Empathy | PECOP Blog

When the COVID-19 pandemic forced me to shift all teaching online in March 2020, I scrambled to modify and adapt my course-based undergraduate research experiences (CUREs) as well as my student-centered discussion-based animal physiology course to a remote format. Working fully from home I felt like I never left my computer. And I got a taste of what some of my students were experiencing in dealing with unstable Wi-Fi, constant interruptions, and a less than ideal learning environment. In the animal physiology course, modifying a flipped teaching format that was being used prior to the pandemic helped smooth the transition to online instruction; the pre-class preparation resources and the active learning materials that were already in place for flipped teaching were helpful in this transition, letting us focus on reconfiguring learning activities and assessments from the face-to-face format to the online platform (1, 2). In my lab courses, students prepared research proposals rather than research progress reports since they were unable to work in the lab and generate their own data.

In the second half of the spring 2020 semester, assignment due dates morphed into shifting targets rather than fixed goals, and other assignments were just dropped as I was simply too tired to adapt them to an online format. That summer, I spent hours and hours thinking about the structure of each of my courses, including the assignments, activities, and assessments, and what I could/would/should revise for the next offering of the course. I struggled with the uncertainty of planning for teaching in the Fall 2020 semester without knowing “how” classes would be. As the pandemic spiked in Houston and I continued to work from home, there was one key question that was always in the back of my mind: “What do I really want my students to learn and how can I help them get there?” (see 2).

Although I had requested an exemption from dual delivery for my lab courses, which were scheduled to meet in person, I wasn’t sure we would meet for class until the semester actually started. In over 20 years of teaching undergraduate labs, I have never seen students as happy to come to lab as they were last year – and none of them complained on those days when lab sessions went longer than scheduled. For most of them, this course was their only face-to-face class and they were genuinely hungry for in-person interactions.

For both semesters of the 2020-2021 academic year, faculty and students at Rice faced the challenges of not only the mode of instruction but also shortened semesters. The Fall 2020 semester was shortened from 15 to 13 weeks – students did not return to campus after the Thanksgiving holiday. The Spring 2021 semester started 3 weeks later than usual, and in-person classes were delayed until the fourth week of the semester due to a spike in COVID-19 cases in Houston. To add to this stress, we lost a full week of classes the fourth week of the semester due to a freak winter storm in Texas – so in-person meetings for my lab classes that had exemptions from remote delivery did not begin until Week 5 of the semester. Because of the winter storm, the spring semester was also shortened to 13 weeks of instruction. Additionally, throughout the spring semester there were 5 days that classes were not offered – these “Sprinkle Days,” which were in lieu of a week-long spring break, were especially challenging for faculty because we were not permitted to have any assignments due the day of or the day after a Sprinkle Day. These days with no classes disrupted the rhythm and flow of a “normal” semester for both faculty and students, especially for courses with multiple sections, where we had to stagger work and assignments over multiple weeks.

With shortened Fall 2020 and Spring 2021 semesters, faculty had less time to offer course material, and students had less time to work on projects in the lab and less time to learn content in lecture courses. Lab courses were mostly in-person for the entire year but with limited occupancy in each lab room, which was the biggest adjustment for student teams to work on their open-ended research projects together – the entire team of students was not always able to work in the lab at the same time; whole class meetings were held via Zoom. Additional safety precautions, such as wearing face shields in addition to masks and having plexiglass dividers at the student work benches, made communication more challenging as it was harder to talk and hear each other during lab. Lecture courses that were less than 25 or 40 students (Fall 2020 and Spring 2021, respectively) were allowed to be in-person in larger rooms that allowed for a 6-foot physical distance. Lecture courses that were greater than 25 or 40 students, respectively, were all online and were dual delivery.

The Fall 2021 semester was supposed to return to normal, with all classes meeting fully in-person. But due to some problems with COVID tests for the incoming class of students, we had yet another delay to the start of the semester – and when we started mid-week, we were online only for the first couple of weeks. We have now returned to full occupancy in the teaching labs, and face shields and plexiglass dividers are no longer required so the lab environment is much improved. We continue to use Zoom for some of the class meetings as it is easier for students to share presentations and for instructors to create short course videos. Although we anticipate an on-time, fully in-person start to the spring semester, we still must plan for alternative instruction as we do not know what will happen over the winter break with the omicron variant and the infection rate in Houston and elsewhere.

