Category Archives: Active learning

Developing a Community of Practice in an A&P Course

This blog is about striving to create a Community of Practice (CoP) to engage students in Situated/Social Learning by using Team-based activities and assessments along with the web-based social learning annotation platform, Perusall.

We have all experienced those “Aha” moments when something we were struggling with suddenly becomes clear.  Think back to a time when you experienced real/durable learning.  When I did that, three things popped into my mind:  a hallway discussion in graduate school with classmates in my neurophysiology class about the Goldman-Hodgkin-Katz equation; American Physiological Society – Institute of Teaching and Learning (APS-ITL) conferences/interaction with Physiology Educators Community of Practice (PECOP); and the Community of Practice at HCC via the Instructional Development Center (IDC) which organizes and facilitates Best Practices and Faculty Academy.  And what this made me realize was that I learned best in a social setting with peers rather than isolated in my room/office tackling a topic by myself.  Although this was new to me, Lave and Wenger realized this long ago.

Lave and Wenger put forth the social learning theory of situated learning and communities of practice (CoP) in the early 90s.  Core ideas of their theory are that learning is identity formation through social participation and that communities of practice are groups of people (communities), brought together by a need for shared learning (domain) for something they do together (practice) and learn how to do it better as they interact regularly (Lave and Wenger, 1991; Wenger, 1998). And I believe, in a classroom setting, this should be framed within a significant learning environment. See Fink (2003) for explicit steps that can be taken to create an environment conducive to learning.

While a CoP is often discussed relative to professional societies, I believe that a CoP can develop within an A&P course and bring about durable learning through social interaction.  In this case, then, the domain includes the students who are in the course to learn A&P – shared learning needs; the community includes the class as well as the community within student groups/teams; and the practice includes interactions and participation in evidence-based teaching best practices from the resources those produce.

The following infographic is a summary of best practices in evidence-based teaching (Petty, 2006) which Michaelson and Sweet (2011) suggest can be met by and are a part of Team-based Learning (TBL). These include Visual presentation and graphic organizers which are met in my classes by team projects; feedback and assessment for learning; cooperative learning; reciprocal teaching e.g., peer instruction; whole-class interactive teaching; requiring concept-driven decisions e.g., concept questions and higher-order thinking levels for summative assessments.  This provides a very strong rationale for using TBL.  And TBL, by its very nature, promotes social learning.

Michaelsen and Richards (2005) identified the four key components of TBL: group formation; meaningful team assignments; routine feedback; and accountability.  The following infographic includes the components of TBL and summarizes some of the ways they are addressed in my courses.  I will go into more detail on some of these throughout the blog.

Formation of diverse teams is very important for the successful use of team-based learning.  In the physical classroom, I used a ‘show of hands’ to questions asked on the first day of class and had the students line up, then I counted them off into the appropriate number of groups. Questions used were: “How many have ……had me as an instructor before?; had medical terminology?; a college degree or certificate?; been born outside of IL?” etc.  This provides transparency in how the teams are formed and lets students know what things the instructor thinks are important to include in each team.

For the virtual, online-synchronous classroom, I use the web-based platform, CATME Smarter Teamwork, Team-maker tool.  Team-maker tool page can be found at this link.  The Team-maker tool simplifies the team-assignment process, for the virtual classroom, and creates diverse teams.  Instructors decide which criteria will be used to form teams/student groups.  For example, it is helpful for team members to have similar work schedules to facilitate group work.  It is also helpful for team members to have dissimilar GPAs.  Instructors can also write custom questions and criteria to add to the Team Maker Tool survey.  CATME Smarter Teamwork platform is a product of and administered by Purdue University.  General information about the CATME Smarter Teamwork platform can be found at this link.

In addition to properly forming teams, teams must be properly managed. Team members should receive feedback regarding their effectiveness in the team early and often.  I use Peer Evaluation (PE) Surveys administered by the CATME Smarter Teamwork platform to help teams and team members become more effective.  The TBL community uses the phrase “forming, storming, and norming,” to describe phases teams go through during the semester.  PE surveys helps teams to progress to the norming phase more quickly.  Team members are evaluated in 5 areas: contributing to the team’s work, interacting with teammates, keeping the team on track, expecting quality, and having relevant knowledge, skills, and abilities.

Three PE surveys are administered over the course of the semester.  The first two PE surveys (week 5 and week 10) were formative and the third one (week 15) was summative.  Students’ PE score is based on how well they evaluate their teammates and how well their teammates evaluate them.  I used the ‘additional questions’ option for each PE survey.  They provide information on team dynamics and effectiveness which is very helpful to identify teams that are struggling which might require instructor intervention. Survey results can be viewed and then released to the students.  Students receive anonymous information on how their teammates evaluated them compared with how students evaluated themselves and this provides encouragement when they have rated themselves lower than their peers and praises students whose teammates have rated them highly. It is important to emphasize that students are evaluating, not judging, their teammates.  The CATME Smarter Teamwork website has a plethora of resources for instructors and students to help improve team effectiveness.

In addition to the CATME Smarter Teamwork PE surveys the Peer Evaluation form obtained from the University of Buffalo Case Study Workshop I attended is used to evaluate teammate participation in the team projects.  This evaluation produces a score that is used as a multiplier to the grade on the team project which helps to improve student accountability.

To promote learning, team development, and provide timely and frequent feedback, I use Just-in-time-teaching, combined with Peer Instruction (PI) and Concept Questions that are assessed using a classroom response system (Learning Catalytics) in a manner described by Mazur (1991).  Students are to complete pre-class reading assignments followed by a pre-quiz in the Learning Management System (LMS).  The pre-quizzes check for knowledge comprehension as well as identify confusing topics which are the focus of the concept questions used in the ensuing class meeting.  Each concept question has an individual round followed by a team round.  Students answer the individual questions on their own from memory.  Once students have answered the individual questions, they are instructed to discuss it with their teammates, using all available resources before the question is asked again.  These activities provide formative feedback to students and the instructor alike and provides practice for team-based summative assessments which focus on the conceptual application of material and strive for more authentic assessments with questions situated in a clinical scenario.  Learning Catalytics, the classroom response system used in my classes, has a variety of question types that can be used to write questions that require lower-order or higher-order thinking skills.

Additionally, the PI and team interaction help students negotiate their identity in the group and facilitates new learning, which are earmarks of social learning in a community of practice.  Of course, all of this is dependent upon students coming to class prepared.

Much to my dismay, even though pre-quizzes are given to hold students accountable, rather than read the assignment, they tend to ‘hunt and peck’ in the textbook or search Google for answers which are out of context and don’t really answer the question.  Funnily enough, pre-class reading assignments and pre-quizzes didn’t even hold Harvard physics students accountable to complete the reading assignments.  So, Eric Mazur and his team developed the social annotation platform Perusall.  Information about the platform can be found at this link.

Perusall allows for/encourages social interaction ‘outside’ of class and uses programs like those used in social media. Students annotate pre-class reading assignments and can comment on classmates’ annotations, “like” comments, and ask and answer questions; they are not reading/processing material alone. Students can interact with classmates in the entire class, rather than only with their teammates, which expands the community for social learning.  By clicking on an annotation in a pre-reading assignment a current conversation window opens, and the thread of conversation shows who made comments and when they were made.  This shows the asynchronous social interaction taking place in Perusall, and documents social learning taking place outside of class.  It lets the students know they are not alone in their struggle to understand a topic and offers opportunities for students to offer explanations and suggestions to help classmates learn.

Using Perusall helps students to become better prepared for in-class activities.  Following the adoption of Perusall, 88% of students annotated 80-100% of the pre-class reading assignments throughout a semester. Whereas only 69% of students completed 80-100% of the pre-quizzes associated with the pre-class reading assignment before using Perusall.  Completing the pre-quiz, as mentioned above does not necessarily indicate that students read the assignment.  They may have just Googled the answers.

So far, I have talked about Perusall as a social annotation platform that encourages students to thoughtfully annotate reading assignments as a way to promote social learning and a sense of community which is one of the main reasons I use Perusall and why I believe Perusall helps to build a CoP in my courses.  However, I think it is important to point out that the adoption implementation of Perusall is very easy and offers valuable features without adding to the instructional load.  Once the course is set up, which does not take long, there is little to no extra work for the instructor.  The quality of the annotations is graded automatically using a machine algorithm to assess intellectual content.  Also, with a click of a tab, instructors receive a ‘confusion report’ listing the top three points of confusion with the top three annotations articulating the confusion and other analytic reports. Perusall also automatically sends emails to students who have missed reading assignments.  For anyone interested in viewing a course in Perusall a demo course has been set up – course code = CHAPMAN-GJZQV.  To access the course, follow this link and click the ‘register’ link provided on the page.  Once the registration is complete there will be an option to enroll in a course, click on that tab and enter the course code listed above.  Or just jump into the deep end of the pool and register as an instructor just to see how easy and intuitive the platform is to use.

By putting students into diverse, permanent/fixed student groups the sense of community can grow. During group work and the social annotation of reading assignments throughout the semester, students negotiate their identity in the group, negotiate new learning, and work together to learn anatomy and physiology. The following photo is of a team on the last day of the semester.  The “CEO” of the team made the t-shirts using team members’ identities negotiated throughout the semester and gave them to all teammates near the end of the semester.

When it works properly a Community of Practice can develop.  I have witnessed tremendous learning in my classroom which is the result of helping my students create a community of practice within the framework of efforts to create a significant learning environment and allowing students to socially interact via team-based activities/assessments and social interaction while annotating pre-class reading assignments.

References:

Fink, L.D. (2003) Creating Significant Learning Experiences: An Integrated Approach to Designing College Courses, Jossey-Bass, San Francisco, CA.

Lave, J. Wenger, E. (1991) Situated Learning: Legitimate Peripheral Participation. Cambridge UK: Cambridge University Press.

Michaelsen, L. K., Knight, A. B., and Fink, L. D. (2004) Team-Based Learning: A Transformative Use of Small Groups in College Teaching. Sterling, Va.: Stylus.

Michaelsen, L. K., Parmelee, D. X., McMahon, K. K., and Levine, R. E. (eds.). (2008) Team-Based Learning for Health Professions Education: A Guide to Using Small Groups for Improving Learning. Sterling, Va.: Stylus.

Michaelsen, L., & Richards, B. (2005). Commentary: drawing conclusions from the team-learning literature in health sciences education: a commentary. Teaching and learning in medicine, 17(1), 85-88.

Michaelson, L.K., and Sweet, M.  Team-based Learning.  (2011) New Directions for Teaching and Learning.  no. 128. Wiley Periodicals, Inc. Published online in Wiley Online Library. DOI:10.1002/tl.467.

Petty, G. (2006) Evidence-Based Teaching. Gloucestershire, U.K.: Nelson-Thornes, 2006.

