Category Archives: Course Design

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

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

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

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

 

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

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

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

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

 

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

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

 

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

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

3.       Appreciate the importance of animal physiology

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

5.      Exercise responsibility and teamwork.

 

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

 

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

How were we assessing student learning?

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

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

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

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

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

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

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

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

 How will I know if my students learned animal physiology?

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

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

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

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

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

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

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

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

References

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

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

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

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

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

 

 

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Stay safe friends!

Mari

References:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Reference:

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

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

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

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

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

1) Use an integrative textbook.

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

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

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

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

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

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

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

5) Solicit student feedback.

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

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

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

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

7) Over-communication.

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

8) More assessments. More practice. More activity.

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

9) Utilization of LMS Discussion Forums.

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

10) Online presence for both lecture and lab.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Examples of tasks performed.

1 – Practice exam questions

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

2 – Multiple choice questions – Quizzes

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

3 – Completing sentences or matching answers

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

4 – Filling in the gaps

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

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

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

References

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

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

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

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

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

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

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

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

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

Backward planning of lab course to enhance students’ critical thinking
Zhiyong Cheng, PhD
Food Science and Human Nutrition Department
The University of Florida

Development of critical thinking and problem-solving skills hallmarks effective teaching and learning [1-2]. Physiology serves as a fundamental subject for students in various majors, particularly for bioscience and pre-professional students [1-8]. Whether they plan on careers in science or healthcare, critical thinking and problem-solving skills will be keys to their success [1-8].

Backwards course design is increasingly employed in higher education. To effectively accomplish specific learning goals, instructions are to begin course development with setting learning objectives, then backwardly create assessment methods, and lastly design and deliver teaching and learning activities pertaining to the learning objectives and assessment methods. In terms of development of critical thinking and problem-solving skills, a lab course constitutes an excellent option to provide opportunities for instructors and students to explore innovative paths to their desired destinations, i.e., to accomplish specific learning goals.

In a traditional “cookbook” lab setting, detailed procedures are provided for the students to follow like cooking with a recipe. Students are usually told what to do step-by-step and what to expect at the end of the experiment. As such, finishing a procedure might become the expected goal of a lab course to the students who passively followed the “cookbook”, and the opportunity for developing critical thinking skills is limited. In a backwards design of a lab course; however, the instructor may engage the students in a series of active learning/critical thinking activities, including literature research, hypothesis formulation, study design, experimental planning, hands-on skill training, and project execution. Practically, the instructor may provide a well-defined context and questions to address. Students are asked to delve into the literature, map existing connections and identify missing links for their project to bridge. With the instructor’s guidance, students work together in groups on hypothesis development and study design. In this scenario, students’ focus is no longer on finishing a procedure but on a whole picture with intensive synthesis of information and critical thinking (i.e., projecting from generic context to literature search and evaluation, development of hypothesis and research strategy, and testing the hypothesis by doing experiments).

An example is this lab on the physiology of fasting-feeding transitions. The transition from fasting to feeding state is associated with increased blood glucose concentration. Students are informed of the potential contributors to elevated blood glucose, i.e., dietary carbohydrates, glycogen breakdown (glycogenolysis), and de novo glucose production (gluconeogenesis) in the liver. Based on the context information, students are asked to formulate a hypothesis on whether and how hepatic gluconeogenesis contributes to postprandial blood glucose levels. The hypothesis must be supported by evidence-based rationales and will be tested by experiments proposed by students with the instructor’s guidance. Development of the hypothesis and rationales as well as study design requires students to do intensive information extraction and processing, thereby building critical thinking and problem-solving skills. Students also need to make sound judgments and right decisions for their research plans to be feasible. For instance, most students tend to propose to employ the hyper-insulinemic-euglycemic clamp because the literature ranks it as a “gold standard” method to directly measure hepatic gluconeogenesis. However, the equipment is expensive and not readily accessible, and students have to find alternative approaches to address these questions. With the instructor’s guidance, students adjust their approaches and adopt more accessible techniques like qPCR (quantitative polymerase chain reaction) and Western blotting to analyze key gluconeogenic regulators or enzymes. Engaging students in the evaluation of research methods and selection helps them navigate the problem-solving procedure, increasing their motivation (or eagerness) and dedication to learning new techniques and testing their hypotheses. Whether their hypotheses are validated or disproved by the results they acquire in the end, they become skillful in thinking critically and problem solving in addition to hands-on experience in qPCR and Western blotting.

