Category Archives: Course Design

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.

 

Desperate times call for desperate measures: Teaching Physiology in a hybrid/online format and block schedule

Physiology and STEM educators at colleges and universities around the world have deployed creative and innovative strategies to preserve class and laboratory instruction during a pandemic.

My residential, liberal arts, undergraduate institution implemented a hybrid learning format, as did many others.  The hybrid format was adopted by the institution because room capacities were reduced to accommodate physical distancing and because we expected that COVID quarantines and isolations would force faculty and students to attend remotely.  Classrooms were outfitted with cameras and microphones in the HyFlex model to facilitate remote participation.  All classes and laboratories were forced to move online during certain blocks as a response to regional COVID rates and some students participated remotely for the entire year—including those who participated from their international homes.

More drastically, we converted our “normal” semester schedule (students complete four courses across a semester) into a block schedule.  Under the block schedule, students enrolled in one course at a time, intensively, for just under four weeks per course.  Courses met for three hours per day, four days per week.  Students completed a forced-choice mini-exam at the end of each unit and larger exams with forced-choice and short answer questions at the middle and end of the course (Table 1).  Laboratories were scheduled as additional meeting times.  Instructors and departments were granted a great deal of flexibility in laboratory scheduling so there were many permutations to lab schedules within a block—sometimes a student attended laboratory for three-hour sessions twice per week, other times a student attended for 1.5 hours four times per week.

In this post, I’ll address the changes that we made to our Human Anatomy and Physiology I and II (Biology 325 and Biology 326) sequence.  I’ll also reflect on the successes and challenges of the revisions and what we have retained in our return to in-person, normal semester scheduling.

Although we no longer utilize the block schedule at my institution, these reflections may be useful to instructors who are considering intensive summer courses and to instructors who would like to facilitate active and remote learning for other reasons.  It is important to note that the difficulties I address below are more likely to affect underserved, underprepared, or otherwise disadvantaged students and faculty, so particular attention to equity is important in considering how to deliver remote and/or intensive learning experiences.

Class (“lecture”) revisions

We adopted a flipped approach to the classroom portion of the course.  We chose this approach primarily in recognition that three-hour time blocks could only be successful with substantial interaction.  The flipped approach also helped us to navigate the hybrid format given that we anticipated technical concerns and/or limited attention spans would negatively impact the quality of meetings for remote students (three hours is an exceptionally long time to attend a Zoom class!).  Four instructors taught the courses each semester.  We divided each semester’s material into four units and each instructor created pre-class lecture videos of the relevant material for their assigned unit (Table 1).  Pre-class lecture videos totaled approximately one hour to 1.5 hours per class meeting.  The instructor also developed in-class materials for their assigned unit—typically case studies and/or worksheets.  Class began with instructors answering questions about pre-class video content and daily class objectives in response to student small group discussions.

Importantly, the block schedule reduced net class meeting hours and required us to prune as much content as possible.  We also integrated units that were previously separate.  For example, rather than address cellular physiology and skeletal physiology in separate units, cellular physiology was delivered using the calcium homeostasis and skeletal physiology for application (Table 1).

Lessons learned:

As noted above, instructors divided video and class material preparation by unit.  This required a high level of trust between instructors, and a willingness to try new ideas and pedagogies.  It worked well because our instructional team is cohesive and, although our pedagogical approaches vary, we value each other’s approaches.  Students benefitted from the lecture styles of four different instructors.

The flipped approach was helpful for practice and application of material.  The block schedule affords little time between class meetings given that classes meet for three hours per day on consecutive days.  Case studies and worksheets that applied lecture content helped students to identify points of confusion and build understanding. Further, students loved the ability to return to pre-lecture videos and rewatch points of confusion.  We now have a wealth of videos and in-class activities in our toolbox.  We continue to use many of the videos and assignments and recommend this approach to others– you might try flipping portions of class meetings as a starting point.

The intensive nature of the block schedule was advantageous in that students focused on one course at a time (so only needed to catch up in one course if COVID forced them to miss class).  A single course was their primary school-related responsibility during a block because they had no other courses and sports were largely on hold.  On the other hand, the intensive schedule left little time to develop content retention and build conceptual mastery.  There was little to no opportunity for spaced repetition.  We are currently seeing under-retention of content from last year in this year’s students.  If others attempt intensive schedule courses, it is important to recognize that content retention may be curtailed but conceptual development could be preserved with sufficient practice and application.