Wenger, E. (1998) Communities of Practice Learning, Meaning and Identity. Cambridge, UK: Ca

After a post-doctoral fellowship at Washington University School of Medicine, Jane began her academic teaching career at Benedictine University in the graduate programs in exercise physiology.  After that Jane taught in the Physician Assistant Programs at Rosalind Franklin University and the University of Kentucky. For the past 18 years Jane taught Anatomy and Physiology at Heartland Community College in Normal, IL, where innovative, student-centered instruction is encouraged. For the last decade, Jane employed Just-in-Time Teaching with Peer Instruction and concept questions assessed with a classroom response system.  Recently, permanent, fixed teams were used in her classes, along with team-based summative assessments, as well as with in-class and post-class forced retrieval activities. Jane is a Professor Emerita of Biology and had served as the Anatomy and Physiology course coordinator.

Jane received her B.S. from Eastern Illinois University, her M.S. from Illinois State University, and her Ph.D. from Marquette University.

mbridge University Press.

Flipped and Distant Multi-Section Teaching: An A&P Course Director’s Perspective, Pandemic Plan, and Transition Back to the Classroom.
Historically, flipped classrooms have been around since the mid-2000s and began as bottom-up pilot experiments in a single classroom or section of a course at the will of an inventive instructor. With a robust body of literature deeming these modern content delivery models effective in achieving student success in the classroom and beyond, many educators in the sciences have adopted this approach to active learning. However, I doubt very few decided the pandemic-forced transition to distance learning was the right time to pull the trigger on flipped classroom implementation at the course director level in a multi-section course. I’m happy to share my wild idea and the wild ride we (myself and the A&P faculty at Jefferson) have been on while we were “building the plane as we flew it” over the past 2 years.

I direct A&P undergraduate courses at Thomas Jefferson University and manage a large staff (12 faculty) consisting of myself and a largely part-time adjunct workforce serving about 300 undergrads spread across 12 sections of lecture and 20 sections of lab. Since 2019 when I took the job at Jefferson we have been ballooning with growth and the demand for A&P courses has nearly doubled in the past 3 years. I was just getting used to the new course director role, when we were all challenged in March of 2020. Overnight I went from settling into my new job, to calling upon every skill and resource I had in my academic tool bag.

This unique choice to flip at the director level was borne out of pandemic-generated necessity for a means to deliver a single series of digital content of core A&P concepts, remotely, to all students to ensure an equitable experience across sections. The A&P courses at Jefferson have historically been face-to-face only with the exception of a few “snow days” with “take-home” assignments across the Spring semester during hard Philadelphia winters. The decision to flip a classroom in general aligns well with Jefferson’s active (Nexus) learning approaches, however a flipped distant digital classroom taught in a course director-led multi-section, multi-instructor course is something only a pandemic makes one crazy enough to dream up.

Additional rationale for the implementation of the flip in Fall of 2020 was to seize the day, using March of 2020 as an opportunity to fully revamp a dated class, albeit in a very stressful crisis mode. At that very infamous time, during widespread lockdown, emergency recordings of A&P lectures over slides were the go-to tool to preserve the integrity of the course. With a small amount of course director forethought and rock star faculty teamwork, those initial post-spring break A&P II content videos were recorded with the thought and intention to not waste any effort as the entire sequence would in all likelihood need to be converted to a digital format to carry the FA20/SP21 rising cohort of students though the standard 2 semester A&P sequence.

While I can currently say from the perspective of the course director/major course designer that the goal of generating a flipped classroom that works both at distance and in person was absolutely, successfully, met.  I cannot yet speak to the experience of the faculty members who were handed the curricula and directed to teach in a new modality adopted over a short summer break in July of 2020. In hindsight, the A&P faculty ended up being tested much more than the students with little prep time, and direction to teach in a way they may be unfamiliar with, the flipped classroom, online. A plan for reflection and a revelation of the faculty member experience is in the works.

To better describe the design, active learning is implemented both equitably and autonomously across sections. All sections share the same assignment types, but not necessarily identical assignments nor the same instructor. All students must give two “teach-back” presentations where the student is tasked with becoming an expert on a single learning outcome (LO), and then “teaching-back” that learning outcome to a classroom audience of students. “Teach backs” account for about 25-30% of synchronous class time. The other 70-75% of synchronous class time is devoted to reviewing core concepts, demonstrating study strategies, and facilitating active learning activities. The active learning activities are curated by the course director with the intention that the individual instructors modify and adjust activities as they go, but have a safety net of resources to deliver the course as is.

Noteworthy, not all activities were totally unknown to the faculty with institutional knowledge when the new core curricula materials were shared. There were some upcycled former laboratory activities that were really “dry” classroom friendly labs. For example, basic sensory tests could be done at home with any willing quarantine mate. Activities requiring materials did have to wait for in person days. The future goal is to add more in-house generated collaborative work to the shared instructor pool to elevate each iteration of the course. However, “not fixing anything that wasn’t already broke” was deemed a resourceful jumping off point.

The course, now, is robust and both A&P I & II lab and lecture have run online in FA2020/SP2021. The course is now mid re-test during our first in person semester back, FA2021/SP2022, with the same content and resources generated in crisis mode March 2020-Summer2020-Fall 2020. We, transitioned synchronous lecture back to masked-face-to-masked-face in person learning in Fall of 2021 and the course is running as planned. No major changes needed to be made to Canvas sites housing core lecture content to make the shift back to in person. Courses were relatively easy to share and copy over to individual instructors prior to the start of the semester to allow time for autonomous course personalization.

The story is still in progress as we have only just begun to experience Spring of 2022. The course is being tested in another way now, with a virtual start and a mid-semester transition back to in person as the pandemic distance learning challenges keep coming. At this point I’m very grateful to say the course can also seamlessly transition with little notice from remote-to-face-to-face and back again. Collaborative drawing activities on white boards work on digital white boards with screen sharing. Paper worksheets can also be completed digitally and collaboratively in small digital break out rooms. Not every activity will transfer perfectly, but that is what makes a growing pool of shared instructor resources important and valuable. The flipped classroom does not have to be grassroots anymore. A growing body of generous teacher networks, education organizations, and professional societies continue to share and widely make active learning resources available to all and often, free.  And finally, there is also nothing like a global pandemic bearing down under uncompromising deadlines to force a little creativity and development of new ideas to share back to the community.

**Illustration by Andrea Rochat, MFA

Dr. Nanette J. Tomicek is an Assistant Professor of Biology in the College of Life Sciences at Thomas Jefferson University, East Falls where she has been a faculty member since 2019. Currently, she directs the undergraduate introductory A&P courses serving a variety of basic science, and clinical-track majors. Dr. Tomicek specializes in large lecture course, and multi-section course management and has previously done so at both Penn State (2006-2017) and Temple Universities (2017-2019). Her current work focuses on pedagogy, active learning, laboratory, and excellence in biology education. Dr. Tomicek is also an adjunct faculty member for Penn State World Campus in the Eberly College of Science. She has been teaching a special topics course, The Biology of Sex for almost 10 years and is an expert in reproductive physiology and digital course delivery. Past doctoral work at Penn State and research interests include developing targeted cardiovascular therapeutics for aging women, examining downstream estrogen receptor signaling pathways in the heart in an ovariectomized rat model of aging and estrogen deficiency. Dr. Tomicek earned her Ph.D. in Spring of 2012 at Penn State in the Intercollege Graduate Degree Program in Physiology, and is a proud active member of the Human Anatomy and Physiology Society.
Pourquoi? Course Redesign: A Story of How and Why.

This is a story of why and how my courses underwent an all-encompassing course redesign.

Why?

Once upon a time, early during my tenure at Heartland Community College, the nursing faculty invited the A&P instructors to lunch to discuss what was covered in the A&P courses because the nursing students were replying that they “didn’t learn that” in A&P.

The dialog went like this: “Do you teach the autonomic nervous system?”

“Yes, we do!”

“The students say they didn’t learn that.  Do you teach the cranial nerves?”

“Yes, we do!”

“The students say they didn’t learn that.”

Etc.

After that meeting, I had a revelation that rocked my world: I wasn’t teaching, and the students weren’t learning!

Then the question was what to do about it? Retirement or Remediation?  Well, shortly after my revelation the economy tanked so retirement wasn’t an option.  Remediation, on my part, was the only course of action to take. I went back and hit the books.

I found and used many excellent resources and used parts of all, but it wasn’t until I was searching for how to assess conceptual understanding that I found methods that were used for the major redesign of my courses.

How?

When I hit the books, I read that third graders could learn to do physics.  So, I thought there should be no reason that the method developed by a physics professor/research scientist at Harvard, couldn’t be used for A&P courses at Heartland. Therefore, I chose to redesign my courses using a combination of Just-in-Time Teaching (JiTT), Peer Instruction (PI), and Concept Questions (CQs) that are assessed with clickers, in a manner described by Eric Mazur.

It is very important to make expectations known. In the first week of class, students are asked to complete an anonymous, on-line introductory questionnaire (Mazur, 1997).  This helps to make sure that the student’s expectations conform to what will be taking place in class.  The results of this questionnaire are compiled into a handout and discussed in class.  This questionnaire is followed up with another questionnaire (Mazur, 1997) during the fourth week of the semester to identify is there is anything I can do to improve the in-class experience to help their learning and to address any expectations that are contrary to what we are doing in class.  The result of using these questionnaires is an improved sense of cooperation.

The first week of the semester is also used expressly to help students get acclimated with the flow of the course and the technology used in class with several non-graded assignments and assessments completed just for practice.   Students must become familiar with the Learning Management System (LMS) and the classroom response system (CRS).

Basically, how it works is students are given pre-class reading assignments and are required to take a pre-quiz following the completion of the reading assignment which are posted in the LMS.    In one way, the quizzes are used to check for reading comprehension.  In another way, the pre-quizzes allow the students to identify and verbalize areas of confusion.  This emphasizes that knowledge acquisition occurs outside of the classroom so that in class, based upon their input, the focus is placed on what students are having difficulty with.

The last question of the pre-quizzes is the JiTT part of the pre-quiz.  “Please tell me briefly what single point of the reading that you found most difficult or confusing.  If you did not find any part of it difficult or confusing, please tell me what you found most interesting.” (Mazur, 1997) Many times students tell me something they found interesting when they didn’t answer any of the questions correctly.  So, they indirectly tell me they don’t know what they don’t know.  In either case, their feedback determines the topics for discussion the next day.

Generally, there are about three topics that are identified from the pre-quizzes.  CQs to be used in class are written for those topics.  The following flow-chart demonstrates how it works in class.  This process forces students to think through the arguments being developed and provides a way to assess their understanding of the concept.

Questions can be written to begin easy and progress to more conceptual content such as application and prediction questions, etc.  This allows for scaffolding of knowledge to occur.  It is important to monitor discussions to keep students on task, find out how students are thinking, and to identify possible sources of confusion.

The CQs are assessed with the classroom response system.  Sometimes technologies fail so it is good to have a back-up plan.  I have letter cards available in such situations.  The CQs and are graded upon completion, not on correctness.  Doing so encourages cooperation among students.  Students must be continually reminded that it is okay to get questions wrong and by just committing to an answer will help produce more durable learning.

