Category Archives: Course Design

Reworking the recipe: Adding experimentation and reflection to exercise physiology laboratories

What do you get when you follow a recipe? We suppose it depends on how carefully you follow the instructions, but assuming you stay true to the steps and have the requisite skills, you get something that approximates the taste described on the food blog (it never looks as good). While following a recipe can get you an expected result in the kitchen, it does not make you a chef—you probably will not learn to create new dishes, improve tired ones, or reverse-engineer your favorite take-out order. What do you do if you run out of vanilla!? We think the same is true in a science laboratory: You don’t develop the skills of a scientist by just following instructions. Sure, scientists follow instructions, but they also need to choose, create, and improve instructions. How do scientists become nimble with their craft? They experiment, make mistakes, troubleshoot, and iterate (or “Take chances, make mistakes, and get messy” for those who grew up with Miss Frizzle). If we asked you where undergraduate students learn to become scientists, we expect “laboratories” would be the most common answer, but unless laboratory activities are intentionally designed to develop the curiosity, creativity, and skills to pose and answer questions, they won’t produce adept scientists. In contrast to traditional laboratory activities, inquiry-based laboratory activities allow learners to develop important scientific skills.

Two years ago, we began a project aimed at improving student learning by replacing recipes with authentic science in exercise physiology laboratories. With one year remaining in our project, this blog post will explore our rationale, progress, and future plans.

Section 1: Put the scientist cookie-cutter back in the drawer

In undergraduate exercise physiology courses, laboratory-based learning is common, but it focuses more on students learning techniques than experimenting (9). In our experience, a typical undergraduate laboratory activity requires students to follow step-by-step procedures to measure one or more variables in a limited number of participants, most commonly their lab mates. Students administer exercise protocols on bikes, treadmills, and dynamometers to collect a variety of data, including oxygen uptake, heart rate, and muscle strength. These labs are largely descriptive. For example, a quintessential undergraduate exercise physiology laboratory involves performing a graded exercise test to measure the maximal rate of oxygen uptake (V̇O2max). Students assume the role of physiologist, repeatedly increasing the speed of a treadmill (or power output of a cycle ergometer) while sampling expired gases until the participant is unable to continue due to exhaustion. Students are discouraged (actually, prohibited) from altering the protocol and rarely given the chance to fix mistakes in a future laboratory (don’t forget the nose clips!). While the specific results may not be known in advance—they depend on characteristics of the participant—this activity is not an experiment. This traditional approach to laboratory teaching is standard (8, 11, 13). In contrast, an inquiry-based approach allows students to act like scientists and experiment.

There is a terrific description of levels of student inquiry in science for interested readers outlined in Bell et al. (4) and summarized in Table 1 below. The authors describe four levels of inquiry, and in our early stages of reforming labs, we found these levels very helpful for grappling with and revising laboratory learning activities and assessments. In our experience, only level 1 inquiry-based activities are regularly included in undergraduate laboratories: For example, our students compare post-exercise blood lactate concentration responses to passive and active recovery. Even though the results are known in advance and students are following the instructor’s procedures for level 1 inquiry, learners are frequently assessed on their ability to create laboratory reports where they find themselves toiling over uninspired post hoc hypotheses and rewriting a common set of methods in their own words. This process is disingenuous. Furthermore, knowing that they are attempting to verify a known result may lead some students to engage in questionable research practices to obtain that result (14).

Table 1. The four levels of inquiry, as described by Bell et al. (4).

Level Type Description of student activities
1 Confirmation Students verify or confirm known results
2 Structured inquiry Students investigate instructor-determined question using instructor-determined procedures (results not known in advance)
3 Guided inquiry Students investigate instructor-determined question using student-determined procedures
4 Open inquiry Students develop questions and procedures for rigorously answering them

 

We think traditional laboratory teaching goes against the spirit of what science actually is: The application of rigorous methods in the pursuit of answers to questions. Although students may develop technical skills by completing descriptive activities and low-level inquiry activities (e.g., data acquisition, data analysis, technical writing), there is a missed opportunity to develop the habits of mind and skills of a scientist in traditional laboratories. More than that, there is a misrepresentation, or at least obfuscation, of science. If we pretend these laboratories represent the scientific process, how do we expect students to become curious about, inspired by, and ultimately capable of doing science on their own? Students need to progress to higher levels of inquiry-based learning, but implementing these types of laboratories can be challenging in exercise physiology.

It is understandable that exercise physiology laboratories tend to exclude inquiry-based learning, as all tests are performed on human participants. First, there are legitimate safety concerns in exercise physiology laboratories, as participants are asked to exert themselves, often maximally; manipulations have physiological consequences; and some techniques are invasive. It would be irresponsible to let students change data collection protocols on the fly and jeopardize the health and safety of their peers. Second, as multiple testing sessions may be required to collect experimental data, manipulating independent variables may also be impractical for an undergraduate course aiming to cover a broad curriculum. For example, with sessions spread over multiple weeks, standardizing for diet is difficult. Third, the types of interventions that would have large enough effect sizes to be observable with small sample sizes (with a reasonable amount of “noise”) may be impractical or inappropriate in an undergraduate laboratory. For example, learners may not want to exercise for prolonged durations in the heat or deplete their muscle glycogen in advance of an exercise test. And finally, laboratory instructors may be uncomfortable or inexperienced with facilitating inquiry-based laboratories that go beyond level 1 (to say nothing of the confidence and ability of the learners themselves).

In addition to the practical concerns of adding more inquiry to undergraduate labs, we know students must learn the technical skills associated with fitness assessment, as exercise physiology is a health profession. If students pursue exercise physiology as a career path, they will apply advanced technical skills to accurately measure variables that impact exercise prescription, health assessments, and disease prognosis. Technical rigor is paramount in this profession, and imparting these skills is a major reason to offer exercise physiology laboratories. Unless specializing in research, exercise physiologists may not perform scientific experiments in their occupation. It is also challenging to collect most physiological data, and certainly learners cannot become scientists without acquiring data collection skills. Students need to practice and develop confidence using laboratory equipment before they can answer their own questions.

We understand that performing true experiments (especially student-led experiments) is difficult in undergraduate exercise physiology laboratories and we also appreciate why technical skills are essential. Yet, we do not believe that an exclusive focus on technical skills is the best strategy for students to learn scientific reasoning, critical thinking, and problem-solving skills. Regardless of a students’ career path, these are transferrable skills, and a laboratory is the ideal venue to nurture scientific thinking.

Section 2: Can we move beyond cookbook style laboratories?

What makes a good scientist? This answer probably varies across disciplines: Some scientists may be skilled in animal surgery, some may interrogate enormous data sets, and others may focus on theoretical concepts and proofs. There is probably no single skill set that is common among all scientists. But, if we put the specific technical skills aside, students need to ask questions, create hypotheses, solve problems, and think critically in order to conduct experiments. The mechanism for developing any skill is practice: Learners need opportunities to develop and refine their skills, whether they are technical or cognitive. Some students may be able to walk into a first-year laboratory and create an experiment, but many more will need additional support to reach this level of competency. In short, students need to practice being scientists. To be effective, this practice must be authentic: As scientists do not just follow instructions, a recipe-based approach to laboratory learning will not develop a good scientist. The higher levels of inquiry, (see Table 1), are where students get to practice being scientists.

Including higher level inquiry-based learning in exercise physiology isn’t entirely novel. For example, Kolkhorst et al. (11) described the implementation of an inquiry-based learning model in an undergraduate exercise physiology course. The structure of this course was (i) an introductory laboratory session; (ii) five laboratory sessions focused on key concepts in exercise physiology; and (iii) nine laboratory sessions to complete two separate research projects (4-5 sessions each). In the latter portion of the course–an example of level 4 inquiry (Table 1)–students proposed research questions and hypotheses and worked with instructors to devise an experiment, collected and analyzed data, and presented their results to the class. After addressing one research question, students repeated this process with a new research question focused on a different physiological system. Following the initial iteration—from which Kolkhorst et al. (11) noted students were not sufficiently prepared for undertaking the research projects—the authors devised a more structured transition, providing students with more opportunities to practice answering research questions and developing technical skills (i.e., level 2-3 inquiry). The results of this shift in laboratory learning were largely positive: The authors reported that students were more enthusiastic about the inquiry-based labs and better able to describe and discuss physiological principles. A separate study (8) indicated that students reported preferring high-level as opposed to low-level inquiry in exercise physiology laboratories, crediting the independence, responsibility, freedom, and personal relevance as key influences on their satisfaction. These qualitative results are further supported by quantitative data from Nybo and May (13), which demonstrated greater test scores for students who completed an inquiry-based laboratory session related to cardiopulmonary exercise physiology compared to a traditional laboratory on the same topic. Collectively, these studies demonstrate that enabling students to experiment in undergraduate exercise physiology is possible and beneficial.