More generally, we are finding that students forgot how to time-manage and study in the block schedule.  They did not need to balance multiple classes or, for the most part, sports and social engagements.  The intensive nature of the block meeting schedule meant that much of their out-of-class time was spent preparing for the next day’s class rather than reviewing and studying material.  Some students (particularly those who are already disadvantaged) balanced this experience with intensified caregiving demands amid COVID restrictions.  Overall, student study habits declined—they are now struggling to optimize location, motivation, strategies, and pacing for self-regulated learning.

Students often operated in semi-isolation last year—often interacting with black boxes on a screen instead of classmates—and struggled to stay engaged via Zoom, even in breakout rooms.  This is a particular struggle for small, residential, liberal arts institutions where learning is typically done in small communities supported by close relationships.  Faculty found it difficult to build relationships with students during a four-week class with 50% remote participation each day and a requirement for meetings via Zoom (office visits were prohibited).  Students were less able to build a sense of STEM identity and belonging given the weaker relationships and reduced laboratory engagement (see below).  Sense of belonging and identity was likely especially challenging for individuals from minoritized groups with already lower STEM identity and belonging.

Lab revisions

All physiology experiments were removed from the laboratory sequence for the 2020/2021 academic year in response to the block schedule and to requirements for physical distancing and reduction of respiratory droplets.  The laboratory sequence consisted entirely of human anatomy.  We immediately recognized that learning a semester’s worth of human anatomy in four weeks—on top of class material—would be near impossible.  Therefore, we proposed a self-paced online anatomy lab experience that students could complete outside of their other coursework across the entire semester.  We utilized the Complete Anatomy platform (Elsevier; https://3d4medical.com/) and required students to submit a schedule for studying and completing practicals based on their own course schedule and other obligations each block.  Instructors held weekly instructional sessions via Zoom and met with students for tutoring as needed.  Instructional sessions were recorded and provided to students.

Lessons learned:

Any online, self-paced instructional platform will be subject to technical difficulties including spotty or slow home internet access and limited computing resources.  In addition, the Complete Anatomy platform posed surprising technical difficulties with gradebook access, content generation, and personal computer compatibility.  There were also notable technical glitches when delivering assessment via the Complete Anatomy platform.  We were able to either troubleshoot or work around each of the difficulties (for example, uploading Complete Anatomy images into our LMS for assessment), but it was labor-intensive and stressful.  Content generation was time-intensive and required a team of undergraduate teaching assistants during each semester and the prior summer.  We were lucky to have an outstanding team of teaching assistants who were so capable that they were awarded as institutional Student Employee Team of the Year (https://www.csbsju.edu/news/student-employee-awards-2021).

We were hopeful that the 3D visualization aspect of the platform (https://cdn.3d4medical.com/media/complete-anatomy-3/2019/screens.mp4) would help students improve mental 3D visualization abilities given that this has been a struggle for past students.  This did not seem to occur, although it is difficult to be sure given that most student work was completed away from instructors.  This year we paired Complete Anatomy software with physical models for in-person lab instruction and the combination works well.  We value Complete Anatomy as a study tool but some technical difficulties have continued, making it less suitable for assessment.  Online anatomy assessment was, of course, also limited because we had no way of enforcing a closed-book requirement.

Instructors observed that students did not retain as much content compared to previous years.  This is likely a result of multiple factors, including procrastination and approaches to learning.  Regardless of the original schedule developed by each student, many procrastinated and completed a flurry of practicals near the end of the semester.  Clearly those students were not practicing the spaced repetition that is important for learning.  Additionally, students often approached practicals as an item to be checked off a to-do list rather than a learning task.  When we hold laboratory sessions in-person, we can motivate and encourage students toward deep-, rather than surface-, learning in a way that we were unable to do remotely.  If we were to repeat the self-paced structure, we would enforce the students’ planned schedules more strictly.

Summary

We are happy to be back to a normal schedule with in-person instruction—made possible (thus far) by an institutional vaccination requirement for students and faculty and by masking requirements.  We have retained tools and strategies from last year, including flipped instructional materials and Complete Anatomy as a study tool.  We have moved away from other tools and strategies.  However, we (and others) may continue to offer intensive online summer options in which many of these approaches may be retained.

