Category Archives: Inclusion

Cultivating Belonging through Asynchronous Discussion Assignments and “State Your Perspective”

Advancing diversity, equity, and inclusion (DEI) within college classrooms, whether virtual or in-person, has perhaps never been as high a priority as now. One outcome of pandemic teaching has been critical evaluation of historic teaching practices, placing the onus on instructors to provide inclusive learning environments that are responsive and adaptive to a wide range of individualized circumstances. At the same time, some students have expressed feeling isolated and disconnected from peers, reducing motivation and academic persistence. Cultivating a sense of community and belonging in educational spaces, for all learners, is a current hot topic in higher education. In fact, two recent PECOP blogs have centered around the related idea of incorporating team-building practices to enrich learning in physiology education (From a Group to a Team: Medical Education Orientation Curriculum for Building Effective Teams and Developing a Community of Practice in an A&P Course)

Belonging, or the belief that one’s individual abilities and attributes are valued, respected, and on par with others’ abilities, is a strong driving force for persistence in STEM fields (1, 2, see also the Iowa State University Center for Excellence in Learning and Teaching webpage: Foster a Sense of Belonging and the Indiana School of Education Building a Sense of Community for All resources). I am not an expert on this, yet I care about supporting the community of learners within the courses that I teach.  This led me to ask: What can I do to build students’ understanding of physiology while also deepening their belief that they belong here, in my classroom, which in turn may foster resilience, persistence, and improved satisfaction within college-level coursework?

Collaborative work is included in all courses I teach. These collaborations take different forms based on the learning goals for the course, learner characteristics (first year versus fourth year students, for example), and topic complexity. Summarized below is one course activity I have used which aims to: (1) help students master challenging physiology concepts through peer-to-peer interactions, (2) develop communication skills related to expressing ideas about human function (a highly-valued professional skill),  and (3) build community and a sense of belonging.

Asynchronous Discussion Assignments and “State Your Perspective”. One course I teach is an in-person, large lecture-style Human Physiology service course for second, third, and fourth year undergraduate students (as well as a handful of graduate students) from biomedical sciences, biomedical engineering, pharmacy interest, public health, and other STEM programs. Many students express trouble “learning how to learn” human physiology, which can be quite different compared with the academic work typical for their varied primary programs of study. They also report feeling isolated in a large classroom and that they have trouble finding study groups, which they value while preparing for exams.

Traditionally, exams in this Human Physiology course were comprised predominantly of multiple choice questions and a few short answer questions (e.g., 3-4 sentences in length). I recently found myself asking: WHAT IF students moved from providing short written explanations on exams that lacked detail due to time constraints to having sufficient time to carefully think through how to explain a physiological process? And, WHAT IF this activity could be designed in such a way to help students recognize what they understand (and what they don’t understand) in advance of an exam, giving them the opportunity to review course materials and try again? And, WHAT IF groups of students were working through this together, leveraging peer-to-peer learning?

These questions, along with experiences from the online and blended instruction I have been doing for many years, gave rise to incorporating asynchronous, online discussion assignments that students would complete in small groups (6-8 students per group). The goal was to give students an opportunity to practice using appropriate anatomical and physiological terminology to precisely describe how the human body functions in a relatively low-stakes setting that supported peer interactions. Students were given a discussion prompt (see below for examples) to which they posted an initial response in the LMS-based virtual discussion forum. Next, all group members were responsible for reviewing their peers’ initial posts and providing two follow-up responses, adding to and building upon the initial physiological descriptions. There were a total of four sets of discussion assignments, one per unit, across the semester. While the discussion assignment structure remained similar from unit to unit, the expectation to communicate increasingly complex ideas was inherent within the discussion prompts.