Although writing specifically about physics education, Drs. Emily Smith and Natasha Holmes (14) advise us to eliminate confirmation (level 1) work and attempts at learning theory in laboratories. Based on extensive research, they suggest increasing the amount of laboratory time students spend (i) making predictions about what they think might happen; (ii) doing activities that involve trial-and-error; (iii) practicing decision making; and (iv) processing how things went. By allowing students to devise questions, design experiments, and collect data (with the opportunity to fix mistakes), students are practicing being scientists. By design, inquiry-based laboratory activities facilitate the first three suggestions; however, whether Smith and Holmes’ fourth recommendation occurs in inquiry-based laboratory activities is hard to determine, but this recommendation is important. This processing phase of laboratory learning improves students’ capacities to make good decisions over time. Including this reflective step in laboratories is something we have taken to heart and into all of our reformed labs.

Section 3: Adding inquiry and mixing reflection into exercise physiology laboratories

In our project, we are focused on two specific exercise physiology courses, an introductory undergraduate course (n = 80-200 students, depending on the semester) and an advanced graduate course (n = 10), both of which have a weekly 3-hour laboratory session. Prior to intervening, we surveyed the nature of laboratory teaching in each course, finding that students indeed followed step-by-step instructions without the opportunity to make decisions or investigate new questions. The only form of inquiry-based learning was level 1 (Table 1). We planned to make two broad types of changes: (i) provide students with more autonomy in the laboratory, and (ii) encourage students to reflect on the activities they were completing. As the graduate course was much smaller, this was deemed the easier place to start, and because of its size, this course was also allowed to remain in-person during the COVID-19 pandemic. Accordingly, most of our progress to date has been in revising this graduate exercise physiology course.

Initially, our changes to the graduate course’s laboratory focused on asking students to make and validate predictions while using a standard set of protocols (i.e., level 1 inquiry). In our first iteration, we modified four laboratory sessions to focus on the “unexpected” breakdown in the linear relationship between oxygen uptake and cycling power output that occurs during exercise with constant-load efforts and the difficulty in identifying the boundary between the heavy and severe exercise intensity domains (10). We (and students in the course) felt these activities were successful, so we modified the laboratory again the following year to allow students to focus on answering novel questions rather than verifying results. Using a gradual implementation approach similar to Kolkhorst et al. (11), students were first asked to create and test unique hypotheses for a set of data they collected over four laboratory sessions, combining aspects of level 2 and 4 inquiry (i.e., instructor-led procedures and student-led questions). Next, based on an article read earlier in the course (1), students worked as a group to determine whether fatiguing one limb influenced measures of exercise performance and fatigue in the contralateral limb when contractions were isometric (level 2). Finally, with a focus on inquiry-based learning and professional development, students were challenged to develop their own laboratory activity for a hypothetical course, which required devising an experiment to teach an important concept in exercise physiology and collecting pilot data to demonstrate feasibility (nearing level 4). To fully understand the impacts of these changes, we have collected survey and semi-structured interview data from students in reformed laboratories, which we hope to formally report at the end of the project.

Despite teaching our undergraduate exercise physiology course online this year, we attempted to create a virtual exercise physiology laboratory that focused on developing the skills needed to answer research questions. Learning activities focused on hypothesis creation, research design, data analysis, and statistical analysis. For one activity, we asked students to design a hypothetical study comparing mechanical aspects of sprinting for two groups of athletes (e.g., bobsleigh vs. fencing). Although new to research design, students were given the freedom to choose the sample size, the variable of interest, and the two types of athletes (selected from normative data published by Haugen et al. (7)). Martin used the students’ choices to simulate datasets, and students performed statistical analysis to test their hypotheses. While students couldn’t collect their own data, this activity allowed them to pose and answer a question, while learning about sprinting and research design. When this lab returns to in-person learning, plans are being formulated to include inquiry-based learning, similar to the structure that Kolkhorst et al. (11) and Henige (8) reported.

After two years of tinkering with our graduate course and beginning to reform our undergraduate course (despite its online format), we have realized that we simply need to give students more time in the laboratory to work on their own questions. Note that Kolkhorst et al. (11) and Henige (8) each provided 4-5 sessions for their level 4 inquiry laboratory activities. This can be a tough sell for instructors (ourselves included): It means we need to cover fewer topics. But, sometimes the best addition to a recipe is a subtraction (e.g., prohibiting pineapple on pizza). The battle over which absolutely essential topic has to be removed has already begun!

While we think increasing autonomy and inquiry in the lab is an important part of enhancing student learning, we also think students need to be able to debrief learning activities and process their experiences to enrich their learning. For both courses described above, students were asked to engage in reflective activities each week. We know reflection can move learning from surface to deep and even transformative levels (12). Reflection is a form of cognitive housekeeping and processing that enables students to develop their understanding of complex or unstructured ideas (12). When students actively engage in a constructive sense-making process, they understand complex systems and concepts better (6). Metacognitive practices are shown to improve self-regulation and commitment to lifelong learning; however, instructional strategies often neglect or assume students are engaging in metacognition (2). Evidence suggests metacognition at the end of STEM learning activities enriches learning (17). Based on this evidence and our experiences with reflection as a catalyst for curiosity and connection-making, we integrated a small amount of reflection with learning activities and added a low-stakes assessment in both courses. Students were asked to thoughtfully reflect on and respond to a specific prompt in approximately 100 words at the end of each lab. Questions like those listed below acted as a call to metacognition:

What did you find most challenging (or surprising, or interesting) in this lab and why?

What did you learn in this lab? What would you still like to know?

What do you think is the major obstacle to performing high-intensity interval training?

How would you explain the importance of fat oxidation to a lay person interested in exercise?

By asking students to connect their experience, knowledge, ideas, and sometimes uncertainty to their lab learning activities, we hoped to support them in deepening, extending, and amplifying their learning.

As we reformed student learning activities and move away from recipe-only laboratories, our teaching practices needed to change too. Recognizing that the laboratory instructors had mostly been trained through traditional style laboratories, we identified a need for some targeted professional development for our group of educators. To meet this need, Cari developed an asynchronous learning module called “Teaching to Enable Learning in Exercise Physiology,” for the instructional team to complete prior to the start of term, and we debriefed this 6-8 hour module together at our first meeting. This meeting set the tone and expectation in many ways for the teaching practices we were expecting teaching assistants to try in labs. We took a community of practice (CoP) approach to supporting laboratory teaching and learning throughout the semester. A CoP is a group of practitioners who meet regularly, reflect and problem solve collaboratively to learn to do their practice (for us, teaching) better (16). CoPs have been used to facilitate teaching and learning change in many higher education projects (5, 15). Each week, we (Martin and Cari) invited the lab technician, the teaching assistants (i.e., laboratory instructors), and a graduate student researcher (Joy Camarao) to reflect on and share both positive and negative teaching experiences from the week that was.

Conclusion

Years after completing an undergraduate degree in biology, the laboratory activities that stuck with me (Martin) the most are those that let me experiment. My favorite laboratory activity involved transplanting barnacles from the exposed side of a breakwater to the inner harbor on the coast of Nova Scotia to examine phenotypic plasticity in leg morphology. My lab mates and I chose the topic and designed the experiment, basing our question on a relationship observed in a related species of barnacle (3). We drove to the coast to find and transplant the barnacles, and we returned weeks later to collect the barnacles for analysis, hypothesizing that they would increase their leg length to optimize feeding in the calmer waters. Unlike most of my other laboratory experiences, we were performing a real experiment with real hypothesis and a (somewhat) novel question. Our study had flaws, and our results weren’t perfect, but the laboratory report was authentic, and so was my excitement. This type of lab is a challenge in exercise physiology, but it’s possible and worthwhile. As we enter the final year of our project, we hope to give students more opportunities to experiment.

Image Credits: Image 1- Nicole Michalou, Image 2- Maarten VanDenHeuvel, Image 3 William Choquette, Image 4- Frans VanHeerden.