Table 1:  Class schedule

Pre-class video topics In-class activities
Unit 1 Day 1 ·       Course introduction

·       Homeostasis

·       Endocrine system

·       Osteoporosis case part 1

·       Study plan

Day 2 ·       Cellular signaling

·       Microscopic structure of bone

·       Bone remodeling mechanisms

·       Bone remodeling regulation

·       Osteoporosis case study part 2
Mini-exam 1
Day 3 ·       Cellular junctions

·       Passive membrane transport

·       Active membrane transport

·       Ca++ transport (osteoclast and intestinal epithelial cell)

·       osteoporosis case study part 3
Day 4 ·       Bone growth and fracture repair ·       Osteoporosis case study part 4

·       Bone growth disorders activity

Mini-exam 2
Unit 2 Day 5 ·       Resting membrane potentials ·       Resting membrane potential worksheet and practice questions
Day 6 ·       Neuron functional anatomy

·       Graded potentials

·       Neuron functional anatomy worksheet

·       Graded potentials worksheet

Mini-exam 3
Day 7 ·       Action potentials

·       Action potential propagation

·       Action potential worksheet and practice questions
Day 8 ·       Synapses and synaptic transmission

·       Synapses and synaptic integration

·       Synapses and synaptic integration worksheet and practice questions
Exam 1
Unit 3 Day 9 ·       Nervous system introduction

·       CNS protection

·       Brain trauma case study
Day 10 ·       Functional brain anatomy ·       Brain regions functional scenarios activity
Mini-exam 4
Day 11 ·       Receptor physiology (somatosensation)

·       Pain

·       Neanderthal pain discussion (Zeberg et al., 2020)
Day 12 ·       Vision

·       Autonomic nervous system

·       Autonomic nervous system case studies
Mini-exam 5
Unit 4 Day 13 ·       Control of movement

·       Functional skeletal muscle anatomy

·       Brain machine interface worksheet (Flesher et al., 2016; Moritz et al. 2008; O’Doherty et al., 2011; Sasada et al., 2014)

·       Muscle functional anatomy worksheet

Day 14 ·       Sliding filament theory

·       Neuromuscular junction

·       Excitation contraction coupling

·       Neuromuscular junction worksheet

·       Malignant hyperthermia case study

Mini-exam 6
Day 15 ·       Graded contractions

·       Muscle metabolism and fiber types

·       Motor recruitment worksheet

·       Muscle training worksheet

Exam 2

 

Jennifer Schaefer is an Associate Professor of Biology, the Biology Department Chair, and the Neuroscience Minor Director at the College of St. Benedict/St. John’s University.  She earned her B.A. in Biology from St. Olaf College in 2002 and her Ph.D. in Physiological Sciences from the University of Arizona in 2010.

Jennifer’s teaching expertise is in anatomy & physiology and neurobiology.  Her research in the science of teaching and learning investigates the interaction between metacognition and self-efficacy for student academic performance.  Jennifer collaborates on an ongoing national collaboration to develop a consensus set of core concepts for undergraduate neuroscience education and her research in neurobiology investigates motor control circuits in Drosophila.

Jennifer is a member of the American Physiological Society, Society for Neuroscience, Faculty for Undergraduate Neuroscience, and Phi Beta Kappa

Jennifer E. Schaefer

Associate Professor of Biology

College of Saint Benedict and Saint John’s University

Physiology as an Interpretive Lens for the Clinician’s Dilemma

Clinicians are faced with a dilemma – the need to make decisions based on a universal set of evidence and experience that usually does not explicitly include that individual. My understanding of the clinician’s dilemma germinated while working toward my professional Master’s in Physical Therapy and became clear during graduate course work in epidemiology. I didn’t have a chance to write about it and propose some vague abstract solutions until 2005,[i] and didn’t propose tangible solutions until 2014 which are embedded into a curriculum I developed for a new Doctor of Physical Therapy (DPT) program at Plymouth State University (2015-2017) and were then published in 2018.[ii] And to be clear, no one has solved this dilemma. At best we have some inkling of the types of reasoning that make it less poignant, or at least enable a clinician to have a rationale for decisions. There’s a gulf between a clinical researcher saying “Your practice is not evidence based”, and the clinician saying in response “Your research isn’t practice based”. A hardline stance of evidence-based practice not including mechanistic causal reasoning and only including (or giving strong priority to) randomized controlled trials that focus on outcomes as the primary determinant of the best treatment is not practice based.[iii]

The CauseHealth[iv] project considers the problem in their book Rethinking Causality, Complexity and Evidence for the Unique Patient[v]. Clinicians must be able to inquire and reason about unique situations and consider what, whether, how, when, and to what extent clinical practice guidelines and evidence from systematic reviews and randomized controlled trials apply in that particular situation. Clinicians consider mechanisms as causes underlying particular situations even when they are part of a unique arrangement of a complex system and when the observation of prior situations exist, or the ability to repeat the situation is limited.

