Category Archives: Course Design

Achieving Small Goals Can Lead to Bigger Changes Than You Might Expect

I started writing this blog with the intention to talk about the undergraduate physiology course I revamped this semester. Don’t worry, I still plan to talk about it because it is a fantastic course. However, since this blog is set to be posted around December 31st, I thought I might start off by reflecting on my past year. If you learn anything from my journey, I hope it’s that even achieving small goals can lead to bigger changes than you might expect.

 

To begin this year, my goal was to attend Experimental Biology (EB). It was one of my favorite conferences to attend as a graduate student and postdoc, but I hadn’t gone since becoming faculty (4yrs). In late 2021, I became acquainted with how helpful the Teaching Section for APS could be for my career as a physiology educator. I thought attending EB would be a good way to network and get new ideas for my courses. Being Non-Tenure track faculty, with 100% teaching effort, I don’t have grants to fund my travel. So, I depend on my department for support. I was a bit scared to ask, but looking back, I don’t know why. I’m not sure if anyone else fears asking their department for travel funds. I guess I didn’t want to be a burden during tight financial times, but my goal was to go to EB, so asking was one very small step. Just a quick email:

Hi Charlie,

I was wondering if I could go to EB this year to learn from the other physiology educators. Is there money in the department’s budget for travel for me?

-Erin

With an even quicker reply:

Yes indeed.

And that was that! So stinking easy! Goal achieved! ✅

Now, I wouldn’t make a big deal about setting small goals leading to bigger changes, if that was the end of the great things 2022 had to offer. No, that was just the beginning. Going to EB set off what seemed to be a rocket-ship of networking that led to an incredible opportunity. The PrEP-E Fellowship. PrEP-E stands for Preparing Effective Physiology Educators. This incredible fellowship is an APS Professional Skills Training Course. Before going to EB, I didn’t even know it existed, let alone that I was the target audience for the course. As a Lecturer who has not yet been promoted, I am still considered a trainee for our section. I had no idea! So many of the wonderful members of the teaching section encouraged me to apply. I had just met them, and they made me feel like I could do anything! I’m not sure I’ve ever felt so welcomed by so many people in such a short amount of time. I am forever grateful (I’m not crying…I swear).  Anyway, as soon as I got back to Florida, I applied. Then I got the notification a month later that I was awarded the fellowship! I couldn’t believe it! I was so proud. It felt like it all happened so fast! This amazing fellowship connected me with peers who are also at the beginning stages of their careers and building incredible courses all over the country. I was also given a mentor, Dr. Lisa Anderson. She gave me career advice specific to teaching faculty. We discussed my Teaching Philosophy, DEI statements (an interesting thing to navigate in Fl, at the time, and another story all together), and my Tenure and Promotion Packet. We began planning an education research project together. The switch from bench science to education research was a difficult transition for me. I honestly didn’t know where to start. Having a mentor to guide me was comforting. Just knowing that you are supported, and you have someone who understands what you are trying to accomplish, can have a major impact on your work. I am so grateful for Lisa and her mentorship.

Additionally, as part of the PrEP-E course, I attended my first Institute on Teaching and Learning (ITL). It was a wonderfully overwhelming experience. I met more physiology educators with similar goals as mine. We all want to make the learning environment for our students robust, engaging, inclusive and equitable. ITL gave us tools to implement these goals. I used these tools when remodeling my advanced undergraduate level physiology course: Human Physiology in Translation. Dr. Kayon Murray-Johnson gave us tools to consider when focusing on race and equity in the classroom (1). Dr. Katelyn Cooper encouraged us to consider how active learning might affect students of the LGBTQ+ community, or those dealing with depression/anxiety, or who may have learning or physical disabilities (2). Both of these extraordinary women showed me that if I can be more open with my students and show compassion when they need it, they might feel more comfortable in my classroom, and thus be more open to learning. I like to think that I made steps in the right direction this semester. While creating the syllabus, I made sure to include a diversity, equity and inclusion (DEI) statement for the first time. On the first day of class, I took the time to get to know my students and asked what was important to them as members of a team. I used their suggestions to create a Rubric they would use for peer grading. This set the tone for the year. The students wanted an equitable and inclusive classroom, and I assured them I would provide that space for them.

 

In addition to a more inclusive and equitable classroom, I was also inspired by my fellow educators to create a more engaging classroom. For years, my course has been a series of didactic lectures taught by a team of professors from our department in four self-contained modules: Endocrinology, Neural and Muscle Physiology, Cardiovascular and Renal Physiology, and Respiratory and Circadian Rhythms. At the end of each module students took a multiple-choice exam, with these 4 exams being the sole assessments for the year. During the 1st year of COVID (2020), I added discussions as a participation grade, which worked when we were fully online. However, when we went to a hybrid classroom in 2021, students mostly posted responses online, and only a few showed up in person. It seemed like a waste of time for the professors to come and sit in a mostly empty room, while I tried to spark some kind of discussion. It was boring and awkward for everyone involved. I knew I needed to change the set up. I wanted a flipped classroom, I just needed to figure out how to engage students better in person.

At ITL, an abstract titled, “Using the ‘flipped classroom’ to promote equity in undergraduate biology courses,” from Drs. Marisol Lopez and Donika Rakacolli gave me the push I needed. I agree with their assessment that providing content for students to study at their own pace outside of the classroom allows for a more equitable learning environment to reinforce the difficult concepts during class time (3). I knew I wanted to use class time for discussions, and Dr. Lopez gave me advice on how to provide more structure, and to ensure buy-in from the students. I did this by adding “Team Based Learning” quizzes (IRAT and TRAT) for each class (4). This ensured students would come to class prepared, and ready for the questions the professors posed. Additionally, the Rubric the students created included “Commitment to the group by coming to class prepared,” and “Contributing quality information to the group for the TRAT, discussions, and projects.” It worked. We had very robust discussions during class time. I learned more about what interested the students as the semester progressed and asked the professors to think about how their system might affect or be affected by exercise and/or pregnancy and come prepared. This was rewarding for everyone. Some of our professors who normally don’t teach or even think about the physiology of pregnancy, now had to answer very thoughtful questions about how their system might have to adapt. I was excited to come to class knowing that we would be having invigorating discussions about our topics in ways we never had before.

You may have noticed that I mentioned ‘projects’ in reference to the student prepared Rubric. This comes from another abstract that inspired me at ITL, “Clinical and Translational Physiology: Student perceptions of processed based learning to create an authentic learning experience.”(5)  Dr. Joseph Rathner walked me through the work he did in his course, and I couldn’t help but notice how similar our courses were. Much like my Human Physiology in Translation course, Dr. Rathner’s course is divided into modules but instead of relying on exams, quizzes, and participation grades, he assigned team projects in each module. I thought this was the solution I needed to address the lack of diverse assessments in my course. For each module, I gave the students a list of pathophysiology’s to choose from and told them they could present on their chosen topic in any way they wanted: social media, websites, infographics, the sky was the limit. They had to designate an “intended audience,” of their choosing. For example, elderly patients that might be affected, or experts in the field wanting updates on the treatment options. The only requirement was to hit each mark from the provided Rubric. Did they specify the audience, and was their presentation appropriate for said audience? Did they show an understanding of the related physiology and pathophysiology? Was their presentation dynamic and engaging? The final rule was that they couldn’t present in the same way twice. With 8 students in the class, we had 2 groups of 4, Team AVORA and Team Sting. In the first module, Sting gave a power-point lecture, and AVORA designed an infographic. In the second module, Sting gave an abstract presentation for “Research Day at UF” (they made it up), and AVORA gave a power-point presentation and a dramatization (more on that later) to “High School Students.” In the third module, both groups recorded videos. This was a perfect example of how these flexible assignments accommodated my students. Three of my 8 students were exchange students from Spain. During the scheduled presentation, they were going to be out of town. With the flexibility of the assignment, they received full marks of participation, despite not being physically present during the presentation. In the final module the students gave the most dynamic presentations. Because they could not do the same format twice, they needed to get more creative. Team AVORA created an Instagram account @shiftworkdisorders (please follow and smash that like). Team Sting created an entire skit with 2 students playing MDs, and the other 2 playing a young patient being diagnosed with Asthma and her mother. It was fantastic! I am so proud of how they progressed through the semester.

It is later…So, time for more on “Dramatization.” At ITL, I attended a workshop given by Drs. Helena Carvalho, Patricia Halpin, and Elke Scholz-Morris, “Teaching strategies/tools: learning how to use dramatization to teach difficult concepts in physiology.” (6) I loved this workshop! We learned how to think of creative ways to ‘dramatize’ common physiological concepts using the students as the ‘parts’ in the system. For example, in dramatizing the cardiac cycle, each student becomes a part of the heart (SA node, myocyte, etc.) and has to contract and relax to pump ‘blood’ (another student) out of the heart.

