April 23rd, 2018
Thoughts from the Future

 

 

April 23, 2028

 

Dear Dave Harris of 2018,

It has been a long time my friend, in fact 10 years.  I have plenty of good news to share with you, which may be shocking or expected!

First, I am happy to inform you that the past decade has been extremely good for your Philadelphia Eagles!  After winning Super Bowl LII in 2018, they have gone on to win 3 more with Carson Wentz running new “Philly Specials” year after year!  Tom Brady finally retired after he dropped another wide-open pass in Super Bowl LV.  However, the biggest surprise for you may be that the Cleveland Browns won Super Bowl LV!

I am also happy to tell you that the educators survived the Great Medical Education Transformation of the 2020s! I knew that you saw this coming around 2015, but the speed at which the Transformation occurred was mind-blowing for many faculty!  We lost a few good “soldiers” in the process when they failed to adapt their educational views and styles, but as of now, medical education has never been better and there have been substantial improvements in patient safety and outcomes!  I am sharing some of the changes with you to prepare the faculty of the future!

One of the first recognizable changes was the manner in which students approached medical school curricula.  Even during your time, schools saw drastic reductions in class attendance and student engagement with the formal curriculum.  The millennial students were used to obtaining information how they wanted and immediately when they wanted.  Recording of lectures led to students remaining at home so that they could double speed your voice to sound (you have no idea how they describe you!), allowed them to view these lectures at midnight in their pajamas, and gave them the ability to stop and take notes.  Many faculty mistook this as student disengagement and tried to “force” them into class by making mandatory sessions or increasing the frequency of assessments. However, students responded by stating that some sessions were a “waste of time” and “took time away from studying for Step 1”.  They continued to vote with their feet and migrate away from the classroom!

However, what caught most faculty of your time off guard was the use of external resources outside of your own curricular items.  The emergence of the “hidden curriculum”!  Students were presented with alternative options such as Anki, Sketchy Medical, Osmosis, First Aid, Khan Academy and Pathoma to name a few!  At first faculty were unaware and put up a staunch resistance.  It was even postulated by some that the core curriculum of basic science could be delivered as a shared Medical Curricular Ecosystem (Le and Prober) that would help reduce redundancy in medical schools.  This caused an imbalance in the galaxy and many of the upset faculty tried to prevent this from coming. However, many astute faculty quickly realized that it was already there!!  At that point the faculty rebel forces decided to become proactive instead of reactive!

Town hall meetings, focus groups, and interviewing revealed many weaknesses in the medical school schema to date.  Faculty struggled to realize that the millennial students grew up with the internet and basically a cell phone attached to their hand.  Finding content was not an issue for them and what faculty discovered was that much of the content delivered in lectures was identical to what could be viewed in a video in 8 minutes.  They also discovered that students grew up in a world where everyone was connected through social media and available almost 24 hours a day!  They expected responses from their friends on a chat within seconds!  After all, how many people sleep with their cell phone next to them?  Faculty also discovered in these town halls that the generation valued work/life balance and anything that was deemed inefficient cut into this time that they could be doing something else.  Through these important meetings, faculty also discovered that students were excellent at recalling facts and regurgitating knowledge. However, when asked to apply that knowledge to a problem, the students went back to recalling the facts. Students had mistaken memorizing for learning!  And many faculty had mistaken learning for telling!  Some faculty reflected back and actually admitted that we may have enabled the behaviors with our constant barrage of standardized tests of knowledge!

At least, the good news is that this led to some drastic changes in medical education!  Gross anatomy has been severely trimmed down in an effort to focus on clinically relevant anatomy for undifferentiated medical students. Gross anatomy dissection is reserved for students interested in a surgical career as an elective.  Much of that experience of cutting through muscle layers and isolating each artery, nerve and vein, and picking through layers of fat to get there has been replaced by complex computer programs that help students visualize the anatomy in 3D!  Since ultrasound is currently available to any physician through their phone, more emphasis of anatomy related to ultrasound aspects has been a focus of instruction.  For many of the pathological or anatomical variations, 3D printing has allowed for much cheaper and better alternatives for learning.  Everything is currently related to clinical medicine and focuses on key concepts that are necessary to master as opposed to “knowing” everything!  However, the changes did not stop there!

Much of the basic physiology content knowledge is now presented to the students in alternative ways using directed, short videos or providing references.  The class time has been reserved for higher level threshold concepts where students are placed in situations in which misconceptions and dangerous reasoning can be identified and corrected.  Simulations and standardized patients (robots) have become common place where students have to integrate what they were learning in Doctoring courses with real life physiology.  Students enjoy the safe environment and as faculty discovered the role of affect in cognition, they quickly realized that this was a time efficient pedagogy.  Faculty have discovered that 1 hour of intense, clinically oriented, and high yield threshold concept learning is much more beneficial and time efficient than 4 hours of didactic lecture. And faculty discovered it was fun!

Another aspect under appreciated by faculty of your time is that students enjoy being able to learn in their own environment as opposed to in the classroom.  In your day coffee shops were filled with students studying away, but technology has allowed for large communities of learners to “get together” from their own homes.  Time spent traveling from various hospital sites during the clerkships was saved by developing online communities for learning and using technology to facilitate discussion.  Students felt more at ease critiquing another’s differential with this new design and appreciated the time saved from travel.

As I said my friend, medical education has been transformed in exciting and very positive ways!  Successful faculty have worked with the students to enhance the learning experience as opposed to trying to teach the way we were taught!  Faculty focused more on the learning process as opposed to trying to relay knowledge to the students.  It was discovered that technology could not substitute for poor teaching. Faculty learned to develop activities to get students out of their comfort zones so that true learning could occur.  And lastly, faculty realized that their roles were not eliminated. Rather the role of faculty had to change from the expert sage on the stage to the facilitator of student learning!

Well, I can’t wait to see what the next ten years will bring!  You will be happy to know that your two daughters have grown up to be beautiful, caring people!

 

See you in 10 years and Fly Eagles Fly!!

Dave Harris of 2028

 

———————————————————————————————————————————————————————

 

I realize that this letter may be viewed as provocative, crazy, and aspiring!  However, I hope that the conversations in medical education can begin to REALLY improve patient safety and outcomes in the future.  What changes do you think will occur in medical education in the next 10 years?

 

David M. Harris, PhD, is currently an Associate Professor of Physiology at the University of Central Florida College of Medicine in Orlando, Florida.  He received his PhD from Temple University School of Medicine, completed his post-doctoral research at Thomas Jefferson University, and was offered his first faculty position at Drexel University College of Medicine. He moved away from Philly to Orlando in 2011.  He has written several educational research manuscripts, mostly about the use of high fidelity mannequin simulators in medical physiology and currently serves as an Associate Editor for Advances in Physiology Education.  He is also on the Aquifer Sciences (formerly MedU Science) leadership team developing a curriculum that provides tools or how to integrate basic science knowledge with clinical decision making  to prevent harm.

Reference:  Le TT, Prober CG. A Proposal for a Shared Medical School Curricular Ecosystem. Acad Med, March 6, 2018

April 9th, 2018
Surviving Hurricane Maria: A professor’s story (Part 2)

Previously in our story…Hurricane Maria had just ravaged the island nation of Dominica

Flag of Saint Kitts and Nevis

While I waited, my school did what many said could not be done. Our staff and administration arranged for us to be able to complete the fall semester, on the only-lightly damaged island of St. Christopher (usually called St. Kitts), which had been grazed by both Irma and Maria.  They arranged for a large passenger ship which normally ferried cars and people from Italy to Spain and back to sail over to the Caribbean and be modified into a floating campus for our thousand-plus student body for the rest of the year.  They arranged for temporary accommodations for faculty and staff on St. Kitts, where our other sister school, Ross University School of Veterinary Medicine (10), is located.  They revised the schedule to have us resume our semester in October and finish in early January.  And then they set these plans in motion.

In mid-October, I finally got the notice I’d been waiting for, my reporting day to arrive on St. Kitts for my temporary assignment there.  I’d lived on St. Kitts before while working at one of my former schools, so I knew that it wasn’t the same as Dominica.  It was wealthier, far wealthier, with so many cruise ships coming to call during high season that we were almost an afterthought to them.  It had the movie theater and the golf courses and the high-end hotels, and the island infrastructure to handle the mass of tourists who came and went by the planeload and shipload every day.  But on the same token, in Dominica we were a part of the community, we were welcomed by the people, and we were careful to try to be good neighbors.  In St. Kitts, we were mostly treated like tourists, who were perhaps staying a little longer than usual, and on a ship that wasn’t going to sail away with us.  Most of the Kittitians were still the very friendly people you can find everywhere in the Caribbean, of course, but it wasn’t Dominica and I knew it before I arrived.  We faculty were to arrive a few days before the students to get situated and find places to live on the island while the student accommodations/our campus continued its journey across the Atlantic to our new home away from home.

Belle Mont Farm Eco-Resort

When I got to St. Kitts, it was…a pleasant surprise.  It wasn’t half as hard to get through customs as I had feared, and the Marriott is a nice hotel.  We stayed there a day or two before the students started to arrive.  To make room for the students, most of the faculty were moved to an eco-resort on the far side of St. Kitts for about a week, which opened in its off-season just for us.  While I appreciated their going above and beyond on our behalf, I only stayed one night before moving into an apartment in town. I just wanted to unpack my suitcases, settle in somewhere, and get back into a routine.

