Category Archives: 6 – 2018 June Highlights – Faculty Paths in Physiology Education

Why Teaching? Why a Liberal Arts school?

Why Teaching? Why at a Liberal Arts school? These are two questions that I am often asked. I used to give the standard answers. “I enjoy working with the students.” “I didn’t want to have to apply for funding to keep my job.” “A small, liberal arts school allows me to get to know the students.” But more recently those answers have changed.

A year or so ago, I returned to my undergraduate alma mater to celebrate the retirement of a biology faculty member who had been with the school for almost 50 years. As I toured the science facilities—which had been updated and now rival the facilities of many larger research universities—I reflected on where I had come from and how I came to be a biology professor at a small liberal arts school in Iowa.

I was born and raised in the suburbs of Harrisburg, Pennsylvania. In fact my parents still live in the house they purchased before I was born. My parents valued education and believed it was their job to provide their three children with the opportunity to go to college. Because there were three of us, it was expected that we would attend college in Pennsylvania. At that time, the way to learn about colleges was to go to the guidance counselor’s office or to sift through all of the mailings that came to the house. One of the schools I chose to visit was Lebanon Valley College (LVC), a small, private, liberal arts institution in Annville, PA (central Pennsylvania). LVC had a strong biology program but my reasons for choosing LVC were I liked the campus, the school was neither too big nor too small, and it was far enough from home but not too far from home. That is how I ended up at LVC.

I was a biology major, pre-med my entire four years at LVC. The biology department at LVC was fantastic. The professors had high expectations, held students to these high expectations, and helped the students to reach those expectations. The professors gave me a solid background in the sciences and opportunities to work in a lab. Both the knowledge I gained and the lab experiences I had allowed me to succeed as a scientist. However, during my journey at LVC, I found that there was more to me than being a biology major or a Pre-Med student. From the beginning of my time at LVC, my professors saw something in me that I could not and chose not to see. My professors saw a person who loved to learn, a person who loved to explore, and a person who loved to share information. They saw an educator, a leader, and a communicator. But regardless of what they saw or what they said, I had to find these elements on my own and for myself.

During my time at LVC, I did not understand what the liberal arts meant or what the liberal arts represented. Back then if you had asked me if I valued the liberal arts, I probably would have said I have no idea. Even when I graduated from LVC, I did not realize the impact that my liberal arts education would have on me. It is only now when I reflect on my time at LVC that I can appreciate and value the impact that my liberal arts education had on the achievement of my goals. It was the courses that were required as a part of the liberal arts program and the professors who taught them that made me a better scientist. The writing and speech classes provided the foundation for my scientific communication skills that continued to develop after graduation. It was in these classes that the professors provided constructive feedback which I then incorporated into future assignments. The leadership, language, literature, philosophy, and art courses and professors provided opportunities to develop my ability to analyze, critique, and reflect. The religion courses taught me that without spirituality and God in my life, there was little joy or meaning to what I accomplished. The liberal arts program provided me with skills that were not discipline specific but skills utilized by many academic fields. These courses allowed the person who loved to learn, the person who loved to explore and ask questions, and the person who loved to share information to flourish. These courses taught me to value all experiences as opportunities to learn and to become a better person. Lebanon Valley College, through the people I met and the education I received, put me on the path to finding the elements that form my identity.

After graduation from LVC, I explored. I accepted a position as a research technician in a laboratory where I remained for three years. During that time, I improved my science skills, but I also had the opportunity to use and improve those other abilities I learned at LVC. After three years, I decided I wanted to go to graduate school. I loved asking new questions, performing experiments, and the feeling I had when an experiment worked and provided new information. I also liked working with students. I loved sharing information and guiding students through the process of learning. I applied to graduate school, was accepted, earned my Ph.D, and then completed two postdoctoral fellowships. My graduate advisor and postdoctoral advisors were supportive of me and allowed me to teach in addition to my research. After two successful postdoctoral fellowships, I had to decide where to go next. I chose teaching and I chose Clarke University. I chose teaching and specifically Clarke because I wanted to go back to my roots. I wanted to take the knowledge and skills I had attained and share them. I chose Clarke University because I saw similarities between it and LVC. I chose Clarke University because of its liberal arts heritage and its focus on the students.