Specifically to address DEI and belonging, students were to begin their initial responses with a “State Your Perspective” statement. “State Your Perspective” entailed providing a 1-2 sentence summary statement to describe the context by which the topic at hand was viewed. In Human Physiology, this might be knowledge based on prior coursework, the focus of the lab in which they worked, practical clinical experiences for those who work in health care settings, and such. While ice-breaker introductions are frequently incorporated into group work, the use of bolder “State Your Perspective” language is intentional. It helps to move from a generic introduction that generally alludes to differing background experiences to an explicit and purposeful statement intended to summarize the specific context for the way a particular physiological function is understood.

Here are excerpts of the discussion prompts and how “State Your Perspective” is modeled for students.

UNIT 1 Discussion Prompt: One theme for UNIT 1 has been to develop connections between new information and previously-known concepts in order to understand how the human body works:  What have you learned in prior courses that apply to human physiology? Specify (1) the prior knowledge/what you knew before this course, and (2) the new ideas presented UNIT 1 that expands upon your background knowledge and therefore your understanding of human function.

  • “State Your Perspective”: Include a 1-sentence introduction at the beginning of your initial post that includes your major and anything else important for your group members to know that provides context for your perspective. For example “I am a third year biomedical sciences student and I work in a research lab that studies RNA, therefore I have learned ….”.
  • As you will see, some of your group members may have academic backgrounds that are different from yours, and they might present concepts in a different way. This is great! We hope the discussions become more interesting from sharing multiple ways to view the same physiological concept.

UNIT 2 Discussion Prompt: Prepare an answer to one of the Exam 2 Study Guide prompts to share with your group members. Include at least one type of conceptual model within your response: how one “Core Concept of Physiology” can be used to remember this process [see Reference 3 for information about the Core Concepts of Physiology], an originally-created concept map, an analogy, an annotated figure, or another self-generated study tool.

  • Begin your response with a 1-sentence “State Your Perspective” that provides context for your response. For example “I am a pharmacy interest student, and it is important for me to learn about neurotransmitters and receptors because ….”

UNIT 3 Discussion Prompt: Summarize one physiology concept presented in UNIT 3 for your group members, in your own words and including the appropriate anatomy and physiology terminology. Suggested length:  4-6 sentences. NEXT: Create four different 1-sentence statements about your topic, including two statements that are TRUE and two statements that are FALSE (but don’t identify which is which, see below).

  • Begin with a 1-sentence introduction, similar to previous discussion forums so that your new group members understand something about your perspective. Example: “I am an interdisciplinary studies student interested in healthcare; therefore, I found the lecture on hypertension really interesting ….”
  • For your responses to classmates: Carefully review each statement. Select one that you think is false and provide a physiological rationale to support your reasoning. Next, make the appropriate corrections to turn it into a TRUE statement.

Teaching Hint #1: This is manageable in a large lecture course of 150-250 students because I have teaching assistants who understand their primary responsibility is to regularly engage directly with students in the small-group discussions and provide feedback for correct and incorrect descriptions (this is a high priority for students. Practically speaking, this equates to each TA managing 6-10 groups of ~8 students each.

Teaching Hint #2: Once the grading is completed, I ask the TAs to summarize what they learned about how students learn physiology. This has been a good way to mentor TAs and prompt thoughts about their own teaching philosophies. I sometimes ask them what they would change (nothing like grading 50+ discussion assignments based on a poorly-worded prompt…). In fact, this is how the UNIT 3 true/false statements came to be; a graduate student proposed it as a way to incorporate greater critical thought and reasoning within discussion assignments.

So what did students think about this type of discussion assignment? Here are examples of comments provided on the end-of-class evaluation forms, paraphrased and in aggregate form (i.e., these are not actual student comments but represent themes in responses):

  • The discussion assignments were a good way for me to think critically about one idea then communicate my understanding of human function to my peers.
  • Discussions were a great way to see what my classmates were doing to learn human physiology that I could apply to my own learning—my group members proposed study strategies and ways of thinking about the human body that I hadn’t thought of before.
  • I enjoyed learning from my peers, who might know something more than me based on their experiences outside of class.
  • Even though this was a large lecture course with quite a bit of content presented online, I enjoyed interacting with my peers, the professor, and TAs in the discussions. I felt like everyone was there to support my learning.