Evidently, students can benefit from backwards planning in different ways because it engages them in problem-based, inquiry-based, and collaborative learning — all targeted to build student problem solving skills [1-8]. For a typical lab course with pre-lab lectures; however, there is only 3-6 hours to plan activities. As such, time and resources could be the top challenges to implement backwards planning in a lab course. To address this, the following strategies will be of great value: (i) implementing a flipped classroom model to promote students’ pre- and after-class learning activities, (ii) delivering lectures in the lab setting (other than in a traditional classroom), where, with all the lab resources accessible, the instructor and students have more flexibility to plan activities, and (iii) offering “boot camp” sessions in the summer, when students have less pressure from other classes and more time to concentrate on the lab training of critical thinking and problem solving skills. However, I believe that this is a worthwhile investment for training and developing next-generation professionals and leaders.

References and further reading

[1] Abraham RR, Upadhya S, Torke S, Ramnarayan K. Clinically oriented physiology teaching: strategy for developing critical-thinking skills in undergraduate medical students. Adv Physiol Educ. 2004 Dec;28(1-4):102-4.

[2] Brahler CJ, Quitadamo IJ, Johnson EC. Student critical thinking is enhanced by developing exercise prescriptions using online learning modules. Adv Physiol Educ. 2002 Dec;26(1-4):210-21.

[3] McNeal AP, Mierson S. Teaching critical thinking skills in physiology. Am J Physiol. 1999 Dec;277(6 Pt 2):S268-9.

[4] Hayes MM, Chatterjee S, Schwartzstein RM. Critical Thinking in Critical Care: Five Strategies to Improve Teaching and Learning in the Intensive Care Unit. Ann Am Thorac Soc. 2017 Apr;14(4):569-575.

[5] Nguyen K, Ben Khallouq B, Schuster A, Beevers C, Dil N, Kay D, Kibble JD, Harris DM. Developing a tool for observing group critical thinking skills in first-year medical students: a pilot study using physiology-based, high-fidelity patient simulations. Adv Physiol Educ. 2017 Dec 1;41(4):604-611.

[6] Bruce RM. The control of ventilation during exercise: a lesson in critical thinking. Adv Physiol Educ. 2017 Dec 1;41(4):539-547.

[7] Greenwald RR, Quitadamo IJ. A Mind of Their Own: Using Inquiry-based Teaching to Build Critical Thinking Skills and Intellectual Engagement in an Undergraduate Neuroanatomy Course. J Undergrad Neurosci Educ. 2014 Mar 15;12(2):A100-6.

[8] Peters MW, Smith MF, Smith GW. Use of critical interactive thinking exercises in teaching reproductive physiology to undergraduate students. J Anim Sci. 2002 Mar;80(3):862-5.

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

Building bridges: Medical physiology teaching in China
Ryan Downey, Ph.D.
Assistant Professor
Co-Director, Graduate Physiology Program
Team Leader, Special Master’s Program in Physiology

Department Pharmacology and Physiology
Georgetown University Medical Center
Washington, D.C.

The Chinese Society of Pathophysiology hosted the 2019 Human Functional Experiment Teaching Seminar and the Second Human Physiology Experimental Teaching Training Course 25-27 October. Across two and a half days, educators from across China met at Jinzhou Medical University in the province of Liaoning to discuss and workshop the latest ideas in active learning and interactive teaching techniques. In many ways, especially in terms of the esteem in which this meeting is held by its attendees, this meeting was not dissimilar from the APS Institute on Teaching and Learning, which will hold its next biennial meeting this coming June in Minneapolis. For the 2019 meeting, the organizers decided to invite an international speaker, which is how I found myself on a plane headed to China. As part of my visit, not only did I get to attend the workshop hosted at Jinzhou Medical University, but also I was hosted by several of the meeting organizers at their home institutions to see their facilities. In this writeup, I will reflect on some of the observations that I made during the many different conversations that I had with the educators participating in the meeting.

The most common question that I got from my hosts was, “What kinds of technology do you use in your classrooms and labs and how do you use them?” What surprised me the most about this question wasn’t the actual question itself, but the perception that many of the educators at the meeting held that they were lagging behind in the implementation of using technologies as   teaching and learning tools. The large majority of teaching spaces that I visited were equipped with much the same technology as any classroom or lecture hall that I would find in an American university: computers, projectors, large-screen LCD displays, and power at every seat to accommodate student personal electronic devices. While there was the occasional technological oddity, such as a computer here or there that was still running Windows XP, the technology available to these educators was very much on par with the technology I would expect at any modern university, which is why I was surprised that the educators had the perception that they were behind in implementing different technologies. In my conversations with them, I discussed the use of audience response systems like iClicker and PollEverywhere as well as interactive elements like gamification through websites such as Kahoot!, but my emphasis in these conversations was exactly the same as I have with educators at home: we need to make sure that there is a sound pedagogical basis for any engagement we use with our students and that the technology doesn’t matter. I can use 3×5 colored  index cards to create an audience response system that functions as well as (or sometimes even better!) than clickers because no one has any problems with the WiFi while using a 3×5 card. The technology facilitates our instruction and should never drive it for the sake of itself.