Now, 10 years later, I am a guide for a new generation of students at Clarke University. While there are so many differences between my generation and this generation, I still see similarities. I see students eager to come to class so they can learn. I see students excited when they understand a difficult concept. I see students who want to make a difference in this world. I do not know what a student would say if I asked them if they valued their liberal arts education or me as their teacher. My guess is that many of them are just like I was and do not know what the liberal arts represent. Some might even say they do not value the liberal arts or the professors. I can only hope that one day, when the students I teach reflect on their undergraduate careers, they can recognize and appreciate the influence Clarke University, the liberal arts program, and their professors had on them. I know that without my professors and without my liberal arts experience at Lebanon Valley College, I would not be me—the educator, the scientist, the author, the leader, the life-long learner. Nor would I be me—the mother, the wife, the daughter, the sister, the friend, the colleague. Lebanon Valley College and my liberal arts education helped me become the person I am today.

Melissa DeMotta, PhD is currently an Associate Professor of Biology at Clarke University in Dubuque, IA. Melissa received her BS in biology from Lebanon Valley College. After working for three years at Penn State’s College of Medicine in Hershey, PA, she received her PhD in Physiology and Pharmacology from the University of Florida in Gainesville. Following postdoctoral fellowships at the University of Arizona and Saint Louis University, Melissa joined the Biology Department at Clarke University. Melissa currently teaches Human Physiology and Exercise Physiology to physical therapy graduate students and undergraduates. She also enjoys teaching non-majors life science courses as well.

Thoughts from the Future

April 23, 2028

Dear Dave Harris of 2018,

It has been a long time my friend, in fact 10 years. I have plenty of good news to share with you, which may be shocking or expected!

First, I am happy to inform you that the past decade has been extremely good for your Philadelphia Eagles! After winning Super Bowl LII in 2018, they have gone on to win 3 more with Carson Wentz running new “Philly Specials” year after year! Tom Brady finally retired after he dropped another wide-open pass in Super Bowl LV. However, the biggest surprise for you may be that the Cleveland Browns won Super Bowl LV!

I am also happy to tell you that the educators survived the Great Medical Education Transformation of the 2020s! I knew that you saw this coming around 2015, but the speed at which the Transformation occurred was mind-blowing for many faculty! We lost a few good “soldiers” in the process when they failed to adapt their educational views and styles, but as of now, medical education has never been better and there have been substantial improvements in patient safety and outcomes! I am sharing some of the changes with you to prepare the faculty of the future!

One of the first recognizable changes was the manner in which students approached medical school curricula. Even during your time, schools saw drastic reductions in class attendance and student engagement with the formal curriculum. The millennial students were used to obtaining information how they wanted and immediately when they wanted. Recording of lectures led to students remaining at home so that they could double speed your voice to sound (you have no idea how they describe you!), allowed them to view these lectures at midnight in their pajamas, and gave them the ability to stop and take notes. Many faculty mistook this as student disengagement and tried to “force” them into class by making mandatory sessions or increasing the frequency of assessments. However, students responded by stating that some sessions were a “waste of time” and “took time away from studying for Step 1”. They continued to vote with their feet and migrate away from the classroom!

However, what caught most faculty of your time off guard was the use of external resources outside of your own curricular items. The emergence of the “hidden curriculum”! Students were presented with alternative options such as Anki, Sketchy Medical, Osmosis, First Aid, Khan Academy and Pathoma to name a few! At first faculty were unaware and put up a staunch resistance. It was even postulated by some that the core curriculum of basic science could be delivered as a shared Medical Curricular Ecosystem (Le and Prober) that would help reduce redundancy in medical schools. This caused an imbalance in the galaxy and many of the upset faculty tried to prevent this from coming. However, many astute faculty quickly realized that it was already there!! At that point the faculty rebel forces decided to become proactive instead of reactive!