Because I left the eco-resort so early, I was available to help the students come in on their arrival day.  And come in they did, one charter flight at a time to the airport, and one to three buses (they call them cruisers) at a time to the Marriott.  Tired, bleary-eyed, some clearly still suffering the effects of six or more days on Dominica under indescribable conditions ending in evacuation and weeks of uncertainty, the students came.  You couldn’t help but feel for the ordeal they had survived… or admiration for their grit to return anyway, when a small group of others had taken a leave of absence.  On that day and night when the students came in charter flight after charter flight, wave after wave, a dozen volunteers and I helped each group one by one.  We were the friendly faces from home greeting them after their long ordeal.  We smiled and shook their hands and took their bags inside, helped them through check-in, provided them some simple meals, and tried to make each returning student feel special.  It started for me in the afternoon, and then into the evening, and then into the night, with each group of students arriving more and more exhausted.  By 1 a.m. I was feeling pretty exhausted too, but we kept going until the very last group made it in somewhere close to 2 a.m.

I am told that still more planeloads of students flew in the next morning, but I slept in.  That afternoon, students were being transported from the hotel to the port, where our ship had come in.  The lines were long and the sun was hot and the students just wanted to get inside and get to their new berths.  Many of the faculty who were staying at the eco-resort had come into town that morning to help students move in during the morning/afternoon shift.  I showed up for the afternoon/evening shift.  As we had done the previous day, we volunteers did our very best to keep everyone comfortable at the port, as students went through the tedious process of being identified, cleared to come onto the ship, given berth assignments, and other things past my station at the port.  I made a point to smile and joke and most students appreciated it.  By mid-evening the last students had made it past my sorting station at the dock entrance and headed into the ship, so I stumbled home for another exhausted sleep.

There was a lot more involved in starting work at the temporary campus than just showing up, but I and the other faculty made do.  The ship had just one large cafeteria so we sometimes had to wait in meal lines during its designated breakfast-lunch-dinner times.  Many of the prior amenities on the ship (e.g., a movie theater and a pool deck) had been converted into classroom and study areas before we boarded, and other spaces were modified for student use later.  This included the conversion of an entire deck of the ship which is usually a car garage into an air-conditioned suite of temporary study spaces, clinical exam rooms, and simulation labs. Since the ship spent most days at sea, it was rather crowded at first.  We faculty didn’t have offices per se but like the students we each found our place to be during the day.  My place was at the back of the third semester classroom, in a corner with AC, electric hookups, and a view of the harbor.  I usually teach in second semester as do most physiologists, so I absorbed a lot of clinical applications even as I worked on lectures and active learning sessions, module directing, pre-mini-workshop design, and all the other routines of a typical teaching-oriented school.  And in so doing I, like so many other faculty who don’t get to know a lot of students normally, did connect with many of them.  When we had to get up at 3:30 a.m. to catch the 4:15 a.m. bus to get us to the boat before it sailed at 5:00 a.m. to make room for a set of larger cruise ships throughout the day, we shared in the students’ experience of having to make sure they too were up at the same time, early enough to download their most important materials of the day before we sailed, just in case the harbormaster put us far out at sea.  When the days came that other ships left late and we didn’t dock until 7:30 at night, the students shared that with us too.

Photo: St. Kitts in the morning light, mid-November 2017. Photo credit: Bruce Wright

Along the way, we made time for some activities.  Twice I went scuba diving with fellow members of our RUSM (Med School) Scuba Club (11); others went diving even more regularly.  People organized groups for exercise on the outside deck every morning and night.  There were religious services, club meetings, and other miscellaneous activities on the boat.  Off the boat there was at least one school-planned movie outing, an island tour, and a few students even made it to a “beach bash” hosted by the RUSVM (Vet School) Scuba Club.  More informally, the port facilities were nice as one would expect at a regular Caribbean cruise ship stop, with everything that entails. It became a shared experience of life in close quarters, dedicated to a common purpose and with a common spirit that we would make it through, together and with no drop in our commitment to teaching and learning despite it all.

Would I have traded it for a nice quiet semester in Dominica with no Hurricane Maria in the first place?  Well, sure!  But you have to deal with what life gives you and we made the best of it.  And the quality of the teaching did not go down.  We might have been in close quarters but we delivered virtually the same curriculum in the fall as we had in the previous spring and summer.

By mid-November, air service to Dominica was spotty but running, so I booked a trip there for a few days including Thanksgiving Day.  We’d just found out that we were going to be in Knoxville, Tennessee for the January semester but no one knew much more than that.  While some people started actively looking for places to live, I planned my return to Dominica and hoped the school would handle the Knoxville move for me and many others (it did).  I booked a room at the only hotel open in Portsmouth, Dominica, just in case my cottage was uninhabitable, and then I hoped for the best.

Photo: Sunset in Dominica, late November 2017. Photo credit: Bruce Wright

When I flew in, it was afternoon and, well, the island I loved looked different.  This was now two months after Hurricane Maria did its damage and still the island was brown, not green.  The volcanic ridges were sharp and distinct, and the remains of trees were all over them, standing tall and naked.  But if I looked closely, I could see that at the tops of the trees, leaves had started growing again.  Not enough to cover the scars on the land, not yet, but enough for some hope.  I had the taxi driver take me to my cottage before going to the hotel, and amazingly almost everything had survived.  The food and other perishables were gone with a few other items (e.g., my Swiss army knife), but overall I had a lot of things to ship home.  When someone had built the place he or she had cemented the window frames into the concrete wall for extra strength, which isn’t standard practice anywhere but it worked there.  Whoever it was had also put odd-looking vents under the roof which somehow prevented the roofs from flying.  As a result, though my furniture was flooded at floor level, almost everything else was salvageable.  It was a miracle compared to the sheer devastation we’d driven through from the airport to town.  That night I saw my first sunset on Dominica in many months, and it was beautiful.

Photo: Looking north from Portsmouth, Dominica, Thanksgiving Day 2017. Photo credit: Bruce Wright

I spent the next two days getting almost everything from my cottage packed up and sent to the local shipping agent for transport back to the USA.  Since my office had survived intact (another unexpected blessing) I took a couple of textbooks and other important items from there. But I didn’t take everything. I left most things in my office against the day I would return.  I also took a few photographs. I chose to avoid taking pictures of the damaged areas. Instead I shot photos of things I’d never seen before, like the caved-in side of a cliff face on the mountain north of town that to me looked just like a monkey’s hand.  Along the way I saw the determination of the people to recover even as they all hoped we would be back in May, and I hoped the same thing.  But it was not to be.  As I flew out with my bicycle sold, my cottage empty, and my most essential items from home and office in two suitcases, I was pretty sure that Dominica wouldn’t be ready for us by then.  There were still too many without power, too many living under tarps and in barely-repaired dwellings, too many roofs still off and the insurance companies being slow to pay claims.

The semester ended relatively uneventfully.  The students adjusted to where they were going to be in the spring, and so did I.  Knoxville, Tennessee is a nice southern city with both friendly people and all the movie theaters one could ever want. I even went once!  Most of our students are here with us, though some are still in St. Kitts with some of our faculty.  We’ve learned we’re to be here through the September 2018 semester so we have some sense of permanence.  Though I would love to return to Dominica as soon as possible, having a safe, happy Dominica with functional buildings, power, water, cell service, and the other non-movie theater basics restored is really important too, so I can’t complain.  Here I am, a professor at a medical school in the United States, just like I wanted to be so many years ago.  And whether here or Dominica or anywhere else my fate takes me, I’ll get by.

As I told one of my advisees who was having a bad day last December, in the end a school isn’t buildings at all.  A medical school is its people, medical faculty training students through increasingly difficult tasks until at the end the students have risen up to a higher level, doctors ready to begin their postgraduate medical education journey.  The medical arenas and the classrooms and the simulation labs and the journal collections and the fraternity/sorority homes and even the occasional Italian ship sailing thousands of miles to become a “floating campus” are all just the scaffolding around what is really important.  That one student, his or her classmates, his or her basic science and clinical faculty, and everyone else from the Dean to I.T. to the people washing dishes in the back of the cafeteria who make sure everything else runs…these people are the real school.  They make it possible for that one student to excel.

And that’s something that no hurricane– however powerful– can stop.  Ask LSU if it stopped for either Camille or Katrina.  Ask Hofstra if it stopped for Sandy, Baylor if it stopped for either Rita or Harvey, or Nova Southeastern if it stopped for either Andrew or Irma.  Like those other disasters, Hurricane Maria is part of history now. And just like those other schools went on after their respective storms, we’ll keep going too, training the next generation of physicians, semester after semester.  As we do, I’ll be right there doing my part for my students, my school, and the greater medical education community.  Because in the end, that’s not only what I was trained to do, it’s still my passion today.

Bruce E. Wright graduated with a PhD in Physiology from LSU Health Sciences Center in 1993.  He had postdoctoral fellowships/research faculty positions at the University of Florida and East Carolina University.  He served several years as faculty at a liberal arts college in Georgia.  He worked at three Caribbean medical schools from 2005-2008 before joining the faculty at Ross University School of Medicine in 2008.  He worked for two years at a US-based osteopathic medical school in 2013 and 2014 before returning to Ross University in late 2014.  Dr. Wright is currently Treasurer/Award & Event Coordinator for the American Physiological Society’s Teaching Section.  He has served as a reviewer for Advances in Physiology Education.  He is National Faculty for the National Board of Osteopathic Medical Educators (NBOME), for whom he has written and reviewed items for different exams.  He regularly attends Experimental Biology and was an attendee and presenter for the first Institute for Teaching and Learning meeting in Bar Harbor, Maine in 2014.  He is currently interested in educational research involving teaching methodologies.