 

During the workshop, one group came up with a skit to demonstrate insulin signaling and glucose transport. Another group demonstrated steroid hormone signaling. Our group demonstrated sarcomeric contraction. I used each of these examples in my class. I also created a new way to think of action potentials. It wasn’t as big a dramatization, because with only 8 students, we didn’t have enough people to play each part.  So, I used candy. I created a “membrane” with dry erase markers, and the students stood on either side of the table and, as pairs, acted as either a voltage-gated Na+ ion channel, a voltage-gated K+ ion channel, or the Na/K ATPase. The Na+ and K+ ions were different colored candy. The students went through the phases of the action potential, by moving the different ‘ions’ through their channels. One student said, “I have been taught this so many times, but this is the first time I feel like I actually understand it.” Music to my ears!

With all of the changes I made to this course, I asked one of my students to give me feedback after each module. I wanted to ensure I actually created a robust, inclusive learning environment from the student’s perspective. With this blog coming at the end of the semester, she has graciously agreed to share her feedback with you. The following is a question and answer with my student, Julia Henault.

 

How does this course compare to other courses you have taken?

          This course was completely different from any course I have taken before. While I have taken flipped classrooms before, never have I experienced one as interactive and engaging as this class. Since different chapters of the course were taught by different faculty members, each class discussion came to be a unique experience. We were able to ask the respective professor more personal questions about their field of study and learn the material in a much deeper way than if we just attended a lecture and studied on our own. The fact that there were so few students also created such a collaborative atmosphere. Whether we were acting out a physiological concept or answering quiz questions, we really worked as a team to understand the material.

What was your favorite part of the course? Why?

          While there were so many aspects of the course I really enjoyed, I have to say the dramatization learning activities were the most engaging and memorable. One of my favorite dramatization days was when we were learning about blood flow throughout the heart. Dr. Bruce assigned each of us to heart chambers and connecting valves and we had to figure out ourselves how to correctly assemble in the order of blood flow. When we were ready, Dr. Bruce acted as the blood and moved through our created chambers, coordinated to our “contractions” and directions. These acting activities were my favorite because while they were fun and engaging, they also made me realize gaps in my knowledge I wasn’t aware of. By listening to the lecture on blood flow the day prior, I thought I understood the order of the steps. But acting it out made us think critically. What was stopping the blood from flowing backwards? Why do the ventricles have to contract more forcefully?

We covered a lot of material. What physiological concept do you remember the most? Why?

          I was joking with my parents the other week that my two biggest takeaways from this course are how exercise is one of the best things you could do for your body, and how pregnancy is the craziest. I say this jokingly because in actuality, we dove deep into the physiology of several different body systems, such as respiratory, nervous, cardiac, and muscular. While this information was interesting, I most remember the topics we learned during in-class discussion, where we could go beyond basic physiology and discuss applications, like pregnancy and exercise. These real-life applications are ones that I have never learned about in my other pre-medicine courses, yet I learned such important information that I wish everyone could learn.

What would you improve in the course?

          As I mentioned earlier, the course material was taught by the UF physiology department, which meant different professors taught different material based on their area of expertise. While I loved this format, as it helped me connect with different professors and learn the material in a deeper way, I sometimes felt that the information could have been more cohesive between different professors. In the future, I think this course would benefit by more communication between the professors so they can coordinate their lectures at the same level of depth and difficulty.

Thank you so much, Julia! I sincerely appreciate your feedback, and all of your work this semester.

What I have taken away from Julia’s feedback, as well as my other students, is that the small class size, the dramatizations, and the discussions with professors were the best parts of the course. I could see that my students were comfortable with me, and I felt comfortable with them. Aside from this course, I had a really stressful semester. Coming to this class three days a week was like taking a break from the world and just having fun. I could see the difference our time made in their lives as well. So, when I say, one small goal can lead to bigger changes, this course is my proof. Had I not gone to EB, I would not have applied for, let alone been awarded, the PrEP-E Fellowship or gone to ITL. Without that inspiration, I may not have made the dramatic changes to my course that had such a positive impact on my students. A small pebble can have a wide ripple effect. What will your small goal be this year? I hope you will achieve that goal and see the ripples you will create. Happy New Year!

Resources:

  • Murray-Johnson, K. (2022). “Where do we go from here? Race and equity focused teaching in trying times.” Plenary Lecture and Concurrent Workshop 1.
  • Cooper, K. (2022). “The opportunities and challenges of active learning for student anxiety/depression, LGBTQ+ students and students with disabilities. Plenary Lecture 2.
  • Lopez, M. & Rakacolli, D. (2022). “Using the “flipped classroom” to promote equity in undergraduate biology courses.” Abstract 10.3
  • Sibley, J. & Spiridonoff, S. University of British Columbia faculty of Applied Science; Center for Instructional Support. Team Based Learning Collaborative (2022). “A handout on ‘Why and how TBL works’” org/more-resources
  • Rathner, J., Tay, J.A., Fong, A., Sevigny, C., (2022). “Clinical and translational physiology: Student perception of processed based learning to create an authentic learning experience.” Abstract 19.4
  • Carvalho, H., Halpin, P., Scholz-Morris, E. (2022). “Teaching strategies/tools: learning how to use dramatization to teach difficult concepts in physiology.” Concurrent Workshop 6.
Erin Bruce is a Lecturer at the University of Florida College of Medicine in the Department of Physiology and Aging. She teaches Physiology to Undergraduates, Post-Baccalaureates online, Graduate Students, Medical Students, and Physician Assistant students. Her research interest has moved to Educational Research and looks forward to learning more about the field.
Impactful activities to create a framework to support team-based activities

While the recent pandemic has forced a number of rapid reforms in learning and teaching, the need to rethink how we learn and teach at the tertiary level began well before that. This has been exemplified by increasing interest in topics such as flipped classrooms, authentic assessments, and students as co-contributors. Although one might argue that the idea of flipped classroom is not new, there has been a growing push to create authentic learning experiences and authentic assessments to better prepare our graduates for the next stage of their careers – be it further professional education or employment. To work towards this goal our department recently restructured our final-year physiology courses to create an environment that empowers students to be agents of their own learning. We believe that over their lifetimes of their degrees, the students should transition from learning through knowledge transfer to self-guided agents in their own learning to promote lifelong learning. To achieve this aim, our assessments were restructured to shift the focus and emphasis from tests and exams, to more authentic assessment tasks. Here we will share an example of one such assessment and the guides we provide to help the students succeed.

In one subject Physiology: Adapting to Challenges, the students are required to work in a team on a project to be presented in a mini-student conference at the end of the semester, to mimic a scientific conference. While a team presentation might not be a truly novel idea, a few factors that we have included in the project design make it distinctive from other similar assessments.

In the early years we were concerned that students would shy away from the team project aspect of the subject. We, like many of our colleagues, thought that the students would detest the prospect of group work and thus be put off by a group project as was observed in a study at another Australian University (White et al. 2007). However, when we surveyed our second- and third-year Physiology students, it was interesting to find that approximately 75% of respondents in both second- and third-year preferred working in groups rather than individually, and the majority of the students understand the importance of acquiring teamwork skills. Many raised concerns about working in a group from prior negative experiences, similar to concerns raised in a previous blog post here. This led us to come up with ways to support the students’ success in this team project. Here we will share some of the lessons we have learned along the way.

1) Broad topics with multiple possible directions

The students were presented with a number of broad research topics or questions of physiology, examples of topics include “Tips and tricks to aging well.” Or “Stress: is it always bad?”. While at first these topics might seem like ‘bad’ topics as they do not appear to provide any research direction, this apparent flaw is also the beauty of this design, as the ‘vagueness’ of the topic gives the student groups flexibility and scope to develop and identify their own common interests within the broad field of physiology and is one of the unique aspects of this assessment. As the starting point covers a broad range of potential directions, the team must arrive at a consensus on the ultimate and final direction of the project. This freedom was an intentional design to give students agency and choice in their project. While some teams do find this lack of direction challenging, the majority of the feedback from the students was positive, with 85% of the respondents in an end of semester survey enjoying the flexibility this provides. In fact, some students stated that they have never experienced this type of freedom in taking their learning into their own hands in their university degree and felt empowered by this option. The feedback from academics who help review these presentations was overwhelmingly positive and we have been consistently impressed by the quality and depth of work produced by our undergraduate students.