Town hall meetings, focus groups, and interviewing revealed many weaknesses in the medical school schema to date. Faculty struggled to realize that the millennial students grew up with the internet and basically a cell phone attached to their hand. Finding content was not an issue for them and what faculty discovered was that much of the content delivered in lectures was identical to what could be viewed in a video in 8 minutes. They also discovered that students grew up in a world where everyone was connected through social media and available almost 24 hours a day! They expected responses from their friends on a chat within seconds! After all, how many people sleep with their cell phone next to them? Faculty also discovered in these town halls that the generation valued work/life balance and anything that was deemed inefficient cut into this time that they could be doing something else. Through these important meetings, faculty also discovered that students were excellent at recalling facts and regurgitating knowledge. However, when asked to apply that knowledge to a problem, the students went back to recalling the facts. Students had mistaken memorizing for learning! And many faculty had mistaken learning for telling! Some faculty reflected back and actually admitted that we may have enabled the behaviors with our constant barrage of standardized tests of knowledge!

At least, the good news is that this led to some drastic changes in medical education! Gross anatomy has been severely trimmed down in an effort to focus on clinically relevant anatomy for undifferentiated medical students. Gross anatomy dissection is reserved for students interested in a surgical career as an elective. Much of that experience of cutting through muscle layers and isolating each artery, nerve and vein, and picking through layers of fat to get there has been replaced by complex computer programs that help students visualize the anatomy in 3D! Since ultrasound is currently available to any physician through their phone, more emphasis of anatomy related to ultrasound aspects has been a focus of instruction. For many of the pathological or anatomical variations, 3D printing has allowed for much cheaper and better alternatives for learning. Everything is currently related to clinical medicine and focuses on key concepts that are necessary to master as opposed to “knowing” everything! However, the changes did not stop there!

Much of the basic physiology content knowledge is now presented to the students in alternative ways using directed, short videos or providing references. The class time has been reserved for higher level threshold concepts where students are placed in situations in which misconceptions and dangerous reasoning can be identified and corrected. Simulations and standardized patients (robots) have become common place where students have to integrate what they were learning in Doctoring courses with real life physiology. Students enjoy the safe environment and as faculty discovered the role of affect in cognition, they quickly realized that this was a time efficient pedagogy. Faculty have discovered that 1 hour of intense, clinically oriented, and high yield threshold concept learning is much more beneficial and time efficient than 4 hours of didactic lecture. And faculty discovered it was fun!

Another aspect under appreciated by faculty of your time is that students enjoy being able to learn in their own environment as opposed to in the classroom. In your day coffee shops were filled with students studying away, but technology has allowed for large communities of learners to “get together” from their own homes. Time spent traveling from various hospital sites during the clerkships was saved by developing online communities for learning and using technology to facilitate discussion. Students felt more at ease critiquing another’s differential with this new design and appreciated the time saved from travel.

As I said my friend, medical education has been transformed in exciting and very positive ways! Successful faculty have worked with the students to enhance the learning experience as opposed to trying to teach the way we were taught! Faculty focused more on the learning process as opposed to trying to relay knowledge to the students. It was discovered that technology could not substitute for poor teaching. Faculty learned to develop activities to get students out of their comfort zones so that true learning could occur. And lastly, faculty realized that their roles were not eliminated. Rather the role of faculty had to change from the expert sage on the stage to the facilitator of student learning!

Well, I can’t wait to see what the next ten years will bring! You will be happy to know that your two daughters have grown up to be beautiful, caring people!

See you in 10 years and Fly Eagles Fly!!

Dave Harris of 2028

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I realize that this letter may be viewed as provocative, crazy, and aspiring! However, I hope that the conversations in medical education can begin to REALLY improve patient safety and outcomes in the future. What changes do you think will occur in medical education in the next 10 years?

David M. Harris, PhD, is currently an Associate Professor of Physiology at the University of Central Florida College of Medicine in Orlando, Florida. He received his PhD from Temple University School of Medicine, completed his post-doctoral research at Thomas Jefferson University, and was offered his first faculty position at Drexel University College of Medicine. He moved away from Philly to Orlando in 2011. He has written several educational research manuscripts, mostly about the use of high fidelity mannequin simulators in medical physiology and currently serves as an Associate Editor for Advances in Physiology Education. He is also on the Aquifer Sciences (formerly MedU Science) leadership team developing a curriculum that provides tools or how to integrate basic science knowledge with clinical decision making to prevent harm.