Photograph: The author with three RUSM students (from left to right, Armin Hojjat, Harenda Ipalawatte, Bruce Wright, and Eddy Mora) just after a double-tank scuba dive, off St. Kitts, November 2017. Used with permission by Harenda Ipalawatte.

References/links/other:

  1. http://www.dominica.gov.dm/about-dominica/country-profile
  2. https://medical.rossu.edu/about.html
  3. http://www.dominica.gov.dm/tropical-storm-erika
  4. https://weather.com/storms/hurricane/news/tropical-storm-harvey-forecast-texas-louisiana-arkansas
  5. https://weather.com/storms/hurricane/news/hurricane-tropical-storm-irma-recap-2017
  6. https://en.wikipedia.org/wiki/Hurricane_Maria
  7. https://www.youtube.com/watch?v=l-5fHwER-Zc
  8. https://www.caricom.org/media-center/communications/press-releases/dominica-prime-minister-roosevelt-skerrit-addresses-the-un-general-assembly
  9. https://www.wunderground.com/cat6/category-5-hurricane-maria-hits-dominica
  10. https://veterinary.rossu.edu/about.html
April 2nd, 2018
Surviving Hurricane Maria: A professor’s story (Part 1)

It’s funny, as I begin to write this blog, that I realize that it’s nearly 25 years now since I received my Ph.D. in Physiology in New Orleans.  Back then, I was sure that my career track would lead me to becoming a full professor at a medical school in the United States one day, though I didn’t know exactly how I would get there.  Not being a world traveler, I certainly never expected to spend a day in the Caribbean, but life is funny sometimes.

Like so many other graduates of my day, the “optimal” career track didn’t pan out for me.  My postdoctoral experience didn’t involve receiving any federal grants, so instead of moving straight into medical school, I became involved in undergraduate education. Several years later while advising students, I learned about Caribbean medical schools. When I studied them in more depth, I discovered one program in particular in which I could teach college seniors advanced A&P part-time while I took medical school courses part-time too.  I took a leap of faith and applied for it. Shortly after they accepted me, I took my first flight over the turquoise-blue of the Caribbean Sea.

 

That was the day my life changed

There was and is something different about the Caribbean, its varied islands and its colorful people, so friendly in some places and so unfriendly in others, but always full of life and adorned in bright colors.  Along the way I picked up medical-level Gross Anatomy and with that extra qualification, moved into full-time faculty positions at a couple of small medical schools in the British and Dutch Caribbean.  On those tiny islands I relearned my discipline as a generalist as few others of my generation have done.  There I was THE physiologist with no backup and neither a travel allowance for attending conferences or taking trips home to see my family, nor support for any research.  Instead I had to not only teach the entire medical physiology course by myself three times per year, I also had to assist the anatomy faculty in cadaver dissection twice per week and occasionally teach in an undergraduate course.  My typical medical school course load was 14-16 hours per week of just contact time in lecture and lab, not counting writing exams every three weeks and having many, many meetings with students.  It was hard but it changed me, and made me a better teacher. With this Caribbean-acquired training as a medical physiology generalist, in 2008 I moved up to a first-tier Caribbean medical school in the Commonwealth of Dominica (not the Dominican Republic!), initially to teach digestive physiology.

 

Flag of the Commonwealth of Dominica

Dominica will always have a special place in my heart.  It is a small volcanic island in the British Caribbean that is shaped like a chrysalis (1).  At its widest it’s only about 18 miles and at its longest 29 miles, but it is almost a mile high. It has no five star resorts, no golf courses, and no movie theaters.  It’s hard to get to by air, and even cruise ships mostly go past it in favor of better-developed ports on the islands north and south of it. When I first arrived the entire population on-island was only about 73,000, mostly hugging the west (Caribbean) coast. But for several years I lived in a house on a hillside 500 feet above the Caribbean Sea watching the sun set over the ocean every night from my front porch. On Saturday I would sometimes go down to the village of Mero below me where there would be a half mile of pure gray sand beach and only a dozen people on it.  On Sunday, I might go down again to where five hundred locals had come to party on the beach, or I might have just sat on my porch and listened to the music from far below, as the stars came out and the Southern Cross hung in the April sky. One time, and only one time, I climbed the 4800 foot mountain in the center of the island where there is no trail up to the cloud-cloaked peak.  One time, I swam, dove, and rappelled down a river through a canyon greener than the Emerald City.  And along the way, I taught at a very special school, with smart, tough, high quality faculty and students alike, Ross University School of Medicine (2).

 

Photo: Dominica from my cottage porch, April 2017. Photo credit: Bruce Wright

Through most of my years there, Dominica was spared the worst that Mother Nature could bring to bear.  We liked to say that it was in the perfect place in the Lesser Antilles, too far north for the big Cape Verde hurricanes that would not be turned north as they tracked west through the Central Atlantic to hit, and too far south for those Atlantic storms that did get pulled north as they approached the islands.  Sometimes a tropical storm would come and dump a lot of rain but that just turned the tap water brown or white for a day, no big deal.  The island stayed its radiant green from the tropical rain forests, only browning out for 1-2 months per year in the dry season from January to April.

 

 

In 2015, Tropical Storm Erika formed almost on top of us, and hit the island with the worst rainfall it had experienced in decades.  Dozens of people died and whole towns were cut off for months.  We thought we’d been hit by the Big One, as the estimated damage from Erika’s island-wide flash flooding was about 500 million dollars, or well over half of Dominica’s gross domestic product (3). For two years the island slowly recovered, rebuilding its water treatment facilities, repairing washed-out bridges, and helping rebuild flooded coastal communities.

By August 2017, Dominica was almost completely back.  We too were back.  Our school had had its own water supply even before Erika hit, and the electricity never went out in Portsmouth afterwards. Like the rest of Dominica, my school did lose cell phone service and internet for several days after that storm, which was a serious concern.  Once we were reconnected with the world, we moved to make sure our school would never be caught like that again.  My school installed its own satellite, set up evacuation plans, and built a new student center rated to withstand a Category 5 hurricane. Along the way it continued to matriculate three sets of students per year, semester in and semester out.  Collectively, we thought we’d survived the worst and recovered very well.

No one expected the hurricane onslaught of 2017.  Three major hurricanes, three major disasters, with consequences felt in several parts of the United States, were always theoretically possible but most people didn’t expect more than one to pan out. In the middle of August, I was on vacation at my wife’s home in Georgia as eventual Major Hurricane Harvey formed in the Atlantic and passed south of Dominica as a tropical storm.  Most storms that go that way fizzle out in the eastern Caribbean, but Harvey survived and went on to ravage Houston and the surrounding region of the northwestern Gulf of Mexico like few hurricanes ever had (4). The United States’ people and its government mobilized to help Texas and Louisiana, as it so often does after a major disaster.  I breathed a sigh of relief that Dominica was spared again even as I too donated to help the Gulf coast.

I returned to work before the beginning of the September semester.  Irma was still far out to sea in the Central Atlantic, but it looked like it was going to be trouble almost as soon as it cleared Africa.  I told many first semester students days before Hurricane Irma reached the Lesser Antilles that they should invest in a full set of hurricane supplies as if it would be the worst storm they would ever experience in their lives. Then, when it didn’t hit, they could eat the food, drink the bottled water, and cook with the extra propane all semester long.  Some took this advice to heart and others didn’t.  As Hurricane Irma came closer and closer, it kept heading straight for Dominica, defying days of forecasts that it would turn northwest, and strengthening all the way to one of the strongest Category Five storms of all time.  Only at the last minute seemingly did it turn at last.

Irma was a terrible storm, even by historical standards (5).  It destroyed St. Maarten and several other islands but all we got from it was severe rain and tropical-storm force winds, with only minor damage to our fragile infrastructure.  We grieved for our comrades including our sister school American University of the Caribbean north of us, and then watched as this storm’s heaviest rain bands hit the Miami area, causing even more flooding damage only weeks after Houston’s deluge.  As our University headquarters were there, this had some effect on our operations, but again from Dominica we breathed a sigh of relief.  We had been spared the worst again.

Chugging along some distance behind Irma, another tropical wave came off of the African coast, looking suspicious right from the start.  Maria, as it was to eventually be named, was absolutely the worst case scenario for the island of Dominica and for our basic science campus there (6).  It wasn’t supposed to be a major hurricane when it hit.  The forecasts all said if it hit at all, it was likely to be a strong tropical storm, maybe a Category One.  Nevertheless, in preparing for a business trip to Chicago for the second week of September, I had a group meeting with my mentees a week early, because sometimes even a simple rainstorm over Puerto Rico could delay my return by a day, and I was to return on Monday, September 18th.  I took my work computer with me on the trip on a hunch I might need it before I got back to Dominica.  I had no idea how right I was.

As I worked at my business meeting, I kept following the progress of Maria, joking that it might just prevent me from returning on Monday, but hoping that it would turn like so many storms before it.  This was not to be. By late Saturday even though it was only tropical storm strength, it was apparent that on Sunday the regional airlines were going to evacuate their small aircraft to havens like Aruba and Curacao to the south and Central America to the west.  Since there weren’t going to be any flights, my travel agent arranged for me to go back to my family in Georgia on that Monday to wait out the storm.  We expected I probably wouldn’t get back to Dominica until air service was restored to Puerto Rico, probably four to six days after I’d originally been scheduled to return to Dominica.

September 18th, 2017… Imagine being inside a tornado.