2) Create groups based on common interest

The groups were created based on the student nominated projects and not randomly assigned. The students are asked to nominate and rank their top three picks of the projects, together with a short description of their reason for picking that project. The student groups are created from their nominations and the rationale for their interest in the project. This creates groups with a common goal and facilitates the group formation process. While diversity in groups is a well-recognized factor in strong groups, it is also important that groups have common goals. A fine balance must be struck between diverse groups and the common goal. Student feedback on this aspect of the assessment was positive as it gave them a choice on what to research on a topic of their choice. Something that they don’t often get a chance to do in other subjects.

3) Nominate a team mate – if you want

Our previous experience in group formation has shown us that being introduced to a group of unfamiliar people can be a stressful experience for some students, especially with the added stress of an associated assessment. We found that many students appreciated the option and opportunity to nominate a team mate. This reduced their social anxiety in the formation phase of the team. While some students did try to ‘cheat’ the system by either nominating multiple people, or in some cases nominating people in a chain, it is up to the academic to decide whether to allow or disallow these cases. It is important to keep in mind a number of other factors such as making sure that no single student in any group is the solo person without a nominated ‘buddy’ to minimize social exclusion, and still maintaining diversity in the group. The observation from the tutors and teaching staff was that this nominated ‘buddy’ system reduced the social anxiety in early group formation and allowed the groups to move forward to the next stage to discuss their direction sooner.

4) Effective ice breaker activities

Most of us would have experienced ice-breaker activities in a workshop or other types of settings and may have cringed at the idea of these activities. However, finding effective ice breaker activities can help overcome the initial social anxiety and allow the students to get to know each other. The key to effective ice breakers is to choose ones that require and assist their communication, whether it is discussing an idea that is not associated with the assessment (e.g. team name) to reduce the stress, or activities where the team members get to learn something about each other, or work towards a common goal that is not assessment associated. The ultimate aim is to get them to start conversing and help ease the more in depth and intense discussions that will follow. Indeed, in a survey of our students following the ice-breaker activity, the students noted that the ice-breaker activities were cliche but did benefit by increasing comfort with team members by the end of the activity and thus could see the benefit of the activity.

5) Team contract

Following the ice breaker activity, the student teams are asked to discuss and sign a team contract. The team contract provides a framework for the students to discuss and outline their expectations within the team. It includes basic information such as contact information. There are also general procedural discussions such as location for sharing documents, the best means of communication within the team, the preferred method for everyone. The students are advised to set up a team chat that everyone can access. This was an extra layer of challenge in the online learning space as some messaging tools may not be available in some geographical locations.

As the team progresses through the contract, the discussion topics get progressively deeper. The team is asked to discuss their goals and expectations of the project and of each other. They are encouraged to discuss the frequency and duration of meetings outside of scheduled class times; to include discussion of people work responsibilities so they can be considerate of others in setting alternative meeting times; preparation for meetings; note taking in meetings. Finally, the team is asked to discuss how they will deal with conflicts in their group, including topics such as assigning specific tasks, or unmet expectations. The students are provided with scenarios on potential conflicts that they might face and given the time to work through the scenarios as a team. Thus, the team contract guides the teams in a structured and scaffolded discussion about some of the challenging situations they may face.

For the majority of students, this is the first time they have encountered this type of document and it was a daunting task to begin with. However, many students also found the structure of the document with the guided discussion points helpful in navigating some of the more tricky questions.

6) Peer-review and feedback

The student teams undergo two rounds of peer review over the course of 8 weeks. The first peer-review is a required (hurdle) task but is not included in the assessment. This peer review takes place 3 weeks after the groups are formed. The first peer-review is entirely a formative feedback for each member so they have the opportunity for self-reflection and to receive anonymous feedback from their team. This feedback provides the students with an opportunity to adjust any problem behaviors before the final peer review at the end of the project. It also provides the academics with an opportunity to identify any group dynamic issues before it gets too late!

The second peer-review occurs after the final presentation and is counted towards the student grade. The average of the grade they receive from their team mates is used for the grade. In each peer review, the students are asked to assess their team members in a number of criteria:

  • Initiative / self – motivation / motivates others
  • Communication
  • Accountability & sense of responsibility
  • Timeliness and preparation
  • Contribution to the team work & Commitment to the team success
  • Respect & Adaptability

Another key factor is that the peer-review score may be used to adjust the team presentation grade if the student receives a low grade from their team. This increases the student accountability to their team. This also provides the team members a means to hold their team mates to account and minimizes the impact of ‘freeloading’ in the team project. Student feedback on this aspect confirms that peer review is a good way to encourage individual accountability and contribution to the team project with 83% of the respondents in our end of semester survey agreeing to that statement.

We used the tool Feedback Fruit for the peer-review process and it has been a smooth process as this is integrated into our learning management system (Canvas) and the groups synch and import automatically. This reduces the workload tremendously! Before Feedback Fruit become available we tried the same process with Qualtrics. However, this required much more background work to set up the groups for the peer-review process.

We have now run this assessment or similar variations of it, for 5 years, over this time we have made a number of tweaks and adjustments to improve the student learning experiences. Here we have shared some of the lessons we have learned along our journey that we hope readers will find useful. We believe that with some careful sign posts and guard rails we have created a positive and enjoyable learning experience for the students. Not only has this made for an enjoyable learning experience and environment for the students, the workshops have become a highlight of our weeks as we watch the student projects develop and grow. This is reflected in the overall feedback from students, tutors, and assessing academics. Most pleasing is perhaps the student feedback that many found this to be an enjoyable and highly memorable experience and was a highlight of their university journey and they may have learned some interesting facts about physiology that they will take with them as they continue their life journeys.

Angelina is a senior lecturer and the Physiology discipline coordinator in the Department of Anatomy and Physiology in the Faculty of Medicine, Dentistry and Health Sciences, at the University of Melbourne. Her current learning and teaching focus is on practical-based in practical classes, using technology to engage learners in large cohorts in Physiology, and in integrating employability skills within the science and biomedicine curriculum.

Dr Angelina Y Fong PhD GCUT | Senior Lecturer

Physiology Discipline Coordinator

Department of Anatomy and Physiology

School of Biomedical Sciences

Faculty of Medicine, Dentistry and Health Sciences
The University of Melbourne, Victoria, Australia

White, F., Lloyd, H., & Goldfried, G. (2007). Evaluating student perceptions of group work and group assessment. Sydney University Press

 

The Great Student Disengagement

With excitement and anticipation for a “return to normal,” faculty, staff and administrators were especially excited to launch Spring semester 2022.  People were vaccinated, students would be attending class with their peers on campus, and extracurricular activities would return to campus. However, it was soon discovered that a return to campus would not mean a return to “normal.”

In addition to the period of “great resignation” and “great retirement,” we soon discovered that a return to campus could be described as the “great student disengagement.”  Faculty observed concerning student behaviors that impacted academic success. Students on our campus have been vocal about their desire to remain at home and on MS TEAMS/ZOOM©. Classroom sessions were required to shift and were often a mixed modality (high flex) as students and faculty underwent COVID protocols that required remote attendance. In a curriculum in which all sessions are mandatory (approximately 20 hours each week in a flipped environment), students requested far more absences in the spring semester than ever before. Even when students were physically present in class, blatant disengagement was observed by faculty.  Attempts to appeal to students’ sense of responsibility and professionalism had little impact in changing behavior.

In attending the Chairs of Physiology meeting at Experimental Biology (EB), student disengagement was an impactful topic of discussion. Somewhat surprisingly, it quickly became apparent that the environment on our campus was somewhat ubiquitous across all institutions of higher education represented in the room that day. Although we shared similar observations, few potential solutions were offered.

Serendipitously, on the final day of EB meetings, the Chronicle of Higher Education published an article by Beth McMurtrie titled “A Stunning Level of Student Disconnection.”  The article shared insight gained from faculty interviews representing a wide range of institutions:  community colleges, large public universities, small private colleges, and some highly selective institutions. Ms. McMurtrie shared stories of faculty who described how students’ brains are “shutting off” and limiting their ability to recall information. The article reports that far fewer students show up to class, those who do attend often avoid speaking, and many students openly admit that they do not prepare for class or complete assignments. Faculty commonly described students as defeated, exhausted, and overwhelmed.

Although specific causes of the “great student disengagement” have not been substantiated, many believe it is the after-math of the pandemic. It seems plausible that the learning environment became more individualized and flexible with fluid deadlines and greater accommodations during the pandemic. Thus, a return to normal expectations has been difficult.

It also seems reasonable that amid the more pressing issues of life (deaths within families, financial struggles, spread of disease), students are reporting high levels of stress, anxiety and general decline in mental health. Perhaps being absent or disengaging while in class (being on cell phones/computers, frequently leaving the room) are simply avoidance mechanisms that allow the student to cope.

