Person First Teaching in Physiology

Many of us are continuously trying to be as inclusive in our teaching as possible. One early concept I learned in this effort was to use person-first language, where one “puts the person before the disability, and describes what a person has, not who a person is”. This small change can lead to a more comfortable and inclusive classroom and also model behavior that future health professionals (the majority of my students) will need to employ in their careers.

 

Yet, there’s another ‘person first’ approach that I take in my classes and interactions with students that I think also builds inclusivity and perhaps more importantly, trust and understanding between my students and me. I try to be a person first, and a professor second. I try to see my students as people first, and students second. In the past year, during the unprecedented COVID-19 pandemic, this has been especially important as we all attempt to deal with additional life stresses, course modalities, and uncertainties.

 

As a person, the past year has not only been marked by the pandemic, but rather a significant medical challenge. In March 2020, amidst emergency planning to send students home permanently for the semester and move to remote teaching, I was diagnosed with Stage IV metastatic breast cancer. In 2014, in my second year as a faculty member, I had gone through chemo, surgery, radiation, and continued therapy for what was at that time stage III breast cancer. Remission lasted nearly five years. Since the original diagnosis, while I never felt like cancer defined me, it became an essential part of me, as a person, and as a professor.

 

The hormonal treatment regimen I followed from 2015-2019 provided a real-life example of many of the principles of the endocrine system that I taught my mid-level Human Physiology students. Along with an example of my grandmother stubbornly tapering off high-dose IV steroids after a kidney infection, I began to teach “my story” as our application of the endocrine system chapter in my flipped-classroom course.

 

I present a case study on “Patient X”, only revealing that I am in fact patient X after the relevant physiology is covered. As I explain to students, it’s not just an example to allow them to apply what they are learning to a clinical situation. Rather, it’s my attempt to demonstrate that the knowledge they are (hopefully) gaining, the vocabulary and critical thinking skills are not meant to just serve their future professional goals, but their personal life as well. They may be the one in the future helping a loved one navigate a challenging health situation. I’ve been forever grateful for my own physiological knowledge helping me to deal with my diagnosis, treatment, and prognosis.

 

This year, with the progression of my disease, the lesson takes a slightly different tone (although better this semester since my current infusion treatment has led to some regression of lung metastases). I also take the time to have a “soapbox moment” (and yes, I call it that…) to also inform students about metastatic breast cancer in general, some statistics, and the importance of early detection. I remind the students about the importance of drug discovery and clinical trials in changing people’s lives, mine included.

 

This year, in anticipation of writing this post, as part of the pre- and post- reflection students complete about “why is important to understand hormones?” I asked them for feedback on my person-first approach of sharing my own story. In addition to many students reflecting that they did in fact “see the bigger picture” of why we learn basic physiology, many provided comments that support my approach. A selection of some of their responses:

 

I really liked that you incorporated your own personal story into class because it made me feel like I genuinely knew you better as a person rather than just my professor – students really don’t get to see their teacher’s lives outside of class, but I think it’s really special when they do and when they are vulnerable with us and can share things like you did. It also gave us some insight as to why you do the things you do and why you are interested in what you teach. Thank you for sharing!”

You sharing your story today and being vulnerable with us gave real-life application to what we are learning. We are able to now better understand that learning this information is not just about memorizing facts to get a good grade. Rather, it shows us the importance of what we are studying and how we can use it to help others throughout our lifetime. So, thank you very much for sharing and inspiring other teachers to share as well.”

I am really happy that you shared your personal story. I think case studies are a great way to learn in general, but actually knowing the person in the case makes is so much more powerful. I will never forget today’s class and I genuinely have a much better understanding and appreciation for the material that we covered.”

Obviously, not everyone has their own story to tell, but my guess is that we all have ways that we can be vulnerable and connect the material to our own lives, encouraging our students to do the same. Storytelling and narrative medicine have received recent attention as ways to promote empathy and build trust. Why not then share our own stories? Why not put the person first in our teaching?

To summarize, I am a person with cancer. I am a person who teaches physiology. I am a person who utilizes my cancer to help me teach physiology.


Anne Crecelius 
(@DaytonDrC) is an Associate Professor in the Department of Health and Sport Science at the University of Dayton..  She teaches Human Physiology, Introduction to Health Professions, and Research in Sport and Health Science. She returned to her undergraduate alma mater to join the faculty after completing her M.S. and Ph.D. studying Cardiovascular Physiology at Colorado State University.  Her research interest is in the integrative control of muscle blood flow.  She is a member of the American Physiological Society (APS) and on the leadership team for the Physiology Majors Interest Group (P-MIG).

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