Imagine looking up to see your roof flying away and then the wind and rain coming in on top of your inadequate shelter as you brace your feet against the closet door, hoping it will hold.  Imagine hanging on for hours and hours of storm, enduring howling winds and painful rain and your stuff blowing away around you, hoping you wouldn’t die. If you have trouble imagining it, so do I, because I wasn’t there.  My colleagues who were there said that I was the luckiest person at the school, to be thousands of miles away that fateful day. From my computer screen at home that night I watched the storm give Dominica a direct hit with 160 mile per hour sustained winds, and turning only as the eye was literally over the island such that the entire west coast of the island was struck by the eyewall of Category Five Hurricane Maria.  As I flew home over the United States that day, eighty to ninety percent of the buildings in the country were about to be damaged or destroyed, the hospital, power generators and water reservoirs damaged or destroyed, and the roads and bridges so shakily repaired after Erika destroyed again (6).  The morning after the storm, people went out and saw that not one tree had escaped unscathed on the entire island, and in many places the trees had lost their bark or been snapped in two (7).  Virtually every telephone pole was either in need of repair or down entirely. The airport was knocked out again from both rain and the river beside it washing through the terminal and over the runway. Unlike with Erika, the seaport and its dock and warehouse capacity on the west coast was heavily damaged as well.  And of course, dozens of people were dead and dozens more are still missing to this day. The island was brought to its knees.

A few days after the storm, the prime minister declared in a speech to the United Nations General Assembly that “Eden is broken” (8).

Photo: GOES-16 visible image of Maria just before sunset, at 5:17 pm EDT Monday, September 18, 2017. Image credit: NOAA/RAMMB. (9)

At our campus, that brand new hurricane-proof building delivered.  All of our people were safe, though many of our older buildings were heavily damaged.  The French islands north and south of us weren’t so badly damaged and they were able to get helicopters up to survey the scene of total devastation that Dominica had become.  Our campus became a site for them and other rescuers to base, as it was more functional than any other location on the north side of the island.  With help from many others including the U.S. military, over a thousand students, faculty, staff, and family members were evacuated off the island through seas crowded with entire forests of dead trees and other debris.  Our CEO was there to greet many Ross refugees in Miami as they returned to the US to an uncertain future.  And as before, I watched it all from a distance, not personally devastated as they were but a refugee just the same.  I found out from a colleague who had been my neighbor that my concrete cottage had held up better than most. Like three of the other cottages in the complex it still had both a roof and windows following the storm, but no one could say if anything inside had survived the flooding, or whether the post-storm looters who sadly went through many other places had broken in after they were evacuated.  As soon as I could, I checked in with my school to let them know where I was and that I was safe. I was told to sit tight and wait for instructions, just like everybody else.  So that’s what I did, for several weeks.

Stay tuned for next week’s exciting conclusion…

 

Bruce E. Wright graduated with a PhD in Physiology from LSU Health Sciences Center in 1993.  He had postdoctoral fellowships/research faculty positions at the University of Florida and East Carolina University.  He served several years as faculty at a liberal arts college in Georgia.  He worked at three Caribbean medical schools from 2005-2008 before joining the faculty at Ross University School of Medicine in 2008.  He worked for two years at a US-based osteopathic medical school in 2013 and 2014 before returning to Ross University in late 2014.  Dr. Wright is currently Treasurer/Award & Event Coordinator for the American Physiological Society’s Teaching Section.  He has served as a reviewer for Advances in Physiology Education.  He is National Faculty for the National Board of Osteopathic Medical Educators (NBOME), for whom he has written and reviewed items for different exams.  He regularly attends Experimental Biology and was an attendee and presenter for the first Institute for Teaching and Learning meeting in Bar Harbor, Maine in 2014.  He is currently interested in educational research involving teaching methodologies.

References/links/other:

        1. http://www.dominica.gov.dm/about-dominica/country-profile
        2. https://medical.rossu.edu/about.html
        3. http://www.dominica.gov.dm/tropical-storm-erika
        4. https://weather.com/storms/hurricane/news/tropical-storm-harvey-forecast-texas-louisiana-arkansas
        5. https://weather.com/storms/hurricane/news/hurricane-tropical-storm-irma-recap-2017
        6. https://en.wikipedia.org/wiki/Hurricane_Maria
        7. https://www.youtube.com/watch?v=l-5fHwER-Zc
        8. https://www.caricom.org/media-center/communications/press-releases/dominica-prime-minister-roosevelt-skerrit-addresses-the-un-general-assembly
        9. https://www.wunderground.com/cat6/category-5-hurricane-maria-hits-dominica
        10. https://veterinary.rossu.edu/about.html 
March 19th, 2018
Writing—Work in Progress

As a scientist and educator over the years, I have had the good fortune and pleasure to write and edit many manuscripts and documents, especially in collaborations with mentors, colleagues, and students. As most of us in the business know, writing doesn’t always come easy. It is often very challenging to convey information, thoughts, and ideas in a coherent and straightforward manner, and leave little room for misinterpretation, confusion, and ambiguity. In addition, it can be hard to convey excitement in writing. Writing is an art and deserves time and effort to create a masterpiece. Realistically though, time is rarely on our side for routinely creating works of art. However, we should still try!

 

Writing for me is work in progress, but very enjoyable. I know that I can always improve. Consequently, I seek better and more creative ways to express myself. I certainly wasn’t always enthusiastic about writing. Graduate students and postdoctoral fellows please take note! As a graduate student writing my early manuscripts, I would often string a few sentences together that seemed reasonable and whisper to myself, “This is close and good enough.” It rarely was. My doctoral mentor, Dr. Walter F. Boron (presently at Case Western Reserve University) almost always caught those good enough sentences when we sat together meticulously reviewing every sentence when editing a manuscript. This experience was humbling, yet highly educational, and certainly one of the high points of my graduate school years. I have continued this tradition in my own lab— enduring the occasional sighs of annoyance from my students.

 

The extra effort in writing can be a wonderful and rewarding experience. Many helpful resources are available. Don’t be afraid to pull out that composition/grammar book when needed. I am particularly fond of The Random House Handbook (1), which remains dust-free on my office bookshelf. Also, make use of that Thesaurus tab in Microsoft® Word! Finally, learn from the creativity of others in their writing prose, sentence structure, and expression usage.

I leave you with a list of some of my favorite writing points and guides from over the years.

I acquired most of these from my former advisor, Dr. Boron; I owe him a great deal of gratitude. I also used Ref. 1 to supplement my understanding. Write on and become my fellow artists!

1. Tell a story with the goal of exciting your readers (yes, even with a scientific manuscript).

2. Assemble outlines.

3. Write rather than stare at a blank screen/page for too long. You can always edit a mess later.

4. Edit exhaustively, but spaced out over time.

5. Get input from others.

6. Scrutinize every sentence.

7. Ask the following for every sentence:

“Does it say what I want it to say?”

“How can I make it clearer and/or shorter?”

8. Write active sentences. For example, “Compound X caused effect Y” is better than, “The effect Y was caused by compound X.”

Writing active sentences also holds when citing the work of others. For example, “Smith et al. showed that…” is stronger than, “It has been shown that… (Smith et al.).”

9. Use parallel construction in multi-part sentences. For example, “Compound X caused an increase in Y, and Compound A caused a decrease in B.”

Use parallel construction for multiple sentences that are clearly linked. For example, if you are making three points and you start the first sentence with, “First,…,” then you should have a “Second,…” and a “Third,…”

10. Give the direction of an effect whenever possible. Using the example above, “Compound X caused an increase in Y” is better than, “Compound X had an effect on Y.” Sentences should be as informative as possible.

11. Use present tense when discussing a universal truth.

12. Be consistent in using declarative or non-declarative statements in main headings, in-line headings, figure legends, etc. throughout a body of work.

13. Be careful assigning an action to an inanimate object such as an experimental result. For example, “Experiment X showed Y.” Did the experiment really perform an action?

14. Use caution when starting a sentence with This or These. The reference needs to be clear.

15. Use then in if/then statements. Many writers leave out the then. For example, “If you add media A, then the cells will die” flows better than, “If you add media A the cells will die.” If you use if in an if/then sentence, then hunt for the expected then.

16. Use more gerunds, which are refreshingly active. For example, “Applying X increased Y” is more appealing than, “Application of X increased Y.”

17. Experiment with less frequently used forms of punctuation, e.g., the semicolon and em dash. It’s fun!

18. Don’t confuse that and which clauses. That is used in a restrictive clause to understand sentence meaning. Which is used in a nonrestrictive clause to present additional information; which follows a comma.

19. Use because instead of since in many cases. Since refers to time.

20. Minimize split infinitives. Some will argue with me on this one. For example, “to argue incessantly” is better than, “to incessantly argue.” It is sometimes difficult to avoid splitting up to-base verb pairs because they then sound clumsy. Some will reason that a split is acceptable in those cases. My Father’s response: “No. Rewrite the sentence.”

21. Be careful with generic terms such as numerous, many, variety of, etc. Ask yourself, “Is the term accurate? How many exactly?” Consider giving an appropriate example to the reader.

22. Use respectively sparingly. For example, “The results from experiments A, B, and C were 5.6, 8.9, and 4.3, respectively” is hard to follow and tedious. A good general rule: Avoid sentences that require the reader to match up terms in different parts of the sentence.

23. Remember the neither…nor combination.

24. Know the difference between i.e. and e.g.

25. Consider abandoning the old-fashioned, two-space rule between sentences that was popular with typewriter use. We’re in the age of computers with line justification.