Tangible benefits from the redesign include:

For most of the CQs asked throughout a semester the percentage of correct responses after PI were greater than before PI.  Students were able to convince their classmates what the correct answer was.  Occasionally, the percent of correct responses following PI was lower than before PI.  This was usually due to a poorly worded or ambiguous question, or a discussion between a student who was confidently wrong and one who was correct but not confident.

Persistence after the redesign was greater than before the redesign.  Before the redesign 18% of students ended up dropping the course; after the redesign only 12% of the students ended up dropping.

Students liked using the classroom response system and student discussions. Students responded to open ended questions on anonymous, end of the semester surveys: “Discuss your thoughts on the use of clickers in the classroom”; “Please discuss your thoughts on the ‘convince your neighbor’ portion of the course.”  Numerical value to their responses were assigned on this Likert scale: 4 = really liked; 3 = liked; 2 = disliked; 1 = really disliked.  The mode/median for the responses regarding using clickers was 4; and 3 for responses regarding the ‘convince your neighbor’ portion of the course.  In their responses, students also raised some concerns: “my partner never did the readings, so he wasn’t a lot of help; but it did help me to try to explain things to him;” “convincing your neighbor never really helped me mainly because my neighbor was never sure.”

Intangible benefits of the redesign include:

Students are conversing using the language of the discipline and are provided with an opportunity to identify and verbalize what they don’t know.  Answering the CQs is a form of forced retrieval which leads to more durable learning. Students must formulate arguments to support their position when “convincing their neighbors.” And lastly, by listening to student discussions instructors can identify confusing questions, misconceptions, students with clear answers, students with faulty logic/reasoning or who are confidently wrong, etc.

The following are recommendations to address issues of concern identified by students and the instructor.

Recommendations:

  1. To reinforce the importance of pre-class reading assignments, in addition to the reading assignments posted to the LMS along with the pre-quizzes, give the students a hardcopy of all the reading assignments in the first week of the semester and post it to an informational page in the LMS.
  2. Explicitly tell the students that work outside of class is expected. The following chart is provided to the students so that they can visualize the general layout of the course.
  3. To reduce knowledge voids and the influence of confidently wrong students, encourage students to seek advice from classmates all around them rather than those sitting next to them. If you use Learning Catalytics (LC) as a classroom response system, it can be set to run the class automatically which will tell each student who they should consult with.  The instructor sets up the parameters (i.e., three students, with different answers, within a certain number of seats or if it is in a small class – anywhere in the room) but LC uses a sophisticated program to reduce the influence of confidently wrong students.  Having diverse permanent/fixed teams and having students discuss the CQs with their teammates also addresses this issue.
  4. To alleviate some anxiety from this non-traditional format students are given lecture notes. Traditional lectures aren’t given, but students are given the next best thing – the lecture notes.
  5. To help motivate the students and to reinforce the importance of meaningful learning and moving away from rote memorization exams should have 50% conceptual questions.

So, there you have it – the why and how I completely redesigned my courses.  Is that the end of the story, you ask?  Of course not.  Teaching is an iterative process and with anonymous, end of the semester input from students, self-reflection, and professional development, the changes have been continual.  Perhaps, in a future blog, I will write the tale of why and how this course redesign evolved and changed overtime.

References for Redesign and Remediation:

Bransford, J.D., Brown, A.L., Cocking, R.R., eds. (2000). How people learn: Brain, mind, experience, and school. Washington, DC: National Academy Press.

Broida, J. (2007). Classroom use of a classroom response system: What clickers can do for your students. Upper Saddle River, NJ: Prentice Hall.

Bruff, D. (2009) Teaching with classroom response systems: Creating active learning environments. San Francisco, CA: Jossey-Bass.

Bybee, R.W. (ed.) (2002).   Learning science and the science of learning. Arlington, VA: NSTA Press.

Duncan, D. (2005). Clickers in the classroom: How to enhance science teaching using classroom response system. San Francisco, CA: Pearson Addison Wesley Benjamin Cummings.

Ellis, A. B., Landis, C.R., & Meeker, K. Classroom assessment techniques: ConcepTests. http://www.flaguide.org/cat/contests/contests2.php

Fink, L. D. (2003). Creating significant learning experiences: An integrated approach to designing college courses. San Francisco, CA: Jossey-Bass.

Finkel, D.L. (2000). Teaching with your mouth shut. Portsmouth, NH: Boynton/Cook.

Herreid, C.F, ed. (2007). Start with a story: The case study method of teaching college science. Arlington, VA: NSTA Press.

Mazur, E. (1997). Peer instruction: A user’s manual. Upper Saddle River, NJ: Prentice Hall.

Michael, J. A. & Modell, H. I.  (2003) Active learning in secondary and college classrooms: A working model for helping the learner to learn. Mahwah, NJ: Lawrence Erlbaum Associates.

Novak, G. M., Patterson, E. T., Gavin, A. D., & Christian, W., (1999). Just-in-Time Teaching: Blending active learning with web technology. Upper Saddle River, NJ: Prentice Hall.

Sullivan, W.M. & Rosin, M.S. (2008).  A new agenda for higher education: Shaping a life of the mind for practice. San Francisco, CA: Jossey-Bass.

Woditsch, G.A. & Schmittroth, J. (1991). The thoughtful teachers guide to thinking skills. Hillsdale, NJ: Lawrence Erlbaum Associates.

After a post-doctoral fellowship at Washington University School of Medicine, Jane began her academic teaching career at Benedictine University in the graduate programs in exercise physiology.  After that Jane taught in the Physician Assistant Programs at Rosalind Franklin University and the University of Kentucky. For the past 18 years Jane taught Anatomy and Physiology at Heartland Community College in Normal, IL, where innovative, student-centered instruction is encouraged. For the last decade, Jane employed Just-in-Time Teaching with Peer Instruction and concept questions assessed with a classroom response system.  Recently, permanent, fixed teams were used in her classes, along with team-based summative assessments, as well as with in-class and post-class forced retrieval activities. Jane is a Professor Emeritus of Biology and had served the Anatomy and Physiology course coordinator.

Jane received her B.S. from Eastern Illinois University, her M.S. from Illinois State University, and her Ph.D. from Marquette University.

 

Course-based Research Experiences Help Transfer Students Transition

As transfer student numbers increase at 4-year institutions, we need to provide opportunities for the formation of learning communities and research experience. Course-based research experiences allows for both. Students receive course credit toward their degree, work on independent research, and engage with peers and faculty in a small setting.

Several studies have been conducted to show the advantages of undergraduate research as a value-added experience. (1,2,4,6,8). As an R1 university, we have a tremendous amount of resources devoted to STEM research – but we are unable to accommodate all of our undergraduates who are looking for lab experience. The development of course-based research experiences (CUREs) across colleges and universities has increased the availability of research opportunities for undergraduates. (1,3,5). In addition, they have provided an increased sense of community and interaction with faculty – two factors that were highly valued by all students. The question for us was how can we provide more of these courses given space and personnel constraints and are there student populations that might benefit more directly from these courses?

Several years ago, we increased the number of transfer students we accepted from community colleges and elsewhere. But there was no transfer-specific programming for those students and they had little sense of community. Transfer students tend to be a much more diverse student population in several ways. Their average age is higher than our incoming first-year class, they are more likely to be PELL Grant-eligible (40% of transfer vs 20% of first-year students), first-generation college students (30% of transfer vs 15% of first-year students) and are more likely to work and live off-campus. Although they recognize the value of community and research experience according to surveys, they often state they don’t have the time to invest as they are trying to graduate as quickly as possible.

We received a grant through HHMI (in part) to train faculty to develop CUREs specifically for transfer students. STEM courses that “counted toward graduation” was a way to get buy-in from the students and to be funded by grants and aid. All transfer students needed additional life science courses to complete their degree, and this was a course that wasn’t transferred in through the community colleges so there was space in their degree audits. These were small enrollment courses that lent themselves to forming cohorts of student learning communities as they proposed hypotheses, designed and implemented their experiments, and presented their findings to the class. This allowed transfer students to receive course credit toward graduation in a lower-stress way during that first transition semester.

Course-based Research Experiences Help Transfer Students Transition

Lisa Parks 9.30.2021

Figure 1

Cell Biology CURE Example:

Testing whether environmental compounds or other chemicals induce cell death

Protocols Provided:  Cell seeding and growth, Cell counting, Measuring cytotoxicity, Bradford Assay, Western Blot, Immunofluorescent Analysis

There are thousands of chemicals and compounds that either potentially affect cell growth, metabolism, and death.

This project has a lot of room for student individuality. Students could do endocrine disruptors, for example, or Parkinson’s disease related compounds (i.e., things that kill mitochondria), environmental toxicants, heavy metals, etc. They could test across cell types, concentrations, diseases, etc.  They could use the cancer cells and we could get a screen of compounds. Or they can pre-dose with a potential protectant (GSH?) and then expose the cells to something toxic to see if cell death can be attenuated.

This is particularly important because one issue we struggle with is that students with a 2-year associates degree automatically receive credit for all general education requirements through the NC Articulation Agreement. This means that transfer students are left with stacks of required difficult STEM courses with little opportunity to balance their course load for their remaining semesters. In addition, they are often trying to graduate “on time” so they are starting at a new, much larger, state university with little formal introductory programming and often, unfairly heavy STEM course loads. This isn’t the best way to set these students up for success. We found our transfer students falling behind in GPA and time to graduation. Tracking transfer students that take these first-semester CUREs will help us see if this approach increases student retention in the STEM majors, their graduation rates, and through surveys, their feelings of community at NCSU.

Teams of tenured or tenure-track research faculty and teaching-track faculty along with a handful of post-docs continue to develop these courses. As you can imagine, COVID interrupted this effort as we scrambled to go online and closed our lab spaces to undergraduates, but the CURE development continued.  Anecdotally, we noticed an increased collaboration and a sense of community among the faculty that extended beyond the workshop training. This has been seen in several studies at other institutions (7,9). As these labs have been developed, it has led to increased team teaching, research projects, and publications. Teaching faculty have had another mechanism for staying current and being engaged in research and literature while giving them another outlet for scholarly work. Research faculty have had another mechanism for exploring side projects that they may not have had the time or funds to pursue in their own labs and allowing them an opportunity to get into the classroom.

Faculty write up or discuss a proposal with each other – an idea that they wish they had time or space to devote to. It’s typically no more than a page. Students take it from there. They spend the first third of the semester learning techniques and protocols, and writing their experimental designs. The rest of the semester is devoted to implementing their experiments, presenting results and receiving feedback at weekly lab meetings, and re-working or replicating their experiments. Final findings are presented as a poster session in our main lobby where all faculty and students are encouraged to stop by. A sample CURE is provided in the box.

As this approach to teaching has increased in our department, it has begun to influence space allocation within the buildings. We are beginning to influence how future buildings are designed and how renovations to existing space can accommodate this approach. We have begun to question whether we need large amphitheaters for 300+ students in a classroom and we are starting to see how we can divide up that space into learning labs and rooms with moveable chairs and tables – facilities that will promote the formation of learning communities and critical thinking skills as opposed to memorization of content.

Thank you to Dana Thomas and Jill Anderson for collecting and providing data about our transfer students.