A common thread of many discussions was the use of internet technologies in teaching. While there is much to be said about the limitations of the ‘Great Firewall’ of China and the amount of government regulation that occurs over their communications, it’s important to note how little these limitations affect the day-to-day activities of the majority of citizens. There are Chinese versions of almost every single internet convenience that we would take for granted that function at least as well as our American versions. Their social media system has grown to the point that many international users are engaging on their platforms. There are food delivery apps and the local taxi services have all signed on to a common routing system (at least in Beijing) that functions in a similar way to Uber or Lyft. In a side-by-side comparison between my phone and one of the other meeting participants, there is near feature parity on every aspect. From an educational standpoint, however, there are some notable differences. The lack of access to Wikipedia is a notable gap in a common open resource that many of us take for granted and there is not yet a Chinese equivalent that rivals the scope or depth that Wikipedia currently offers. Another key area in which internet access is limited is their access to scholarly journals. This lack of accessibility is two-fold, both in the access to journals because of restrictions on internet use as well as the common problem that we are already familiar with of journal articles being locked behind paywalls. The increasing move of journals to open access will remove some of these barriers to scholarly publications, but there are still many limits on the number and types of journal articles that educators and learners are allowed through Chinese internet systems.

The most common request that I received while attending the educators meeting was, “Tell me about the laboratories you use to teach physiology to your medical students.” I think this is the largest difference in teaching philosophy that I observed while in China. The teaching of physiology is heavily based on the use of animal models, where students are still conducting nerve conduction experiments with frogs, autonomic reflex modules with rabbits, and pharmacological studies in rats. These are all classic experiments that many of us would recognize, but that we rarely use anymore. One key area of the workshops were modules designed to replace some of these classic animal experiments with non-invasive human-based modules, such as measuring nerve conduction velocities using EMG. My response that the majority of our physiology teaching is now done through lecture only was met with a certain degree of skepticism from many of them because the use of labs is so prevalent throughout the entire country. Indeed, the dedication of resources such as integrated animal surgical stations runs well into the hundreds of thousands of dollars per laboratory room set up, and to facilitate the entirety of students each year, there are multiple labs set up at each university. As the use of non-invasive human experiments expands, an equal amount of space and resources are being given to setting up new learning spaces with data acquisition systems and computers for this new task. In this area, I think that we have much to gain from our Chinese counterparts as many of the hardest concepts in physiology are more easily elucidated by giving students the space to self-discover in the lab while making physiological measurements to fully master ideas like ECG waves and action potential conduction.

Upon returning home, I have been asked by nearly everyone about my travel experiences, so I think it may be worth a brief mention here as well. I cannot overstate the importance of having a good VPN service setup on all of your electronic devices before traveling. Using a VPN, I had near-normal use of the internet, including Google and social media. My largest problem was actually trying to access local Chinese websites when my internet address looked like I was outside of the country. I have had good experience with NordVPN, but there are several other very good options for VPN service. Carrying toilet paper is a must. There are lots of public restrooms available everywhere in the city, but toilet paper is either not provided or available only using either social media check-ins or mobile payments. For drinking water, I traveled with both a Lifestraw bottle and a Grayl bottle. This gave me options for using local water sources and not having to rely on bottled water. The Lifestraw is far easier to use, but the Grayl bottle has a broader spectrum of things that are filtered out of the water, including viruses and heavy metals, which may be important depending on how far off the tourist track you get while traveling. My final tip is to download the language library for a translator app on your mobile device for offline use so that you can communicate with others on the streets. When interacting with vendors and others not fluent in English, it was common to use an app like Google Translate to type on my device, show them the translated results, and they would do the same in reverse from their mobile device.

One of the themes across the meeting was building bridges — bridges between educators, bridges between universities, bridges across the nation and internationally. I’m glad to have had the opportunity to participate in their meeting and contribute to their conversation on building interactive engagement and human-focused concepts into the teaching of physiology. Overall, the time that I spent talking to other educators was useful and fantastic. Everyone I met and interacted with is enthusiastic and excited about continuing to improve their teaching of physiology. I left the meeting with the same renewed energy that I often feel after returning from our ITL, ready to reinvest in my own teaching here at home.