Although post pandemic conditions have brought student disengagement to our awareness, some faculty have seen this coming for years.  In a 2020 Perspectives on Medical Education article by Sara Lamb et al. titled “Learning from failure: how eliminating required attendance sparked the beginning of a medical school transformation,” the authors reported low attendance rates, at times as low as 10%, which they attempted to fix with a mandatory attendance policy.  However, over the next six years, student dissatisfaction rose due to the inflexible and seemingly patronizing perception of the policy. This led students to strategize ways to subvert the policies while administration spent significant time attempting to enforce them.  To address the situation, the school transitioned away from required to “encouraged” and “expected” for learning activities.  This yielded both positive and negative results, including but not limited to: increased attendance to non-recorded activities which students deemed beneficial to their learning; reduced attendance to activities that were routinely recorded and posted leading to increased faculty discouragement; reduced administrative burden and tension; and increased student failure rate and feelings of isolation and loneliness.  The authors go on to describe efforts to mitigate the negative outcomes including empowering faculty with student engagement data, and training in active learning pedagogies to enhance student engagement.

As the definitions and root causes of student disengagement pre-date COVID and are somewhat ambiguous, finding effective solutions will be difficult. Perhaps the rapid evolution of teaching and learning brought about by COVID now dictates an evolution of the academic experience and the rise of scholarly projects to address both causes and solutions.

Suggestions on solving the disengagement crisis were published by Tobias Wilson-Bates and a host of contributing authors in the Chronicle of Higher Education dated May 11, 2022. Although we will leave it up to the reader to learn more by directly accessing the article, a list of topics is helpful to recognize the variety of approaches:

  1. Make Authentic Human Connections
  2. Respect Priorities
  3. Provide Hope
  4. Require Student Engagement
  5. Acknowledge that Students are Struggling
  6. Fight Against Burnout

Although we rely on faculty to address student disengagement, it is also useful to consider the stressful environment of faculty. In addition to experiencing the same COVID conditions that students experience, faculty are being asked to continue to provide up-to-date content, utilize engaging teaching modalities, become skillful small group facilitators, as well as advise, coach and provide career counseling.  It is perhaps not surprising that faculty may also feel stressed, isolated, and burned out, surmising that nothing they do makes much difference – opting instead to remain hopeful that students will bounce back.

Regardless of the learning environment on your campus, it is safe to say that now is the time to come together as faculty, students and administrators to discuss the best path forward. Collectively we can work together to set solutions into motion and gather evidence for our effectiveness. It is time to leverage our shared experiences and lessons learned over the past several years of transitioning away from and back into face-to-face classroom instruction. Such reflection and study will support teaching and learning as we all seek to find a “new normal” that meets the needs of students, faculty, and administration alike.

Lamb, Sara & Chow, Candace & Lindsley, Janet & Stevenson, Adam & Roussel, Danielle & Shaffer, Kerri & Samuelson, Wayne. (2020). Learning from failure: how eliminating required attendance sparked the beginning of a medical school transformation. Perspectives on Medical Education. 9. 10.1007/s40037-020-00615-y.

A Stunning Level of Student Disconnection  https://www.chronicle.com/article/a-stunning-level-of-student-disconnection

How to Solve the Student Disengagement Crisis https://www.chronicle.com/article/how-to-solve-the-student-disengagement-crisis

 

Mari Hopper, PhD, is an Associate Dean for Pre-Clinical Education at Ohio University Heritage College of Osteopathic Medicine where she facilitates the collaboration of faculty curricular leadership and their engagement with staff in curricular operations.  Dr Hopper’s areas of professional interest include curricular development, delivery and management; continuous quality improvement including process efficiency and the development of positive learning environments and work culture; and mentorship of trainees in medical education.
Leah Sheridan, PhD, is a Professor of Physiology Instruction at Ohio University Heritage College of Osteopathic Medicine where she serves in curriculum innovation, development and leadership. Dr. Sheridan’s areas of professional interest include the scholarship of teaching and learning, physiology education, and curriculum development.
Don’t Panic!

I write this post at the end of my career in UK higher education (HE) and it was suggested that I reflect on how the sector (in the UK at least) has changed since the early 1990s? For weeks, nothing grabbed me. Completely unrelated to this brief, and for pleasure (much under-rated), I revisited the late Douglas Adams’ Hitch-hiker’s Guide to the Galaxy (H2G2) and to my surprise these two threads – my lived experience of UK HE and the imaginary world of H2G2 – have emerged from my subconscious as a couple of rather bizarre waking dreams. These dreams have provoked me to reflect broadly on education, particularly on HE.  Anyone familiar with H2G2 might comment that the eve of retirement is rather late in the day to start thinking about education. They would be right!

I’ve borrowed more than my title from the H2G2; ‘Don’t Panic’ being ‘written in large friendly letters’ at the start of eponymous guide. In H2G2, the Earth (and everything on it) was a computer tasked with finding the question to which the answer was 42.  My task here is to imagine the question to which the answer is education.  Ever since I revisited H2G2 I’m haunted by the thought that we are to the development of education as those who set out in the B Ark were to the development of the wheel (all thought of shape was subdued whilst they argued over what color it should be).  In my waking dreams, I was tasked with explaining what we were doing (in university education) to several key educational figures from my mind’s limited databank: Aristotle; John Ruskin; and John Dewey.  My surprise that Aristotle spoke flawless English aside, I was struck by their puzzled looks and their questions. My abiding impression was that my imaginary visitors believed that I had something in common with the B Ark architects of the wheel; we were both confidently and blissfully clueless. From that moment I’ve been wondering if we have become lost or confused and that we no longer serve society well.

I want you to stop reading for a second and reflect on what you understand by the suitcase term, ‘education’. What is the purpose of education; what is its role in society?

I think it’s necessary to point out that education changes over time; it evolves, not in a Darwinian sense, but by episodes of what we fervently hope turns out to be intelligent design.  So, what is ‘education’? What does it require or imply?  How was education regarded in the past?

In antiquity, education was not made available to all, but its value was clearly appreciated as shown by Aristotle’s assertion that

‘a man should be capable of engaging in business and war, but still more capable of living in peace and leisure; and he should do what is necessary and useful, but still more should he do what is noble. These then are the aims that ought to be kept in view in the education of the citizens both while still children and at the later ages that require education.’  (Rackham, 1944; book 7, sections 1333a and b).

The key point, for me, is that education should encourage citizens to ‘do what is noble’. In today’s parlance that means to have high moral principles (to include honesty, integrity and generosity).

By the early 20th century, education was becoming more technical but the capacity for critical analysis in the service of judgment was clearly valued, as illustrated by John Dewey, who suggested that education provided one with the tools for analysis and interpretation necessary for intelligent action (Dewey, 1938; pages 105-6). It was also Dewey who crystalised a view that, for me, comes closest to defining the value of education to any modern [democratic] society. In ‘Moral Principles in Education, Dewey argued that education should develop in all citizens what he termed ‘force of character’, elements of which he listed as ‘initiative, insistence, persistence, courage, and industry’. (Dewey, 1909, page 49)

Because I think it is justified, I’ll give a little more room to Dewey’s conception of education. In Democracy and Education, Dewey asserts that a society’s values and beliefs are communicated from generation to generation through education (Dewey, 1916, page 17).  Dewey is by no means alone in believing that education has a special role in any modern society; education, in a very real sense, is the means by which the knowledge, wisdom and values of a society are shared with successive generations (to be adopted, adapted or rejected). For this reason, I regard education as the most important responsibility of a society.

Dewey was nevertheless concerned by the relative neglect of wider societal concerns within the context of education, and this was voiced by non-other than President Franklin Roosevelt, who claimed that

‘There is not in all America a more dangerous trait than the deification of mere smartness unaccompanied by any sense of moral responsibility’.  (Roosevelt, 1903).

I confess that since reading Roosevelt’s assertion, I see little evidence that we still make a virtue of ‘moral responsibility’ in UK HE. There clearly are groups of people (often young) who are highly motivated by ethical and moral issues (e.g. climate activism) and too often they are not supported by the generation with the power and influence to effect change. In contrast to the student-led activism of the 1960s, Universities in recent years don’t seem to foster the same degree of critical thought and action.  Perhaps there are just too many issues?

As our society has become more complex, the interdependence on others felt by anyone with sufficient money to pay rent, buy food and stay warm has become less visible. Moreover, the huge financial incentives for those who increase profits (or influence public opinion) seems to erode the notion of societal value in favour of personal enrichment, as outlined in Mark Carney’s 2020 BBC Reith Lectures and in the 2016 Netflix documentary, The Great Hack. In consequence, it might be argued that focusing only on technical education goals and ignoring the development of societal values is reckless in the extreme. With luck, humanity will persist and so observe our present with the benefit of hindsight; with the perspective to judge the merits of this concern.

As I said at the outset, I write this at the end of my career in HE. What changes have I witnessed?