 

References

  1. Amann M, Venturelli M, Ives SJ, McDaniel J, Layec G, Rossman MJ, Richardson RS. Peripheral fatigue limits endurance exercise via a sensory feedback-mediated reduction in spinal motoneuronal output. J Appl Physiol 115: 355–364, 2013.
  2. Ambrose SA, Bridges MW, DiPietro M, Lovett MC, Norman MK. How learning works: Seven research-based principles for smart teaching. John Wiley & Sons., 2010.
  3. Arsenault DJ, Marchinko KB, Palmer AR. Precise tuning of barnacle leg length to coastal wave action. Proceedings Biol Sci 268: 2149–2154, 2001.
  4. Bell RL, Smetana L, Binns I. Simplifying inquiry instruction. Sci Teach 72: 30–33, 2005.
  5. Elliott ER, Reason RD, Coffman CR, Gangloff EJ, Raker JR, Powell-Coffman JA, Ogilvie CA. Improved student learning through a faculty learning community: How faculty collaboration transformed a large-enrollment course from lecture to student centered. CBE—Life Sci Educ 15: 1–14, 2016.
  6. Eyler JR. How humans learn: The science and stories behind effective college teaching. West Virginia University Press, 2018.
  7. Haugen TA, Breitschädel F, Seiler S. Sprint mechanical variables in elite athletes: Are force-velocity profiles sport specific or individual? PLoS One 14: e0215551, 2019.
  8. Henige K. Undergraduate student attitudes and perceptions toward low- and high-level inquiry exercise physiology teaching laboratory experiences. Adv Physiol Educ 35: 197–205, 2011.
  9. Ivy JL. Exercise Physiology: A Brief History and Recommendations Regarding Content Requirements for the Kinesiology Major. Quest 59: 34–41, 2007.
  10. Keir DA, Paterson DH, Kowalchuk JM, Murias JM. Using ramp-incremental VO2 responses for constant-intensity exercise selection. Appl Physiol Nutr Metab (2018). doi: 10.1139/apnm-2017-0826.
  11. Kolkhorst FW, Mason CL, DiPasquale DM, Patterson P, Buono MJ. An inquiry-based learning model for an exercise physiology laboratory course. Adv Physiol Educ 25: 117–122, 2001.
  12. Moon JA. A handbook of reflective and experiential learning: Theory and practice. Routledge, 2013.
  13. Nybo L, May M. Effectiveness of inquiry-based learning in an undergraduate exercise physiology course. Adv Physiol Educ 39: 76–80, 2015.
  14. Smith EM, Holmes NG. Best practice for instructional labs. Nature 17: 662–663, 2021.
  15. Tinnell TL, Ralston PA, Tretter TR, Mills ME. Sustaining pedagogical change via faculty learning community. Int J STEM Educ 6: 1–16, 2019.
  16. Wenger-Trayner B, Wenger-Trayner E. What is a community of practice? [Online]. 2011. https://wenger-trayner.com/resources/what-is-a-community-of-practice/ [25 Jun. 2021].
  17. Wieman C, Gilbert S. The teaching practices inventory: A new tool for characterizing college and university teaching in mathematics and science. CBE—Life Sci Educ 13: 552-569., 2014.
Dr. Martin MacInnis is an assistant professor who studies exercise and environmental physiology from an integrative perspective, focusing on the skeletal muscle mitochondrial content, red blood cell volume, interval training, and applications of wearable technology. Martin teaches courses in exercise physiology at the undergraduate and graduate levels, and his SoTL research, in collaboration with Dr. Cari Din, focuses on using labs to develop scientific thinking.
Dr. Cari Din, PhD,  is an instructor, leadership fellow, and teaching scholar at the University of Calgary in the Faculty of Kinesiology. She works closely with Dr. Martin MacInnis, to support continuous improvement in teaching and learning experiences for students and graduate teaching assistants in the courses Martin leads. Cari works to enable agency, curiosity, and connection between learners in all of her work. She lives near the Rocky Mountains and appreciates hiking in them.
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!

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  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.
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.

 

What do I really want my students to learn about animal physiology?

Each spring semester my colleague and I teach an undergraduate course in animal physiology that emphasizes primary literature and incorporates multiple evidence-based teaching strategies. Using an integrative and comparative approach, students investigate strategies that vertebrate animals use to meet their energy needs, take up and transport oxygen, and maintain hydration and salt balance, with a special emphasis on how animals have adapted to extreme environments. Our course incorporates a flipped teaching (FT) format (2, 4), where students are assigned readings from the textbook and articles from the primary literature outside of class and class time is spent discussing the material and applying that information to explore physiological mechanisms. Instead of lecturing, class time is focused on interactive learning through group work – teamwork is emphasized throughout the course, with students working in groups both inside and outside of class.  Our course learning goals are:

 

1.       Acquire a fundamental knowledge of “how animals work”

2.       Recognize how prior and new knowledge relate to current/future work

3.       Appreciate the importance of animal physiology

4.       Understand how to collect, integrate, and communicate information

5.      Exercise responsibility and teamwork.

 

When Rice University moved all classes online due to the COVID pandemic in spring 2020, we were at mid-semester. So like most other educators around the United States, we moved our class to Zoom. The transition from face-to-face to online instruction went fairly smoothly. Although we had only two weeks to make this shift, we did not have to frantically record lectures since our class meetings were discussion based. Additionally, students had been working in teams since the beginning of the semester so we had an established community in our classroom. Students still attended class online and were engaged for the most part. That being said, we observed that students did not turn on their cameras unless we asked them to and definitely seemed more hesitant to answer and ask questions in Zoom. Student engagement and participation increased dramatically when we put students in small groups in breakout rooms; here they interacted as a team, just like they did at round tables in the classroom pre-COVID. Student feedback at the end of the semester revealed that most of them felt like class didn’t change that much after moving online – however, they did miss the in-person interactions with us and their classmates, and some activities did not translate well to an online format; they truly appreciated our efforts to adapt our teaching and made some great suggestions for how we could improve the course in the future for online and/or face-to-face teaching.

 

After the semester ended, I finally had some time to reflect upon my teaching pre-COVID and during the pandemic. Over the summer, I spent many hours thinking about the course structure and what we would revise for our next offering of the course. As the COVID pandemic continued to rage throughout the fall semester, my colleague and I decided that we would teach our animal physiology course fully online for the spring 2021 semester. And we just learned that due to a spike in COVID cases after Christmas in the Houston area, classes at Rice will be fully remote at least until mid-February. During the pandemic last spring, throughout the summer and fall, and now with classes starting in just two weeks, one key question has guided me as I work on this course: “What do I really want my students to learn about animal physiology?”

How were we assessing student learning?

During the spring 2020 semester, student learning was assessed in multiple ways including individual exams, group exams, a semester long team project, homework, reading quizzes, reflections, etc. Although these mostly formative assessments and the team project require a great deal of effort and time from the students, exams contributed to 70% of the total grade for the course; the team project accounted for 20% of the grade, and all other assignments (e.g., homework, quizzes, reflections) were worth just 10% of the grade. Although there were short “mini exams” every other week, some students still became stressed and anxious when taking the exams, even though they demonstrated an understanding of course material in class discussions and on homework assignments. Once the pandemic forced us to remote instruction, we did modify the exam format to give them more time to take the exam online than they would have had in the classroom; they had a flexible window so they could choose what time/day to take the exam; and the final exam was “open resources.” And we dropped a third exam based on a research article since we lost about two weeks of instruction. We were not overly concerned about cheating since all of our exam questions are short answer format and typically require application and/or synthesis of foundational knowledge to answer the questions (i.e., you can’t just Google the answer).

Overall, student performance on the exams did not change much from pre-COVID to during the pandemic. Still, this weighting of assignments seemed imbalanced to me, with too much emphasis on student performance on exams. I started thinking about how I could shift the weighting of assignments to better reflect student achievement of learning goals. For example, the semester long team project, where students create a fictional animal (1) and showcase their animal during the last week of classes, requires students to understand integration of body systems as well as explain how the systems work together (or don’t) and recognize tradeoffs and physiological constraints. Shouldn’t this creative outlet that requires the highest level of Bloom’s taxonomy count as much towards their course grade as exams? What about all of the other work they do inside and outside of class?

 How did I intentionally redesign my course with strategies to promote student success?

Never having taught a course online before the spring 2020 semester and not being sure how to help students cope with additional stresses caused by the pandemic, I attended or participated in numerous webinars, such as the National Institute on Scientific Teaching SI Happy Hours (https://www.nisthub.org), the APS Institute on Teaching and Learning Virtual Week (https://www.physiology.org/detail/event/2020/06/22/default-calendar/institute-on-teaching-and-learning?SSO=Y), and the APS Webinar Series – Physiology Educators Community of Practice (https://www.physiology.org/detail/event/2020/07/23/default-calendar/physiology-educators-community-of-practice-webinar-series?SSO=Y). Support and resources from the Rice Center for Teaching Excellence (https://cte.rice.edu/preparing-for-spring-2021#resources) have been invaluable as I redesign my course.