Ryan Downey is an Assistant Professor in the Department of Pharmacology & Physiology at Georgetown University. As part of those duties, he is the Co-Director for the Master of Science in Physiology and a Team Leader for the Special Master’s Program in Physiology. He teaches cardiovascular and neuroscience in the graduate physiology courses. He received his Ph.D. in Integrative Biology from UT Southwestern Medical Center. His research interests are in the sympathetic control of cardiovascular function during exercise and in improving science pedagogy. When he’s not working, he is a certified scuba instructor and participates in triathlons

Using Quests to Engage and Elevate Laboratory Learning
Sarah Knight Marvar, PhD
American University

My students, like me, enjoy a challenge. Occasionally this challenge comes in the form of staying on track, using our lab time efficiently to achieve the learning outcomes and staying engaged with the material. There are specific topics that we cover in our undergraduate human anatomy and physiology course, such as the skeletal system, that had become a little dry over time. Classes occasionally included students sitting at desks looking disinterestedly at disarticulated bones glancing at their lab manual and then checking their phones. I felt that the students were not getting enough out of our laboratory time and weren’t nearly as excited as I was to be there!

With other faculty members I recently devised some new laboratory activities that include a series of quests that closely resemble a mental obstacle course, to try to encourage engagement with the material and make our learning more playful and memorable. There may also be some healthy competition along the way.

I teach an undergraduate two semester combined anatomy and physiology course, in which I lead both the lecture and laboratory portions. Students who are enrolled in this course are majoring in Biology, Neuroscience, Public Health and Health Promotions. Many of the enrolled students are destined for graduate school programs such as Medicine, Nursing, Physical Therapy, Physicians Assistant and PhD Programs. An example of the quest format we used recently in a bone laboratory is described here.

The Quests

The laboratory is set up with multiple quest stations that each represent a multi-step task on areas within the overarching laboratory topic. All of the tasks are designed to enable students to achieve the learning outcomes of the laboratory in an engaging way. The quest stations are designed to encourage the students to physically move around the laboratory in order to interact with other students, touch the exhibits, explore case studies, complete illustrations and build models. Each student begins with a quest guide which provides instructions and upon which they take notes, answer questions and complete drawings. Students move at their own pace and work in self-selected pairs or groups of three. They are able to ask for assistance at any stage of a quest from either of two faculty members present.   

Clinical case studies

Because of the students’ interest in patient care, we use clinical case studies as a major component of the obstacle course. X-ray images of a variety of pathological conditions as well as healthy individuals challenged students’ ability to identify anomalies in bone structure and surgery outcomes. The images that we used included a skull of a newborn showing clearly the fontanelles, an example of osteoporosis and joint replacement surgery. Students are required to identify anatomical location of the image as well as any anomalies, pathology or points of interest. Because of the student demographic of this class, many of them are destined to enter healthcare professions, they are particularly interested in this quest and are invested in solving the mystery diagnoses.

The Creative Part

Illustrations

An example of a student’s histological drawing.

The coloring pencils and electric pencil sharpener have come into their own in the laboratory and like Grey’s Anatomy illustrator Henry Vandyke Carter created before them, amazing anatomically accurate drawings are appearing on the page. Histology has been a particularly challenging aspect of our course for students with little previous exposure to sectioned specimens. In an attempt to allow students to really process what they are looking at and reflect on the tissue function I have asked students to draw detailed images of the histological specimens, label cell types and reflect on specific cell functions. This exercise aims to elevate the student’s ability to look closely at histological specimens and gain a better understanding of what they are observing and contemplate specific cell function.

Another quest involves categorizing bones and making illustrations of them, making note of unique identifying features and their functions.

3-D Modeling

Student synovial joint models with notes on function

Reminiscent of scenes from my three year old’s birthday party, I brought out the modeling clay and tried to stifle the reflex instruction to “don’t mix the colors”! Students were tasked with creating a 3-dimensional model of structures such as synovial joints. This is a particularly successful exercise in which students work with colored modeling clay to construct models of joints and label parts of the joint and describe the function of each part. This allows students to consider the relationship between the structure and function and move beyond looking at two-dimensional images from their textbooks and lecture slides. Students submit images of their completed models to the faculty for successful completion of the quest.

Other quest stations that were part of this particular laboratory session included Vertebrae Organizing, Mystery Bone Identification and Bone Growth Mechanisms.