Despite believing with every fibre of my being that I’m right (see cognitive bias), I should acknowledge that the changes I describe might be more imaginary than real. The last two years of COVID-19 imposed change notwithstanding, not much has changed if one were to judge only on the movements of people from room to room, or the movements of the written word between students and educators. Lectures persist, as does laboratory work, small group teaching and a myriad of assessments.  What has changed in 35 years might appear more or less trivial; changes in the methods of presentation (chalk for computer graphics, with and without recordings) and notetaking (transcribed on paper or a tablet, or annotation of pre-circulated presentations). The point is that the activities appear to have undergone only a minor technical evolution, far short of a revolution. I would argue that appearances can be deceiving. In my opinion, several factors account for subtle but important changes in the process of education. My top three are 1) information overload, 2) marketisation of education and 3) intellectual isolation.

Information overload has at least two dimensions, first, we have more detailed knowledge of the cellular and molecular basis of biomedical science. Mastery of the additional detail imposes greater demands on the same educational window of opportunity. Second, there has been a proliferation of information sources that are readily available via a browser. Many of these information sources attempt to simplify the complex and some introduce substantial errors that are often not obvious to the learner. When simplifying the complex, we should make the effort to explain the unavoidable risks inherent in all simplification.

The marketisation of HE was intended to bring about the same sorts of improvements and efficiencies as seen in manufacturing and service industries (Molesworth, et al 2010). In the UK this has coincided with substantial expansion of student numbers, increasing the staff:student ratio. In practical terms, the competing needs for research outputs (in most HEIs) and student (customer) satisfaction is an equation that can only be balanced by extracting more from staff who teach and conduct research.  Despite the reports of higher workloads in HE, there is a reduced opportunity for dialogue between educators and students – there is finite supply of time and a larger number of calls on our time. Larger numbers of students is a relatively minor factor in the increased consumption of staff time – most staff report substantial increases in administration relating both to research and to teaching.

Intellectual isolation seems somewhat unlikely given the much-vaunted power of social media to ‘connect people’ and yet even those most closely aligned with social media are dubious of its merits. It is possible for students to have access to a million points of view without discussing them in any meaningful way. How does one properly evaluate the evidence for so many opinions without the combination of many minds and the probing power of discussion? It is relatively easy to find an information source that confirms our bias and which we, therefore, immediately recognise as right-thinking and entirely reasonable, regardless of what it might be that we believe. The emergence of a rainbow of myths and wisdom regarding effective treatment (or prevention) of COVID-19 infection over the last two years surely demonstrates this to be true.

Am I optimistic for the future?  Yes. Innovation in society is a lot like an experiment in nature, even if the innovation were the result of intelligent design. If it is seen to be beneficial, it will be retained and propagated.  If it is not beneficial it might persist but is unlikely to propagate.  If it is harmful, the harm will (eventually) be recognised and steps taken to discourage what the innovation initially encouraged. Child-labour and tobacco smoking are very conspicuous examples, but there many such examples in our collective histories. That said, the damage done can sometimes persist and things that cause harm in the long-term seem to be tolerated if short-term effects are positive (think alcohol and sugar).

So, what sort of steps could we take? Information overload could be reduced if what is expected of an undergraduate degree is re-imagined.  We might do better to focus on how to pare away unnecessary detail to find the key issues and to then frame good questions for further [curious and creative] thought or research. Marketisation within HE has been a creeping cancer (my view) and the solution will require surgery – all other treatment choices are palliative! Making the university system into an industry that has no aspiration beyond expansion has been a foolish experiment. The university system needs to be regarded by everyone as a social good, regardless of one’s personal interaction with it.  Intellectual isolation can be reduced in a host of ways. In the 1999 work, ‘Seven complex lessons in education for the future’, the French philosopher Edgar Morin (now 100 years old), argues that the development of separate scientific disciplines was closely linked to information overload – the human mind was too limited – and that despite advances, this isolation ultimately limits understanding and stifles innovation. The recent emergence of cross-disciplinary teaching and research is a move in the right direction.

More generally, I believe it would benefit society if we could make a virtue of exploring the choices we’ve made in the past and how well our current choices fit our society for the future. When economies were mainly local, interests could be local but as the developed countries now operate in a global market economy, our interests must be similarly global; we can’t pretend otherwise and to try is to gamble everyone’s future. A democracy can’t be led honestly if the population is ignorant of factors that make difficult change necessary (political parties would use public ignorance to manipulate opinion and voting habits). I’d like to see society (through education) champion wisdom and integrity rather more enthusiastically and perhaps we should all try to go to sleep behind Rawls’ veil of ignorance – not knowing the colour of our skin, our gender or our place in society when we wake the next day. Afterall, you never know whether the Earth will still exist tomorrow![1]

 

References (not included as in text hyperlinks)

Dewey, J. (1909). Moral Principles in Education. Riverside Press, Section V – The psychological aspect of moral education, page 49; https://www.gutenberg.org/files/25172/25172-h/25172-h.htm

Dewey, John. (1938). Experience and education. New York: Macmillan. Pages 105-106

Dewey, J. (1916). Democracy and education. Project Gutenberg. https://www.gutenberg.org/files/852/852-h/852-h.htm#link2HCH0002 – Chapter 2: Education as a Social Function, page 17

Molesworth, M., Scullion, R., & Nixon, E. (Eds.). (2011). The marketisation of higher education and the student as consumer. London: Routledge.

Rackham, H. (Harris), 1868-1944, trans.: Politics, by Aristotle (HTML at Perseus, Aristot. Pol. 7.1333a/b)

Roosevelt, T. (1903, May 2). Speech of President Roosevelt at Abilene, Kansas, May 2, 1903. Theodore Roosevelt Papers. Library of Congress Manuscript Division. Retrieved from https://www.theodorerooseveltcenter.org/Research/Digital-Library/Record?libID=o289769

[1] In H2G2 the Earth was demolished by aliens only minutes after humanity became aware that aliens existed.

Phil Langton is a senior lecturer in the School of Physiology, Pharmacology and Neuroscience, University of Bristol, UK.  A biologist turned physiologist, he worked with Kent Sanders in Reno (NV) and then with the late Nick Standen in Leicester (UK) before moving to Bristol in 1995.  Phil has been teaching respiratory and GI physiology for vets, nerve and muscle physiology for medics and cardiovascular and respiratory physiology for physiologists. He also runs a series of units in the second and third (final) years that are focused on the development of soft (but not easy) skills.  He has been interested for years in the development of new approaches to old problems in education.
Assessing Students’ Learning — Not Their Googling Skills! — in an Online Physiology Course

As of March 2020, when the SARS-COV-2 pandemic sent teachers and students home to figure out online instruction and learning, I had been teaching high school biology/AP biology for 27 years and anatomy & physiology at the two local community colleges for 7 years. Since I had been practicing flipped coursework for years, I knew that my biggest challenge would be how to fairly assess my students and their learning. This challenge would be compounded by an at-home virtual testing environment without any proctoring.

As I pondered the best approach to my assessment challenge, I was naturally drawn to the College Board’s 2012-13 redesign of the AP (Advanced Placement) Biology curriculum and examination. In the redesign, the AP curriculum focuses on four “Big Ideas” or broad themes covering a number of subtopics/concepts that are further broken down into learning objectives for students. The examination focuses on measuring student learning and skills using what the College Board (AP Higher Education, 2012-2013) calls an “evidence-centered-design approach that parallels the curriculum’s understanding-by-design approach.” The examination consists of a mix of multiple-choice and short-answer/free-response questions. I know from my many years of grading student AP essays/short answers that, when students turn to Google for their answers, they often fail. Students will frequently regurgitate the rubrics for grading the prompts rather than dissecting and answering the question. Subsequently, the students fail to demonstrate their own learning or understanding of the material. This is unfortunate as it is also a missed opportunity for feedback, correction and/or remediation.

In designing a new accelerated online physiology course, I really wanted the course assessments to mimic the AP Biology style of assessments. I wanted them not only to be aligned with course objectives, but to require students to think about and demonstrate the skills and concepts they were learning. I was skeptical, but hopeful I could also find an approach in which I would not have to rewrite the entire examination from scratch each term. In my search for related pedagogies, I ran across an article in the May 2020 HAPS Educator, “Testing in the Age of Active Learning: Test Question Templates Help to Align Activities and Assessments,” and recognized the name of one of the authors, Dr. Greg Crowther (Everett Community College, Everett, WA) from a previous association. I reached out to Greg and requested some more details about Test Question Templates (TQTs). What I found was a pedagogical gold mine!