Despite initial skepticism, very few students conveyed negative comments about the discussion assignments or described them as “busy-work”.

Beyond student feedback, here are a few subjective comments conveying my personal observations about classroom dynamics that arose from this course activity.

  • By design, one aim of “State Your Perspective” statement was to help students recognize that they hold certain views on a topic based on their background experiences. For some 20-something year-olds, it might not be intuitive that they, in fact, have certain perspectives and attitudes that they bring into group work. “State Your Perspective” has the potential to be affirming—when articulating prior experiences it can become more explicit, to ourselves and others, that we all have something unique to contribute to group work.
  • Sharing perspectives, along with the underlying narrative (but briefly, in 1-2 sentences), seemed to normalize the idea that we all have different backgrounds and experiences so OF COURSE we may hold different perspectives, or ways of viewing things.
  • Because the context for why discussion prompts were answered with a particular focus was evident, it seemed to reduce the pressure that every student should know “everything”. Instead, over time and through several rounds of discussions, students became more comfortable talking about what they understood and what they didn’t understand. Clarifications could be made and misperceptions could be corrected by peers, who almost always demonstrated remarkable diplomacy and kindness toward their classmates.
  • In some cases, the online and asynchronous nature of these discussions seemed to reduce barriers with regard to asking for help. It seemed to move students from a mindset of “I should know this but I don’t/everyone knows this but me” to the non-threatening “This is a topic maybe I need to ask about.” Students seemed less self-conscious when asking questions.

In summary, collaboration during small group, asynchronous discussion assignments seemed to promote a sense of community and belonging among students in a Human Physiology for non-majors course. As the instructor, it was rewarding to see improvement in students’ abilities to explain physiological processes across the semester. It was also extremely rewarding to see the great care exhibited by students to be inclusive and supportive of their peers.

 

References:

  1. Herman J, Hilton M. Supporting Students’ College Success The Role of Assessment of Intrapersonal and Interpersonal Competencies (Consensus Study Report of the National Academies of Sciences, Engineering, and Medicine). Washington, DC: The National Academies Press, 2017.
  2. Wilton M, Gonzalez-Nino E, McPartlan P, Terner Z, Christoffersen RE, Rothman JH. Improving academic performance, belonging, and retention through increasing structure of an introductory biology course. CBE Life Sci Educ, 18:1-13, 2019.
  3. Michael J, Cliff W, McFarland J, Modell H, Wright A. The Core Concepts of Physiology A New Paradigm for Teaching Physiology. New York: Springer, 2017.
My Perspective: I am an Associate Professor of Instruction in the Department of Health and Human Physiology at the University of Iowa. I am the Program Director for the B.S. Human Physiology program, which serves approximately 625 majors. I am also an active participant in several undergraduate student success initiatives at the collegiate level.  The most rewarding part of my job is learning about how students learn physiology, in their own words. I solicit student feedback for their academic experiences regularly.

Jennifer Rogers, PhD

Associate Professor of Instruction

Department of Health and Human Physiology

University of Iowa

 
Expanding “normal” in physiology

We are not formal authorities, rather informal allies who have enacted a few small classroom and content related changes related to diversity and inclusivity in our medical school. We hope that our experience will help you in your pursuits in the education of all students.

It took someone in power (a Departmental Leader and Course Director) to act. Author KSC recognized that key person group diversity content was missing and that societal and student sentiment had shifted. This was in the early fall following the 2020 “Black Lives Matter” demonstrations.  Knowing that even with firm institutional commitment, change would take time, author KSC inserted intentional diversity and inclusivity curricular time into the Cardiovascular Systems course (USA medical year 2, 5-week Fall course) in 2020. The social determinants of healthcare and related topics received some curricular coverage but were less present in foundational coursework. Three required elements were added to the course that would both have learning objectives and corresponding assessment items, as assessment often indicates importance in coverage and content to students.