One of the primary things that I learned from this exercise was that designing game-like scenarios in the classroom is far more enjoyable and entertaining for me as well as for the students, a win-win scenario. Overall from the perspective of the teaching faculty, the level of engagement was significantly increased compared with previous iterations of the class. The quality of the work submitted was high and in addition, this quest-based laboratory design is suitable for a wide range of topics and activities. I am currently designing a muscle physiology laboratory in a similar format that will include an electromyogram strength and cheering station as well as a sliding filament muscle contraction student demonstration station. In reflection I feel that my personal quest to find a novel and interesting way for the students to learn about bones was successful. Now onto the next quest……

Sarah Knight Marvar received her BSc in Medical Science and PhD in Renal Physiology from the University of Birmingham, UK. Sarah is currently a Senior Professorial Lecturer and Assistant Laboratory Director in the Biology Department at American University in Washington DC. Sarah teaches undergraduate Anatomy and Physiology, general biology classes as well as a Complex Problems class on genetic modification to non-majors as part of the AU Core program. Sarah’s research interests include using primary research literature as a teaching tool in the classroom, open educational resources and outreach activities.

How do you feel about sharing with the world? The Open Educational Resources (OER) phenomenon.

Joann May Chang, PhD
Professor of Biology & Director for the Center for Instructional Excellence at Arizona Western College
Yuma, Arizona

I recently attended a training on Open Educational Resources (OER) and what it truly means to offer an OER course.  What is an OER course?  If you offer a course that uses an e-text with other content found on the web to supplement without costing the student any money, this would be defined as being free of costs and not truly an OER course.  Why? That leads to the key question Matthew Bloom, OER Coordinator for Maricopa Community Colleges, posed to our group during the training: “How do you feel about sharing with the world?” 

OER has become a prominent topic in higher education to save students on textbook costs, but also a movement in building high quality accessible teaching materials for educators without being tied to a publishing company.  In a 2017 blog post by Chris Zook, he provided infographics of data associated with the increase in textbook prices that have outpaced inflation, medical services, and even new home costs. [attached graphic 1 & 2]  As Chris Zook also noted, community college students are two times more likely to purchase textbooks with their financial aid than four-year college students which increases their financial burden to complete their degree.  When faculty build OER courses, they can decrease this burden and share their course content with others who are working towards giving equal access to higher education.

OER is at the forefront of Arizona Western College because it is an integral part of our institution’s strategic planning goals to make higher education more accessible for our student population where the average yearly salary is only $38,237.    We are a year into this goal with our first formal OER training taking place in June 2019.  When Matthew first asked us if we share our teaching materials, most of us said “Sure! We share with our colleagues often.”  But then he followed that up with “How willing are you to share your developed content with the world?”  And that is the difference between a free versus an OER course.  If a faculty member develops open course content and licenses it under the Creative Commons License, the material can be retained, reused, revised, remixed, and redistributed (known as the 5R activities) by others.  The creator of the open content can control how their material is used with the different Creative Commons licenses. [Creative Commons License gif] With the shared content, the OER movement aims to provide quality teaching materials that can be used in an open creative and collaborative manner while benefitting students in reducing textbook costs.

I did not realize the importance of Matthew’s question until I started my search for OER content with Creative Commons Licensing for our OER transitioning Anatomy and Physiology courses.  We will be using the OpenStax A & P textbook starting this Fall and even though Matthew gave us some good starting points to search for open resources that follow the 5R activities, it has been difficult finding pictures and diagrams that can be used in lecture and activities.  I have been able to find various posts to labs, power point slides, videos, and open textbooks that can be used for A&P.  The most common issue is the lack of quality science pictures or diagrams offered as open content, which I have also heard is a problem from other colleagues transitioning to OER. 

So, here’s my challenge question for you: Are you willing to share your developed content, pictures, and diagrams with the world?  If you are, please license them and share so that you can be a part of this OER movement and others can also collaborate and build that open content. Ultimately, this is about the ability to be inclusive and provide quality higher education for our students without burdening them with textbook costs.

If you are interested in this OER movement and are looking for information or content, please check out the following resources:

This list is in no way inclusive.  There are many other resources out there, they just take time to find and to search through.  I hope more of the scientific community takes part in this OER movement and can provide more resources for everyone to use or collaborate on.  It truly makes a difference to our students and their education.

Joann Chang, Ph.D. is a Professor of Biology and the Director for the Center for Instructional Excellence at Arizona Western College (AWC), a community college in Yuma, Arizona.  She currently manages the professional development for AWC and teaches A&P and Introduction to Engineering Design.  When she’s not teaching or directing, she is keeping up with her twin daughters, son, husband, three cats and one dog.  On her spare time, she is baking delicious goodies for her friends and family.