The TQTs are based on somewhat general learning objectives, much like the four Big Ideas of the AP Biology exam. Students often ignore these learning objectives because they don’t know what they mean or how they will be assessed, but TQTs are formatted as input-output statements that tell the student exactly what they will be assessed on. Two examples (“Example A” and “Example B”) are provided for the students, followed by a prompt encouraging students to create their own test question following the template format.

The timing of my find was perfect for incorporating TQTs into the design of the new course. Since I am totally online, I took the time to video each TQT. On video, I present the input-output statement for each TQT and present Example A, along with approaches to answering the question or solving the problem. My TQT videos are attached to a weekly discussion board in the course management system, where students are then encouraged to work on solving Example B and creating a third example. I frequently visit the discussion board and provide feedback and guidance as needed throughout the week.

Below is an example of a TQT input-output statement and examples given to students ahead of the examination in the discussion board and used to model the examination question:

TQT 3.1. Given the chemical structure or chemical formula of an ion or molecule (chemical structure or text description), list the most likely mechanism(s) by which it crosses cell membranes.

  • Example A: See structure below left. By which process(es) is this molecule most likely to cross cell membranes? Explain your reasoning. [add chemical structure of a molecule like urea]
  • Example B: See structure below right. By which process(es) is this molecule most likely to cross cell membranes? Explain your reasoning. [add image of a peptide like insulin]
  • Example C: Make up an example (think of an ion or molecule that you’ve heard of) and ask your classmates!

In the previous unit, students had been instructed on chemical structures/formulas and bonding properties. In this unit, students are asked to extend and apply their understanding of chemical structures, bonding properties (polar, nonpolar, ionic) with their new knowledge of cell membrane structure (phospholipid) and cell transport mechanisms (passive or active).

Examinations are carefully aligned with the objectives, formative assessments and exact input-output statements given to students in the TQTs. The examination contains 10-11 short answer questions and approximately 25-30 multiple choice questions. I have added a statement on the examination for students to sign, reminding them not to use any outside resources (people, notes, internet….) along with the consequences for doing so. Students are reminded to use what they are learning in the course to answer and solve exam problems/questions. I explain to students how I will know if they don’t follow the rules.

I will admit that the new course has gotten off to a rough start. For reasons I can only guess at, more than half my students are procrastinating until the last minute to start assignments (lecture, reading, lab, formative assessments, TQTs…). This approach is not consistent with my suggestions to space out their learning, practice, or repetition of concepts that we know is so important to learning and applying the information to new situations.

Not surprisingly, students who participated during the week and spaced-out lecture segments, formative assessments and TQTs did much better on the examination than those who did not. Those who chose alternative approaches to the course material often googled their way through the examination and failed miserably. Using Google, they could identify a molecule, how it is made, and where it is found, but they couldn’t answer the questions asked.

It has taken several examinations to convince many of the students that physiology is not simply about googling or memorizing facts, but about developing critical thinking skills and a higher-order understanding of the material that will persist beyond the course. More students are now actively preparing, studying and asking more complex questions throughout the week than previously (as evidenced by the course management system analytics and student contact). Many have shown improvement not only on their overall exam scores, but in their demonstrations of reasoning on assignments and exams.

After the initial rough weeks of getting students on board, students are now reaching out via email to report progress in their learning, growth, and ability to connect the material to their work as CNAs and Medical Assistants.  For example, one young man in the course writes, “As we’ve progressed onward to future chapters I feel like my knowledge is increasing gradually and I personally feel that like I CAN do this, it has been a struggle I’m not going to lie and say it was a breeze but, I feel like I’m truly getting a ton of knowledge from these chapters, I’ve found much interest on the systems we’ve been studying especially with the TQT examples and formative questions that you help me with your feedback.” Another young lady states, “I am sorry I am not doing well. I have never been forced to study before and though the TQTs are hard I am finding that I am learning a lot and am really interested in learning more. I am glad I didn’t give up.”

In summary, both the AP Biology redesign assessment questions and the TQTs have allowed me to better assess my students’ knowledge and skills. These approaches have also given me insight into student misconceptions and helped me provide feedback, remediation, and other support as needed. I can easily write (or rewrite) questions based on the TQT input/output statements without having to rewrite entire examinations each term. Students are learning that simply googling will not let them ace the exams; instead, they are learning to more carefully read the questions and answer the questions based on their own understanding.

“ACKNOWLEDGMENTS: The author thanks Greg Crowther for help implementing TQTs and for feedback on this blog post.”

References:

  1. AP Higher Education (2012-2013). AP Course and Exam Redesign. https://aphighered.collegeboard.org/courses-exams/course-exam-redesign
  2. Crowther, G., Wiggins, B., Jenkins, L. HAPS Educator (May 2020). “Testing in the Age of Active Learning: Test Question Templates Help to Align Activities and Assessments.”
    Julie Gallagher, professor of anatomy and physiology, has been teaching at Barstow Community College (Barstow, CA) since 2014 and was a high school AP Biology teacher for 27 years at Serrano HS (Phelan, Ca).  Believing in equity and inclusion, Professor Gallagher has built state-of-the-art online anatomy and physiology courses, focused on helping all students succeed.
Flipped and Distant Multi-Section Teaching: An A&P Course Director’s Perspective, Pandemic Plan, and Transition Back to the Classroom.
Historically, flipped classrooms have been around since the mid-2000s and began as bottom-up pilot experiments in a single classroom or section of a course at the will of an inventive instructor. With a robust body of literature deeming these modern content delivery models effective in achieving student success in the classroom and beyond, many educators in the sciences have adopted this approach to active learning. However, I doubt very few decided the pandemic-forced transition to distance learning was the right time to pull the trigger on flipped classroom implementation at the course director level in a multi-section course. I’m happy to share my wild idea and the wild ride we (myself and the A&P faculty at Jefferson) have been on while we were “building the plane as we flew it” over the past 2 years.

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

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

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

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

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

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

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

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

**Illustration by Andrea Rochat, MFA

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

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

Why?

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

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

“Yes, we do!”

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

“Yes, we do!”

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

Etc.

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

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

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

How?

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

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

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

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

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

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

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

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

Tangible benefits from the redesign include:

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

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

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

Intangible benefits of the redesign include:

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

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

Recommendations:

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

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

References for Redesign and Remediation:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 
Using Reflection to Help Find Certainty in an Uncertain Time

As we begin the spring 2022 semester, we are met with yet another uncertain path ahead. Will I have to teach remotely? Will I be able to teach in person? Will I have the option? What will be the option for students? Will all of this change in a few weeks? How are the students going to handle another stressful semester? The list goes on. I certainly do not have the answers to any of the aforementioned questions, but the recent (and not so recent) uncertainty has prompted me to spend time reflecting on my courses and teaching practices.

But, before I dive into that, here’s a bit on my background to help with the context of this reflective exercise. First, I am relatively new to the teaching profession, and I started my first tenure track position in the fall of 2017, after an exhilarating and challenging visiting position the year before (2016-2017). As a visiting professor I found my calling as an educator and mentor, and while I was working more than I ever thought possible, I loved every minute of it. As you may remember from your first few years of teaching, these first years are filled with exponential growth as an instructor, faculty member, and person. I was developing new courses almost every semester and/or making significant changes to previously used courses. I worked with colleagues at my institution and others, soliciting feedback on how I could improve assessments, student engagement, and advising. Needless to say, very little was the same semester to semester – lots of editing and revising. And right as I’m starting to get the swing of things, mid-way through year 3, BAM – COVID! As a relative newcomer to the classroom, when COVID hit in the spring of 2020, I had a mere 3.5 years of teaching in the pre-COVID era and very little consistency in my coursework (or so I thought). And since then, every semester since the start of COVID has been different in terms of course delivery, assessments, and student engagement. Some courses have been fully remote, some hybrid, some in person, some switched back and forth with student options also constantly changing. It’s exhausting to think about.

As a result of all of this inconsistency, when I started planning for yet another uncertain semester (spring 2022) I decided to spend some time thinking about what has been consistent in my courses throughout the years (both before and after COVID). To obtain additional data, I also reviewed those dreaded course evaluations in order to review feedback that wasn’t from my own biased brain. While somewhat scary, this reflective activity allowed me to sort out a few things that paint a clear picture of “my classroom” regardless of the delivery method or state of the world:

 

  • ORGANIZED – If you were to run a word cloud on all of my course evals the largest word would most likely be “organized” or some iteration of that. And for those that know me, this probably isn’t a huge surprise. I am organized, perhaps a bit over-organized, and this is very clear in my course design. Students take this as a positive – I know, or at least look like I know, exactly where this course is headed, and they trust me to lead them on this journey.