REFERENCES

  1. Auchincloss LS, Laursen SL, Branchaw JL, Eagan K, Graham M, Hanauer DI, Lawrie G, McLinn CM, Pelaez N, Rowland S, Towns M, Trautmann NM, Varma-Nelson P, Weston TJ, Dolan EL. Assessment of Course-Based Undergraduate Research Experiences: A Meeting Report. CBE Life Sci Educ 13(1):29-40, 2014.
  2. Banasik MD, Dean JL. Non-Tenure Track Faculty and Learning Communities: Bridging the Divide to Enhance Teaching Quality. Inn Higher Educ 41: 333-342, 2016.
  3. Bangera G, Brownell SE. Course-Based Undergraduate Research Experiences Can Make Scientific Research More Inclusive. CBE Life Sci Educ 13: 602-606, 2014.
  4. Beckham J, Metola P, Strong L. Year-long Research Experiences in Drug Discovery May lead to Positive Outcomes for Transfer Students. FASEB Journal 31:S1. 589.8, 2017.
  5. Eagan MK, Hurtado S, Chang MJ, Garcia GA, Herrera FA, Garibay JC. Making a Difference in Science Education: The Impact of Undergraduate Research Programs. Am Educ Res J 50:683-713, 2013.
  6. Griswold W. Launching Sustainability Leadership: Long-Term Impacts on Educational and Career Paths in Undergraduate Research Experiences. J Coll Sci Teach 49:19-23, 2019.
  7. Kezar A. Spanning the Great Divide Between Tenure-Track and Non-Tenure-Track Faculty, Change: The Magazine of Higher Learning, 44:6, 6-13, 2012. DOI: 10.1080/00091383.2012.728949
  8. Nagda BA, Gregerman SR, Jonides J, von Hippel W, Lerner JS. Undergraduate Student-Faculty Research Partnerships Affect Student Retention. Rev of Higher Educ 22:55-72, 1998.
  9. Ward HC, Selvester PM. Faculty Learning Communities: Improving Teaching in Higher Education, Educational Studies, 38:1, 111-121, DOI: 10.1080/03055698.2011.567029
Lisa Parks is a Professor of Teaching and Director of Undergraduate Programs in Biological Sciences at North Carolina State University. In addition to her regular teaching load of cell biology and advanced human physiology, she has helped develop several courses and is currently developing several course-based research opportunities for transfer students. She has been a participant, a mentor, and a current grant recipient with the Howard Hughes Medical Institute where she was bitten by the “research as pedagogy – inquiry-based learning – critical thinking” bug. She gladly drops what she is doing to talk about this. Lisa received her BS in Zoology from Duke University and her PhD in Biology with a concentration in cell physiology at Georgia State University.
Using Google Jamboard for Collaborative Online Learning in Human Physiology

Active and cooperative learning strategies are useful tools for engaging students in the classroom and improving learning (Allen & Tanner, 2005; García-Almeida & Cabrera-Nuez, 2020; Montrezor, 2021). These learning strategies require students to engage with course content by “seeking new information, organizing it in a way that is meaningful, and having the chance to explain it to others” (Allen & Tanner, 2005, p. 262). Both active and cooperative learning emphasize peer interactions and give students opportunities to demonstrate understanding.

The COVID-19 pandemic provided an opportunity for instructors to practice new pedagogies in face to face, hybrid, and remote learning environments. Prior to the pandemic, I often asked students to use the classroom white boards collaboratively to draw diagrams, processes, and outline concepts. Given limitations on face to face interactions in hybrid and remote classes, I used Google’s Jamboard to recreate this in-class experience for a virtual Human Anatomy & Physiology course. Students were Exercise and Health Science majors and minors. The course was offered in 15, three-hour class periods over a four-week course block in spring 2021. The three-hour class periods necessitated a variety of pedagogies to maintain student engagement.

Jamboard is a virtual white board space that can be used collaboratively by sharing a link with others. Before sharing, the link settings must be adjusted to allow any user with the link to edit the Jamboard. Each board can hold up to 20 different frames, or white board spaces, which can be modified by adding figures, text, drawings, and sticky notes. I began the first day of class demonstrating to students how to use Jamboard. We started with a blank frame and I asked students to add “sticky notes” to the board with thoughts about how they would stay engaged with the course during our three-hour meeting time. Students also practiced using various editing tools such as the pen, textbox, and creating shapes. The students and I both found Jamboard very user friendly and easy to navigate.

In subsequent classes, I created specific Jamboard frames prior to class with the outline of an activity or figures. Some frames were created for the class to contribute to collaboratively, similar to a jigsaw format. For example, a picture of a neuron was added to one frame (Figure 1).

Preassigned student groups worked in Zoom breakout rooms to identify one anatomical location and describe its primary function on the neuron. Each group was assigned a different neuron structure and reported back to the class after their group work. During the cardiovascular physiology unit, student groups were each assigned one component of the cardiac cycle on a Wigger’s diagram. Groups worked in Zoom breakout rooms to identify their component of the cycle and write an explanation on the diagram. Groups also collaboratively completed a chart with each group completing one row or column in the chart (Figure 2). Jamboard was also useful for students to order and label steps in a physiological process. In the skeletal muscle unit, students worked in groups to correctly order the steps of muscle contraction. Each group was assigned one picture on the Jamboard frame, groups placed their picture in the correct order and used a textbox or sticky note to describe the picture.

 

 

 

 

 

For other activities, frames were created once and duplicated for each group with the group number noted at the top of the frame. Frames containing concept map instructions or feedback loop skeletons were duplicated for each group. For example, groups worked in Zoom breakout rooms to design a concept map demonstrating the relationships between cell membrane components (Figure 3) or outline a control system for different responses to deviations for homeostasis. During the homeostatic control system activity, each group was assigned a different control system. Groups reported back to the class as a whole and described their work to the class (Figure 4).

 

At the end of the course, students were surveyed about our Jamboard use. Of 17 students, 11 completed the survey. Overall, students indicated that Jamboard was an effective learning (100%, n=11) and group engagement tool (100%, n=11). In open-ended responses, students indicated that Jamboard was most effective for engaging in collaboration and checks for understanding during class. They especially liked that Jamboard helped create an in class feeling and kept them engaged with their class and their group in an interactive way. Even though groups were often labeled on Jamboard (e.g.- one frame labeled “Group 1 Concept Map” or a diagram with a “1” and arrow pointing to a specific area for identification for Group 1), several students remarked that they liked the anonymity provided by Jamboard and the lower perceived pressure to answer correctly. Students listed labeling diagrams (n=10), creating concept maps (n=7), and drawing physiological processes (n=6) as their favorite Jamboard activities. The students also appreciated that the boards were available after class for review. I posted the Jamboard link to our learning management system (Canvas) and students could return to the boards to review after class. 100% (n=11) of student respondents indicated they went back to the Jamboards two or more times after class to review.

From the instructor perspective, Jamboard provided an easy online collaborative tool for teaching physiology. Jamboard was user-friendly, flexible, and easy to set up before or during class. I found that my students were able to sustain engagement during three hours of remote class. The Jamboard group assignments were not graded, but asking student groups to report back to the class was effective motivation for producing quality group work. Challenges associated with Jamboard were consistent with most online activities including student access to a computer and reliable internet. Students occasionally had issues accessing the board anonymously if they were logged into their personal google accounts.

In moving back to face to learning, the Jamboard activities could be easily done on a whiteboard; however, collaborative drawing and annotating diagrams and charts might still be difficult without appropriate projectors or smartboard technology. Additionally, extra steps involved in taking a picture of the white board and uploading the picture to a course webpage may be barriers to making the collaborative work available after class for review. Jamboard could also be used for out of class individual or group assignments such a pre- or post- class assignments or for brainstorming activities. While the class size in the present example is quite small (17 students), use of Jamboard in these ways would be easily adaptable to larger classes and may improve student engagement in large classes (Essop & Beselaar, 2020)

 

Overall, Jamboard was an effective online collaborative tool for teaching and learning human physiology. Jamboard was user-friendly, easy to prepare before class, and kept students engaged with the class and their groups.

 

 

 

 

 

 

 

References

Allen, D., & Tanner, K. (2005). Infusing Active Learning into the Large-enrollment Biology Class: Seven Strategies, from the Simple to Complex. Cell Biology Education, 4(4), 262–268. https://doi.org/10.1187/cbe.05-08-0113

Essop, M. F., & Beselaar, L. (2020). Student response to a cooperative learning element within a large physiology class setting: Lessons learned. Advances in Physiology Education, 44(3), 269–275. https://doi.org/10.1152/advan.00165.2019

García-Almeida, D. J., & Cabrera-Nuez, M. T. (2020). The influence of knowledge recipients’ proactivity on knowledge construction in cooperative learning experiences. Active Learning in Higher Education, 21(1), 79–92. https://doi.org/10.1177/1469787418754569

Montrezor, L. H. (2021). Lectures and collaborative working improves the performance of medical students. Advances in Physiology Education, 45(1), 18–23. https://doi.org/10.1152/advan.00121.2020

Dr. Mary Stenson earned her B.S. in Biology from Niagara University and her M.S. and Ph.D. in Exercise Physiology from Springfield College. She is an Associate Professor of Exercise Science and Sport Studies at the College of Saint Benedict/Saint John’s University in Saint Joseph, Minnesota. Dr. Stenson teaches exercise physiology, research methods, anatomy & physiology, and health & fitness. Her research focuses on recovery from exercises and improving health of college students. Dr. Stenson mentors several undergraduate research students each year and considers teaching and mentoring the most important and fulfilling parts of her work.
Pandemic, Physiology, Physical Therapy, Psychology, Purpose, Professor Fink, Practical Exams, and Proficiency!

Pandemic

To say that the COVID-19 pandemic has affected education would be an understatement.  Physical distancing measures that were introduced across the world to reduce community spread of SARS-CoV-2 (the COVID-19 pathogen), necessitated a cessation or reduction of in-person instruction, and the introduction of what has come to be known as “emergency remote education”(1, 2).  Emergency remote education or teaching (ERE or ERT) is different from remote or online education in that, it is not planned and optional, but rather, a response to an educational emergency (3).

Physiology for Physical Therapy Students

Against the backdrop of the COVID-19 pandemic, as I was trying to keep my primary research program on regenerative and rehabilitative muscle biology moving forward (4), engaging with the scientific community on repurposing FDA-approved drugs for COVID-19 (5, 6), and working on the Biomaterials, Pharmacology, and Muscle Biology courses that I teach each year; I was requested to take on a new responsibility.  The new responsibility was to serve as the course master and sole instructor for a 3-credit, 15-week course on Physiology and Pathophysiology for Professional Year One (PY1) Doctor of Physical Therapy (DPT) students.  I had foreseen taking on this responsibility a couple of years down the road, but COVID-19 contingencies required that I start teaching the course in January 2021.  I had always believed that within the Physical Therapy curriculum, Anatomy, Physiology and Neuroscience, were courses that could only be taught by people who were specialists – i.e. you had to be born for it and should have received a level of training needed to become a master of Shaolin Kung Fu (7).  With less than a year to prepare for my Physiology and Pathophysiology course, and with the acknowledgment that I was not trained in the martial art of Physiology instruction, I looked for inspiration.  The Peter Parker Principle from Spider-Man came to mind – “With great power comes great responsibility” (8).  Unfortunately, I realized that there was no corollary that said “With great responsibility comes great power”.  Self-doubt, anxious thoughts, and frank fear of failure abounded.