In an article submitted to Inside Higher Ed about helping students in times of trauma (3), Mays Imad said,

As teachers, we don’t simply impart information. We need to cultivate spaces where students are empowered co-create meaning, purpose and knowledge — what I have termed a “learning sanctuary.” In such a sanctuary, the path to learning is cloaked with radical hospitality and paved with hope and moral imagination. And it is our connections, the community of the classroom and our sense of purpose that will illuminate that path.”

How can I create a “learning sanctuary” in my classroom environment? What approaches can I take to minimize stress and maximize engagement for students? Here are some strategies I’ve adopted for this upcoming semester to promote student success as we teach our animal physiology course fully online:

  • Shift weighting for assignment categories to an even distribution – exams are worth only 25%!
  • Further modify the exam format to decrease student anxiety and likelihood of cheating – all exams are open resources!
  • Incorporate new assignments to assess student learning – students write a mini review paper about their favorite vertebrate animal.

 How will I know if my students learned animal physiology?

Our overall course goal is “We aim to have you learn mechanisms by which animals solve day to day problems of staying alive; learn skills, strategies, and ways of thinking that are particularly relevant to the study of physiology; and perhaps most important of all, enjoy learning the marvelous phenomena of the animal world.” Throughout the course we strive to help our students learn, not just memorize a bunch of facts that they will forget as soon as they take an exam. In their final reflection about the course, we ask these questions:

1.       What impact has something you learned had on your own perceptions?

2.       What long-term implications did a specific discovery/piece of information have on you/on society?”

3.       What is one or more specific thing that you learned about animals this semester that you will never forget?

I love reading their reflections where they share what they learned in our course. Here are a few of my favorites from the spring 2020 semester:

  •        …This class totally changed my mindset. I’m glad it was animal examples, with maybe a handful of human connections, rather than human examples with animal connections. I think in my past reflections, I have said repeatedly my favorite part was the animal examples, whether it’s a specific example or the comparative examples. I think my very favorite animal we “did” this semester were the diving seals – every kid who has ever been on swim team always had those competitions to see who could hold their breath the longest and the seals were an interesting callback to that. But even before that, I think I learned new information about how animals lived and worked each and every week of this class. Just ask my friends: every week, I’d be sharing some interesting fact from “animal class,” like the reindeer eyes… I now have learned a lot more about animals and have a greater appreciation for them as they compete to survive in their own circumstances. I can safely say I haven’t been this passionate about animals since I was little, going through my “animals” phase, and am hoping to keep this excitement and stay a lifelong learner about different animals and how special they are!
  •         …My perceptions of the importance and complexity of different organisms in physiology has been strongly shifted by this class. I’ve gained an appreciation of different animal systems as they function in different kinds of vertebrates. While I previously had a more human-centric view of physiology from taking the MCAT, I am glad I was able to broaden my perspective to learn more about the different tricks and systems animals employ to suit themselves to their environments…
  •       …It was cool to see the adaptions that different species of animals have to cope in their environment. Some of them seemed so wild, like being able to change how blood flows through your heart, or lungs collapsing in diving mammals. Even mammalian life on our own planet can seem so alien at times. Most of us are familiar with how the human body works, at least in broad strokes, but there are so many other ways to live…
  •       …when you understand how an animal works. When you understand why they do what they do and why they look the way they look, a lot of fear and misunderstanding melts away. It not only cultivates a sense of amazement but also one of understanding and respect.

Even in the midst of a pandemic, I feel confident that my students not only learned physiology but also gained an appreciation for the importance of studying animal physiology. After taking this course, most if not all of them would agree with me that “Animals are Amazing!” And that is what I really want my students to learn about animal physiology.

NOTE: All protocols were approved by the Institutional Review Board of Rice University (Protocol FY2017-294).

References

1.       Blatch S, Cliff W, Beason-Abmayr B, Halpin P. The Fictional Animal Project: A Tool for Helping Students Integrate Body Systems. Adv Physiol Educ 41: 239-243m 2017; doi: 10.1152/advan.00159.2016.

2.       Gopalan C. Effect of flipped teaching on student performance and perceptions in an Introductory Physiology course. Adv Physiol Educ 43: 28–33, 2019; doi:10.1152/advan.00051.2018.

3.       Imad M. Seven recommendations for helping students thrive in times of trauma. INSIDE HIGHER ED, June 3, 2020; https://www.insidehighered.com/advice/2020/06/03/seven-recommendations-helping-students-thrive-times-trauma.

4.       McLean S, Attardi SM, Faden L, Goldszmidt M. Flipped classrooms and student learning: not just surface gains. Adv Physiol Educ 40, 47-55, 2016; doi:10.1152/advan.00098.2015.

Beth Beason-Abmayr, PhD, is a teaching professor of biosciences at Rice University in Houston, TX, and a faculty fellow of the Rice Center for Teaching Excellence. She has developed multiple course-based undergraduate research experiences and a student-centered integrative animal physiology course. Beason-Abmayr is a longtime judge for the International Genetically Engineered Machine (iGEM) competition and a member of the iGEM Executive Judging Committee. She is a past recipient of the George R. Brown Award for Superior Teaching and the Teaching Award for Excellence in Inquiry-Based Learning at Rice and has published in Advances in Physiology Education and the Journal of Microbiology & Biology Education. A National Academies Education Mentor in the Life Sciences, Beason-Abmayr is chair of the Organizing Committee of the American Physiological Society’s 2022 Institute of Teaching and Learning and is an associate editor for Advances in Physiology Education. She earned her PhD in physiology and biophysics at The University of Alabama at Birmingham.

 

 

 

 

Protecting yourself means more than a mask; should classes be moved outside?
Mari K. Hopper, PhD
Associate Dean for Biomedical Science
Sam Houston State University College of Osteopathic Medicine

Disruption sparks creativity and innovation. For example, in hopes of curbing viral spread by moving classroom instruction outdoors, one Texas University recently purchased “circus tents” to use as temporary outdoor classrooms.

Although circus tents may be a creative solution… solving one problem may inadvertently create another. Moving events outdoors may be effective in reducing viral spread, but it also increases the skin’s exposure to harmful ultraviolet (UV) radiation from the sun. The skin, our body’s largest organ by weight, is vulnerable to injury. For the skin to remain effective in its role of protecting us from pollutants, microbes, and excessive fluid loss – we must protect it.

It is well known that UV radiation, including UVA and UVB, has deleterious effects including sunburn, premature wrinkling and age spots, and most importantly an increased risk of developing skin cancer.

Although most of the solar radiation passing through the earth’s atmosphere is UVA, both UVA and UVB cause damage. This damage includes disruption of DNA resulting in the formation of dimers and generation of a DNA repair response. This response may include apoptosis of cells and the release of a number of inflammatory markers such as prostaglandins, histamine, reactive oxygen species, and bradykinin. This classic inflammatory response promotes vasodilation, edema, and the red, hot, and painful condition we refer to as “sun burn.”1,2

Prevention of sunburn is relatively easy and inexpensive. Best practice is to apply broad spectrum sunscreen (blocks both UVA and UVB) 30 minutes before exposure, and reapply every 90 minutes. Most dermatologists recommend using SPF (sun protection factor) of at least 30. Generally speaking, an SPF of 30 will prevent redness for approximately 30 times longer than without the sunscreen. An important point is that the sunscreen must be reapplied to maintain its protection.

There are two basic formulations for sunscreen:  chemical and physical. Chemical formulations are designed to be easier to rub into the skin. Chemical sunscreens act similar to a sponge as they “absorb” UV radiation and initiate a chemical reaction which transforms energy from UV rays into heat. Heat generated is then released from the skin.3  This type of sunscreen product typically contains one or more of the following active ingredient organic compounds: oxybenzone, avobenzone, octisalate, octocrylene, homosalate, and octinoxate. Physical sunscreens work by acting as a shield. This type of sunscreen sits on the surface of the skin and deflects the UV rays. Active ingredients zinc oxide and/or titanium dioxide act in this way.4  It’s interesting to note that some sunscreens include an expiration date – and others do not. It is reassuring that the FDA requires sunscreen to retain their original “strength” for three or more years.

In addition to sunscreen, clothing is effective in blocking UV skin exposure. Darker fabrics with denser weaves are effective, and so too are today’s specially designed fabrics. These special fabrics are tested in the laboratory to determine the ultraviolet protection factor (UPF) which is similar to SPF for sunscreen.  A fabric must carry a UPF rating of at least 30 to qualify for the Skin Cancer Foundation’s Seal of Recommendation. A UPF of 50 allows just 1/50th of the UV rays to penetrate (effectively blocking 98%). Some articles of clothing are produced with a finish that will wash out over time. Other fabrics have inherent properties that block UV rays and remain relatively unchanged due to washing (some loss of protection over time is unavoidable) – be careful to read the clothing label.