Having passion and insight does not mean that this person must deliver the content. Author TEW was the person selected to deliver the material since the topic of “normal” had been informing his teaching for several years, especially in developing physiology content for Pediatrics and Gerontology medical blocks and an understanding that 50% of people could be excluded if sex as a biological variable is not included.  In 2017, author TEW also led a teaching workshop at the International Union of Physiological Sciences in Brazil with the goal of challenging physiology educators from across physiology societies to include sex and lifespan material in physiology education and to teach these differences not as special topics but as “normal” physiology.

The three elements covered included: sex, lifespan (older and younger), and USA person groups with historic health disparities. One lecture (“Normal” physiology and how it changes across the lifespan and between sexes – covering respiratory, renal, and cardiovascular systems) and 6 podcasts (Selected sex-specific issues in BP control & hypertension, Selected race & ethnicity issues in BP control & hypertension, An innovative approach to hypertension care in African American males, Sex-specific physiology: CV signs and symptoms, Sex-specific physiology: Heart disease, and CV epidemiology delineated by race and ethnicity) were incorporated and spaced within an integrative organ-based content.  We attempted to have material that was race/culture-informed but not race/culture based, which allows some separation of social constructs, the individual vs. person group, and a determinant vs. prevalence. In other Year 2 medical courses, Department physiologists added information on historical bias in normative prediction equations (pulmonary function testing and glomerular filtration rate) as well as environmental justice and air quality.  These other additions were in the form of one to a few formally presented slides, part of a case presentation, or as a brief class discussion topic.

Were the additions easy? No. It took curricular time, administrative support, and a great deal of learning on our part. Documents such as APS Medical Physiology Learning Objectives do not directly address diversity and inclusivity to guide the field in what is important to include.  Perhaps as a Society this is a change we can implement.  Some take-homes for physiology educators: 1) no matter your background, you can contribute (very few people have formal training in this area), 2) collaborate with other faculty, 3) obtain feedback from all person groups and from students, as perception and intent can be quite different, 4) be intentional and precise with wording, and 5) implement small changes. We encourage you to expand “normal” physiology in one or two ways this upcoming semester, but do not be surprised if students are quite interested and request more.

 

 

 

 

 

Ken Campbell is a Professor and Director of Graduate Studies in the Department of Physiology. He also in the Co-course Director of the Cardiovascular Course in the Year 2 medical curriculum University of Kentucky College of Medicine.

 

 

Thad Wilson is a Professor and Director of the Graduate Certificate in Physiology Teaching in the Department of Physiology. He also is the Co-course Director of the Respiratory Course in the Year 2 medical curriculum and teaches physiology in several of the other medical courses at University of Kentucky College of Medicine.

 

 
Fostering an Inclusive Classroom: A Practical Guide

Ah, the summer season has begun! I love this time of year, yes for the sun and the beach and baseball games and long, lazy summer reading, but also because it gets me thinking about new beginnings. I’ve always operated on a school-year calendar mindset, so if you’re like me, you’re probably reflecting on the successes and shortcomings of the past year, preparing for the upcoming fall semester, or maybe even launching into a new summer semester now. As campuses become more diverse, fostering an inclusive learning environment becomes increasingly important, yet the prospect of how to do so can be daunting. So where to start?

First, recognize that there is not just one way to create an inclusive classroom. Often, the most effective tactics you use may be discipline-, regional-, campus-, or classroom-specific. Inclusive teaching is a student-oriented mindset, a way of thinking that challenges you to maximize opportunities for all students to connect with you, the course material, and each other.

Second, being proactive before a semester begins can save you a lot of time, headaches, and conflict down the road. Set aside some dedicated time to critically evaluate your course structure, curriculum, assignments, and language choices before ever interacting with your students. Consider which voices, perspectives, and examples are prominent in your class materials, and ask yourself which ones are missing and why. Try to diversify the mode of content representation (lectures, videos, readings, discussions, hands-on activities, etc.) and/or assessments types (verbal vs. diagrammed, written vs. spoken, group vs. individual, online vs. in-class, etc.). Recognize the limits of your own culture-bound assumptions, and, if possible, ask for feedback from a colleague whose background differs from your own.