Mark O. Bevensee, PhD is an Associate Professor in the Department of Cell, Developmental & Integrative Biology at the University of Alabama at Birmingham. His laboratory focuses on studying the cellular and molecular physiology of acid-base transporters involved in regulating intracellular pH in health and disease. Dr. Bevensee also teaches— primarily cell and renal physiology to graduate and professional students. He has served as the Director of the Renal Module for medical students since 2006, and currently serves as the Co-Director & Interim Director of the Master of Science in Biomedical and Health Sciences post-baccalaureate program. He is a member of many education committees, including the Medical Education Committee of the University of Alabama School of Medicine. He serves on the editorial board of Advances in Physiology Education (American Physiological Society, APS) and Medical Science Educator (International Association of Medical Science Educators, IAMSE), as well as the Membership committee of IAMSE. He has been a member of the APS for over 20 years, and is the newly elected Awards Councilor of the Cell and Molecular Physiology Section (CaMPS) Steering Committee of the APS.

Reference:

1. Crews, F. C. (1992). The Random House Handbook, 6th Ed. McGraw-Hill, Inc., New York.

March 5th, 2018
Are you prepared – to prepare an “Olympian”?

Recently, the 2018 Winter Olympic Games came to a close. The games included a number of thrilling surprises (Red Gerard) and heart-breaking spills (figure skaters). Although medals awarded late in the Olympic schedule helped boost Team USA’s medal count, most would agree that the U.S.’s performance in PyeongChang fell below expectations. Looking for answers, TV commentators remarked that the US pipeline for development of Olympic athletes has diminished in recent years.

While taking in the splendor of the Olympic Games, I began to wonder…should we be training future scientists is a manner similar to our athletes? Is the pipeline for development of talent well established and supported?  How do we get the American public to rally behind the performance of high performing physiologists?  What if local businesses, and corporate sponsors proudly displayed “we employ future teachers, scientists, and health care providers”?

As an avid follower of the games, it became obvious to me that Olympic athletes cluster in specific regions of the US. The Gold medal men’s curling team included 4 men from Minnesota (3 from Duluth), and one from nearby Wisconsin. Three young Olympic snowboarders (Red Gerard, Kyle Mack, and Chris Corning) all hail from Silverthorne, Colorado. The city of Federal Way (located along Federal Highway U.S. 99 in Washington State) is an incubator of U.S. short-track speed skating talent, and has sent American speed skaters to the past five Winter Olympics (Ohno, Celski and Tran).

Is it possible that certain high schools and undergraduate institutions could be considered “incubators” for development of physiologists (scientists in general)? Can we consider our school a “hot bed” for training and development of those with a passion for science?  As professionals, are we fulfilling our role to prepare our youth for their “Olympic” performance, or are we falling behind expectations?

To assist in preparing future physiologists, the American Physiological Society supports the “pipeline” by providing a number of programs and awards (see links below). However, these offerings require us to identify students and encourage and support their applications. We are called upon to build programs and opportunities that are sustainable, and produce measurable outcomes.

I have to admit that prior to writing this post, I had not FULLY considered my role in developing our future physiologists (Olympians).  I personally pledge to re-evaluate my role, and hope to bring others into the conversation to ponder the questions posed.

In closing, I would ask you to consider a quote from former Olympic Gold medalist Mia Hamm, and think about specific and personal ways each of us can help build the fire, and light the match.

“I am building a fire, and every day I train, I add more fuel. At just the right moment, I light the match.” – Mia Hamm, American soccer player and gold medalist.

Undergraduate Awards
http://www.the-aps.org/mm/awards/Other-APS-Awards/Undergraduate

 

K-12 Awards
http://www.the-aps.org/mm/awards/Other-APS-Awards/K-12-Student

  • APS Science Fair Awards: APS members make APS awards at local or regional science fair at the elementary, middle, or high school level.
  • ISEF Awards: APS participates as a Special Awards Sponsor for the International Science and Engineering Fair (ISEF)

 

Program brochures for diversity and higher education:
http://www.the-aps.org/education/publications.aspx

 

Mari K. Hopper, PhD, is currently an Assistant Professor at Indiana University School of Medicine. In addition to teaching physiology in a variety of systems based courses, she serves as the Director of Research, Hospital Medical Education, and other Scholarly work. Prior to this position, she taught physiology based courses at the undergraduate level for over 20 years. She is currently on the HAPS Conference Site Selection Committee, Chair of the Chapter Advisory Committee of the American Physiological Society, and Past-President of the Indiana Physiological Society. Her research interests include both student academic engagement (active learning) and student health.
February 19th, 2018
Beyond Content Knowledge: The Importance of Self-Regulation and Self-Efficacy

You can lead students to knowledge, but you can’t make them understand it …

Undergraduate physiology education has been steadily morphing from a traditionally instructor-centered, didactic lecture format to a more inclusive array of practices designed to improve student engagement and therefore motivation to learn.  Many excellent resources are available regarding the theory and practice of active learning (4) as well as guidelines specific to teaching physiology (2).  Common questions instructors ask when redesigning courses to be student-centered, active learning environments are often along the lines of:

  1. What specific content areas should I teach, and to what depth?
  2. What active learning strategies are most effective and should be included in course design? Common methodologies may be in-class or online discussion, completion of case studies, team-based learning including group projects, plus many others.
  3. How do I align assessments with course content and course activities in order to gauge content mastery?
  4. How do I promote student “buy-in” if I do something other than lecture?
  5. How do I stay sane pulling all of this together? It seems overwhelming!

These last two questions in particular are important to consider because they represent a potential barrier to instructional reform for how we teach physiology– the balance between student investment and responsibility for their learning versus time and effort investment by the instructor.  All parties involved may exhibit frustration if instructor investment in the educational process outweighs the learner’s investment.  Instructors may be frustrated that their efforts are not matched with positive results, and there may be concerns of repercussions when it comes time for student course evaluations.  Students may perceive that physiology is “too hard” thus reducing their motivation and effort within the course and possibly the discipline itself.

To improve the likelihood of a positive balance between instructor and student investment, perhaps we should add one additional question to the list above: What is the learner’s role in the learning process?   

Students often arrive to a class with the expectation that the instructor, as the content expert,  will tell them “what they need to know” and perhaps “what they need do” to achieve mastery of the factual information included as part of course content.  This dynamic places the responsibility for student learning upon the shoulders of the instructor.  How can we redefine the interactions between instructors and students so that students are engaged, motivated, and able to successfully navigate their own learning?

 

Self-Regulated Learning: A Student-Driven Process

Self-regulated learning is process by which learners are proactive participants in the learning process.  Characteristics associated with self-regulated learning include (4):

  • an awareness of one’s strengths and weaknesses broadly related to efficacious learning strategies (e.g., note-taking)
  • the ability to set specific learning goals and determine the most appropriate learning strategies to accomplish goals
  • self-monitoring of progress toward achieving goals
  • fostering an environment favorable to achieving goals
  • efficient use of time
  • self-reflect of achievement and an awareness of causation (strategies à learning)

The last characteristic above, in particular, is vitally important for development of self-regulation: self-reflection results in an appreciation of cause/effect with regard to learning and mastery of content, which is then transferrable to achievement of novel future goals.  Applied to undergraduate physiology education, students learn how to learn physiology.

At one point recently I was curious about student perceptions of course design and what strategies students utilized when they had content-related questions.  The following question was asked as part of an anonymous extra credit activity:

The results of this informal survey suggest that, at least in this cohort , undergraduate students generally did have a strategy in place when they had content-related questions—utilization of online resources, the textbook, or the instructor via e-mail to review how others have answered the question.  The good news (if we can call it that) is that only one student reported giving up and did not attempt to find answers to questions.  However, it is interesting to see that only 14% of respondents reported using critical thinking and reasoning to independently determine an explanation for their original question.  Extrapolating to a professional setting, would I want my health care provider to be proficient at looking up information that correlates with signs and symptoms of disease, or would I prefer my health care provider capable of synthesizing a diagnosis?  Thus, self-regulation and having an action plan to determine the answer for a particular question (or at least where to find an answer) may only be part of the learning process.

 

Self-Efficacy: A Belief in One’s Ability to Achieve a Defined Goal

While self-regulation refers to a collection of self-selected strategies an individual may use to enhance learning, self-efficacy is the confidence that the individual possesses the ability to successfully apply them.

Artino (1) has posed the following practices associated with building self-efficacy in medical education.

  • Help students with the goal-setting process, which could be related to learning or the development of skills and competencies; facilitate the generation of realistic and achievable goals
  • Provide constructive feedback, identifying specific areas for which students are demonstrating high performance and areas for improvement
  • Provide mechanisms to compare self-efficacy to actual performance; this could take the form of instructor feedback, metacognitive strategies, self-assessments, and self-reflections
  • Use peer modeling and vicarious learning; best practices would be to use peers at a similar level of competence who are able to demonstrate successful achievement of a learning goal

I am interested in the relationships between self-regulated learning, self-efficacy, how students learn physiology, and tangentially student perceptions of my role as the instructor.   Thus, here is another example of a self-reflection activity that was offered in an online class-wide discussion forum as extra credit (Hint: extra credit seems to be a sure-fire way to promote student engagement in self-reflection).  Once students responded to the prompt shown below, they were able to review other student’s responses.  Following the due date, I diplomatically consolidated all responses into a “peer suggestions for how to learn physiology” handout.

Three outcomes were in mind when creating this activity:

  1. To encourage students to think about the control they have over their own learning and recognize specific practices they can utilize to empower learning; also peer modeling of learning strategies
  2. To set reasonable expectations for what I can do as the instructor to foster learning, and what I cannot do (I would make it easy to understand all physiological processes, if only I could…)
  3. To plant the seed that course activities build content knowledge applicable to a future career goal, which hopefully translates into increased motivation for active participation in course activities

 

Beyond Content Knowledge: Integration of Self-Regulation and Self-Efficacy into Course Design

Incorporation of activities to build self-regulation and self-efficacy can be included along with content knowledge in the active learning classroom environment.  Moving away from didactic lecture during class time to a more flexible and dynamic active learning environment provides opportunities to discuss and model different learning strategies.  If incorporated successfully, students may experience increased self-efficacy and self-confidence, setting the precedent for continued gains in academic achievement and subsequently the potential for professional success.

