Category Archives: Classroom Content

Student Preparation for Flipped Classroom

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

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

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

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

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

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

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

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

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

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

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

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

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

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

   Ed Merritt is an assistant professor in the Department of Kinesiology at Southwestern University in Georgetown, Texas. Ed received his doctorate in Kinesiology from the University of Texas at Austin and completed a postdoctoral fellowship in Cellular and Integrative Biology at the University of Alabama at Birmingham. Ed was a faculty member at Appalachian State University until family ties brought him back to central Texas and Southwestern University. Ed’s research focuses on the molecular underpinnings of skeletal muscle atrophy after trauma and with aging, but he is also equally involved in the scholarship of teaching and learning and melding educational outreach activities with service learning.
Teaching Backwards

 

Generating new ideas and cool learning experiences has always been natural and fun for me. My moments of poignant clarity often came during a swim workout or a walk with my dog as I reflect on my classes. As I visualize this activity, my students are as enthusiastic as I am and are learning. Then, reality returns as I grade the next exam and see that less than half of the class answered the question related to that activity correctly. Accounting for the students who learn despite what I do, I quickly see that I only reached a quarter of my students with this great activity. Why did this happen? What can I do about this?

Well, my life as an instructor changed the day I walked into my first session of University Center for Innovation in Teaching and Education (UCITE) Learning Fellows at Case Western Reserve University.  This program is a semester long session on how learning works where the focus is on evidence-based learning practices and provides an opportunity to discuss successes and failures in teaching with peers.  It was here that I learned about “Backwards Design”1.

What is Backwards Design?

Essentially, it is designing your course with the end in mind. I think of it as “Teaching Backwards” – that is, I visualize my students 5-10 years from now in a conversation with a friend or colleague discussing what they learned from my class. I ask myself these questions:

  1. How do I want them to describe my class? Hansen refers to this as the “Big Idea” or broad objective. An example from one of my classes is provided in Table 1.
  2. What do I want them to be able to tell their friend or colleague that they learned from the class in 5 to 10 years? Hansen has termed this as “Enduring Understanding” (see Table 1).

The next phase is to write learning objectives for each of the enduring understandings (see Table 1). We continue the journey backwards into linking learning objectives to assessment methods and developing the details of each class session. During this process, we must always take into account the student’s prior knowledge (refer to How Learning Works2).

Table 1: Example of Backwards Design Concepts for “Exercise Physiology and Macronutrient Metabolism” class.

Class: Exercise Physiology and Macronutrient Metabolism
Big Idea Enduring Understanding Learning Objective
Exercise-Body Interaction Substrate utilization during exercise depends on type, intensity, and duration of exercise. Students will be able to describe substrate utilization during exercise.
Fatigue during exercise has been associated with low glycogen levels, but scientists are not in agreement as to the underlying cause of fatigue. Students will be able to debate the theories of fatigue.

What did backwards design do for me?

Backwards design provided me focus. It allowed me to step back and ask myself: What are the key take-aways? Does that cool, creative idea I have help to achieve my end game for the course? Is there a better way to do this? Overall, the framework has helped me develop a higher quality course. With that said, I still run into exam questions where I thought I did better at teaching the material than represented by the students’ responses.  So, while there is always room for improvement, this has definitely been a step in the right direction for better learning by my students.

References:

  1. Hansen EJ. Idea Based Learning: A Course Design Process to Promote Conceptual Understanding. Sterling VA: Stylus Publishing, LLC; 2011.
  2. Ambrose SA, Bridges MW, DiPietro M, Lovett M, Norman MK.How Learning Works: 7 Research Based Points for Teaching. San Francisco CA: Jossey-Bass, 2010.

 

Lynn Cialdella-Kam, PhD, MBA, MA, RDN, LD joined CWRU as an Assistant Professor in Nutrition in 2013. At CWRU, she is engaged in undergraduate and graduate teaching, advising, and research. Her research has focused on health complications associated with energy imbalances (i.e. obesity, disordered eating, and intense exercise training). Specifically, she is in interested in understanding how to alterations in dietary intake (i.e., amount, timing, and frequency of intake) and exercise training (i.e., intensity and duration) can attenuate the health consequences of energy imbalance such as inflammation, oxidative stress, insulin resistance, alterations in macronutrient metabolism, and menstrual dysfunction.  She received her PhD in Nutrition from Oregon State University, her Masters in Exercise Physiology from The University of Texas at Austin, and her Master in Business Administration from The University of Chicago Booth School of Business.  She completed her postdoctoral research in sports nutrition at Appalachian State University and is a licensed and registered dietitian nutritionist (RDN).
How Much Material Should We Cover?

womanedhatI’m not sure where the phrase “the tyranny of content” was first coined, but picturing this bloated and oppressive ruler issuing dictates from on high does seem apt at times. Now, of course, there is no one telling us[1] that we have to cover every last bit of Physiology, but yet we often end up trying to do just that. This is in spite of numerous articles and publications telling us and showing us that trying to cover less is more effective[2].