Third, know that you don’t have to change everything all at once. If you are developing an entirely new course/preparation, you’ll have less time to commit to these endeavors than you might for a course you’ve taught a few times already. Recognize that incremental steps in the right direction are better than completely overwhelming yourself and your students to the point of ineffectiveness (Trust me, I’ve tried and it isn’t pretty!)

Below, I have included some practical ways to make a classroom more inclusive, but this list is far from comprehensive. As always, feedback is much appreciated!

Part 1: Course Structure and Student Feedback

These strategies require the largest time commitment to design and implement, but they are well worth the effort.

  • Provide opportunities for collaborative learning in the classroom. Active learning activities can better engage diverse students, and this promotes inclusivity by allowing students from diverse backgrounds to interact with one another. Furthermore, heterogeneous groups are usually better problem-solvers than homogeneous ones.
  • Implement a variety of learning activity types in order to reach different kinds of learners. Use poll questions, case studies, think-pair-share, jigsaws, hands-on activities, oral and written assignments, etc.
  • Select texts/readings whose language is gender-neutral or stereotype-free, and if you run across a problem after the fact, point out the text’s shortcomings in class and give students the opportunity to discuss it.
  • Promote a growth mindset. The language you use in the classroom can have a surprising impact on student success, even when you try to be encouraging. How many of us have said to our students before a test, “You all are so smart. I know you can do this!”? It sounds innocent enough, but this language conveys that “being smart” determines success rather than hard work. Students with this fixed mindset are more likely to give up when confronted with a challenge because they don’t think they are smart/good/talented enough to succeed. Therefore, when we encourage our students before an assessment or give them feedback afterwards, we must always address their effort and their work, rather than assigning attributes (positive or negative) to them as people.
  • Convey the same level of confidence in the abilities of all your students. Set high expectations that you believe all students can achieve, emphasizing the importance of hard work and effort. Perhaps the biggest challenge is maintaining high expectations for every student, even those who have performed poorly in the past. However, assuming a student just can’t cut it based on one low exam grade may be as damaging as assuming a student isn’t fit due to their race, gender, background, etc.
  • Be evenhanded in praising your students. Don’t go overboard as it makes students feel like you don’t expect it of them.

Part 2: Combating Implicit Bias

Every one of us harbors biases, including implicit biases that form outside of our conscious awareness. In some cases, our implicit biases may even run counter to our conscious values. This matters in the classroom because implicit bias can trigger self-fulfilling prophecies by changing stereotyped groups’ behaviors to conform to stereotypes, even when the stereotype was initially untrue. Attempting to suppress our biases is likely to be counterproductive, so we must employ other strategies to ensure fairness to all our students.

  • Become aware of your own biases, by assessing them with tools like the Harvard Implicit Association Test (https://implicit.harvard.edu/implicit/takeatest.html) or by self-reflection. Ask yourself: Do I interact with men and women in ways that create double standards? Do I assume that members of one group will need extra help in the classroom – or alternatively, that they will outperform others? Do I undervalue comments made by individuals with a different accent than my own?
  • Learn about cultures different than your own. Read authors with diverse backgrounds. Express a genuine interest in other cultural traditions. Exposure to different groups increases your empathy towards them.
  • Take extra care to evaluate students on individual bases rather than social categorization / group membership. Issues related to group identity may be especially enhanced on college campuses because this is often the first time for students to affirm their identity and/or join single-identity organizations / groups.
  • Recognize the complexity of diversity. No person has just one identity. We all belong to multiple groups, and differences within groups may be as great as those across groups.
  • Promote interactions in the classroom between different social groups. Even if you choose to let students form their own groups in class, mix it up with jigsaw activities, for example.
  • Use counter-stereotypic examples in your lectures, case studies, and exams.
  • Employ fair grading practices, such as clearly-defined rubrics, anonymous grading, grading question by question instead of student by student, and utilize activities with some group points and some individual points.