In physical therapy this requires a depth and breadth of physiological understanding that starts with the core concepts and proceeds to integrated, complex, mechanistic causal relationships. Physical therapists “diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives” (APTA).[vi] A core component to the knowledge used in practice for this profession is physiological knowledge. Beyond understanding pathophysiology, physical therapists must be able to reason through the consequences of various situations – when is physiology as expected vs. not as expected and how does a set of expectations (or non expectations) influence our understanding of the current particular situation. In other words, clinicians are reasoning through causal models, either implicitly or explicitly. And often, much of what happens at the causal model level of knowledge for practice includes physiology.

My writing and teaching promote the use of causal models as representations of knowledge for clinical reasoning, and the use of graphical causal models for the clear articulation and sharing of such knowledge. This approach is helpful for the consideration of how universal concepts learned through an empirical process and thought to be true for a population can be applied in a particular situation. When teaching DPT students how to use physiology in clinical reasoning we approach causal models of physiological mechanisms as an interpretive lens for the clinician’s dilemma.

Clinical research utilizes statistical inference to estimate, from a sample, what a population characteristic or cause-effect relationship may be. The cause-effect relationship may be intervention-outcome, or it may be exposure-disease. The patient in front of a clinician was usually not in the original sample. The question then becomes, is this patient part of the population that this study (or these studies) represent via statistical inference? And is this patient part of that population in a manner that is important given the physiological mechanisms involved in the cause-effect relationship? This is a physiological question. We immediately can consider whether the inclusion and exclusion criteria of the research includes or excludes this particular patient. Those are obvious reasons to question whether the patient you are working with is part of the same population to which these studies inferred. We naturally look at age, sex, comorbidities and severity of the situation. All of these considerations imply variation in the underlying physiological state of the particular patient from the inferred population. But even if the particular patient is similar to the inferred population on all of these considerations, underlying physiological assumptions based on the mechanisms remain and should be considered.

For example, research demonstrates that electrical stimulation of the major skeletal muscles involved in walking is causally associated with positive outcomes in people with chronic heart failure such as maximum oxygen consumption (VO2max), six minute walk distance (6MWD) and even, to a lesser extent, health related quality of life (HRQOL).[vii]  Figure 1 depicts the simple graphical causal models that the clinical research (randomized controlled trials) has investigated as part of an evidence-based practice empirical approach to understanding the relationship between interventions and outcomes (made with DAGitty).[viii] Even when assuming a particular patient would be included (based on meeting inclusion criteria and not meeting exclusion criteria for these studies), there are several very poignant physiological mechanisms when considering the use of electrical stimulation in practice that impact the probability of the intended outcome.

No one assumes that electrical simulation directly improves health related quality of life, or six minute walk distance, or even oxygen consumption. There are physiological and even psycho-physiological, behavioral and cultural mechanisms involved in the connection between electrical stimulation and these three outcomes, and these three outcomes are very likely connected to one another.  Figure 2 is one possible graphical causal model that fills in some of the possible mechanisms.2

The clinician is working with many competing hypotheses, and is “faced with all sources of variation at the same time and must deal constantly with the full burden of the complex system.”Let’s take a closer look at the many causal assumptions of the model in Figure 2. As a graphical causal model, the first thing to realize is that all edges in the graph with an arrow encode the knowledge that one variable causes the other (and the lack of an arrow implies no causal connection). This does not have to be a definite causal connection; in fact, most of them are probabilistic and can be stated as conditional probabilities. For example, this graph encodes the knowledge that ES acts as a cause on muscle function. Which can be stated as a conditional probability: the probability of improved muscle function given ES is greater than the probability of improved muscle function given no ES. The model in Figure 2 also includes additional interventions since ES would rarely be considered the only intervention available. In fact, the patient in the condition where ES is the only intervention available probably would not be in the inferred population (for example, there are no studies on the use of electrical stimulation with patients with chronic heart failure that were not ambulatory or were unable to do other forms of exercise). This model includes aerobic training (AT), resistance training (RT), ES, adaptive equipment (AE), inspiratory muscle training (IMT), all as possible interventions for improving 6MWD, VO2max, and HRQOL in people with HF.