Psychology and Purpose

Call it coincidence, grace, or anything in between; at the time when I started preparing to teach Physiology and Pathophysiology, I had been working with a psychological counselor who was helping me process my grief following my father’s passing a couple of months before COVID-19 was declared a pandemic.  In addition to processing my grief, through counseling, I had also started learning more about myself and how to process anxious thoughts, such as the fear of failing in my new superhero role of teaching Physiology and Pathophysiology to Physical Therapy students.  Learning how to effectively use my “wise mind” (an optimal intersection of the “emotional mind” and “reasonable mind”), writing out the possible “worst outcomes” and “likely outcomes”, practicing “self-compassion”, increasing distress tolerance, working on emotional regulation, and most importantly embracing “radical acceptance” of the things I cannot change, helped me work through the anxiety induced by my new teaching responsibility.  This does not mean that my anxiety vanished, it just means that I was more aware of it, acknowledged it, and worked my way through it to get to what I was supposed to do.  I also learned through counseling that purpose drives motivation.  I realized that my anxiety over teaching Physiology was related to the value I placed on the teaching and learning of Physiology in Physical Therapy and other health professions.  Being a Physical Therapist and Physiologist who is committed to promoting movement-centered healthcare, I found motivation in the prospect of training Physical Therapists to serve as health educators with the ultimate goal of improving human movement.  Therefore, the idea of developing a course that would give my students a solid foundation in the Physiology and Pathophysiology of Human Movement began to excite me more than intimidate me.  The aspects of my personality that inspired me to publish a paper on the possible pathophysiological mechanisms underlying COVID-19 complications (5), stirred in me the passion to train the next generation of Physical Therapists, who through their sound knowledge of Physiology would likely go on to transform healthcare and promote healthier societies through movement (9).

The point about purpose being a positive driver of motivation, mentioned above, has been known to educational psychologists for a while.  When students see that the purpose of learning something is bigger than themselves, they are more motivated to learn (10).  So, rather than setting up my course as a generic medical physiology course, I decided to set it up as a Physiology and Pathophysiology of Human Movement course that is customized for human movement experts in training – i.e. Student Physical Therapists.  I set my course up in four modules – Moving the Body (focused on muscle and nerve), Moving Materials Around the Body (focused on the cardiovascular and pulmonary systems), Fueling Movement (focused on cellular respiration and the ATP story), and Decoding the Genetics of Human Movement (focused on how genetic information is transcribed and translated into proteins that make movement possible).

Professor Fink

For those of you who have not heard of Professor Steven Fink, you should look him up (11).  A Ph.D.-trained Physiologist and former member of the American Physiological Society (APS), Professor Fink has posted over 200 original educational videos on YouTube, covering Anatomy, Physiology, Pharmacology, and other subjects.  I had found his YouTube videos several years ago, while looking for good resources for my Pharmacology course, and never stopped watching them ever since then.  I would watch his videos while exercising, and listen to them during my commute (and sometimes even during my ablutions!).  There were two topics in Physiology that scared me the most – cellular respiration and genetics.  I had learned these topics just well enough to get me through high school, four years of Physical Therapy School, one year of Post-Professional Physical Therapy training, six years of Ph.D. training in a Physiology laboratory, six years as a Postdoctoral Fellow (also in a Physiology laboratory), and several years as an Assistant Professor in Physical Therapy.  However, despite the “few years” I had spent in academia and my 10+ years being a member of the APS, I never felt that I had gained mastery over the basic physiology of cellular respiration and genetics.  So, when I started preparing to teach Physiology, I decided to up my number of views on Professor Fink’s videos on cellular respiration and genetics.  Furthermore, I reached out to Professor Fink and asked him if he would serve as a teaching mentor for my new course and he very kindly agreed.  I am fortunate to be a teacher-scholar in a department and university, which places a high priority on teaching, and supports training in pedagogy and the scholarship of teaching and learning through consultation with experts within and outside the university.  As part of our mentoring relationship, Professor Fink gave feedback on my syllabus, course content, testing materials and pedagogical strategies.  He also introduced me to “Principles of Anatomy and Physiology, 16th Edition, by Gerard J. Tortora, Bryan H. Derrickson, which proved to be a useful resource (ISBN: 978-1-119-66268-6).  Through all these interactions, Professor Fink demonstrated that a person can be a “celebrity professor” and still be a kind and gentle human being.  Having him as my teaching mentor played a significant role in building my confidence as a physiology teacher.  Research shows that academic mentoring is related to favorable outcomes in various domains, which include behavior, attitudes, health, interpersonal relations, motivation, and career (12).

Practical Exams

As the COVID-19 pandemic rolled on through the Winter, Spring/Summer, and Fall semesters of 2020, it became certain that I would have to teach my Physiology and Pathophysiology course in a virtual environment come January 2021.  I had to figure out a way to make sure that the learning objectives of my course would be met despite the challenges posed by teaching and testing in a virtual environment.  Therefore, I came up with the idea of virtual practical exams for each of the four modules in my course.  These practical exams would be set up as a mock discussion between a Physical Therapist and a referring health professional regarding a patient who had been referred for Physical Therapy.  Students would take the exam individually.  On entering the virtual exam room, the student would introduce themselves as a Student Physical Therapist and then request me (the referring healthcare professional) to provide relevant details regarding the patient, in order to customize assessment, goal setting and treatment for the patient.  With the patient’s condition as the backdrop, I would ask the student questions from the course content that was relevant to the patient’s condition.  A clear and precise rubric for the exam would be provided to the students in keeping with the principles of transparency in learning and teaching (13).

Proficiency

As we went through the course, the virtual practical exams proved to be an opportunity to provide individualized attention and both summative and formative feedback to students (14).  As a teacher, it was rewarding to see my Physical Therapy students talk about cellular respiration and gene expression with more confidence and clarity than I could do during my prior 12+ years as a Ph.D.-trained Physiologist.  It was clear to me that my students had found a sense of purpose in the course content that was bigger than themselves – they believed that what they were learning would translate to better care for their patients and would ultimately help create healthier societies through movement.

In the qualitative feedback received through a formal student evaluation of teaching (SET) survey, one student wrote “Absolutely exceptional professor.  Please continue to do what you are doing for future cohorts.  You must keep the verbal practical examinations for this class.  Testing one’s ability to verbally explain how the body functions and how it is dysfunctional is the perfect way to assess if true learning has occurred.”  Sharing similar sentiments, another student wrote “I really enjoyed the format of this class. The virtual exams in this class forced us to really understand the content in a way that we can talk about it, rather than learning to answer a MC question. I hope future students are able to learn as much as I did from this class.”

Closing Remarks

When I meet students for the first time during a course, I tell them that even though I am their teacher, I am first a student.  I let them know that in order to teach, I first need to learn the content well myself.  Pandemic pedagogy in the time of COVID-19-related emergency remote education has reinforced my belief that, the best way to learn something is to teach it.  Thanks to my Physiology and Pathophysiology of Human Movement course, I learned more about myself, about teaching and learning, and of course about cellular respiration and genetics.  Do I now consider myself a master of Physiology instruction?  No!  Am I a more confident physiology teacher?  Yes!  Has writing this article made me reflect more on what worked well and what needs to be fine-tuned for the next iteration of my Physiology and Pathophysiology course?  Yes!

REFERENCES:

  1. Williamson B, Eynon R, Potter J. Pandemic politics, pedagogies and practices: digital technologies and distance education during the coronavirus emergency. Learning, Media and Technology. 2020;45(2):107-14.
  2. Bozkurt A, Jung I, Xiao J, Vladimirschi V, Schuwer R, Egorov G, et al. A global outlook to the interruption of education due to COVID-19 pandemic: Navigating in a time of uncertainty and crisis. Asian Journal of Distance Education. 2020;15(1):1-126.
  3. Hodges C, Moore S, Lockee B, Trust T, Bond A. The difference between emergency remote teaching and online learning. Educause review. 2020;27:1-12.
  4. Begam M, Roche R, Hass JJ, Basel CA, Blackmer JM, Konja JT, et al. The effects of concentric and eccentric training in murine models of dysferlin-associated muscular dystrophy. Muscle Nerve. 2020.
  5. Roche JA, Roche R. A hypothesized role for dysregulated bradykinin signaling in COVID-19 respiratory complications. FASEB J. 2020;34(6):7265-9.
  6. Joseph R, Renuka R. AN OPEN LETTER TO THE SCIENTIFIC COMMUNITY ON THE POSSIBLE ROLE OF DYSREGULATED BRADYKININ SIGNALING IN COVID-19 RESPIRATORY COMPLICATIONS2020.
  7. Wikipedia contributors. Shaolin Kung Fu – Wikipedia, The Free Encyclopedia 2021 [Available from: https://en.wikipedia.org/w/index.php?title=Shaolin_Kung_Fu&oldid=1026594946.
  8. Wikipedia contributors. With great power comes great responsibility – Wikipedia, The Free Encyclopedia 2021 [Available from: https://en.wikipedia.org/w/index.php?title=With_great_power_comes_great_responsibility&oldid=1028753868.
  9. American Physical Therapy Association (APTA). Transforming Society – American Physical Therapy Association [Available from: https://www.apta.org/transforming-society.
  10. Yeager DS, Henderson MD, Paunesku D, Walton GM, D’Mello S, Spitzer BJ, et al. Boring but important: a self-transcendent purpose for learning fosters academic self-regulation. Journal of personality and social psychology. 2014;107(4):559.
  11. Fink S. ProfessorFink.com [Available from: https://professorfink.com/.
  12. Eby LT, Allen TD, Evans SC, Ng T, Dubois D. Does Mentoring Matter? A Multidisciplinary Meta-Analysis Comparing Mentored and Non-Mentored Individuals. J Vocat Behav. 2008;72(2):254-67.
  13. Winkelmes M. Transparency in Learning and Teaching: Faculty and students benefit directly from a shared focus on learning and teaching processes. NEA Higher Education Advocate. 2013;30(1):6-9.
  14. Alt D. Teachers’ practices in science learning environments and their use of formative and summative assessment tasks. Learning Environments Research. 2018;21(3):387-406.
Joseph A. Roche, BPT, PhD.  Associate Professor.  Physical Therapy Program.  Eugene Applebaum College of Pharmacy and Health Sciences.  