It is also important to consider that what we do in the classroom, in a single course, is just one piece of the undergraduate educational experience.  Currently there is a call for undergraduate physiology programmatic review and development of cohesive curricula to promote knowledge of physiology as well as professional/transferrable skills and competencies directed toward a future career (3).

If the overarching goal of an undergraduate education is development of knowledge, skills, and abilities transferrable to a future career, as well as life-long learning, it is vitally important that discussion of self-regulated learning and self-efficacy are included within the curriculum.   Although this seems a daunting task, it is possible to purposefully design course structure, and indeed programmatic structure, with appropriate activities designed to enhance learning and self-efficacy.  One key suggestion is to make the inclusion of knowledge, skills, and competencies transparent to boost awareness of their importance, throughout the educational experience.  Here is one example of what this could look like:

 

Students frequently focus upon content knowledge, and subsequently their grade as the primary outcome measure, rather than seeing the “big picture” for how the sum total of course activities most likely directly relate to their professional goals.

A second key component to building well-prepared and high achieving undergraduates is to involve your colleagues in this process.  It takes a village, as the saying goes. Talk to your colleagues, decide which course/s will emphasize specific attributes, and also be a united front.  If students hear the same message from multiple faculty, they are more likely to recognize its value.

Finally, course or curricular reform is time-consuming process.  Don’t expect the process to be complete within one semester.  There are many excellent resources related to backward course design, core concepts of physiology as conceptual frameworks for student learning, student-centered activities, etc.  Be purposeful in selecting 1-2 areas upon which to focus at a time.  Try it out for a semester, see how it goes, and refine the process for the next time around.

 

Jennifer Rogers, PhD, ACSM EP-C, EIM-2 received her PhD and post-doctoral training at The University of Iowa (Exercise Science).  She has taught at numerous institutions ranging across the community college, 4-year college, and university- level  higher education spectrum.  Jennifer’s courses have ranged from  small, medium, and large (300+ students) lecture courses, also online, blended, and one-course-at-a-time course delivery formats.  She routinely incorporates web-based learning activities, lecture recordings, student response activities, and other in-class interactive activities into class structure.  Jennifer’s primary teaching interests center around student readiness for learning, qualitative and quantitative evaluation of teaching  strategies, and assessing student perceptions of the learning process.

Dr. Rogers is a Lecturer in the Health & Human Physiology Department at The University of Iowa.  She is the course supervisor for the Human Physiology lecture and lab courses.  Jennifer also teaches Human Anatomy, Applied Exercise Physiology, and other health science-focused courses such as Understanding Human Disease and Nutrition & Health.

  1. Artino AR. Academic self-efficacy: from educational theory to instructional practice. Perspect Med Educ 1:76–85, 2012.
  2. Michael J, Cliff W, McFarland J, Modell H, Wright A. The Core Concepts of Physiology: A New Paradigm for Teaching Physiology. Published on behalf of The American Physiological Society by Springer, 2017.
  3. Wehrwein EA. Setting national guidelines for physiology undergraduate degree programs. Adv Physiol Educ 42: 1-4, 2018.
  4. Zimmerman BJ. Becoming a self-regulated learner: an overview. Theory Into Practice, 41(2): 64-70, 2002.
February 5th, 2018
Home is Where the Heart(h) is – My Reflections as an Educator

I think I always knew, deep down, that I wanted to be a teacher.

Sure, I considered myself ‘pre-med’ from the time in second grade when I told my best friend that I wanted to be a heart surgeon, until the last day to sign up for the MCAT my junior year in college.  If I’m being honest, I flirted with the idea of transferring into the MD/PhD program after my first year in graduate school.  In any case, after falling in love with my SLAC (small liberal arts college), I knew what I was going to do:

  • go to a medical school and earn a PhD,
  • do a post-doc, and
  • set up my own little corner in the best of both worlds – teaching at a SLAC, with a small, but productive lab, comprised of talented and driven undergraduates.

 

In fact, when I arrived at the Physiology department (at what is now known as the Lewis Katz School of Medicine) at Temple University for my PhD program, I emphatically announced my intent.  While I loved my time in the lab, and particularly my work in cardiovascular physiology and the heart transplant research program, I was meant first and foremost to be a teacher.  I took advantage of the few teaching opportunities in the medical school to hone my craft, I took adjunct work when available, and appropriate, at a local college, and I looked for a post-doc which presented me with the opportunity to study a model system which could be done relatively inexpensively at a small school.

 

Then “life” happened; in 2008 I got married, entered the job market, and found out I was pregnant.  If you recall, 2008 was not a good year for tenure-track candidates.  The words “hiring freeze” were pervasive and debilitating for those of us on the market.  As a result, I continued to hold an adjunct position, working part-time to try to stay relevant as an educator, while also being a part-time stay at home mother.  I questioned everything that led up to this moment – I had the blinders on from the time I was seven with regards to my career progression.  Now, in my new role as a mother and only partially employed, I wondered if the years of higher education and the student loans were worth it.  I was also keenly aware of the problem of watching my employability dwindle away with each passing month, and the competitiveness of the field.

 

The silver lining of this situation was that it forced me to do what I had refused to do pretty much my entire life – slow down, reflect, and figure out where I was headed.  I ended up applying for, and getting, a job as an Assistant Professor at a small liberal arts school, teaching pretty much whatever biology course I wanted, and coordinating the Anatomy and Physiology courses for the health professions.  The down side was that this position was teaching-heavy and while scholarship was not only strongly encouraged, but pretty much required for promotion, there were limited resources and very little time or space to set up a lab. This meant opportunities had to be made elsewhere and on my own time.

 

Then, about three years ago on a whim, I checked the job ads.  The first position that appeared was for a Physiology Educator at my graduate school alma mater.   The questions started.  Did I want to leave my job?  Was I qualified?  Did I really want to go back “home”?  Long story short, the answers were “for the right opportunity”, “apparently yes”, and “absolutely”.

 

This is where I come back to my title – Home is Where the Heart(h) Is.

 

As I came back to Temple, I noticed that some things had changed while others had stayed the same.  It is an incredible privilege to teach beside my own professors and mentors, and I truly feel like I came back home.  One of the changes, as seen both in the curriculum, as well as in the hallways, was the infusion of more humanities.  Student artwork is now found along the wall near the Medical Education offices.  I started thinking about what I, as an alumna, could contribute.

 

My interest and passion for art far exceeds my natural ability, although I have taught myself to quilt over the years.  My interest blends modern with traditional – couldn’t you just see an art quilt of the anatomical heart mounted on that wall with the photographs, oil paintings, and charcoal sketches? – but I am also interested in the history of quilting and the more traditional patterns.

 

One of my favorite patterns, and one of the most versatile yet symbolic, is the Log Cabin quilt.  The American version dates back to at least the 1800s, although there is evidence that a similar pattern has been traced back to Ancient Egypt1,2.  This pattern gained popularity in the United States around the time of the Civil War.  While the components are the same, the colors can vary and the blocks can be arranged in many different ways, conveying different feelings and even meanings.

 

The basic pattern is as follows:  Rectangles of fabric (“logs”) are arranged around a center square (“heart” or “hearth”).  The color of the center square is thought to provide symbolism; for example, red means “hearth”, yellow means “letting light in”, and, anecdotally and through oral history, black is thought to have been used to discreetly identify stops on the Underground Railroad1,2.

 

I have made several Log Cabin quilts over the past decade, but I find myself using red for my center.  Home is where the heart is.  A metaphor for my career progression thus far, as I started at LKSOM as a physiology student in the cardiovascular group almost 20 years ago, which makes Temple the heart.  Each subsequent stop on my journey – the colleges for which I taught as an adjunct, my role as a mother, my previous Visiting Assistant Professor and Assistant Professor positions, my mentors and role models – all serve as logs that make up my cabin.  My cabin looks different than those of my colleagues and my former classmates, who may have taken other paths, like careers in industry, scientific writing, or a traditional academic position, or as a physician.

 

Our cabins might all look different, but in the center is the fire that burns in the hearth, or the light; it is that which centers us and from where our passion comes.  For me, my passion is as an educator.

 

I am forever grateful for those who mentored me along the way, and who continue to serve as mentors and as inspiration.   What I learned (so far) on my journey:

 

  1. Apply for the job

Although it might be human nature that we are apprehensive to take a chance, surveys have shown that more women have the tendency to not apply for a position unless they feel 100% qualified, and more women cite the fear of failure and therefore wasting time as a reason why3.  However, you don’t get 100% of the jobs you don’t apply for.

 

  1. Keep an open mind

The career you think you want might not be the career you end up in for a number of reasons.  Don’t get so hyper-focused that you miss other interesting opportunities.

 

  1. Don’t be afraid to listen to your heart and follow your own path

I spent my undergraduate, graduate and postdoctoral career preparing for a job I didn’t know if I would get, and as it turns out didn’t really exist at the time.  I took every biology course I could in undergrad, assuming I would need to be well rounded to teach in an undergraduate program.  I took time to work on my teaching skills during my graduate and post- doctoral studies, so that by the time I finished, I already had several semesters-worth of teaching and evaluations that made me more marketable for an undergraduate teaching position.

