply means to actively recall information following exposure (e.g., studying). Because tests are a particularly common and effective means by which to prompt the retrieval of specific pieces of information, the learning benefits of retrieval practice are also known as the testing effect. That is, effective tests can do more than simply assess learning; they can strengthen learning by prompting retrieval. It is important to clarify that the key to the testing effect is the retrieval and not the test per se. Therefore, the testing effect pertains to not only traditional assessments like tests and quizzes, but also to free recall. So, silently answering questions in your mind (e.g., self-testing) is an example of testing that promotes learning.

Landmark study by Roediger and Karpicke in 2006a

Figure 1. Repeated testing lead to better long-term recall when compared to repeated studying. Roediger and Karpicke, 2006a.

Although the testing effect has been described by studies that date back more than a century, researchers and articles often cite a 2006a study by Roediger and Karpicke as the source of renewed interest in the strategy and effect. In that study, the investigators asked three groups of undergraduates to read passages that were about 250 words long. One group of students learned the passages by studying (i.e., reading) them four times (SSSS group). A second group learned the passages by studying them three times and then completing a test in which they were prompted to retrieve information from the passages (SSST group). The last group studied the passages just one time and then performed the retrieval test three times (STTT group). All three groups were given a total of 20 minutes to learn each passage, following which their retention was assessed via free recall either 5 minutes or 1 week later. As you can see in Figure 1, there was a modest advantage with the SSSS strategy, as well as a modest disadvantage with the STTT strategy, immediately after learning the passages. However, the exact opposite pattern was observed one week later, as the STTT group’s recall scores were about 5% higher and 21% higher than those of the SSST and SSSS groups, respectively. The results of this study demonstrated that testing/retrieval practice can be a powerful means of improving long-term memory. These advantages to long-term recall have subsequently been confirmed by many different researchers and investigations (see Roediger and Butler 2011; Roediger and Karpicke, 2006b for review).

Retrieval practice and the ability to make inferences; it isn’t just about simple recall

Figure 2. Retrieval practice resulted in higher scores on verbatim and inferential questions. Derived from Karpicke and Blunt, 2011.

One might be concerned that retrieval practice is just a form of drill and practice that merely teaches people to produce a fixed response to a specific cue. Karpicke and Blunt (2011) addressed this concern by comparing the effects of retrieval practice and concept mapping on meaningful learning, which includes the ability to draw conclusions and create new ideas. The investigators chose concept mapping for this comparison because it known to promote elaborative (i.e., complex) learning. In one experiment, one group of students learned a science text by repeatedly reading (i.e., studying) it, another group studied the text and then used it create a concept map, and a third group studied and then recalled the text two times. The total amount of time the concept mapping and retrieval practice groups were given to learn the text was standardized. The students returned the following week and completed a short-answer test that included both questions that could be answered verbatim from the text and questions that required inferences. As is displayed in Figure 2, the retrieval practice strategy resulted in superior scores on not just the verbatim questions, but also on the inference questions. That is, the advantages of retrieval practice extended beyond simple recall and to meaningful learning. These findings are supported by numerous other investigations (see Karpicke and Aue, 2015 for review), including a subsequent study by the same authors (Blunt and Karpicke, 2014).

Okay, so retrieval practice has been shown to enhance recall and meaningful learning, but does it work with the types of information that are relevant to APS members?

Figure 3. The testing strategy resulted in superior performance on both sections of the six month assessment. Derived from Larsen, Butler and Roediger, 2009.

Yes………numerous studies support this claim. One notable example was a study by Larsen, Butler and Roediger (2009) in which two groups of medical residents first attended lectures on the treatments of both status epilepticus and myasthenia gravis. Immediately after the lectures, and then again about two and four weeks later, the residents studied (i.e., read) a review sheet pertaining to the treatment of one of those diseases and they completed a retrieval test that included feedback on the other treatment. Roughly six months after the lectures, the residents completed a final assessment that covered the treatment of both diseases. As you can see in Figure 3, the testing strategy resulted in scores that were about 11% and 17% higher than those associated with the studying strategy on the status epilepticus and myasthenia gravis sections, respectively. It is also worth noting that the overall effect size pertaining to those differences was large (Cohen’s d = 0.91). The same group of researchers went on publish similar findings with groups of first-year medical students (Larsen et al, 2013). In that follow-up study, a testing-based strategy produced superior recall and greater transfer of learning of four clinical neurology topics six months after the students first encountered them.

Our lab has also recently published numerous studies with relevant materials, and we observed several advantages with retrieval practice compared to more commonly-used reading and note-taking learning strategies. For example, we found that retrieval-based strategies resulted in superior recall of exercise physiology (Linderholm, Dobson and Yarbrough, 2016) and anatomy and physiology course information (Dobson and Linderholm, 2015a; Dobson and Linderholm, 2015b), including information that consisted of concepts and terminology that were previously unfamiliar to the students (Dobson, Linderholm and Yarbrough, 2015). We have also observed advantages to independent student learning that resulted in higher scores on course exams (Dobson and Linderholm, 2015a), as well as to the ability to synthesize themes from multiple sources (Linderholm, Dobson and Yarbrough, 2016), which is a skill that requires higher orders of cognition.

Just give me the take home messages.