I am an Associate Professor in the Physical Therapy Program at Wayne State University, located in the heart of “Motor City”, Detroit, Michigan.  My research program is focused on developing regenerative and rehabilitative interventions for muscle loss arising from neuromuscular diseases, trauma and aging.  I have a clinical background in Physical Therapy and have received intensive doctoral and postdoctoral research training in muscle physiology/biology.

https://www.researchgate.net/profile/Joseph-Roche-2

https://scholar.google.com/citations?user=-RCFS6oAAAAJ&hl=en


Down the custom path: Adaptive learning as a tool for instruction and assessment in science education

The spread of COVID-19 via the SARS-CoV-2 virus led colleges and universities around the world to close on-campus instruction for the safety of students, faculty and staff.  This left many instructors, specifically those in the sciences, struggling to find effective methods to present information to students in a manner that both encouraged learning and allowed for assessment of knowledge attainment.  Non-traditional colleges and universities, those that offer most or all of a degree to students in the online environment, were poised to transition easily; continuing to use the tools available in the virtual world to both guide students and assess learning.  As institutions wrestle with the decision to move courses back to the on-campus setting, this blog implores those in higher education, even science education, to consider adaptive learning as a vital component of curriculum.

Prior to my appointment as Lead Faculty at Colorado Technical University, I taught a variety of science courses in on-campus class and laboratory settings.  Both exams and laboratory practica could be cumbersome, both in prep and in grading.  While the questions could be mapped back to unit and/or course learning outcomes, this would require input of each student’s response to each question into a data sheet for analysis.  Even with online administration of exams, assessment methods were limited and instructors like myself were reliant on continuous creation of lectures, worksheets, activities, and online simulations to present course materials.  When it came time to transition to online, students would navigate through a learning management system and open a variety of files, videos, interactive activities, practice sheets, and practice quizzes for one unit in a course.  There had to be a better way to incorporate all the things we know drive student inquiry into one area while allowing assessment of their knowledge, right?  There was.

Enter adaptive learning technology.  Colorado Technical University relies upon Intellipath™ to deliver content to students in the asynchronous classroom in a variety of subjects, including natural sciences, math, engineering, nursing, and health studies.  I entered into teaching and managing faculty as a novice in this tool, and now I want to sing its praises to anyone who will listen. Adaptive learning does just as the title suggests.  It adapts based on the student’s knowledge, adding questions in areas where they need additional practice and allowing those already determined to have a certain understanding of topics to skip on to new materials.  Once these lesson nodes are designed, they can be used over and over again and questions can be delivered in a variety of ways to assess the same outcome. Gone is the need to continuously upload materials as they are all housed within the adaptive learning platform.  Instructors have the ability to see how a student is doing not just in terms of their progress through the unit but also their mastery of a specific topic.  Students have the ability to earn high marks when they demonstrate competency in the subject on their first attempt but are able to improve their score when they didn’t do as well as they had hoped.

The system rolls instruction, interaction, and formative and summative assessments all in together in one data rich place.  Instructors can tailor their outreach and additional instruction to specific students or overall trends within a specific cohort.  Those tasked with the assessment of effectiveness portion of curriculum can pull these data to discern what outcomes are being met.  In modern higher-ed, what students know is important but how we know they know what they know is also a priority.  We have to be able to paint a quantitative picture that our curriculum is effective.

Students are re-evaluating their choices for universities and it is wise of all of us to consider our options for content delivery and knowledge assessment.  I think many educators in colleges or universities have attended at least one meeting at this point to discuss the decline in the number of “traditional” college students and some of us may have even been tasked with figuring out what to do about it.  More and more students are faced with the dilemma of needing to manage being caregivers, members of the workforce, or other life challenges while also attaining a degree.  This is our time to be bold and innovative in the classroom and really personalize a student’s experience.  Will there always be “traditional” college classes?  Only time will tell.  I cannot predict where we will be as educators in a decade but I can say that it will be my goal to evolve to meet the demands of the profession.  Science leads us to advances and adaptations so shouldn’t we be advanced and adaptive in science education?

Dr. Tiffany Halfacre (she/her) earned undergraduate degrees from Berea College (Biology) and Saint Petersburg College (Funeral Services), an MSMS from Morsani College of Medicine at the University of South Florida, and a DHSc from A.T. Still University College of Graduate Health Studies.

She has a varied background as an educator spanning over 10 years.  She has taught courses in general biology, human biology, anatomy, physiology, pharmacology, and health sciences in addition to interdisciplinary work in medical humanities.  She has been involved in course development, programmatic and institutional accreditation, and institutional research and effectiveness.  Her research and service interests include exploring health and nutrition literacy as they relate to geographical and socioeconomic differences. Outside of the classroom, she has been involved in chapel series lectures including one on “Truth in Grief” and was awarded the Excellence in Academic Advising award during her tenure at Carson-Newman University for her work advising pre-health professions students.  Dr. Halfacre currently serves as a Lead Faculty and an Assistant Professor of Health Studies at Colorado Technical University where she not only focuses on faculty preparation and support but also initiatives to retain and encourage success in first year and first generation college students.

Her hobbies include anything outdoors, running, amateur photography, and enjoying various arts, specifically music.

Less is more – focusing on the core concepts

When it comes to teaching a subject in depth and breadth, an instructor may face the challenges of limited time versus unlimited contents. To this end, the instructor may focus on covering as much as possible material in a lecture, or on the key concepts that help prioritize contents and overarch a myriad of information. The former strategy is highly content-centered and can be overwhelming to both the instructor and students, and in fact, studies have shown that instruction time is not necessarily proportional to learning outcome [1]. By contrast, the latter strategy makes time for the instructor and student to interact, discuss, and apply the key concepts to problem solving activities, which fosters an active and interactive learning environment. In line with the evidence showing that students benefit more from an active and interactive learning experience [2], educators have called for less coverage and more inquiry aiming high beyond just the facts so that student’s learning can be enhanced by talking, writing, and collaborating [3-4].

How can one effectively prioritize contents by focusing on the key concepts pertaining to the latter strategy? One of the possible ways is to use learning objectives or anticipated learning outcomes to navigate content prioritization. It is overwhelming to start with materials for teaching planning due to fast growing research and knowledge explosion. However, using a backward design may change the game. Backward design of a course starts with developing clear learning objectives, which aligns selection of lecture contents with anticipated learning outcomes [5-6]. For instance, to accomplish the objective of building students’ critical thinking skills, an instructor will strategically plan time for not only covering materials but also information processing and application. Other than concentrating student learning on facts only, the class will be fueled by problem-based collaborative learning. To this end, it is critical for the instructor to elaborate the key principles or concepts, the very guides students need to address complex problems that demand more than simple factual answers. The collection of facts relevant to the class can be provided as supplemental information or resources for students to look up for problem solving, while it can limit student learning as a major commitment of memorization.

Mastery of basic principles plus being detail-oriented is required for success in experimentation and authentic research in a lab course [7]. To this end, students are expected to pay attention to experimental details in addition to core concepts, raising the question as to how course contents can be prioritized. First, the strategy of backward design still applies. Secondly, the learning objectives or anticipated learning outcomes can be defined such that they focus on core principles and transferrable or interchangeable skills. For instance, the course Laboratory Techniques in Molecular Nutrition covers several sets of lab techniques, one of which is immunoassays. Immunoassays represent a set of methods based on antigen-antibody binding reactions, including Western blotting (WB), immunoprecipitation (IP), co-immunoprecipitation (co-IP), chromatin immunoprecipitation (ChIP), ChIP sequencing (ChIPsec), immunohistochemistry (IHC), immunocytochemistry (ICC), and enzyme-linked immunosorbent assay (ELISA). Each method may take 1-2 weeks (5 hours/week) to cover the principles and operational procedures, and the set of immunoassays alone may occupy a semester. Obviously, it is very challenging to elaborate on each of the immunoassays within a semester given the limited time and resources, plus the needs to cover non-immunoassay techniques. However, it is practical for students to learn about the techniques within 4-5 weeks (5 hours/week) with a prioritized focus by elaborating on the core concepts shared by the eight immunoassays and contrasting the major differences among them. The core principles are shared by all the immunoassays regarding immobilization, blocking, immunobinding, washing, and detection processes. Yet, they are different in assay microenvironments including the solid phases, blocking solutions, antibodies, targets of interest, washing solutions, and detection reagents and instruments. Priority can be given to elaborating the core concepts and major differences (1-2 weeks) and to practicing the most used and accessible immunoassays such as WB, IP, and ELISA (3 weeks).

Practically, use of flipped classrooms can further enhance students’ mastery of key concepts and their ability to apply the concepts to solving problems. In a flipped classroom, the instructor lectures less in class but the course materials and recorded lectures are uploaded to the course management site (e.g., Canvas) for students to study in advance. Students tend to learn more through problem-solving activities with the instructor and peers in class that build critical thinking skills. As such, the learning outcomes can be increased and go beyond the contents by enhancing students’ critical thinking skills, which will benefit their lifelong learning after college.

Taken together, focusing on facts less in class but targeting core concepts and knowledge application more may serve as an effective strategy to build students’ critical thinking skills. The “less” by no means refers to an easy class. Instead, both the instructor and students spend more time outside the class preparing and studying course materials. This is to prepare everyone for more higher-order-thinking activities (e.g., analysis, evaluation, and application) in class. The “less” for “more” pedagogy may benefit student’s lifelong learning experience.

 

References and further reading

[1] Andersen SC, Humlum MK, Nandrup AB. Increasing instruction time in school does increase learning.

Proc Natl Acad Sci USA. 2016 Jul 5;113(27):7481-4.

[2] Dolan EL, Collins JP. We must teach more effectively: here are four ways to get started. Mol Biol Cell. 2015 Jun 15;26(12):2151-5.

[3] Luckie DB, Aubry JR, Marengo BJ, Rivkin AM, Foos LA, Maleszewski JJ. Less teaching, more learning: 10-yr study supports increasing student learning through less coverage and more inquiry. Adv Physiol Educ. 2012 Dec;36(4):325-35.

[4] DiCarlo SE. Too much content, not enough thinking, and too little fun! Adv Physiol Educ. 2009 Dec;33(4):257-64.

[5] Allen D, Tanner K. Putting the horse back in front of the cart: using visions and decisions about high-quality learning experiences to drive course design. CBE Life Sci Educ. 2007, 6(2): 85–89

[6] Hills M, Harcombe K, Bernstein N. Using anticipated learning outcomes for backward design of a molecular cell biology Course-based Undergraduate Research Experience. Biochem Mol Biol Educ. 2020 Jul;48(4):311-319.

[7] DiCarlo SE. Cell biology should be taught as science is practiced. Nat Rev Mol Cell Biol. 2006 Apr;7(4):290-6.

Dr. Zhiyong Cheng received his PhD in Analytical Biochemistry from Peking University, after which he conducted postdoctoral research at the University of Michigan (Ann Arbor) and Harvard Medical School. Dr. Cheng is now an Assistant Professor of Nutritional Science at the University of Florida. He has taught several undergraduate- and graduate-level courses (lectures and lab) in human nutrition and metabolism (including metabolic physiology). As the principal investigator in a research lab studying metabolic diseases (obesity and type 2 diabetes), Dr. Cheng has been actively developing and implementing new pedagogical approaches to build students’ critical thinking and problem-solving skills.
Synchronous and asynchronous experiences in Advanced Exercise Physiology Courses: what teaching tools work best for my students?