 

  1. Make your own opportunities

I attended an in-house conference a few years ago.  One of the panelists suggested that we take care to be more proactive in letting supervisors know if we are interested in a particular opportunity that becomes available.  He relayed a story in which he needed to fill a position, and his mind immediately went to colleagues who had expressed an interest, even if there were several people who were qualified.  I took this advice a few months later and subsequently found myself not only assigned to a new opportunity, but was also invited to participate in related working groups and committees.

 

  1. Don’t discount your previous experience

I was concerned when I left an undergraduate institution to go back to the graduate and professional level.  Would I remember the level of depth and nuance that wasn’t appropriate in the courses I had gotten used to teaching?  Not only did I find it easier in some ways (it’s easier to teach physiology when students have already had physics and chemistry!), I found that my experience working with undergraduates provided me with insight that is unique in that I had a better as to where the students were coming from.

 

  1. Keep in mind work-life balance

This is something I am continuously working on.  Does this even exist?  If anyone has any advice, I’m all ears.

 

Maybe it’s time I dust off my sewing machine.

Dr. Rebecca Petre Sullivan earned her Ph.D. in Physiology from the Lewis Katz School of Medicine at Temple University and completed a Post-Doctoral Fellowship in the Interdisciplinary Training Program in Muscle Biology at the University of Maryland School of Medicine.  She taught undergraduate biology courses at Ursinus College and Neumann University.  As an Associate Professor of Physiology, she is currently a course director for two courses in the Pre-Clerkship curriculum at LKSOM; in addition to teaching medical students, she also teaches cell physiology and cardiovascular physiology in Temple’s dental and podiatry schools and in the physician assistant program.  She was the recipient of a Golden Apple Award from LKSOM in 2017 and the Excellence in Undergraduate Teaching Award from Neumann University in 2012.
  1. Log Cabin Quilts – A Short History. (AQSblog, May 15, 2012, http://www.aqsblog.com/log-cabin-quilts-a-short-history)
  2. Quilt Patterns Through Time: Log Cabin Quilts – Inspirations from the Past. (http://www.womenfolk.com/quilt_pattern_history/logcabin.htm)
  3. Are Women Too Timid When They Job Search? (Forbes, September 11, 2014, https://www.forbes.com/sites/nextavenue/2014/09/11/are-women-too-timid-when-they-job-search/#7fe6961a411d)
January 22nd, 2018
The Power of Compassionate Teachers

The 2018 Golden Globes were down in Nielsen ratings compared to last year.  According to Variety.com in a January 8, 2018 post, the Golden Globes drew in 19 million viewers representing an 5% drop in total viewers from 2017 (20 million).1 Audiences watched the 2018 Golden Globe awards which aired on January 7, 2018 and although viewership was down, the news coverage for the event had a lasting impact as a result of the acceptance speech given by the lifetime achievement recipient of the 2018 Cecil B. de Mille Award – Oprah Winfrey.  Though her moving speech lasted less than 10 minutes, it is one that will be remembered for a long time.

 

If the media’s response is any indication of whether it will go down as one of the greatest acceptance speeches, I’d say it is well on its way.

As of the writing of this blog, one 9.40 min clip posted by NBC of Oprah’s speech garnered over 7.5 million views and a google search of “Oprah Golden Globe 2018 speech” produces over 21 million hits just 5 days after the airing of the show.2

While I can go on about the themes in her speech, cultural statements she made, her great display of emotional intelligence, her well-structured speech, or its timeliness, it is what she didn’t say in her acceptance speech, but rather what she said in the backstage press room that stood out.

In the typical fashion of Golden Globe winners, Oprah exited the stage after her acceptance speech and proceeded backstage to take questions from journalists.  So, what did millions of viewers not hear in her speech that they missed in from her Q&A session with the press? For that information, you had to wait for the fourth question asked by a female journalist.  The journalist asked,

“What advice would you give 7-year-old Oprah (or 13-year-old Oprah) about surviving as a woman in this world?

The full video of her backstage Q&A session was posted by Variety on January 7, 2018 and has an impressive 1.1 million views, 9.55 minutes (within 5 days). 3 Interestingly, Forbes wrote the only news piece about the backstage session. 4 What would Oprah tell her 7-year-old self?  Without hesitation, Oprah responded,

“At seven, I was so sad and um… at seven, all of my real love came from my teachers. And so my teachers, (I would say that to anyone in this room), you have no idea the power of noticing another human being.  And what it feels like when somebody knows that they been seen – truly seen by you.  It is the greatest offering you can give.”

Did you catch that? All of her real love came from her teachers.  During those formative and critical years, her teachers showed her love and noticed her.

Oprah goes on to describe how the core need of humans to be noticed continues into adulthood.

“And all those years of the Oprah show, the greatest lessons I learned was that after every show someone would say invariably in one way or another um, “How was that?” I would finish an interview with…politicians, Barack Obama, George Biden, George Bush…Beyonce… they all say the same thing, “How was that?” and so I started to see that there is this common thread in our humanity, where everybody wants to know, “How was that, did I do okay? Did you hear me?  And did what I say mean something to you?”

Sound familiar?  Feedback. Whether you are being interviewed by a journalist or interacting with the teacher or peers in the classroom – we all desire feedback.  Feedback offers student insight into what they did or did not do well.  Feedback informs students about performance, behavior, competencies, understanding, and it is where learning takes place.  We all desire positive, constructive feedback.

Oprah concludes with a powerful statement on the importance of being heard.

“So, I would have to say that recognizing that in other people has helped me to become, you know, a person of compassion, a person of understanding, a person who can interview anybody about anything cause I know that at the core of you is the same at the core of me, you just want to be heard.”

You won’t see this part of her wisdom highlighted in blogs, news, or features.  Yet, her words give teachers something to think about.  Students (and teachers) have a core need to be noticed, receive feedback, and be heard.  Educational Psychology agrees:

  • Teachers effect student’s personality and performance,5
  • Teachers influence the classroom’s social context on learning and teaching,6
  • Teachers play a role in establishing a climate in which all students are accepted, valued, and respected,and
  • Teachers influence intrinsic motivation for learning in students and encourage life-long learning.7

As we enter a new semester, let us reflect on the influence we have on learners through interpersonal relationships and communication that occurs with our students, and thereby affects learning and student long-term success.

References

  1. TV Ratings: Golden Globes Down Slightly From 2017 http://variety.com/2018/tv/news/golden-globes-ratings-2018-1202656292/#utm_medium=social&utm_source=twitter&utm_campaign=social_bar&utm_content=bottom&utm_id=1202656292 via @variety
  2. Oprah Winfrey receives the Cecil B. de Mille Award at the 75th Annual Golden Globe Awards. https://youtu.be/fN5HV79_8B8
  3. Oprah Winfrey – 2018 Golden Globes – Full Backstage Speech. (9.55 min.) https://youtu.be/4CGBSGEkbKA
  4. Oprah Winfrey – 2018 Golden Globes – Full Backstage Speech. (begins at 06 min., https://youtu.be/4CGBSGEkbKA?t=5m6s)
  5. What Oprah Winfrey, The Star of the Golden Globes, Had to Say Backstage (Fores, January 8, 2018, https://www.forbes.com/sites/maddieberg/2018/01/08/what-oprah-winfrey-the-star-of-the-golden-globes-had-to-say-backstage/#426985353e32)
  6. The effect of teachers’ attitudes on students’ personality and performance. Procidea Social and Behavioral Sciences 30 (2011) 738-742. M. Ulug, M.S. Ozden, and A. Eryilmaz (https://doi.org/10.1016/j.sbspro.2011.10.144)
  7. American Psychological Association, Coalition for Psychology in Schools and Education. (2015). Top 20 principles from psychology for preK–12 teaching and learning. Retrieved from http:// www.apa.org/ed/schools/cpse/top-twenty-principles.pdf
Dr. Jessica M. Ibarra, is an Assistant Professor of Clinical and Applied Science Education at the University of the Incarnate Word (UIW) School of Osteopathic Medicine (SOM) at the Medical Campus in Brook City Base in San Antonio, TX.  Dr. Ibarra teaches gross anatomy and neuroanatomy in the Master of Biomedical Sciences Program. She received her doctorate degree in Cellular and Structural Biology from the University of Texas Health Science Center in San Antonio (UT) where she also completed a postdoctoral fellowship.  Following receipt of her doctorate, Dr. Ibarra joined UIW in 2009 Her scholarly work and interests have led her to teach physiology and anatomical sciences to students interested in pursuing a career in the health professions. As a researcher, she conducted studies to explore the role of key inflammatory factors involved in chronic diseases such as heart failure, arthritis, and diabetes.  When Dr. Ibarra is not teaching, she inspires students to be curious about science with visits to local schools.  She performs hands-on science activities during Physiology Understanding Week, at the Science Fiesta, and the USA Science Engineering Festival in Washington, DC.  Dr. Ibarra’s passion for teaching and service translates into facilitating learning in the next generation scientists and physicians. Dr. Ibarra is a native of San Antonio and is married to Armando Ibarra.  Together they are the proud parents of Ryan, Brianna, and Christian Ibarra.
January 8th, 2018
Student Preparation for Flipped Classroom

Flipped teaching is a hybrid educational format that shifts lectures out of the classroom to transform class time as a time for student-centered active learning. Essentially, typical classwork (the lecture) is now done elsewhere via lecture videos and other study materials, and typical homework (problem solving and practice) is done in class under the guidance of the faculty member. This new teaching strategy has gained enormous attention in recent years as it not only allows active participation of students, but also introduces concepts in a repetitive manner with both access to help and opportunities to work with peers. Flipped teaching paves the way for instructors to use classroom time to engage students in higher levels of Bloom’s taxonomy such as application, analysis, and synthesis. Students often find flipped teaching as busy work especially if they are not previously introduced to this teaching method. Pre-class preparation combined with a formative assessment can be overwhelming especially if students are not used to studying on a regular basis.