  • Dozens of studies have demonstrated that retrieval practice can promote superior recall and meaningful learning when compared to more commonly-used strategies like reading. (Karpicke and Aue, 2015; Roediger and Butler, 2011; Roediger and Karpicke, 2006b).
  • Although some studies have provided evidence that essay and short answer (SA) questions can lead to a greater testing effect than multiple choice (MC) questions (Roediger and Karpicke, 2006b; Butler and Roediger, 2007), a recent study by Smith and Karpicke (2014) indicated that MC and SA questions are equally effective.
  • Multiple repetitions of retrieval practice promote more learning than a single retrieval event (Roediger and Butler, 2011; Roediger and Karpicke, 2006b)
  • The benefits of retrieval practice are enhanced if learners receive feedback after they retrieve (Roediger and Butler, 2011; Roediger and Karpicke, 2006b).

Great, but how do you apply retrieval practice in the classroom?

  • Summative assessments. Tests prompt retrieval, so one way to incorporate more retrieval practice into your classes is to have your students complete both more exams and more cumulative exams.
  • Formative assessments. There are numerous reasons to use low-stakes assessments like quizzes instead of tests. Quizzes may be just as effective at prompting retrieval, and they provide valuable feedback about performance to both instructors and students, but they typically elicit less anxiety and encourage less cheating. Suggested applications include starting class meetings with a short quiz that prompts students to retrieve information that will be developed during the lecture and/or end class meetings with a short quiz to get students to retrieve the important take home messages of the lecture.
  • In-class retrieval assignments. A great way to break up the monotony of lectures is to have students complete retrieval assignments during class meetings. For example, have individuals or groups of students retrieve information and then present it to the rest of the class.
  • Encourage students to use retrieval practice outside of class. One of the greatest benefits of retrieval practice is that it easy to use; all one needs to do is to recall information from memory. I encourage my students to use retrieval practice by first presenting to them some of the evidence of its effectiveness (described above), and then by suggesting some methods they may use to employ the strategy that (e.g., take turns quizzing or teaching fellow students, quiz one-self, or simply freely recall portions of the information). Again, it is important to emphasize that multiple retrieval events are more beneficial, and that each or most of those should include feedback. For example, have students study then retrieve then study again to receive feedback, etc.

 References

  1. Dobson JL, Linderholm T, Yarbrough MB. Self-testing produces superior recall of both familiar and unfamiliar muscle information. Advances in Physiology Education 39: 309-314, 2015
  2. Dobson JL and Linderholm T, The effect of selected “desirable difficulties” on the ability to recall anatomy information. Anatomical Sciences Education 8: 395-403, 2015.
  3. Dobson JL, Linderholm T. Self-testing promotes superior retention of anatomy and physiology information. Advances in Health Sciences Education 20: 149-161, 2015.
  4. Butler AC, Roediger HL. Testing improves long-term retention in a simulated classroom setting. European Journal of Cognitive Psychology 19: 514-527, 2007.
  5. Blunt JR, Karpicke JD. Learning with retrieval-based concept mapping. Journal of Educational Psychology 106: 849, 2014.
  6. Dobson JL, Perez J, Linderholm T. Distributed retrieval practice promotes superior recall of anatomy information. Anatomical Sciences Education DOI: 10.1002/ase.1668, 2016.
  7. Karpicke JD, Aue, WR. The testing effect is alive and well with complex materials. Educational Psychology Review 27: 317-326, 2015.
  8. Karpicke JD, Blunt JR. Retrieval practice produces more learning than elaborative studying with concept mapping. Science 331: 772-775, 2011.
  9. Larsen DP, Butler AC, Roediger HL. Repeated testing improves long-term retention relative to repeated study: A randomized controlled trial. Medical Education 43: 1174-1181, 2009.
  10. Larsen DP, Butler AC, Lawson AL, Roediger HL. The importance of seeing the patient: Test-enhanced learning with standardized patients and written tests improves clinical application of knowledge. Advances in Health Sciences Education 18: 409-25, 2013.
  11. Linderholm T, Dobson JL, Yarbrough MB. The benefit of self-testing and interleaving for synthesizing concepts across multiple physiology Advances in Physiology Education 40: 329-34, 2016.
  12. Roediger HL, Butler AC. The critical role of retrieval practice in long-term retention. Trends in Cognitive Sciences 15: 20-27, 2011.
  13. Roediger HL, Karpicke JD. Test-enhanced learning: Taking memory tests improves long-term retention. Psychological Science 17: 249-255, 2006.
  14. Roediger HL, Karpicke JD. The power of testing memory: Basic research and implications for educational practice. Perspectives in Psychological Science 1: 181-210, 2006.
  15. Smith MA, Karpicke JD. Retrieval practice with short-answer, multiple-choice, and hybrid tests. Memory 22: 784-802, 2014.
 John Dobson is an Associate Professor in the School of Health and Kinesiology at Georgia Southern University. John received his M.S. and Ph.D. in Exercise Physiology at Auburn University. Although most of his research has focused on the application of learning strategies that were developed by cognitive scientists, he has also recently published articles on peripheral neuropathy and concussion-induced cardiovascular dysfunction. He teaches undergraduate and graduate Anatomy and Physiology, Structural Kinesiology, Exercise Physiology, Cardiovascular Pathophysiology courses. He has been an active member of the American Physiological Society since 2009, and he received the Teaching Section’s New Investigator Award in 2010 and Research Recognition Award in 2011.