Covid-19 caught all of us off guard, but educators were hit particularly hard and uniquely. I already have flipped classroom teaching and active learning, so the transition was not too difficult for me. However, I found myself incorporating many technological innovations. Was I doing too much? Which features were helping my students, and which ones were overwhelming? In this blog, I want to share some of the strategies I used with undergraduate students taking Advanced Exercise Physiology synchronously and asynchronously.

 

Additionally, within this blog, I am sharing the student’s perceptions of these technological innovations. In total, fifty-two students enrolled in different sections of “Advanced Exercise Physiology” culminating undergraduate experience (CUE) were invited to participate in a short survey regarding their learning experiences during this current Spring 2021 semester. A total of thirty-nine (n=39) students completed the confidential survey about whether different technological innovations helped them understand the material and study.

Who completed the survey?

Figure 1: Fifty-two students enrolled either in synchronous or asynchronous undergraduate advanced exercise physiology sections were invited to participate, and thirty-nine (n=39) responses were obtained. Seventy-two percent of the responders were enrolled in the asynchronous section, and 27.78% were enrolled in the synchronous section.

 

 

Video assignment for glucose metabolism

 During pre-COVID-19 times, I would teach using active-learning team-based instruction. For the first team-based assignment, student teams were asked to discuss and explain in easy terms one of the most difficult topics for my students: glucose metabolism. For this activity, I would bring Legos, markers of different colors, magnets, and other toys; and students were asked to use the materials and make a video of the complete oxidation of a glucose molecule. This in-class, graded assignment seem to help students to understand the metabolic pathways.  I modified the project due to distance learning, so each student has to create a video using any material desired to explain in simple words (without chemical formulas). This assignment is based on the constructivism theory of learning. It makes it innovative because the students learned that glucose is a six-carbon molecule that has to be fully “broken down” (oxidated) through different stages. Once they understand the steps, they could “name” each step and each enzyme. Some students used coins, Legos, or wrote down the step while explaining the process verbally. Some examples of the submissions can be seen in the links below:

Example submission glycolysis  one and example complete glucose oxidation.

 Students perception on making a video assignment for glucose metabolism

Figure 2: Students’ responses to the question “Having to make the video of metabolism in assignment two helped me understand glucose metabolism.” 71.43% responded true (it was helpful), and 28.57% responded false (it was not helpful)

 

 

 

Incorporation of Virtual Lab Experiences using Visible Body and Lt Kuracloud platforms.

One of the main concerns for me was to maintain and increase engagement while teaching virtually or remotely. I incorporated the Lt Kuracloud, a platform for interactive assignments, immediate feedback, videos, and physiology laboratory experiences in all my courses. I took advantage of the free trial, and I used it for some assignments. I received unsolicited emails from students expressing how helpful they found these assignments.  I also used Visible Body Anatomy and Physiology, which I used for lectures. I recommended it to students as supplemental material and for self-graded quizzes. Visible Body Anatomy and Physiology is available at no cost to students as our Institution’s library obtained the subscription for all the students.

Students’ perceptions: “How helpful do you find the following features? “

Figure 3: Responses to the question: How helpful do you find the following features (from 0 to 100 being 0 not useful to 100 very useful). The mean value for assignments in Lt Kuracloud was 79.08/100 (sd= 21), and for Visible Body was 74.74/100 (sd= 24)

 

Old Reliable Discussion Board

I recently completed my training on Quality Matters (QM) certification (1), and so my courses follow the rubrics of QM Higher Education General Standards. Specifically, QM Module 1 suggests using an introductory welcoming video encouraging the students to introduce themselves to the class using a video, a meme, a photo, or text. The best, and probably the only feature on Blackboard to do this is the “Discussion Board.” The discussion board is a great feature that allows students to increase participation. After all, students are the biggest consumers of social media, videos, and memes. The Discussion Board should be the closest FERPA approved version of TikTok or Facebook, right? WRONG! It worked fine for the first thread entitled “welcome,” most of the students responded by typing to answer the questions. Nobody made a voice thread, a meme, or a video. Afterward, I encouraged participation on the discussion board by posting questions and suggesting posting questions on the discussion board. After a few “virtual crickets” on Discussion Board, I quit posting questions there and developed interactive lectures with pop-up quizzes. As expected, Discussion Board was not very popular among my students.

Students’ perceptions: “How helpful do you find the discussion board on Blackboard? “

 Figure 4: Responses to the question: How helpful do you find the following features (from 0 to 100 being 0 not useful to 100 very useful). The mean value for the discussion board was 43.08/100 (sd= 25).

 Interactive pre-recorded lectures

Pre-recorded lectures are integral components of my synchronous and asynchronous course sections. These are developed using the interactive feature in Camtasia, in which I developed animated lectures. Thus, students are asked to watch the lessons and complete short quizzes that provide immediate feedback. If the concept is mastered, the student continues watching. If not, they are redirected to the lecture or part of the lecture where the concept is explained.

 Students’ perceptions: “How helpful do you find the interactive pre-recorded lectures? “

Figure 5: Responses to the question: How helpful do you find the following features (from 0 to 100 being 0 not useful to 100 very useful). The mean value for interactive pre-recorded lectures was 79.27/100 (sd= 16.8), and for Visible Body was 81.74/100 (sd= 17.8)

 

Quizlet and Quizlet live game

Like many educators worldwide, I teach my students and support their learning throughout our virtual synchronous meetings. Indeed, this is not easy. One day, as I was finishing my class, I heard screams and laughs! My ten-year-old was having so much fun in his most favorite subject. What is going on? I asked, “it was a close one,” my son said, “I got second place.”  It turned out that he was playing a “Quizlet Game.” Quizlet and Quizlet live have been used by teachers and students to reinforce learned material. I decided to try it, and I created a teacher profile to play games during the remote lectures. Every class, I started a Quizlet game; students use their phones or computers to play a race (team and individual). They play a “race” at the beginning of the class and again at the end of the class. This low-risk activity provides me with important information about misconceptions or concepts that are not mastered yet. Students play again towards the end of the class. This simple activity takes 10 minutes of instruction (5 minutes each “race”). However, it has been proven to be both helpful and fun for the students. Quizlet live was used only in my synchronous classes, but the Quizlet study sets were available to both synchronous and asynchronous sections.

I used this with graduate students enrolled in Human Physiology in the previous semester, and it was a hit! Students loved it, and class after class, this became very competitive. Not only were my students very well prepared for class, but also the competition made it so much fun!

Similar to Quizlet are such programs as Kahoot, Brainscape,  and others that are available for free or very affordable options.

Students’ perceptions: “How helpful do you find Quizlet study sets and Quizlet live? “

Figure 6: Responses to the question: How helpful do you find the following features (from 0 to 100 being 0 not useful to 100 very useful). The mean value for Quizlet sets was 76.86/100 (sd= 24), and for Quizlet live was 68.31/100 (sd= 28). One limitation is that most responders were students in the asynchronous section who did not participate in Quizlet live games.

 

MS Teams meetings and/or virtual office hours

 I chose Microsoft Teams (MS) for my virtual meetings simply because it is widely adopted at my Institution, and I prefer to keep it simple for students. For my synchronous section, I used a flipped virtual model, in which we meet once per week, and the other day they work on their own on assignments. I did this to avoid screen burnout students in the synchronous section. However, I have been happily surprised with students attending remote classes and the various office hours I provide. Yes, I do provide different office hours; very much this semester, I made every space available on my calendar as extra office hours. I realize that for many, meeting online for “virtual office hours” is more accessible to them (and perhaps less intimidating) than attending office hours in my office, as we did pre-pandemic.

Why did I offer so many office hours? First of all, because I could. Since I can’t conduct research studies with humans during the pandemic, it freed some time I had set aside for data collection to teaching.

Additionally, not driving to and from campus saved me an average of 75 minutes per day, which allowed me to have another office hour option. In reality, I did not use all these hours in meetings with students. Many times nobody needed to meet. However, there were a couple of times in which I’d meet with a student who was struggling. Not with the class or the content. But struggling with life, some students had somebody close to them sick or dying; some lost their job or financial aid, some were working exceptionally long hours as essential workers. For some, isolation was too much. One student, in particular, told me recently, “I do not have any questions today; I just needed some social interaction.” Flexible and various virtual office hours seemed beneficial for students, particularly for those in asynchronous e-learning experiences.

Students’ perceptions: “How helpful do you find the MS Teams meetings and virtual office hours? “

 

Figure 7: Responses to the question: How helpful do you find the following features (from 0 to 100 being 0 not useful to 100 very useful). The mean value for MS Teams and Virtual Office Hours was 75.86/100 (sd= 21).

 

 

 Conclusions

 Like most higher education instructors, I had to adapt quickly and shift to e-learning due to the pandemic. Fortunately, I had already taught online several times before and introduced several components to my flipped courses. However, I still struggled to find more interactive ways to keep my students engaged. Not only educators have to deal with the mental exhaustion of finding pedagogical tools that work in this new scenario when we have not had the time to produce evidence-based successful approaches to teaching remotely. But also, we are teaching distraught students. From the scarce but rapidly growing literature, we know that “our college students are currently struggling to stay hopeful and positive in the wake of the COVID-19 pandemic” (2). When asked about their feelings during the transition to virtual classes, students reported that they felt “uncertain” (59.5%), “anxious” (50.7%), “nervous” (41.2%), and “sad” (37.2%). (3) We have to teach students that are dealing with a lot of negative emotions and stress. We, educators, are also living with many of those emotions. My goal with this blog was to share some of my experiences teaching virtually and provide some ideas for any physiology educator that may need them.

References

Standards from the Quality Matters Higher Education Rubric, Sixth Edition. Quality Matters. Retrieved from Specific Review Standards from the QM Higher Education Rubric, Sixth Edition

  • Munsell, S. E., O’Malley, L. & Mackey, C. (2020). Coping with COVID. Educational Research: Theory and Practice, 31(3), 101-109.
  • Murphy, L., Eduljee, N. B., Croteau, K. College Student Transition to Synchronous Virtual Classes during the COVID-19 Pandemic in Northeastern United States. Pedagogical Research,5(4), em0078. https://doi.org/10.29333/pr/8485
Dr. Terson de Paleville teaches Advanced Exercise Physiology, Neuromuscular Exercise Physiology, and Human Physiology courses. Her research interests include motor control and exercise-induced neuroplasticity. In particular, Dr. Terson de Paleville has investigated the effects of activity-based therapy on respiratory muscles and trunk motor control after spinal cord injury. Additional research project involves the assessment of the effects of exercise training in elementary and middle school students on balance, visual efficiency, motor proficiency, motor control and behavior in the classroom and at home. Dr. Terson de Paleville is interested in elucidating any links between physical activity and academic skills and performance.