Some individuals prefer relying on protective clothing instead of sunscreen due to concerns about vitamin D synthesis. Vitamin D activation in the body includes an important chemical conversion stimulated by UV exposure in the skin – and there is concern that sunscreen interferes with this conversion. However, several studies, including a recent review by Neale, et al., concluded that use of sunscreen in natural conditions is NOT associated with vitamin D deficiency.5,6 The authors did go on to note that at the time of publication, they could not find trials testing the high SPF sunscreens that are widely available today (current products available for purchase include SPFs over 100).

Additional concern about use of sunscreens includes systemic absorption of potentially toxic chemicals found in sunscreen. A recent randomized clinical trial conducted by Matta and colleagues investigated the systemic absorption and pharmacokinetics of six active sunscreen ingredients under single and maximal use conditions. Seven Product formulations included lotion, aerosol spray, non-aerosol spray, and pump spray. Their study found that in response to repeat application over 75% of the body surface area, all 6 of the tested active ingredients were absorbed systemically. In this study, plasma concentrations surpassed the current FDA threshold for potentially waiving some of the additional safety studies for sunscreen. The authors went on to note that the data is difficult to translate to common use and further studies are needed. It is important to note that the authors also conclude that due to associated risk for development of skin cancer, we should continue to use sunscreen.

Yet another concern for using sunscreen is the potential for harmful environmental and human health impact. Sunscreen products that include organic UV filters have been implicated in adverse reactions in coral and fish, allergic reactions, and possible endocrine disruption.8,9 In some areas, specific sunscreen products are now being banned (for example, beginning January of 2021, Hawaii will ban products that include oxybenzone and octinoxate). As there are alternatives to the use of various organic compounds, there is a need to continue to monitor and weigh the benefit verses the potential negative effects.

Although the use of sunscreen is being questioned, there is the potential for a decline in use to be associated with an increase in skin cancer. Skin cancer, although on the decline in recent years, is the most common type of cancer in the U.S. It is estimated that more than 3 million people in the United States are diagnosed with skin cancers each year (cancer.net). Although this is fewer than the current number of Americans diagnosed with COVID-19 (Centers for Disease Control and Prevention, July 20, 2020) – changes in human behavior during the pandemic (spending more time outdoors) may inadvertently result in an increase in the number of skin cancer cases in future years.  

While we responsibly counter the impact of COVID-19 by wearing masks, socially distancing, and congregating outdoors – we must also continue to protect ourselves from damaging effects of the sun. As physiologists, we are called upon to continue to investigate the physiological impacts of various sunscreen delivery modes (lotion, aerosol, non-aerosol spray, and pumps) and SPF formulations. We are also challenged to investigate inadvertent and potentially negative impacts of sunscreen including altered Vitamin D metabolism, systemic absorption of organic chemicals, and potentially adverse environmental and health outcomes.

Again, solving one problem may create another challenge – the work of a physiologist is never done!

Stay safe friends!

Mari

References:

  1. Lopes DM, McMahon SB. Ultraviolet radiation on the skin: a painful experience? CNS neuroscience & therapeutics. 2016;22(2):118-126.
  2. Dawes JM, Calvo M, Perkins JR, et al. CXCL5 mediates UVB irradiation–induced pain. Science translational medicine. 2011;3(90):90ra60-90ra60.
  3. Kimbrough DR. The photochemistry of sunscreens. Journal of chemical education. 1997;74(1):51.
  4. Tsuzuki T, Nearn M, Trotter G. Substantially visibly transparent topical physical sunscreen formulation. In: Google Patents; 2003.
  5. Passeron T, Bouillon R, Callender V, et al. Sunscreen photoprotection and vitamin D status. British Journal of Dermatology. 2019;181(5):916-931.
  6. Neale RE, Khan SR, Lucas RM, Waterhouse M, Whiteman DC, Olsen CM. The effect of sunscreen on vitamin D: a review. British Journal of Dermatology. 2019;181(5):907-915.
  7. Matta MK, Florian J, Zusterzeel R, et al. Effect of sunscreen application on plasma concentration of sunscreen active ingredients: a randomized clinical trial. Jama. 2020;323(3):256-267.
  8. Schneider SL, Lim HW. Review of environmental effects of oxybenzone and other sunscreen active ingredients. Journal of the American Academy of Dermatology. 2019;80(1):266-271.
  9. DiNardo JC, Downs CA. Dermatological and environmental toxicological impact of the sunscreen ingredient oxybenzone/benzophenone‐3. Journal of cosmetic dermatology. 2018;17(1):15-19.

    All images from:
    Royalty Free Stock Pictures – Public Domain Images
    www.dreamstime.com/

Prior to accepting the Dean’s positon at Sam Houston State University, Dr Hopper taught physiology and served as the Director of Student Research and Scholarly Work at Indiana University School of Medicine (IUSM). Dr Hopper earned tenure at IUSM and was twice awarded the Trustees Teaching Award. Based on her experience in developing curriculum, addressing accreditation and teaching and mentoring of medical students, she was selected to help build a new program of Osteopathic Medicine at SHSU. Active in a number of professional organizations, Dr. Hopper is past chair of the Chapter Advisory Council Chair for the American Physiological Society, the HAPS Conference Site Selection Committee, and Past-President of the Indiana Physiological Society.

Balancing Coursework, Student Engagement, and Time
Jennifer Rogers, PhD, ACSM EP-C, EIM-2
Associate Professor of Instruction
Director, Human Physiology Undergraduate Curriculum
Department of Health and Human Physiology
University of Iowa

First, a true story. Years ago, when my son was very little, he and his preschool friends invented a game called “What’s In Nick’s Pocket?” Every day before leaving for school my son would select a small treasure to tuck into his pocket.  The other 3- and 4- year olds at school would crowd around and give excited “oooh’s” and “aaah’s” as he presented his offering, which had been carefully selected to delight and amaze his friends.  And so it is with the PECOP blog forum—as each new post arrives in my inbox I wonder with anticipation what educational gem has been mindfully curated by colleagues to share with the PECOP community.

My contribution? Thoughts on the balance between coursework, student engagement, and time.  Student engagement in this context refers to a wide range of activities that exist outside of the traditional classroom that offer valuable opportunities for career exploration and development of professional skills.  Examples include:

  • Internships: either for course credit or independently to gain experience within a particular setting
  • Study Abroad opportunities
  • Participation in a student organization
  • Peer tutor/mentoring programs
  • Research: either as a course-based opportunity or as a lab assistant in a PI’s lab (paid or unpaid)
  • Job experiences: for example, as a certified nursing assistant, medical transcriptionist, emergency medical technician
  • Volunteer and community outreach experiences
  • Job shadowing/clinical observational hours

These are all increasingly popular co-curricular activities that allow students to apply concepts from physiology coursework to real-world scenarios as an important stepping stone to enhance career readiness and often personal development.  At the same time, however, students seem to more frequently communicate that they experience stress, anxiety, and concerns that they “are not at their best,” in part due to balancing coursework demands against time demands for other aspects of their lives.  If you are interested in learning more about the health behaviors and perceptions of college students, one resource is the American College Health Association-National College Health Assessment II (ACHA-NCHA II) Undergraduate Student Reference Group Data Report Fall 2018 (1).  Relevant to this blog, over half of the undergraduates surveyed (57% of 11,107 participants) reported feeling overwhelmed by all they had to do within the past two weeks.

I recently gave an undergraduate physiology education presentation that included this slide.  It was an initial attempt to reconcile how my course, Human Physiology with Lab, (a “time intensive course” I am told), fits within the context of the undergraduate experience.

I was genuinely surprised by the number of undergraduates in the audience who approached me afterward to essentially say “Thank you for recognizing what it feels like to walk in my shoes, it doesn’t seem like [my professors, my PI, my parents] understand the pressure I feel. “

In response, and prior to the changes in higher education following COVID-19, I began to ponder how to balance the necessary disciplinary learning provided by formal physiology coursework and participation in also-valuable experiential opportunities.  The Spring 2020 transition to virtual learning, and planning for academic delivery for Fall 2020 (and beyond), has increased the urgency to revisit these aspects of undergraduate physiology education.  As PECOP bloggers and others have mentioned, this is a significant opportunity to redefine how and what we teach. 