These past two years have been mentally draining and physically exhausting! The pandemic definitely heightened the need for empathy and compassion in my teaching (see 3). In both lab-based and lecture-based courses, I modified my teaching to

Balance flexibility, expectations, and rigor: in addition to reducing the number of assignments, I established flexible due dates for most assignments with “soft” or “hard” deadlines
Adapt assessments and feedback: assignments were modified so students could submit them online in our Learning Management System (Canvas), and I gave them more opportunities to revise their work throughout the semester
Make the syllabus “An Invitation to Learn:”
Connect with students: I now hold my “office hours” via Zoom, which gives me more flexibility for meeting with students outside of regular class hours
Create/seek new opportunities for learning: I seek ways to give students more choice and ownership of their work and expand the course content by bringing in guest speakers from Rice or other institutions, either over Zoom or in-person
Think of learning goals more broadly: I considered what outcomes are important to help students learn how to think like a scientist and be a good citizen.

One positive outcome of the pandemic-motivated changes to my teaching is confirmation that authentic assessment of student learning is about so much more than just exams or grades! Incorporation of formative assessments that are either low-stakes or completion grades give students opportunities to engage in learning both during and outside of class. Scaffolding of major assignments throughout the semester encourages students to focus on individual components, improve their time management skills, and incorporate my feedback into revisions of their work. In the classroom, students work on both team and individual projects throughout the semester, encouraging collaboration and creativity.

Many of the adaptations I made for instruction during the peak of the pandemic increased student engagement and improved learning, and I will continue to use these approaches post-pandemic. For example, two major changes I implemented as a direct result of the pandemic in the animal physiology course were to 1) shift the weighting of exams from 70% of the overall course grade to 25-30% and 2) make all exams “open resources.” (Illustration of Kristin Neff’s three steps for self-compassion, graphic recording by Johnine Byrne)

I realize more than ever the role I can and must play in helping students focus on the “big picture” as they learn critical concepts and skills so they don’t get overwhelmed with facts and details. I now incorporate these meta-questions into an end-of-the-semester reflection where I ask students to think about what they have learned:

What is one thing from this course that you want to take with you?
What one thing did you learn in this course that you will never forget?! How has that changed you?
What was the hardest part of this course? What did you do to cope with the difficulty of that aspect?
What was your favorite part of this course?

After overcoming my initial resistance to change and dealing with much angst about whether or not my efforts were actually helping students learn, I now accept and have even come to embrace this “new normal” of teaching, which includes both face-to-face and synchronous and asynchronous online instruction for lecture- as well as laboratory-based courses. The silver lining in the COVID-19 cloud is I am much more adaptable and confident in my abilities to change my teaching strategies when necessary to prioritize supporting students and creating learning experiences that include everyone.

As we enter year three of the pandemic, most of us recognize that our teaching will likely never return exactly to the way it was pre-pandemic and appreciate that it shouldn’t be the same as before. That being said, Michael S. Roth reminds us that “Everything Won’t Be Different” (5) and the lessons we have learned during the pandemic with regards to “inequality, connection, and compassion” should continue to shape and guide our teaching as we resume in-person interactions with students and colleagues. I end this post with a reminder that the mental health of faculty and staff is also important – for us to create a compassionate learning environment for our students, we must be kind to ourselves (5,6).

Beason-Abmayr B, Caprette DR, Gopalan C. Flipped teaching eased the transition from face-to-face teaching to online instruction during the COVID-19 pandemic, Adv Physiol Edu 45: 384-389, 2021; https://doi.org/10.1152/advan.00248.2020.
Beason-Abmayr B. What do I really want my students to learn about animal physiology? January 2021; https://blog.lifescitrc.org/pecop/2021/01/11/what-do-i-really-want-my-students-to-learn-about-animal-physiology/
Schacter HL, Brown SG, Daugherty AM, Brummelte S, Grekin E. Creating a Compassionate Classroom. INSIDE HIGHER ED, December 1, 2021; https://www.insidehighered.com/advice/2021/12/01/compassionate-teaching-yields-most-benefits-opinion.
Roth MS. Everything Won’t Be Different. INSIDE HIGHER ED, January 18, 2021; https://www.insidehighered.com/views/2021/01/18/three-lessons-pandemic-should-guide-colleges-future-opinion.
Illustration of Kristin Neff’s three steps for self-compassion, graphic recording by Johnine Byrne; https://www.lionsroar.com/three-steps-for-self-compassion-illustrated/
Neff KD. The Development and Validation of a Scale to Measure Self-Compassion, Self and Identity 2: 223-250, 2003; DOI: 10.1080/15298860390209035

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 (CUREs) and a student-centered animal physiology course. 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. She is a leader with the National Institute on Scientific Teaching (NIST) and co-director of a 2022 Regional Summer Institute (SI). She also is a longtime judge for the International Genetically Engineered Machine (iGEM) competition and a member of the iGEM Judging Program Committee. Beason-Abmayr is chair of the American Physiological Society’s 2022 Institute on 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.

