Monthly Archives: February 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.
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)