 

  • OVER-COMMUNICATION – The second largest word on the world cloud would be “communication”, and possibly to the point of over-communication. While not every student requires reminders of assignments or expectations, some do. Different modes of communication are helpful too: in person, e-mail, LMS, video chat, etc. Students seem to need more communication during the COVID semesters than in previous ones and I’ve found that my ability to “over-communicate” helps students stay on track and always know the expectations. Plus, I’m hoping that my practice of over-communication helps students feel more comfortable reaching out to me when they need help.

 

  • ACTIVE – From the beginning I did not want my classroom to be one of those that students just passively attended. I wanted them to be excited to come to class at 8:00 am because they knew that they were going to be put to work and be engaged in their learning. This is absolutely a hard sell, especially at 8:00 am, and it takes time for some students to warm up to the idea, while a few never do (and they note that very clearly in the evals). However, for the majority of students, the active classroom is a welcoming and fun learning environment (these comments are more pleasant to read in the evals). Plus, it’s just more fun to teach!

 

  • FLEXIBLE – While flexibility has been of utmost importance during COVID, I noticed that I also had a bit of flexibility in my pre-COVID classroom as well. Flexibility with learning speeds and styles, flexibility with my own content deadlines, flexibility with student requests, and even homework or project deadlines (to an extent). This was absolutely something that I had to work on early on in my teaching career, but I learned a lot from listening to my students and their needs in the classroom and they appreciate my ability to work with them as they struggle.

 

  • CHALLENGING and SUPPORTIVE – Students note that my courses are challenging, but feasible. Yes, I have high expectations, of which they are aware (see above), but they also know I’m here to help them and work with them when they are struggling (with the course or otherwise). The connections we can develop with students are unlike any other, and I love seeing them grow throughout their educational journey.

 

  • EXCITING – Students commented on my ability to be “excited” about anatomy and physiology. (Who isn’t?!?!) I don’t know if this is just because I have more energy than they do at 8:00 am, but I’ll take it. A&P is EXCITING and apparently that is clear both in person and on camera. Also, apparently, I appear taller on camera.

Now, while things are still a bit crazy and uncertain, I encourage you to reflect on your own teaching practices both before and during COVID to uncover some commonalities in your classroom.  We will probably never go back to exactly the way things were pre-COVID, so stopping and reflecting may be a great exercise to help move forward. Spend some time noting what is similar and maybe even what is different. Particularly if you are new to this profession, such as I am, this activity may help you learn a bit more about your teaching style and classroom practices. Then share your revelations with others and encourage them to do the same, perhaps even in the comments section below.

Postscript: Total coincidence that this is similar to the January 13th blog topic, which is also a great reflective exercise. Looks like we are on similar paths. Happy reflecting!

Jennifer Ann Stokes is an Assistant Professor of Kinesiology at Southwestern University in Georgetown, TX. Jennifer received her PhD in Biomedical Sciences from the University of California, San Diego (UCSD). Jennifer’s courses include Human Anatomy and Physiology (I and II), Nutritional Physiology, Intro to Human Anatomy and 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 trail running, cycling, hiking, and baking cookies and cakes for her colleagues and students.
Looking back and moving forward. The importance of reflective assessment in physiology education.

At the end of the 1986 movie Platoon, the protagonist (Chris Taylor, played by Charlie Sheen) provides a very moving monologue that starts “I think now, looking back, we did not fight the enemy, we fought ourselves. The enemy was in us. The war is over for me now, but it will always be there, the rest of my days.”

When Platoon was first released in theaters I was in high school.  I was enthralled with Platoon, and it has held a very special place in my memories ever since.  The ending monologue has echoed through my mind at the end of almost every semester that I have been a faculty member (albeit with a few changes. No insult or mocking of the movie is intended, this is simply my effort to take a powerful cinematic scene and apply it to my personal situation).  My end of semester monologue goes something like this “I think now, looking, back, I did not teach the students but I taught myself. The student was within me.  The semester is over for me now, but it will always be there, the rest of my days.”  And with that, I begin reflective assessment of my teaching.

For many educators, assessment is a dirty word and a necessary evil.  Hall and Hord (1) reported that faulty experience anxiety about assessment because of a lack of understanding of the process or importance of assessment.  Faculty may also disdain participating in assessment due to concerns about accountability, or due to concerns about accreditation negatively impacting their careers (2). Often, faculty also view assessment reports as things that need to be prepared and submitted to meet requirements imposed on faculty from an administrative office within their institution, or some outside accrediting agency, but think that assessment reports are not really pertinent to the day-to-day work of education (3).  To help overcome hesitancy to fully engage in the assessment process Bahous and Nabhani (4) recommend that institutions hire a full-time assessment officer to work one-on-one with faculty.  All of these are relevant to the formal process of assessment and submitting data and reports to meet institutional or organizational requirements.  When done the right way, these assessment reports can be valuable tools in education.  But what I want to discuss in this blog post is a more informal form of assessment that I think all educators should do, and probably already do, which is reflective assessment.

Students and faculty alike perceive Physiology as a very challenging academic subject (5, 6).  The concepts are difficult, and there is a lot of terminology.  Our understanding of physiology is continually expanding, but yet students often still need to have a firm concept of the basic fundamentals before moving on to more complex and in-depth information.  Physiology is often taught in a system by system approach, yet the systems do not operate independently of one another so at times it may feel like the cart is put before the horse in regards to helping students to understand physiological processes. All of these issues with the difficulty of teaching physiology make reflective assessment an important part of teaching.

Quite simply, no matter how well we taught a class or a concept, as educators we may be able to teach better the next time (7, 8).  Perhaps we can tweak an assignment to make it better fit our needs.  Or perhaps we can provide a new resource to our students, like an appropriate instructional video or a scholarly article. Or maybe it’s time to select a new textbook.  Or maybe we have seen something in Advances in Physiology Education or on the PECOP Blog that we would like to incorporate into our teaching practice.  Whatever the reason, reflective assessment provides an opportunity for us to ask ourselves two very simple, but very important questions about our teaching:

  1. What went well in this class, and what didn’t go as well as planned?
  2. What improvements are we willing to make to this course to improve student learning?

The first question is important for identifying strengths and weaknesses in our courses.  We can ponder what went well, and ask why it went well.  Has it gone well each semester? Or did it go well because of changes we made in our teaching?  Or did it go well because of other changes, such as a change in prerequisite courses?

As we ponder what didn’t go as planned, we can also contemplate why things didn’t go as planned.  I think anyone who has taught through the COVID pandemic can identify lots of unforeseen and unusual disruptions to our courses.  But we can also use reflective assessment to identify ongoing problems that deserve some attention.  Or we can identify problems that have previously not been problems, and make a note to monitor these issues in future courses.

The second question, about what changes are we willing to make, is also extremely important.  Sometimes a problem may be outside of our control such as course scheduling, who teaches the prerequisite course, or other issues.  But if the identified problem is something we can control, such as the timing of the exams, or the exam format, or laboratory exercises, then we need to decide if the problem arises from something we are willing to change and then decide how and what to change.  Can the problem be addressed through the acquisition of new instrumentation?  Can the problem be addressed by changing textbooks?  Some of the problems may be easy to solve, while others might be more difficult.  Some problems might require funding, and so funding sources will need to be identified.  But this is where reflective assessment can really help us to prioritize changes to our teaching.

I ask myself these questions throughout the semester as I grade tests and assignments, but in the midst of a semester there is often not time to really ponder and make changes to my classes.  During the semester I keep a teaching diary to make note of the thoughts that come to me throughout the semester. Then, after final grades are submitted and before the next semester begins there is more time to read through the teaching diary and to reflect and ponder about my teaching.  Often, in this less pressured time between semesters, by reviewing my teaching diary I can take a step back to reflect on problems during the semester and determine if this has been an ongoing issue in my classes or an isolated issue limited to only this one semester.  I often find that what seemed like a problem in the middle of the semester has resolved itself by the end of the semester.

Of course there are many other questions that can be asked as part of reflective assessment (7, 8), and any question can lead to numerous follow up questions.  But I think these two questions (1. What went well in this class, and what didn’t go as well as planned? 2.  What improvements are we willing to make to this course to improve student learning?) form the cornerstone of reflective assessment.  And reflective assessment can then lead to a career long endeavor to engage in action research to improve our teaching skills.