The characterization of the intervention (exposure, cause) in this model is discrete (yes/no), but it does not need to be discrete; it can be continuous and can include any of the considered important parameterizations of ES. Also, the effect muscle function is discrete but can be continuous and include any of the important parameterizations of muscle function. In other words, the causal model can encode as much of the ontological information about reality (its variables) as the user would have it encode. As attributed to George Box, “All models are wrong, some models are useful.”

The mathematical and logical implications of the causal model go on to include the multivariable considerations such as the chain rule of conditional probabilities (VO2max), identification of confounders (balance as a confounder), blocking variables (anaerobic threshold), and adjustment sets (6MWD).

My point here is to answer the question—“Isn’t this the same as concept map?” No. Causal models depicted as graphs are based on graph theory and adhere to a set of logical and mathematical rules that allow logical and mathematical implications to be proposed and tested. But they do share concepts. We could say that all causal models are concept maps, but not all concept maps are causal models; therefore, they are not equivalent since equivalence implies bidirectional implication.

Concept maps of physiological mechanisms are great teaching and learning tools. The next step, to use physiology as an interpretive lens for the clinician’s dilemma, is to consider encoding them as graphical causal models. In fact, this is the logical step from the core physiology concept of causation.

Another consideration for the clinician is that no single study has confirmed these causal connections all at the same time. But, a corpus of studies has tested these causal associations. The model in Figure 2 represents knowledge for practice; practicing based on this model is an example of using physiology to help in reasoning through whether to use an intervention with a particular patient. For example, if a particular patient has a problem with balance unrelated to muscle function then the probability of ES improving their 6MWD and even HRQOL is likely lower than in a particular patient without such a problem. And if a particular patient’s problem is mostly from the direct reduction in cardiac output associated with chronic heart failure, then a change in muscle function from ES may have less of an impact than in a particular patient with stronger contribution of muscle function in their reduction in oxygen consumption. And if the particular patient has low inspiratory muscle strength (IS), then IMT may be the best approach to start with – despite the fact that there are no clinical trials that investigate the intricacies of when to use ES vs. IMT. Thus, causal models of physiological mechanisms are an interpretive lens for applying clinical research in clinical practice. And this involves reasoning through causal models of complex physiological mechanisms.

The question is not whether this is already being done in practice (because it is, though usually implicitly not explicitly). The question is how are we teaching future clinicians and students? Is there a way to teach it that expedites the transition from classroom reasoning to clinic reasoning? Effective teaching often includes pulling back the curtain and explicitly revealing that which has been implicitly occurring. When a student asks me how their Clinical Instructor was able to come to some particular conclusion, the answer is usually that they were implicitly reasoning through some assumed causal model. Causal models can explicitly bridge the gap between learning physiology from a standard medical physiology textbook, doing a case study in a clinical course, and seeing a patient in a clinic.

The next step in my journey of using causal models for clinical pedagogy is the relationship between narratives, stories and causal models. If causal models are a more complex depiction of the reality underlying evidence-based causal claims; then narratives and stories are a more complex depiction of the reality underlying causal models. If you’re interested in discussing this further, please let me know.

Thank you to all of my colleagues (which includes all of the DPT students) at Plymouth State University for trusting this vision enough to take a chance on a new DPT program; and thank you to my closest dialogue partners in this and my upcoming work in the causal structure of narratives, Drs. Kelly Legacy and Stephanie Sprout (Clinical Assistant Professors of Physical Therapy); and Dr. Elliott Gruner (Professor of English/Director of Composition).

[i] Collins SM. Complex System Approaches: Could They Enhance the Relevance of Clinical Research? Physical Therapy. 2005;85(12):1393-1394. doi:10.1093/ptj/85.12.1393

[ii] Collins SM. Synthesis: Causal Models, Causal Knowledge. Cardiopulmonary Physical Therapy Journal. 2018;29(3):134-143.

[iii] Howick JH. The Philosophy of Evidence-Based Medicine. John Wiley & Sons; 2011.