It has been somewhat challenging to me to consider how to restructure my course, specifically the physiology labs, in the post COVID-19 era when lab activities need to be adaptable to either in-person or virtual completion.  My totally-unscientific process to identify areas for change has been the “3-R’s” test. With regard to physiology lab, there may be many important learning objectives:

  • An ability to apply the scientific method to draw conclusions about physiological function
  • The act of collecting data and best practices associated with collection of high-quality data (identification of control variables, volunteer preparation/preparation of the sample prior to testing, knowledge of how to use equipment)
  • Application of basic statistical analyses or qualitative analysis techniques
  • Critical thought and quantitative reasoning to evaluate data
  • How to work collaboratively with others, that may be transferrable to future occupational settings: patients, clients, colleagues
  • Information literacy and how to read and interpret information coming from multiple resources such as scientific journals, online resources, advertisements, and others, and
  • Science communication/the ability to communicate information about human function, in the form of individual or group presentations, written lab reports, poster presentations, formal papers, infographics, mock patient interactions, etc.

Arguably, these are all important lab objectives.  Really important, in fact.

So, what is the 3 R’s test, and how might it help?  The 3 R’s is simply my way of prioritizing.  In order to triage lab objectives, I ask myself: What is Really Important for students to master throughout the semester versus what is Really, Really Important, or even Really, Really, REALLY Important?  For example, if I can only designate one activity that is Really, Really, REALLY Important, which one would it be?  The answer for my particular course is science communication.  It is obviously a matter of semantics, but I like being able to justify that all course activities are still Really Important, even if it is only my inner dialogue.  Going into the unknowns of the Fall semester, this will help me guide how course activities in physiology lab are transformed. 

Another worthy goal, in light of academic stress and allocation of effort for maximum benefit, is to improve the transparency of expectations for students.  A common question that arose during the spring semester was if students would still learn what they needed to in preparation for future coursework or post-graduation opportunities.  The identification of one or two primary learning outcomes (the Really, Really, REALLY important ones) may attenuate feeling overwhelmed by a long list of lab-related skills to master if there is another abrupt shift to virtual instruction mid-semester; course objectives can still be met even if we discontinue in-person lab sessions. 

To return to the original topic of balancing time demands allocated to formal coursework and valuable experiences, the two broad conclusions I have reached fall under the categories what I can do in my own courses and suggestions for conversations to be had at the program level.

In My Courses: COVID-19 has sped up the time course for revisions I had already been considering implementing in physiology labs.  Aligning course activities with what is Really, Really, REALLY important will help me manage preparation efforts for the coming fall semester (and hopefully keep my stress levels manageable).  Another important goal is to improve the transparency of course goals for students, ideally alleviating at least a portion of their course-induced stress through improved allocation of effort.  Ultimately, I hope the lab redesigns reinforce physiology content knowledge AND provide relevant experiences to promote career readiness.  *It is also necessary to emphasize to students that both will require focused time and effort.

At the Program Level:  Earning a degree in physiology is not based on acquired knowledge and skills in a single course, rather it is an end-product of efforts across a range of courses completed across an academic program.  Here are some ideas for program-wide discussion:

  • Faculty should identify the most important course outcome for their respective courses, and we should all meet to talk about it. Distribute program outcomes throughout the courses across the breadth of the program.  (Yes, this is backward design applied to curriculum mapping.)  From the faculty perspective, perhaps this will reduce feeling the need to teach all aspects of physiology within a particular course and instead keep content to a manageable level.  From the student perspective, clear communication of course objectives, in light of content presented within any particular course, may promote “buy in” of effort.  It may also build an awareness that efforts both inside and outside of the classroom are valuable if the specific body of content knowledge and aptitudes developed across the curriculum, relevant for future occupational goals, is tangibly visible.
  • Review experiential/applied learning opportunities. Are there a sufficient number of opportunities embedded within program coursework?  If not, are there other mechanisms available to students, for example opportunities through a Career Center or other institution-specific entities?  Establishing defined pathways for participation may reduce student stress related to not knowing how to find opportunities.  Another option would be to consider whether or not the program would benefit from a career exploration/professional skills development course.  Alternatively, could modules be developed and incorporated into already existing courses? 
  • Lastly, communicate with students the importance of engaging in co-curricular activities that are meaningful to them; this is more important than the number of activities completed. Time is a fixed quantity and must be balanced between competing demands based on personal priorities. 

As we consider course delivery for Fall 2020, the majority of us are reconsidering how we teach our own courses.  There are also likely ongoing conversations with colleagues about plans to navigate coursework in the upcoming semesters.  If everything is changing anyway, why not take a few minutes to share what is Really, Really, REALLY important in your courses?  The result could be an improved undergraduate experience related to balancing the time and effort allocations required for success in the classroom along with opportunities for participation in meaningful experiences.

Reference:

1. American College Health Association. American College Health Association-National College Health Assessment II: Undergraduate Student Reference Group Data Report Fall 2018. Silver Spring, MD: American College Health Association; 2018.

Jennifer Rogers completed her PhD and post-doctoral training at The University of Iowa (Exercise Science).  She has taught at numerous institutions ranging across the community college, 4-year college, and university- level higher education spectrum.  Jennifer’s courses have ranged from small, medium, and large (300+ students) lecture courses, also online, blended, and one-course-at-a-time course delivery formats.  She routinely incorporates web-based learning activities, lecture recordings, and other in-class interactive activities into class structure.  Jennifer’s primary teaching interests center around student readiness for learning, qualitative and quantitative evaluation of teaching strategies, and assessing student perceptions of the learning process.

Teaching an Integrated Human Anatomy and Physiology Course: Additional Lessons Learned and Online Course Adjustments
Jennifer Ann Stokes, PhD
Assistant Professor of Kinesiology
Southwestern University

In my previous blog post, I outlined the lessons learned in my first run teaching a year-long integrated upper-division human anatomy and physiology course. It has been about a year and a half since the original post and after having taught the course for a second time I will review and add to my list of initial lessons learned. Additionally, this spring semester brought new challenges with a very swift move to online coursework due to COVID-19, so I will also comment on the resulting course alterations. As a reminder, this course sequence (A&P I and II) is an upper-division junior and senior level course at my college and class sizes are very small (20-24 students) allowing for maximum time for interaction, questions, and instructor guidance both in lecture and lab.

First, I will review the previous lessons learned and add additional commentary based on what I learned in my second year. If you haven’t yet, I would check out the previous blog for the initial notes.

1) Use an integrative textbook.

My textbook of choice is still Physiology: An Integrated Approach by Dee U. Silverthorn. For anatomy, I continued to supplement the anatomy information, such as the specifics of the skeletal system and joints, muscles, histology, etc., through the use of models and other reference material in hands-on lab activities. One addition made in the second year was the use of AD Instrument’s Lt online learning platform.  I discuss the addition of Lt in more detail later in this post, but I think it is important to note here too since the Lt lessons directly complemented the textbook material and helped bridge the gap between lecture and lab for the students.

2) Start building and assessing students’ A&P knowledge from the ground up, and build incrementally.

Laying the foundation for the core concepts is critical to the student’s understanding, application, and mastery of the complex integrative content that this course builds. I took this foundation building more seriously the second time around and, in the end, I did not have to spend more time on the basic content but instead I provided more formative assessment opportunities. This helped the students who did not have as strong a background or understanding of the basic material to recognize that they needed additional assistance. In addition to the weekly homework assignments which were graded for completion only, I added weekly low-stake quizzes using our learning management system (LMS). At first I thought the students would dislike the extra work, but an end-of-the-year survey indicated that they appreciated the extra practice and that the quizzes helped them feel better prepared for the exams.

3) Create a detailed course outline, and then be prepared to change it.

This lesson holds true for just about any course, but I found it especially true for an integrated A&P course – even when teaching it a second time. And it is even more important when you have to switch to online delivery. In the second year, I learned to appreciate that no two cohorts of students are the same and what took the previous cohort a day to master took the next cohort up to two days in some cases. Having the “flex days” at the end of each section was crucial for concept review and content integration. These are days where no new content is introduced, but instead we review and practice together.

4) Constantly remind your students of the new course format.

I cannot emphasize this enough: students will want to revert back to what they are comfortable with and what has worked for them in the past. I constantly remind students that their “cram and forget” method will not serve them well in this course and provide them with ample opportunity to practice this both on the formative and summative assessments. In the second year I continued the individual meetings with each student after their first exam to discuss study strategies and new ways to approach this material, but I also implemented additional check-ins throughout the year particularly with those students who were struggling. I continued to remind the students that the course content not only builds throughout the entire semester but also the entire year! I hammered this point home a bit more with the addition of “retention” quizzes which were delivered unannounced throughout the year and tested major core concepts and application.

5) Solicit student feedback.

Students can be brutally honest, so use that to your advantage. A lot of the new things I added in my second year teaching this course came from the first year-student feedback. I send out my own surveys with specific questions throughout the year which the students fill out anonymously. I find that students are happy to help, especially when they can see a course alteration mid-semester which was based on their feedback.

6) Be prepared to spend a lot of time with students outside of the classroom.

