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:
- What specific content areas should I teach, and to what depth?
- 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.
- How do I align assessments with course content and course activities in order to gauge content mastery?
- How do I promote student “buy-in” if I do something other than lecture?
- 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:
- 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
- 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…)
- 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.
- Artino AR. Academic self-efficacy: from educational theory to instructional practice. Perspect Med Educ 1:76–85, 2012.
- 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.
- Wehrwein EA. Setting national guidelines for physiology undergraduate degree programs. Adv Physiol Educ 42: 1-4, 2018.
- Zimmerman BJ. Becoming a self-regulated learner: an overview. Theory Into Practice, 41(2): 64-70, 2002.