Many of us are continuously trying to be as inclusive in our teaching as possible. One early concept I learned in this effort was to use person-first language, where one “puts the person before the disability, and describes what a person has, not who a person is”. This small change can lead to a more comfortable and inclusive classroom and also model behavior that future health professionals (the majority of my students) will need to employ in their careers.

Yet, there’s another ‘person first’ approach that I take in my classes and interactions with students that I think also builds inclusivity and perhaps more importantly, trust and understanding between my students and me. I try to be a person first, and a professor second. I try to see my students as people first, and students second. In the past year, during the unprecedented COVID-19 pandemic, this has been especially important as we all attempt to deal with additional life stresses, course modalities, and uncertainties.

As a person, the past year has not only been marked by the pandemic, but rather a significant medical challenge. In March 2020, amidst emergency planning to send students home permanently for the semester and move to remote teaching, I was diagnosed with Stage IV metastatic breast cancer. In 2014, in my second year as a faculty member, I had gone through chemo, surgery, radiation, and continued therapy for what was at that time stage III breast cancer. Remission lasted nearly five years. Since the original diagnosis, while I never felt like cancer defined me, it became an essential part of me, as a person, and as a professor.

The hormonal treatment regimen I followed from 2015-2019 provided a real-life example of many of the principles of the endocrine system that I taught my mid-level Human Physiology students. Along with an example of my grandmother stubbornly tapering off high-dose IV steroids after a kidney infection, I began to teach “my story” as our application of the endocrine system chapter in my flipped-classroom course.

I present a case study on “Patient X”, only revealing that I am in fact patient X after the relevant physiology is covered. As I explain to students, it’s not just an example to allow them to apply what they are learning to a clinical situation. Rather, it’s my attempt to demonstrate that the knowledge they are (hopefully) gaining, the vocabulary and critical thinking skills are not meant to just serve their future professional goals, but their personal life as well. They may be the one in the future helping a loved one navigate a challenging health situation. I’ve been forever grateful for my own physiological knowledge helping me to deal with my diagnosis, treatment, and prognosis.

This year, with the progression of my disease, the lesson takes a slightly different tone (although better this semester since my current infusion treatment has led to some regression of lung metastases). I also take the time to have a “soapbox moment” (and yes, I call it that…) to also inform students about metastatic breast cancer in general, some statistics, and the importance of early detection. I remind the students about the importance of drug discovery and clinical trials in changing people’s lives, mine included.

This year, in anticipation of writing this post, as part of the pre- and post- reflection students complete about “why is important to understand hormones?” I asked them for feedback on my person-first approach of sharing my own story. In addition to many students reflecting that they did in fact “see the bigger picture” of why we learn basic physiology, many provided comments that support my approach. A selection of some of their responses:

“I really liked that you incorporated your own personal story into class because it made me feel like I genuinely knew you better as a person rather than just my professor – students really don’t get to see their teacher’s lives outside of class, but I think it’s really special when they do and when they are vulnerable with us and can share things like you did. It also gave us some insight as to why you do the things you do and why you are interested in what you teach. Thank you for sharing!”

“You sharing your story today and being vulnerable with us gave real-life application to what we are learning. We are able to now better understand that learning this information is not just about memorizing facts to get a good grade. Rather, it shows us the importance of what we are studying and how we can use it to help others throughout our lifetime. So, thank you very much for sharing and inspiring other teachers to share as well.”

“I am really happy that you shared your personal story. I think case studies are a great way to learn in general, but actually knowing the person in the case makes is so much more powerful. I will never forget today’s class and I genuinely have a much better understanding and appreciation for the material that we covered.”

Obviously, not everyone has their own story to tell, but my guess is that we all have ways that we can be vulnerable and connect the material to our own lives, encouraging our students to do the same. Storytelling and narrative medicine have received recent attention as ways to promote empathy and build trust. Why not then share our own stories? Why not put the person first in our teaching?

To summarize, I am a person with cancer. I am a person who teaches physiology. I am a person who utilizes my cancer to help me teach physiology.

Anne Crecelius (@DaytonDrC) is an Associate Professor in the Department of Health and Sport Science at the University of Dayton.. She teaches Human Physiology, Introduction to Health Professions, and Research in Sport and Health Science. She returned to her undergraduate alma mater to join the faculty after completing her M.S. and Ph.D. studying Cardiovascular Physiology at Colorado State University. Her research interest is in the integrative control of muscle blood flow. She is a member of the American Physiological Society (APS) and on the leadership team for the Physiology Majors Interest Group (P-MIG).