Still very true, but that’s probably my favorite part of this job. Even when we switched to online course delivery the virtual office hours were busy and students took advantage of the extra review and time to ask questions. 

In this second section, I will add additional lessons learned in my second year of teaching this course and comment on the changes made when the course moved online mid-way through the second semester.  

7) Over-communication.

One of the things I am known for with my students is consistent and clear communication, probably to the point of over-communication. I also emphasize that communication is a two-way street, so just as I am constantly communicating information to them, I expect them to do the same to me, including any accommodations, sports travel, or general course questions. I model this behavior with regular use of our LMS announcement page and I use the start of each class to review important deadlines and open the floor for questions. The move to online instruction only made this over-communication even more important. Early on in the transition period I checked in often to let them know the new plan and opened discussion pages to allow them to ask questions and express any concerns. I checked in multiple times a day using the LMS announcement page, posted a “live” course schedule and tables of new homework and quiz due dates all in one central location, and I added silly memes to the discussion boards to up engagement. I also added resource pages on the basics of Zoom and how to be an online student since this was very new territory for them (and me). Looking back this was a lot of information that was constructed and disseminated very quickly, but an end-of-the-year survey indicated they appreciated the information and that it told them that I was prepared and willing to help them during the transition.

8) More assessments. More practice. More activity.

In my second year, I assigned more practice problems from the textbook to help the students prepare for the exams and held problem sessions outside of class for review. This additional time and practice was well received even when it was a greater time commitment for the students. With the move to online instruction I was thankful that I had already established a fairly homework-heavy course as these assignments became even more important. The assigned “lecture” time was switched to virtual problem solving sessions and the course moved even more toward a flipped-classroom model. Since the switch to online occurred after I had already built a pretty solid reputation with this class (about a semester and a half) they were used to reading and problem solving before class, even if that class was now online. All homework and quizzes moved online which allowed for quicker feedback to the students on their progress and, thus, more time for questions before the exams. The switch to fully online homework and quizzes I plan to keep even when the course moves back to in-person as the quick feedback for the students and less time spent hand-grading by me is worth the extra time it takes to set-up the online modules.

9) Utilization of LMS Discussion Forums.

Honestly, the use of the LMS discussion forums did not start until the course moved online, but their quick success made me question why I had not taken advantage of this tool earlier. When the course moved online I added discussion pages with titles such as “What is going on?!? General course questions.” and “What I am most nervous about with the course moving online is…” The goal was to provide an outlet for students to ask questions and share their concerns. I always started the discussion myself, giving them a sort of “jumping off” point and an example. These discussion pages were utilized by almost all members of the course and were rated very highly in the end. Students could comment any time of day enhancing the accessibility of the discussion. I will modify these to be used in my courses moving forward for both in-person and online courses.

10) Online presence for both lecture and lab.

I actually increased my A&P online presence prior to the mandatory switch to online coursework with the implementation of AD Instruments Lt learning platform in the fall semester. My students received free access to both the anatomy and physiology modules thanks to an award from the American Physiological Society. The Teaching Career Enhancement Award supported a year-long study assessing the use of the ADInstruments Lt learning platform and its interactive and immersive lessons aimed at enhancing knowledge, retention, and practical application of the integrative course content. The Lt platform was fully customized to the course material and was used both in the lecture classroom and in the lab. In the lab, students were able to interact with a data acquisition system that is more “game-like” and familiar, while still collecting high-level human physiology data. Lt also allowed for the creation of new lessons that engaged students with the use of embedded questions in multiple formats, including drag-and-drop labeling, drawing, short answers, and completion of tables. These lessons were used in many ways: for pre-lab preparation, in-lab and post-lab assessment, and for active learning activities in the classroom. Lessons were completed individually or in small groups, and questions were set up with hints, immediate feedback, multiple tries, and/or automatic grading.

These modules were also incorporated in the active-learning lecture component of the course, providing additional exposure and practice with the content. The Lt lessons directly complemented the textbook material and helped bridge the gap between lecture and lab for the students. When the course moved fully online I was incredibly thankful that Lt was already in use in my course and that the students were already comfortable and familiar with the platform. I used Lt exclusively for the online labs and supplemental lecture content for the remainder of the spring semester. Just as before, the lessons and modules were customized by me to fit my course learning objectives and prepare the students for their new online assessments. Students could complete the online coursework at their leisure and stop by the virtual office hours for help or post questions on the discussion boards for feedback. Student feedback indicated that the addition of Lt to this course enhanced accessibility of the course content, provided extra practice and exposure to the material, and overall was rated highly by the students.  

And just as I did before, now I turn the conversation over to the MANY seasoned educators who read this blog. What did you learn in your quick move to online coursework? Did you implement any new pedagogical tools which you will continue to use even with in-person instruction? Please share!

Jennifer Ann Stokes is a soon-to-be Assistant Professor of Kinesiology at Southwestern University in Georgetown, TX, after spending the last three years at Centenary College of Louisiana. Jennifer received her PhD in Biomedical Sciences from the University of California, San Diego (UCSD) and following a Postdoctoral Fellowship in respiratory physiology at UCSD, Jennifer spent a year at Beloit College (Beloit, WI) as a Visiting Assistant Professor of Biology to expand her teaching background and pursue a teaching career at a primarily undergraduate institution. Jennifer’s courses include Human Anatomy and Physiology (using an integrative approach), Nutritional Physiology, Exercise Physiology, Medical Terminology, and Psychopharmacology. Jennifer is also actively engaged with undergraduates in basic science research (www.stokeslab.com) and in her free time enjoys cycling, hiking, and yoga.

A Sabbatical in Australia Cut Short and the Rapid Transition of Course Delivery of an Australian University due to the COVID-19 Global Pandemic
Emilio Badoer, PhD
Professor of Neuropharmacology
School of Health & Biomedical Science with the College of Science, Engineering & Health
Royal Melbourne Institute of Technology (RMIT) University, Bundoora (Melbourne, Victoria, Australia)

Patricia A. Halpin, PhD
Associate Professor of Biological Science and Biotechnology & Visiting Associate Professor at RMIT University
Department of Life Sciences, University of New Hampshire at Manchester (Manchester, NH)

I was thrilled to spend my sabbatical performing education research at RMIT University in Australia during the spring semester of 2020. I met my collaborator Emilio Badoer at the APS ITL in 2016 and at that time we vowed to collaborate someday. I had a smooth flight to Melbourne AU and as we left the airport, I got my first view of the city covered in a smoky haze from the bushfires to the north1. The radio broadcast playing on the car stereo was alerting everyone to the tropical cyclones headed for the east coast and these would soon cause massive flooding in New South Wales. “Welcome to Australia” Emilio said, little did we know at the time that the worst was yet to come. The COVID-19 outbreak in China had caused Australia to close its borders on February 12,3 to foreign nationals who had left or transited through mainland China.  I arrived February 9 and the focus of my attention was the excitement and anticipation of starting our two research projects.  At my small college, my courses usually enroll 10-24 students, at RMIT our first study was working with a large nursing class (n =368) with the primary goal of using Twitter to engage them outside of class with the course content. 

The nursing cohort started two weeks prior to the start of the term, and in the third week, the students went on clinical placements for five weeks. This course is team-taught and Emilio taught during the first two-week period so that content was the focus of our research for this study. We designed the study to collect data using paper surveys to be distributed at face-to-face class meetings at the beginning and end of the term to ensure a high rate of survey completion. The second study performed with his Pharmacology of Therapeutics class (n=140) started on March 2 with one face-to-face meeting followed by four weeks of flipped teaching (FT). During the FT period, we would engage them on Twitter with course content and they would meet during weekly face-to-face Lectorial sessions for review during the usual scheduled class time.  Students completed the paper pre-survey in the first class meeting and the scheduled paper post-surveys were to be distributed during the final Lectorial sessions on March 19 and 20.  Then on Monday March 16th everything changed; Victoria declared a state of emergency to combat the COVID-19 pandemic4 and Qantas announced that they would cancel 90% of their international flights5, with the remaining flights cancelled on March 31. 

I was contacted by friends and family back home urging me to come home right away. RMIT announced the decision that learning would go online starting March 23. In the United States, colleges had previously announced that students heading home for spring break should stay home as their classes would be delivered online due to the COVID-19 concerns 6. The faculty at the US schools had spring break to prepare the transition of their course content for the new delivery mode. At RMIT, they had recently started their semester with no spring break normally scheduled and the only break on the horizon was the distant Easter holiday (April 10-13) long weekend. Our hopes for data collection were quickly dashed as during the last Lectorial sessions only a few students attended, and we would not be able to survey the nursing students in person when they returned from placements.