When I flipped my teaching in a large class of 241 students in an Advanced Physiology course in the professional year-1 of a pharmacy program almost a decade ago, the first two class sessions were very discouraging. The flipped teaching format was explained to students as a new, exciting, and innovative teaching method, without any boring lectures in class. Instead they would be watching lectures on video, and then working on challenging activities in class as groups. However, the majority of the students did not complete their pre-class assignment for their first class session. The number of students accessing recorded lectures was tracked where the second session was better than the first but still far from the actual class size. The unprepared students struggled to solve application questions in groups as an in-class activity and the tension it created was noticeable.  The first week went by and I began to doubt its practicality or that it would interfere with student learning, and consequently I should switch to the traditional teaching format. During this confusion, I received an email from the college’s Instructional Technology office wondering what I had done to my students as their lecture video access had broken college’s records for any one day’s access to resources. Yes, students were preparing for this class! Soon, the tension in the classroom disappeared and students started performing better and their course evaluations spoke highly of this new teaching methodology. At least two-thirds of the class agreed that flipped teaching changed the way they studied. This success could be credited to persistence with which flipped teaching was implemented despite student resistance.

I taught another course entitled Biology of Cardiovascular and Metabolic Diseases, which is required for Exercise Science majors and met three times per week. Although students in this course participated without any resistance, their unsolicited student evaluations distinctly mentioned how difficult it was to keep up with class work with this novel teaching approach. Based on this feedback, I set aside one meeting session per week as preparation time for in-class activities during the other two days. This format eased the workload and students were able to perform much better. This student buy-in has helped improve the course design significantly and to increase student engagement in learning. Flexibility in structuring flipped teaching is yet another strategy in improving student preparation.

While one of the situations required persistence to make flipped teaching work, the other situation led me to modify the design where one out of three weekly sessions was considered preparation time. In spite of these adaptations, the completion of pre-class assignment is not always 100 percent. Some students count on their group members to solve application questions. A few strategies that are expected to increase student preparation are the use of retrieval approach to flipped teaching where students will not be allowed to use any learning resources except their own knowledge from the pre-class assignments. Individual assessment such as the use of clickers instead of team-based learning is anticipated to increase student preparation as well.

Dr. Chaya Gopalan earned her Ph.D. in Physiology from the University of Glasgow. Upon her postdoctoral training at Michigan State University, she started teaching advanced physiology, pathophysiology and anatomy and physiology courses at both the undergraduate and graduate levels in a variety of allied health programs. Currently she teaches physiology and pathophysiology courses in the nurse anesthetist (CRNA), nurse practitioner, as well as in the exercise science programs. She practices team-based learning and flipped classroom in her everyday teaching.
December 18th, 2017
Fastballs, houses, and ECG’s

As adults of ever increasing age, I am sure almost every one of you has had a conversation lamenting your loss of physical abilities over the years. “I used to be able to do that.” “I used to be good at that.” As a parent to two young, energetic, fearless boys I hear (and think) these sentiments almost daily. While watching children play on a playground, sprinting for hours, hanging upside down, contorting their bodies into nearly impossible positions, jumping (and falling), twisting and turning, and literally bouncing off walls, parent conversations almost always include incredulous statements about children’s’ physical capacity followed immediately by a statement of the parents’ lack thereof. More than once I’ve heard a parent say, “If I did that, I’d be in the hospital.”

But have you ever actually thought, “Why can’t I do that anymore?” The answer isn’t just “I’m too old”. Obviously the physiologic changes of age are undeniable, but it’s a more complicated reason. At some point in your life, you stopped playing like children play. You stopped running and jumping and twisting and turning. You move in straight lines. You sit for hours. You don’t try that new move. It looks too hard. You might hurt yourself. As physiologists, we all know about homeostasis and adaptations, and it’s no surprise that our lifestyles have contributed to our physical inability in adulthood. Of course you would hurt yourself if you tried ‘that’, but only because you haven’t tried anything like that in years. Start trying ‘that’ though, and over time you’ll find yourself much more physically capable despite the aging process.

This childhood to adulthood performance decrement is not exclusive to physical capacity though. We are doing much the same to our mental capacity with age. A child will take physical risks on the playground, much as they also take mental “risks” in the classroom. Ask a group of 3rd graders a question, any question, almost all of them raise their hand hoping to answer…even if they don’t know the answer. And the student who got it wrong, will raise his hand again after the next question. Give them a challenge or a mystery to solve and they will dive right in. Let them touch and feel and manipulate. They don’t hesitate. They are on their mental playground. This is how they learn. As adults though, we aren’t going to the mental playground, because that’s not what adults do. We sit in chairs. We watch lectures. We make notecards. We read papers. We study the learning objectives and the PowerPoints.

Just as adults could physically benefit from some time on the playground every day, adults (and I’m including college students in this category) can also benefit from time on a mental playground. Even as educators of other adults, we need to remember this. We often forget the multitude of ways that we can put our students on the mental playground. We don’t do an activity, because the students might think it’s ridiculous. It might waste too much time, and there is too much material to cover today. I have found in my classrooms though, that activities that would work with kindergarteners can work equally well for college students.

To give examples of ways to put college students on the mental playground, I would like to share two activities that I have done in a physiologic assessment of health course that have been very effective. The course consists of juniors and seniors who have already taken several biology, chemistry, and physiology courses beyond anatomy and physiology. The first assignment that I give them is to work with a partner to draw a picture of a person with as many health risk factors as they can think of. I have found that most students who take this class (instructor included) are horrible artists, but this adds to the fun of the assignment. The students love it and come up with thousands of creative ways to represent health risk factors. We have a discussion over which drawings have incorporated the most “official” risk factors (as designated by national organizations like ACSM, AHA, etc.) and why some of the others are certainly not healthy (setting off fireworks indoors), but not listed as official risk factors.  Something about taking the time to draw silly pictures on a specific topic really aids in student understanding (anecdotally in my class, but evidence exists that this is effective (Ainsworth S, Prain V, Tytler R. Drawing to Learn in Science. Science. 333 (6046),1096-1097, 2011.).

Another assignment I’ve had good results with to get students onto the mental playground is half mystery for the students to solve and half drawing pictures. I tell the class that we are going to learn about how the heart works and talk about the electrocardiogram. The first thing I ask them to do is to get out of a sheet of paper and to draw a picture of the house they grew up in as if they were looking at it from the road. Normally confusion ensues and the students want to know if it’s for a grade (yes), and why they’re doing it (trust me, it’ll make sense later). After giving the students time to sketch their house, I ask permission to show each to the class, and then ask the question to the class. “Whose house is bigger?” Ultimately the students come to the conclusion that it is nearly impossible to tell without knowing the perspective and distance from the artist and the other views of the house (the front view is only one of multiple views that would be needed to construct the 3-dimensional size of the house). Then, still without talking about the heart, I ask them to draw a picture of a baseball (just the baseball) being thrown. Once again I show the drawings to the class. All usually agree that everyone probably knows the approximate size of a baseball, but then I highlight how different people drew different sizes on the paper. Once again I discuss perspective and how large a baseball looks when it’s about to hit you in the face, because it takes up your entire field of vision, but if it were thrown at you, it would look smaller relative to your field of vision at the start. If you’re watching people playing catch equidistant from both, the ball might move back and forth without appearing to change size relative to the visual field. But all the baseballs are still the same size!

Finally, after the house and baseball drawings I ask, “what did all of that have to do with the heart and electrocardiograms?” After a few minutes, most students understand the theory behind the electrocardiogram without ever having analyzed one. I’ve even had a strong student who was finishing her clinical exercise testing degree that semester say that even though she had taken several courses on ECG analysis and knew how to read them to get good grades on ECG tests, this was the first time she truly “got it.”

Thousands of other ways to engage students on the mental playground are out there as well. Discussing muscle physiology? Hand out rubber bands before class starts and ask them to think about how muscles and rubber bands are remarkably similar yet not the same at all. Teaching about bones? Pass out a few models to let them hold and manipulate. Then ask the students to pretend they’re cavemen and they need to build all of their tools out of bones, which bones would make a good hammer? A good bowl? Spoon? Fork? Weapon? Teaching about brain physiology? Have the students invoke thoughts, memories, feelings or movements and then tell them which part of the brain is responsible. Be creative and remember that just like our bodies, our minds work best when they’re stretched and twisted and used in different ways on a regular basis.

I do not know enough about educational psychology to understand the underlying mechanisms by which these types of activities work (my PhD is in Kinesiology after all – a content expert told to teach well!).  And admittedly most of my evidence that they work is anecdotal or comes by way of gradually improved student scores on final exam and practical questions related to my course objectives over several semesters in which I certainly adjusted more than one variable. However, I do know that in learning, students attend to touch and feel, emotion, and mystery. The same thing you’ll witness at an elementary school playground. Incorporating these into your lessons, even in the simplest of ways can be beneficial for all different types of learners. I’m asking you to turn your classrooms into intellectual playgrounds. Encourage risk taking. Validate atypical approaches. Make it fun. Make it engaging. All the memorized note cards might be forgotten by next semester if it’s not.

   Ed Merritt is an assistant professor in the Department of Kinesiology at Southwestern University in Georgetown, Texas. 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 was a faculty member at Appalachian State University until family ties brought him back to central Texas and Southwestern University. 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.