[iv] CauseHealth Blog https://causehealthblog.org/ (Accessed 10/15/2021)

[v] Anjum RL, Copeland S, Rocca E. Rethinking Causality, Complexity and Evidence for the Unique Patient: A CauseHealth Resource for Healthcare Professionals and the Clinical Encounter. Springer Nature; 2020.

[vi] American Physical Therapy Association https://www.apta.org/your-career/careers-in-physical-therapy/becoming-a-pt (Accessed 10/15/2021)

[vii] Shoemaker MJ, Dias KJ, Lefebvre KM, Heick JD, Collins SM. Physical Therapist Clinical Practice Guideline for the Management of Individuals With Heart Failure. Physical Therapy. 2020;100(1):14-43. doi:10.1093/ptj/pzz127

[viii] Textor J, van der Zander B, Gilthorpe MS, Liśkiewicz M, Ellison GT. Robust causal inference using directed acyclic graphs: The R package “dagitty.” International Journal of Epidemiology. 2016;45(6):1887-1894. doi:10.1093/ije/dyw341

Figure Legends

Figure 1: Simplified Causal Associations Tested in Clinical Trials (Abbreviations: ES, electrical stimulation; 6MWD, 6-minute walk distance; VO2_max, maximum oxygen consumption; HRQOL, health-related quality of life)

Figure 2: Complex Causal Associations Necessary for Clinical Practice (Abbreviations: AT, aerobic training; (a-v)O2, arteriovenous oxygen difference; IMT, inspiratory muscle training; IMS, inspiratory muscle strength; PaO2, partial pressure of oxygen in the arterial blood; RT, resistance training; Ve, minute ventilation; VQ matching, ventilation perfusion matching )

Sean Collins is a Professor of Physical Therapy at Plymouth State University and was the founding chair and director of the Doctor of Physical Therapy Program.  He earned an ScD in Ergonomics (work physiology focus) and epidemiology at the University of Massachusetts Lowell. He teaches a three-course series on Clinical Inquiry, as well as a course in Clinical Physiology and a course on physical therapy practice with patients that have complex medical and cardiopulmonary conditions. From 2015 through 2021 he served as the Editor of the Cardiopulmonary Physical Therapy Journal, was co-leader and co-author of the American Physical Therapy Association (APTA) Heart Failure Clinical Practice Guideline from 2014-2019, and in 2018 was honored with the Linda Crane Lecture Award by the Cardiovascular and Pulmonary Section of the APTA for his work on using causal models as tools to teach and to join clinical research and practice.

 

Course-based Research Experiences Help Transfer Students Transition

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

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

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

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

Course-based Research Experiences Help Transfer Students Transition

Lisa Parks 9.30.2021

Figure 1

Cell Biology CURE Example:

Testing whether environmental compounds or other chemicals induce cell death

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

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

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

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

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

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

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

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

REFERENCES

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

Think back to your days as a college student majoring in science. Was your college on the smaller scale such that your professor met with you weekly for both your lecture and laboratory in chemistry, biology and physics? Or was your university on the large size, and while you sat among dozens or even hundreds of your peers in an auditorium where your professor lectured, you then met weekly in a smaller laboratory session conducted by teaching assistants? Our past experiences as students may or may not bear similarities to our professional career teaching environment at present.

As college professors in biology, or related science disciplines, our student enrollment in the major and the headcount of part-time versus full-time faculty have likely dictated the course schedule each semester. Such quantitative data, meshed with the physical resources of chairs in a classroom and square footage of laboratory space for teaching purposes, may be the major drivers of curricular practices. Pedagogical tradition perhaps accounts for science course scheduling practices as well. Budgetary matters too weigh heavily on decisions to maintain the status quo, or to experiment with test piloting the implementation of emerging course designs.

I teach at a mid-sized public university that offers graduate degrees alongside our more populous undergraduate majors. Our biology majors number approximately 1,000. Our faculty include part-time adjuncts, full-time lecturers and tenured/tenure-track professors. We do not have graduate teaching assistants in the classroom. Most often the assigned faculty teach both their lecture and laboratory sessions for a given course. A recent trend in our college has been to identify traditional lecture/laboratory courses that could be split such that students enroll in completely separate courses for the lecture versus the laboratory. For example, our microbiology course that used to be one combined course meeting twice weekly for lecture and once weekly for laboratory is now two distinct courses, laboratory versus lecture, although both are taken in the same semester, each course posts an individual grade on the transcript.