Last spring I taught a 300 level[3] physiology course at my previous institution, and this course is their first and usually only exposure to physiology while the students are undergraduates. I thought I had finally put together a pretty awesome course. I reorganized the material in a manner similar to Carnegie Mellon’s Open Learning Initiative A&P course[4] which has a structure that seems to reflect the 5 Core Concepts in Biology and “Core Principles” of Physiology[5]. I mapped out all of my learning outcomes for each unit and aligned my activities and assessments. It wasn’t until after the semester that I happened to put all of the learning outcomes into a single spreadsheet and realized I had 105!

I had the good fortune of moving into a new position right after that semester, one where I am responsible for training and mentoring graduate students and post-docs who are developing and teaching a course for the first time[6]. Sadly, this means I don’t get to teach Physiology any more[7] – but it has allowed me to really reflect on how I approach teaching. This one big question keeps popping back up for me: How much material is the right amount of material to cover?[8]

In preparation for a workshop here at UW-Madison, I went through all of those learning outcomes and pared the list down to ~50. Is that still too many or too few? At the risk of mixing metaphors, am I preventing my students from being buried under this mountain of information or am I just dooming them to being buried later when they go on to professional school?

I think that this gets to one of the big underlying issues associated with managing course content, and that is maybe more important than counting learning objectives – What do I want my students to be able to do once the course is over? My initial response is a partially tongue-in-cheek “understand physiology.” But, even if I was being completely serious that is still a really vague idea. So where to, from here?

A colleague recently related a story to me about a teaching talk that they had heard once upon a time. In it the faculty member discussed how they had for years taught all of these molecular structures, which students would promptly forget as soon as they were out the door after an exam. This faculty member then decided to really focus on 1-2 structures and work with students to make sure that they really understood those structures and the rules that govern them. This would then give them the skills to figure out other structures. Great! What are those handful of things that we could focus on in a human physiology course though?

The “Core Principles” that I mentioned earlier emphasized the following concepts: the importance/function of the cell membrane, homeostasis, cell-to-cell communications, interdependence between cells/structures/organs, and flow down gradients. If a student understands those principles, it would definitely give them the tools to figure out what is going on behind many physiological processes. Obviously a physiology course would need to cover more than just those five areas though, but what? And maybe more importantly, how?

As someone who now mentors first time college science instructors, it has become even more apparent to me that we tend to default to teaching the way we were taught, but all it takes is the right example or the right conversation to spark an entirely new approach to a course. So, this is the point in the process where I want to hear ideas. You can comment on these blog posts, and I’d like to see comments about ideas that you’ve had in terms of focusing your content for human physiology/A&P courses, as well as ideas on making these courses more conceptual/skill-based.  Thanks for your input.


Footnotes

[1] For most of us at least

[2]Brewer, C. A., & Smith, D. (2011). Vision and change in undergraduate biology education: a call to action. American Association for the Advancement of Science, Washington, DC. www.visionandchange.org

Association of American Colleges and Universities (AAC&U). (2007). College Learning for the New

Global Century. Washington, D.C.: AAC& U.

Handelsman, J., Ebert-May, D., Beichner, R., Bruns, P., Chang, A., DeHaan, R., & Wood, W. B. (2004).

Scientific teaching. Science, 304(5670), 521-522.

National Research Council. (2003) BIO 2010: Transforming Undergraduate Education for Future

Research Biologists Washington, DC: National Academies Press.

Schwab, J. J. (1962). The Teaching of Science as Enquiry. Cambridge, Mass.: Harvard University Press.

Schatz, G. (2012). The endangered bond. Science. doi:10.1126/science.1219756

Etc..

[3] So, sophomore & juniors mostly. Almost all ‘pre-health’ of some sort.

[4] http://oli.cmu.edu/courses/free-open/anatomy-physiology/

[5] Michael, J., Modell, H., McFarland, J., & Cliff, W. (2009). The “core principles” of physiology: what should students understand? Advances in Physiology Education, 33(1), 10–16. doi:10.1152/advan.90139.2008 – AND –

Michael, J., & McFarland, J. (2011). The core principles (“big ideas”) of physiology: results of faculty surveys. Advances in Physiology Education,35(4), 336–341. doi:10.1152/advan.00004.2011

[6] Sorry…shameless plug http://biology.wisc.edu/TeachingFellows.htm

[7] At least for the time being

[8] Spoiler Alert! I don’t have the answer, or even AN answer. I am mostly ruminating on this idea.

 
PECOP Trimby picture 2

 

 

 

Chris Trimby is the (Interim) Director of the Teaching Fellows Program and Pre-Faculty Development for WISCIENCE at University of Wisconsin-Madison. As part of this position he mentors graduate students and post-docs while they gain experience teaching and developing course materials. Chris’s research background was in gene therapy and neurotrauma, but that focus has shifted to education practice. He did his Ph.D. in Physiology at University of Kentucky.