My focus shifted to leaving the country as soon as possible. The only way to change my airline ticket home was through a travel agent and my personal travel agent spent a total of 11.5 h on hold with Qantas over a two-day period to secure my ticket home. I left Australia with hordes of anxious Americans. The airports were overwhelmed as we formed long lines trying to check in and then go through security. Everyone had a story to tell of how they had to cut their trip short and then changed their tickets. In Los Angeles I was joined by more Americans who were coming from New Zealand. Many of the American travelers were undergraduates very disappointed that their universities had called them home and they were leaving their semester abroad adventures. We would all soon arrive home safely to a country living in a new reality.

Meanwhile, in Australia, the situation at universities evolved rapidly. In line with the Australian Government mandate, students were told that all new arrivals into the country must self-isolate for 14 days effective March 16. Public gatherings of over 500 people were no longer allowed. Although universities were specifically exempt from this requirement, RMIT University proactively cancelled or postponed any events that were not related to the core business of learning, teaching and research. It also foreshadowed a progressive transition to lectures being delivered online where possible.  The University also indicated that students would not be disadvantaged if they chose not to attend face-to-face classes during the week of March 16. In response to the rapid changes occurring internationally, on March 20, the Australian Government restricted all non-Australian citizens and non-Australian residents from entering the country.  While Australian Universities could remain open and operating it was clear that this would not last for long 7. In response, RMIT University mandated that from Monday March 23 lectures were to be made available online but tutorials and seminars and non-specialist workshops could continue face-to-face until March 30.

On Sunday March 22 the State Government of Victoria (where the main RMIT University campus is based) mandated the shutdown of all non-essential activity from Tuesday March 24 to combat the spread of COVID-19 7. Immediately, RMIT University suspended all face-to-face learning and teaching activity on all its Australian campuses. Overnight, faculty became online teaching facilitators. Emilio produced and is continuing to produce new videos (15-30 minutes duration) covering the content normally delivered during the face-to-face large lecture session. Each week 3-5 videos are produced and uploaded onto Canvas (RMIT’s online learning management system) for the students. 

Unlike many of the US schools that are using Zoom, RMIT is using Collaborate Ultra within Canvas as its way of connecting with students on a weekly basis. Collaborate Ultra has the ability to create breakout groups and faculty can assign students to a specific breakout group or allow students to self-allocate to a specific breakout group. Emilio has allowed students to move between breakout groups to increase engagement. The only stipulation was to limit the group size usually to no more than six. Each student was originally registered to attend one small group Lectorial session that meets once per week for one hour and these groups have between 45-50 students each. The Lectorials were replaced by Collaborate Ultra sessions that were organized for the same times and dates as the normally scheduled small Lectorial sessions. The students and facilitators would all meet in the so-called “main room” where Emilio would outline the plans for the session. The main room session was conducted with Emilio’s video turned on so the students were ‘invited “into his home” and could feel connected with him. Dress code was also important. Emilio was conscious of wearing smart casual apparel as he would have worn had he been facing the students in a face-to-face session. In this way he attempted to simulate the normal pre-COVID-19 environment.

Following the introductory remarks outlining the tasks for the session, students were ‘sent’ to their breakout rooms to discuss and work on the first problem / task discussed in the main room. The analogy used by Emilio was that the breakout rooms were akin to the tables that were used in their collaborative teaching space in which he normally conducted the Lectorial sessions. Each table in that space accommodated approximately six students (hence the stipulation of no more than six in each breakout group). Emilio and another moderator ‘popped’ into each breakout room to guide and facilitate the students in their discussions. To date, the level of engagement and discussion amongst the students themselves generally appears to be much greater than that observed at face-to-face sessions which was a fantastic surprise. After a set time had elapsed, students re-assembled in the main room where the task was discussed with the whole class. This ensured that all students understood the requirements of the task and they had addressed all points that were needed to complete the task to the satisfactory standard. Next followed another task that differed from the first providing variety and maintaining the interest of the students.

Examples of tasks performed.

1 – Practice exam questions

A short answer question requiring a detailed response that would normally take at least 10 minutes in an exam environment to answer properly. Such questions were based on that week’s lecture (now video) course content and was contextualized in a scenario in which physiological/pathophysiological conditions were described and the pharmacological treatments needed to be discussed in terms of mechanisms of action, adverse effects, potential drug interactions or pharmacogenomic influences etc.

2 – Multiple choice questions – Quizzes

Emilio ran these using the Kahoot platform. By sharing his screen, Emilio could conduct such quizzes live providing instant feedback on student progress. This allowed Emilio to provide formative feedback, correct any misconceptions and discuss topics. Additionally, students were able to gauge their own learning progress. These tasks were performed in the main room with all participants.

3 – Completing sentences or matching answers

These could be done effectively in the breakout rooms, where a ‘lead’ student could utilize the whiteboard function in Collaborate Ultra which allowed all students in the group the opportunity to write on the whiteboard allowing discussion regarding the answers written.

4 – Filling in the gaps

Here Emilio would share his screen in which a diagram / figure / a schematic of a pathway etc. with labels/ information missing was provided and students were asked to screenshot the shared information. Then in breakout rooms, one student shared the captured screen shot with the group and the missing information was completed by the members of the group.

The Collaborate Ultra sessions were also utilized to provide students with a platform in which group work could be performed. With a lockdown in force and gatherings of groups forbidden, this utility was very important for enabling connection between students working on group projects. It also provided a sense of belonging within the student cohort.

In conclusion, with minimal preparation, a huge Australian University converted face-to-face teaching and learning to an online digital teaching and learning environment where working remotely was the new norm. It is almost inconceivable just a few short weeks ago that such a transformation could have happened in the timeframe that it did. It is a truly remarkable achievement.  

References

1 Alexander, H and Moir N. (December 20, 2019). ‘The monster’: a short history of Australia’s biggest forest fire. Sydney Morning Herald Retrieved on April 10, 2020 from https://www.smh.com.au/national/nsw/the-monster-a-short-history-of-australia-s-biggest-forest-fire-20191218-p53l4y.html

2 Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV) (Jan. 30, 2020). Retrieved on April 10, 2020 from https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov)

3 Travel Restrictions on China Due to COVID-19 (April 6, 2020). Retrieved on April 10, 2020 from https://www.thinkglobalhealth.org/article/travel-restrictions-china-due-covid-19

4 Premier of Victoria, State of Emergency Declared in Victoria Over COVID-19. (March 16, 2020) Retrieved on April 10, 2020 from https://www.premier.vic.gov.au/state-of-emergency-declared-in-victoria-over-covid-19/

5 Qantas and Jetstar slash 90 per cent of international flights due to corona virus (March 16, 2020). Retrieved on April 10, 2020 from https://www.abc.net.au/news/2020-03-17/qantas-coronavirus-cuts-capacity-by-90-per-cent/12062328

6 Hartocollis A. (March 11, 2020). ‘An Eviction Notice’: Chaos After Colleges Tell Students to Stay Away. The New York Times. Retrieved on April 10, 2020 from  https://www.nytimes.com/2020/03/11/us/colleges-cancel-classes-coronavirus.html

7 Worthington B (March 22, 2020). Coronavirus crackdown to force mass closures of pubs, clubs, churches and indoor sporting venues. Retrieved on April 10, 2020 from https://www.abc.net.au/news/2020-03-22/major-coronavirus-crackdown-to-close-churches-pubs-clubs/12079610

Professor Badoer has held numerous teaching and learning leadership roles including many years as the Program Coordinator for the undergraduate Pharmaceutical Sciences Program at RMIT University in Bundoora AU and he coordinates several courses. He is an innovative instructor that enjoys the interactions with students and teaching scholarship. He has also taught pharmacology and physiology at Melbourne and Monash Universities. In addition, he supervises several postgraduate students, Honours students and Postdoctoral Fellows.

Patricia A. Halpin is an Associate Professor in the Life Sciences Department at the University of New Hampshire at Manchester (UNHM). Patricia received her MS and Ph.D. in Physiology at the University of Connecticut. She completed a postdoctoral fellowship at Dartmouth Medical School. After completion of her postdoc she started a family and taught as an adjunct at several NH colleges. She then became a Lecturer at UNHM before becoming an Assistant Professor. She teaches Principles of Biology, Endocrinology, Cell Biology, Animal Physiology, Global Science Explorations and Senior Seminar to undergraduates. She has been a member of APS since 1994 and is currently on the APS Education committee and is active in the Teaching Section. She has participated in Physiology Understanding (PhUn) week at the elementary school level in the US and Australia. She has presented her work on PhUn week, Using Twitter for Science Discussions, and Embedding Professional Skills into Science curriculum at the Experimental Biology meeting and the APS Institute on Teaching and Learning.