Part 3: Day-to-Day Classroom Culture

These suggestions fall under the “biggest bang for your buck” category. They don’t require much time to implement, but they can go a long way to making your students feel more welcome in your classroom.

  • Use diverse images, names, examples, analogies, perspectives, and cultural references in your teaching. Keep this in mind when you choose pictures/cartoons for your lectures, prepare in-class or take-home activities, and write quiz/test questions. Ask yourself if the examples you are using are only familiar or relevant to someone with your background. If so, challenge yourself to make it accessible to a wider audience.
  • Pay attention to your terminology and be willing to adjust based on new information. This may be country-, region-, or campus-specific, and it may change over time (e.g. “minority” vs. “historically underrepresented”). When in doubt, be more specific rather than less (e.g. “Korean” instead of “Asian”; “Navajo” instead of “Native American”).
  • Use inclusive and non-gendered language whenever possible (e.g. “significant other/partner” instead of “boyfriend/husband,” “chairperson” instead of “chairman,” “parenting” instead of “mothering”).
  • Make a concerted effort to learn your students’ names AND pronunciations. Even if it takes you a few tries, it is a meaningful way to show your students you care about them as individuals.
  • Highlight the important historical and current contributions to your field made by scientists belonging to underrepresented groups.
  • Limit barriers to learning. You will likely have a list of your own, but here are a few I’ve compiled:
    • Provide lecture materials before class so that students can take notes on them during class.
    • Use a microphone to make sure all students can hear you clearly.
    • Consider using Dyslexie font on your slides to make it easier for dyslexic students to read them.
    • Speak slowly and limit your use of contractions so that non-native-English speakers can understand you more easily.
    • Write bullet points on the board that remain there for the whole class period, including the main points for that lecture, important dates coming up, and key assignments.
    • Be sensitive to students whose first language is not English and don’t punish them unnecessarily for misusing idioms.

As a final parting message, always try to be mindful of your students’ needs, but know that you don’t have everything figured out at the outset. Make time to reevaluate your approach, class materials, and activities to see where improvements can be made. Challenge yourself to continually improve and hone better practices. Listen to your students, and be mindful with the feedback you ask them to give you in mid-semester and/or course evaluations.

For more information, I recommend the following resources:

  1. Davis, BG. “Diversity and Inclusion in the Classroom.” Tools for Teaching (2nd Ed). San Francisco: Jossey-Bass, A Wiley Imprint. p 57 – 71. Print.
  2. Eredics, Nicole. “16 Inclusive Education Blogs You Need to Know About!” The Inclusive Class, 2016 July 27. http://www.theinclusiveclass.com/2016/07/16-inclusive-education-blogs-you-need.html
  3. Handelsman J, Miller S, Pfund C. “Diversity.” Scientific Teaching. New York: W. H. Freeman and Company, 2007. p 65 – 82. Print.
  4. “Instructional Strategies: Inclusive Teaching and Learning.” The University of Texas at Austin Faculty Innovation Center. https://facultyinnovate.utexas.edu/inclusive

Laura Weise Cross is an Assistant Professor of Biology at Millersville University, beginning in the fall of 2019, where she will be teaching courses in Introductory Biology, Anatomy & Physiology, and Nutrition. Laura received a B.S. in Biochemistry from the University of Texas and a Ph.D. in Molecular and Cellular Pathology from the University of North Carolina. She recently completed her post-doctoral training in the Department of Cell Biology & Physiology at the University of New Mexico, where she studied the molecular mechanisms of hypoxia-induced pulmonary hypertension. Laura’s research is especially focused on how hypoxia leads to structural remodeling of the pulmonary vessel wall, which is characterized by excessive vascular smooth muscle cell proliferation and migration. She looks forward to engaging undergraduate students in these projects in her new research lab.