When asked to consider if any of the courses I teach would or would not be appropriate for separation of lecture from laboratory, I went to the pedagogical literature to see what I could find on the topic. Where science courses are combined into a single course (one grade) with lecture and laboratory, the lecture may be to a large scale audience, while the labs are disseminated into smaller break out groups led by either the lecture faculty or else another faculty member or teaching assistant. On the other hand, a science “course” may have a completely separate course number where students enroll and earn a grade for lecture, and a distinctly different course number where they enroll and earn a separate grade for the laboratory. Knowing these two variations exist, the literature reveals other alternatives as well.

A paper in the Journal of Scholarship of Teaching and Learning evaluated college introductory biology courses where either the same instructor teaches both the lecture and laboratory sessions versus those where there are different instructors for the lecture versus the lab. The author reports “no general trend indicating that students had a better experience when they had the same instructor for both lecture and laboratory than when the lecture and laboratory instructor differed (Wise 2017).” In fact, he states that students may even benefit from having different lecture and laboratory instructors for the same course as such would afford students exposure to instructors with different backgrounds and teaching styles (this paper’s doi: 10.14434/josotl.v17i1.19583).

When I was a teaching assistant during my graduate school days, I developed my teaching style by trial and error as the TA for the laboratory session break outs from the professor-led large auditorium style lectures for the undergraduate first year students majoring in biology. That was the early 1990s, and it was a mid-sized private university where at the same time they were “experimenting” with upper level undergraduate laboratory classes that were lab only. They called them “super labs” and they were not attached to a concurrent lecture course. Indeed, a 2005 paper in Biochemistry and Molecular Biology Education by D.R. Caprette, S. Armstrong and K. Beth Beason entitled “Modular Laboratory Courses” details such a concept whereby the laboratory course is not linked to a lecture (doi/epdf/10.1002/bmb.2005.49403305351). These modular laboratory-only courses are shorter in duration, ranging from a quarter to a half of semester, for 1 or 2 academic credits. Their intent is to apply the learning of specific skills, methods and instrumentation in their undergraduate biology and biochemistry curriculum. Of note, they recognized that their transition to such modular short-term laboratory courses was eased by their academic program already having their traditional curriculum with individual laboratory courses separate from the lecture courses.

Studio courses had in my mind been those taken by the art majors and other fine arts students. In the literature, however, there is an integrated “studio” model for science courses. A paper in Journal of College Science Teaching details how a small private college converted their Anatomy & Physiology I course, among others, from traditional lecture/laboratory courses to the integrated studio model. Their traditional twice weekly 75 minute lectures with 60 students and 150 minute breakout laboratories with 16 students per section, was reconfigured to 30 students meeting with the same instructor and teaching assistant twice weekly, each for 2 hours. These longer duration class sessions each consisted of, for example, 20 minutes lecture followed by 30 minutes of a context-linked laboratory, and then 20 minutes lecture followed again by 40 minutes of a linked laboratory They report fewer course withdrawals and unsatisfactory grades and cite that students felt “engaged and active” as did instructors who spoke of “immediate application and hands on” activity in the interactive classroom (Finn, Fitzpatrick, Yan 2017; https://eric.ed.gov/?id=EJ1155409).

Based on my experience with comprehension by students with the content delivery, I have decided to redesign my upper level undergraduate Cell Physiology course such that the cell physiology lecture will be a standalone 3 credit course, and students will be encouraged to take either during the same semester or the following semester, the 1 credit cell physiology laboratory course. When viewed thru the course scheduling and facilities lenses, this “split” will afford more students to enroll in a single lecture course section, while then having multiple smaller capacity laboratory course sections. As this is an upper level elective, students may find that a 3 + 1 credit option as well as a 3 credit only option suits their needs accordingly. And they can decide for themselves, together or apart, lecture with laboratory, or taken separately.

Laura Mackey Lorentzen is an associate professor of biology at Kean University in Union, NJ, where her teaching emphasis is general biology for majors as well as cell physiology, neuroscience and senior capstone. She earned a PhD in Biomedical Sciences/Molecular Physiology and Biophysics from Baylor College of Medicine in Houston TX, an MS in Cellular & Molecular Biology from Duquesne University in Pittsburgh PA, and a BS in biology from The University of Charleston, WV. She is a past president of the New Jersey Academy of Science (NJAS) and past editor-in-chief of AWIS Magazine, for the Association of Women in Science.