  1. Hall G, Hord S. Implementing change: Patterns, principles, and potholes (5th ed). New York: Pearson, 2019.
  2. Haviland D, Turley S, Shin SH. Changes over time in faculty attitudes, confidence, and understanding as related to program assessment. Iss Teacher Educ. 2: 69-84, 2011.
  3. Welsh JF, Metcalf J. Faculty and administrative support for institutional effectiveness activities. J Higher Educ. 74: 445-68, 2003.
  4. Bahous R, Nabhani M. Faculty Views on Developing and Assessing Learning Outcomes at the Tertiary Level. J General Educ. 64: 294-309, 2015.
  5. Slominski T, Grindberg S, Momsen J. Physiology is hard: a replication study of students’ perceived learning difficulties. Adv Physiol Educ. 43:121-127, 2019.
  6. Colthorpe KL, Abe H, Ainscough L. How do students deal with difficult physiological knowledge? Adv Physiol Educ. 42:555-564, 2018.
  7. Pennington SE. Inquiry into Teaching: Using Reflective Teaching to Improve My Practice. Networks, An Online Journal for Teacher Research 17, 2015. https://doi.org/10.4148/2470-6353.1036
  8. Reflective Teaching Practices. Int J Instruc. 10: 165-184, 2017. NM, Artini LP, Padmadewi NN. Incorporating Self and Peer Assessment in Reflective Teaching Practices. Int J Instruc. 10: 165-184, 2017.
    Dr. Greg Brown is a Professor of Exercise Science in the Department of Kinesiology and Sport Sciences at the University of Nebraska at Kearney where he has been a faculty member since 2004. He is also the Director of the General Studies program at the University of Nebraska at Kearney. He earned a Bachelor of Science in Physical Education (pre-Physical Therapy emphasis) from Utah State University in 1997, a Master of Science in Exercise and Sport Science (Exercise Physiology Emphasis) from Iowa State University in 1999, and a Doctorate of Philosophy in Health and Human Performance (Biological Basis of Health & Human Performance emphasis) from Iowa State University in 2002. He is a Fellow of the American College of Sports Medicine and

     

The trepidatious return to in-person instruction during the COVID-19 pandemic: valuable lessons applied from online teaching using Lt in the face-to-face classroom

 

To say that the past 20 months of higher education have been a hardship is a gross understatement. The speed at which educators have embraced new technologies to bridge the pivot to virtual instruction has been remarkable.

This has been particularly difficult in courses where hands-on experiences are the norm, such as in anatomy and physiology laboratory courses. Instructors of laboratory courses where students must gain practical skills and experience the process of science found themselves relying on new (to them) technologies to fill the gap in their newfound teaching methods during the forced switch to virtual instruction (1, 4). As such, many platforms stood out amongst a sea of offerings for physiology educators.

Adapting pedagogical approaches in the virtual landscape is not a new phenomenon for anatomy and physiology educators with many successful reports providing best practices to adapt didactic and laboratory methods to online or hybrid learning (2, 3) long before the COVID-19 pandemic. Although online approaches have demonstrated an effectiveness in achieving course objectives, effective combinations of both online and face-to-face instruction must be investigated to help accommodate the convenience that online approaches offer students as we adjust to the return to in-person modalities.

Our experiences at the University of the Incarnate Word (UIW) have mirrored our colleagues in the scramble to identify suitable stand-ins for laboratory courses that still provide as robust an experience as possible. Thanks to a fortuitous introduction during the January 2020 CrawFly Workshop we now host annually at UIW in association with ADInstruments, we were introduced to the Lt suite of laboratory courses, most notably their Human Physiology and Anatomy packages. While we were impressed by the capabilities of their labs and lessons, any thoughts of immediate use were placed on the backburner as we already had the Spring 2020 curriculum planned out – or so we thought.

During the confusing and uncertain switch to virtual instruction in March of 2020, fraught with pandemic panic, we haphazardly pieced together the second half of our virtual lab curriculum relying on any lab simulations we knew of that were free and easily accessible to our students. Following this “dumpster fire” of a semester, we reassessed our future directions for what we were sure was going to be another traipse into the virtual landscape, and we knew that our Frankenstein approach would not be suitable going forward. That is when the decision to completely redesign our Anatomy and Physiology I and II Lab curriculum using Lt was made.

Beginning in the Fall of 2020, 12 laboratory activities were selected from the pre-built modules and lessons available in Lt for human anatomy and physiology that met our pre-determined course objectives for both BIOL 2121 (Anatomy and Physiology I Lab) and BIOL 2122 (Anatomy and Physiology II Lab). We used these pre-built lessons as the outline for each lab and edited the material to accommodate an online lab experience. Where the ADInstruments PowerLab stations, sensors, and electrodes would normally be used for data acquisition with Lt software, we replaced these sections with either videos or descriptions of how data would be collected for each lab. These sections providing the theory and sample protocols were followed by using the Lt sample data sets for students to complete data analysis and formulate conclusions. To help facilitate virtual dissections, we took advantage of the dissection videos and guides provided in the pre-built Lt labs that students could refer to in lieu of having their own specimens at home. The final product allowed us to replace the hands-on experience preferred in an undergraduate anatomy and physiology lab in the best way possible when virtual instruction was our only option.

To gauge student satisfaction with this new platform, and importantly to determine if the educational goals for our students were being met, a survey was designed and administered to students at the end of the semester. This was used to adjust the lab offerings and fine-tune the activities that were used again in proceeding semesters. Figure 1 shows an improvement in the overall rating for Lt where students provided scores in between 1 and 5 with 5 being the highest rating from Fall 2020 to Spring 2021 by just over 8% (from a score of 4.18 to a score of 4.53 in the spring semester). Both semesters were conducted using remote instruction; therefore, the increase is attributed to improvements made to the existing labs in spring based on student feedback.

Moving forward to Fall 2021, our labs returned to mostly in-person instruction with only 30% offered with either asynchronous online or synchronous online instruction. The same Lt Student Survey was administered as the current semester has come to an end and the data demonstrate a further increase in the overall rating for Lt with an average rating of 4.7 (Figure 1). Although we hypothesize that this increase is mostly attributed to the transition back to in-person instruction as students mostly cited comments similar to, “Visually and physically being able to carry out the experiment and dissection labs,” or “Being able to learn things in person and on Lt really helped my learning and broadened my knowledge,” when asked, “What are one to three specific things about the course or instructor that especially helped to support student learning?” This indicated to us that the more hands-on approach with the return to in-person instruction was helping to support our students’ learning.

Importantly, when asked, “If you took an Anatomy and Physiology Lab online in a previous semester, and are currently taking an Anatomy and Physiology Lab in-person with Lt, what about your experience has changed or improved?” students replied with comments such as, “Definitely improved from A&P1 lab, still used Lt in lab but in person as well helped,” or “The labs have definitely improved and the course work… I think that I learned better in person than online.”

Given the data we have collected thus far, we are learning that while students appear to prefer in-person lab instruction, the flexibility provided by the online Lt lab platform still allows for the inevitability of students in quarantine who are unable to attend in-person labs. And although we are still in a period of uncertainty and flux, we think we are finding an effective combination of online and in-person lab instruction to best serve our students and maintain the rigor expected of an undergraduate anatomy and physiology lab experience.

References:

1.       Alves, N., Carrazoni, G. S., Soares, C. B., da Rosa, Ana Carolina,de Souza, Soares, N., & Mello-Carpes, P. (2021). Relating human physiology content to COVID-19: a strategy to keep students in touch with physiology in times of social distance due to pandemic. Advances in Physiology Education, 45(1), 129.

2.       Anderson, L. C., & Krichbaum, K. E. (2017). Best practices for learning physiology: combining classroom and online methods. Advances in Physiology Education, 41(3), 383.

3.       Attardi, S. M., Barbeau, M. L., & Rogers, K. A. (2018). Improving Online Interactions: Lessons from an Online Anatomy Course with a Laboratory for Undergraduate Students. Anatomical Sciences Education, 11(6), 592-604.

4.       Lellis-Santos, C., & Abdulkader, F. (2020). Smartphone-assisted experimentation as a didactic strategy to maintain practical lessons in remote education: alternatives for physiology education during the COVID-19 pandemic. Advances in Physiology Education, 44(4), 579.

Dr. Bridget Ford is an Assistant Professor in the Department of Biology at the University of the Incarnate Word (UIW) in San Antonio, Texas. She obtained her bachelor’s degree at St. Mary’s University in Biological Sciences with a minor in Chemistry. She then went on to earn her Ph.D. in Molecular Medicine at UT Health San Antonio in 2012. Bridget completed her postdoctoral fellowship training at the United States Army Institute of Surgical Research in the Extremity Trauma and Regenerative Medicine task area and at UT Health at San Antonio between the Magnetic Resonance Imaging Division and the Department of Medicine.

 

Bridget serves as the Anatomy and Physiology I and II Lab Course Coordinator and teaches Anatomy and Physiology I and II lecture courses, Endocrinology, and Cell Biology at UIW. She is dedicated to mentoring undergraduates in the research laboratory where her research focuses on understanding the molecular mechanisms involved in renal cell injury in diabetic kidney disease. The overall goal she has for all her trainees is to apply what they learn in the classroom to ask scientific questions in the quest to become independent and creative thinkers.