 

Repurposing the notecard to create a concept map for blood pressure regulation

One amazing aspect of physiology is the coordinated, almost choreographed function of millions of moving parts.  The body has mastered multitasking, maintaining hundreds of parameters within narrow and optimal ranges at the same time.  This very aspect of physiology fuels our passion and enthusiasm for teaching physiology and piques the interests of students.  The networks of numerous overt and subtle interdependent mechanisms and signaling pathways between multiple organs and tissues that regulate plasma calcium or energy intake, for example, also represent major challenges to understanding and learning physiology for students.  We ask our students to combine the wisdom of two old sayings: “You can’t see the forest for the trees’, and “The devil is in the details.”  They need to understand both the bigger picture of the whole animal and the nuanced interlinking of mechanisms, and even molecules, that seamlessly and dynamically maintain different parameters within narrow ranges.  It can be frustrating and discouraging for students.  Furthermore, passing with high marks in systems physiology or anatomy-physiology II is a criterion for eligibility to apply to various health profession programs.  As educators we must acknowledge the complexity of physiology and find ways to help our students literally see and master smaller sections of the larger regulatory network so they can recreate and master the larger network.

For even the best prepared student, as well as the student who cannot take all recommended prerequisite courses for A&P-II or basic physiology, the collection of numerous parts, mechanisms, equations and connections, principles, and laws can represent an obstacle to learning.  Student comments such as, “There is so much to know.”, “It’s so complicated.”, and “Physiology is hard.” are accurate and fair, but also warrant validation.  A little bit of validation and communicating the challenges we encountered as students goes a long way in helping our students’ willingness to endure and continue to strive.  Physiology courses are not impossible, but they are difficult and might well be the most difficult courses a student takes.  I will not pretend or lie to my students.  If I were to dismiss physiology as a whole or a given concept as easy and simple, I risk my student thinking they should be learning principles effortlessly or instinctively and begin to doubt themselves and give up.  It helps to confess apprehensions you yourself felt when first learning various physiological concepts or phenomena.  As a novice physiology student, I had many moments at which I wanted to tap out.  ne major example was my introduction to the beautiful, albeit daunting display of all the electrical and mechanical events that occur in only the heart during a single cardiac cycle in just 0.8 seconds, i.e., the Wiggers diagram.  Every time I project this diagram on the screen, I give students a moment to take it in and listen for the gasps or moans.  I admit to my students that upon seeing that diagram for the first time I looked for the nearest exit and thought to myself, ‘Are you kiddin’ me?”  Students laugh nervously.  They sigh in relief when I tell them that my professor broke down the diagram one panel at a time before putting all together; his approached worked, and that is what I will do for them.  Dr. Carl Wiggers was committed to teaching physiology and developed the diagram over 100 years ago as a teaching tool for medical students (1).  The diagram is instrumental in teaching normal cardiac physiology, as well as pathophysiology of congenital valve abnormalities and septal defects.  Nevertheless, students still need help to understand the diagram.  Again, here an example of the function of just one organ, the heart, being a central element to a larger network that regulates a major parameter – blood pressure.  Learning regulation of blood pressure can be an uphill battle for many students.

Cardiovascular physiology is typically a single unit in an undergraduate physiology course, and it is often the most challenging and difficult exam of the semester.  Several years ago, when preparing to teach this section in an AP-II course I felt compelled to find ways to help students break-down and reconstruct pieces of complex regulation of blood pressure.  I considered the many high-tech digital learning resources and online videos available to our students but wondered whether those resources help or hinder students.  I was also looking for tools that would facilitate multisensory learning, which is shown to yield better memory and recall (2).  Despite all these high-tech resources, I noticed students were still avid users of notecards and were convinced they held the secret to success in AP-I and thus, must also be the key to success in AP-II or systems physiology.  I found this quite amusing, because we used notecards back when I was in college in the 80s – when there were no digital learning platforms and highlighters only came in yellow.  Students tote around stacks of hand-written, color coded notecards that grow taller as the semester progresses, but often their comprehension and ability to connect one concept or mechanism to the next does not increase with the height of the stack.  Students often memorize terms on note cards but cannot readily connect the mechanism listed on one card to that on the next card or explain the consequence of that mechanism failing.  Around this time a non-science colleague was talking to me about her successful use of concept maps with her students.  To me, concept maps look a lot like biochemical pathways or physiological network diagrams.  It dawned on me.  I did not need to reinvent the wheel or make a newer better teaching tool.  I simply needed to help my students connect The Notecards and practice arranging them to better pattern regulatory networks.  Students were already writing a term on one side of the card and a definition and other notes on the back.  Why not build on that activity and more deliberately guide students to use cards to build a concept map of the network for regulation of blood pressure which is central to cardiovascular physiology?

 

Blood pressure is a physiological endpoint regulated by a nexus of autoregulatory, neural and hormonal mechanisms and multiple organs and tissues.  Blood pressure is directly dependent on cardiac output, vascular peripheral resistance, and blood volume, but can be altered by a tiered network of numerous neural, hormonal and cellular mechanisms that directly or indirectly modulate any one of the three primary determinants.  The expansive network, e.g., numerous organs and tissues, and multiple and intersecting effects of different mechanisms within the network, e.g., the renin-angiotensin-aldosterone system modulates both vascular resistance and blood volume) make it difficult to see the network in its entirety.  Nevertheless, students must understand and master the entire network, the individual mechanisms, and the nuances.  Thus, in preparing for the cardiovascular section and planning how to implement the concept map, I made a list of all components that comprised the regulatory network for blood pressure with the first terms being blood pressure, cardiac output, vascular peripheral resistance, and blood volume.  At this point in the semester, the students had learned the basics of cellular respiration and metabolism.  I began the very first cardiovascular lecture with an illustration of the human circulatory system projected on the screen as I worked at the white board.  In the center of the board, I drew a cell with a single mitochondrion and three simple arrows to indicate the use of glucose and oxygen to convert ADP to ATP.  Guided through a series of questions and answers, students collectively explained that the heart must pump blood through arteries and veins to deliver oxygen and glucose and fat needed to generate ATP, as well as to remove carbon dioxide and other wastes.  Using the illustration of the human circulatory system, I then carefully explained the human circulatory system is a closed system comprised of the blood (the medium carrying oxygen, nutrients, CO2 and other wastes), the heart (the pump), and the arterial and venous vessels (the conduits in which blood flows from the heart to the tissues where oxygen and nutrients are delivered and CO2 and other wastes are removed).  If adequate pressure is sustained, blood continues to flow through veins back through the heart and to the lungs to unload CO2 and reoxygenate blood and then back to the heart to make another round.  I further explained blood pressure must be regulated to ensure blood flow to tissues optimally matches both metabolic need for oxygen and nutrients and production of CO2.  On the board, I then wrote “Blood Pressure (BP)” and stated that because this is a closed circulatory system, blood pressure changes in direct response and proportion to cardiac output or volume of blood pumped out of heart into systemic vessels in one minute, the total volume of blood in the system, and the vascular resistance that opposes flow and will be predominantly dependent vasoconstriction and vasodilation.  I wrote the terms “Cardiac Output (CO), Blood Volume (BV), and Vascular or Total Peripheral Resistance (VPR) one at a time underneath BP, each with an arrow pointing directly to BP.  I stated that any factor that changes cardiac output, blood volume, or vascular resistance can indirectly alter blood pressure.  For example, a change in heart rate can change cardiac output and thus, alter blood pressure.  I then distributed the series of hand drawn diagrams shown below.  As I pass out the sheets and display on slides, I tell them they will be learning about all these various factors and mechanisms and will be able to recreate the network and use it as a study aid.

To get students started, I handed out the list of cardiovascular terms, hormones, equations, etc. and several small pieces of paper, e.g., 2”x2” plain paper squares, to each student.  [I found free clean scratch paper in various colors in the computer lab and copy room recycling bins.]  Students can also take their trusty 3”x5” cards and cut each in half or even quarters or use standard-size Post-It® notes.  I explained that as I introduce a term or mechanism they will write the term or conventional abbreviation on one side of the paper and the definition and pertinent information on the other in pencil for easier editing.  [I emphasized the importance of using conventional abbreviations.]  For example, Blood Pressure would be written on one side of the paper and ‘pressure exerted against vessel wall’ on other, along with ‘mm Hg’, and later the equation for mean arterial pressure (MAP) can be added.  I had my own set of terms written on Post-It® notes and arranged BP, CO, BV, VPR and other terms on a white board so they could see the mapping of functional relationships take shape.  As new concepts were taught and learned, e.g., CO = Stroke Volume (SV) x Heart Rate (HR), the respective terms were added to the concept map to reflect the physiological relationships between and among the new mechanism to the existing mechanisms or phenomena already in the concept map.  In that case, on the back of the CO paper or card one might write “volume of blood ejected from ventricle in one minute into aorta”, “CO = HR x SV“, “If HR is too fast, CO will decrease!”, “Right CO must equal Left CO!”  I explained students can lay out their terms on a table, floor, their bed, etc.  I reminded students how important it was to say the terms out loud as they wrote the terms in their best penmanship.  This helps students slow down and deliberately think about what they are writing and refer to their lecture notes or textbook (be it an actual book or e-book).  I had given students copies of the complete concept map of all terms but did not dictate exactly what they should write on the back of the cards.  The small size of the paper or card, almost forces students to annotate explanations; this helped them better encapsulate their ideas.  I was open to checking their annotation and reflecting back to students the apparent meaning of their word choice.  While studying alone or with study partners, students were encouraged to audibly define terms and relationships among mechanisms as they arranged their maps in the correct configuration.  They were encouraged to ‘shuffle the deck’ and recreate subsections of the network to understand mechanistic connections at different points in the network.  Because I had given them the diagrams or concept maps for cardiac output, blood volume, and vascular resistance, students were able to check their work and conduct formative assessments alone or in groups in an accurate and supportive manner.

Students expressed that manually arranging components allowed them to literally see functional and consequential relationships among different mechanisms.  The activity complemented and re-enforced quizzes and formative assessments already in use.  It’s not a perfect tool and certainly has room for improvement.  There are quite a few pieces of paper, but students found ways to keep the pieces together, e.g., binder clips, Zip-lock bags, rubber bands.  Nonetheless, it is simple, portable, and expandable concept map students can use to learn cardiovascular physiology and represents a tool that can be applied to teach and learn other regulatory networks, such as those of the digestion-reabsorption-secretion in the GI tract and calcium homeostasis.

  1. Wiggers C. Circulation in Health and Disease. Philadelphia, PA: Lea & Febiger, 1915.
  2. http://learnthroughexperience.org/blog/power-of-context-learning-through-senses/
Alice Villalobos, Ph.D., is an assistant professor in the Department of Medical Education at the Texas Tech Health Sciences Center in Lubbock, Texas.  She received her B.S.in biology from Loyola Marymount University and her Ph.D. in comparative physiology from the University of Arizona-College of Medicine.  Her research interests are the comparative aspects of the physiology and stress biology of organic solute transport by choroid plexus.  She has taught undergraduate and graduate courses in integrative systems physiology, nutrition and toxicology.  However, her most enjoyable teaching experience has been teaching first-graders about the heart and lungs!  Her educational interests focus on tools to enhance learning of challenging concepts in physiology for students at all levels.  She has been actively involved in social and educational programs to recruit and retain first-generation college students and underrepresented minorities in STEM.