Reference: Le TT, Prober CG. A Proposal for a Shared Medical School Curricular Ecosystem. Acad Med, March 6, 2018

The Emerging Role of Fixed-Term, Non-Tenure Teaching Faculty in Higher Education

The Back Story: I did not set out to become a college professor. My “aha” moment came half-way through my Master’s program when I counted the number of course credits left to complete and realized that I had not yet learned all that I wanted to learn. This led to a Ph.D., followed by a post-doc, followed eventually by a tenure-track faculty position.

Flash Forward to Today: I am now a Lecturer. Leaving a tenure-track position at a small private college to be a Lecturer at a large, research-focused university was the right career choice for me; however, as with everything in life there have been trade-offs.

The primary difference between Lecturers and tenure-track faculty at our institution is the research component. As a general rule, Lecturers are full-time faculty members specifically hired to teach numerous courses so that tenure-track faculty may focus upon their research areas. This is a good plan in theory. Tenure-track faculty benefit from a reduced teaching load. Undergraduate students benefit from courses taught by faculty who have specialized in teaching. For many Lecturers, it is a career “win” to teach in a college or university setting without the expectation to pursue external grant funding and simultaneously balance research against instructional requirements.

And yet . . . there is an element of sensitivity surrounding the “Lecturer” title.

Originally I wondered if perhaps it was my own sensitivity. Interactions with other teaching faculty, from my institution and others, suggest this uneasiness is a more prevalent and widespread issue. Perhaps it is fueled by the uncertainty of uncharted territory.

Whereas there are a handful of Lecturers who have held the job title for 10-20 years, the substantial growth of fixed-term, non-tenure teaching opportunities is a relatively recent phenomenon. A non-tenure teaching position is not the traditional career path, leading to questions such as: What exactly is a “Lecturer”? How stable are fixed-term appointments? By accepting a Lecturer position now, does it limit future job prospects down the road? From the other perspective, I sometimes wonder what tenured faculty think about teaching faculty. Are we consulted as valued and knowledgeable peers within the department and/or college? This matters.

Teaching faculty seem to be placed in an ambiguous category ranked somewhere between graduate students and tenured faculty. Part of the unease comes from the lack of clarity of our roles and the paradox of having demanding departmental responsibilities while being denied full faculty status. The students do not appreciate the difference. In their minds, we are essentially all the same—the bodies up at the front of the room challenging them to learn about the amazing human body.

This is where you, the PECOP reader, come in. Although I have only the lens of my own experiences, it would be interesting to hear the perspectives of other tenure- and non-tenure track faculty regarding the emerging role of teaching-specific faculty at other academic institutions across the country. These are the questions that I will throw out to foster discussion; feel free to add your own!

Question 1: What role do fixed-term, non-tenure track faculty play at your (or other) institutions?

This is a basic question. I have been a Lecturer at one institution, admittedly not a big sample size. Are courses at other colleges or universities primarily taught with the “old” model of tenured faculty, or are teaching faculty trickling in? Does the size of the academic institution influence the use of non-tenure teaching faculty? What is the general perception of teaching faculty and scope of their contributions to the department and college?

Question 2: What should our job title be? (… And remind me again why it is that we cannot receive tenure?)

“Lecturer” appropriately describes what I was hired to do, to teach four courses a semester, but it is a relatively small part of what I actually do on a daily basis. The time outside of lecture is spent predominantly on trouble-shooting student issues to the effect of “I forgot my Clicker, can I still get the points?” and “Is this [insert your own small, random fact] going to be on the test?”, acting in a more administrative capacity to coordinate coursework across numerous sections and numerous instructors/TAs, participating in departmental matters and curriculum development, answering endless e-mails, and so on.

There are, however, other titles describing teaching faculty. Listed below are a few that are relatively common:

Lecturer (as mentioned): with possible promotion to Senior Lecturer
Instructor, Teaching Instructor, or Teaching Professor: sometimes Associate, Professor status (still non-tenure, though)
Assistant, Associate, Professor of Practice

A confounding issue is the wide range of abilities across the fixed-term, teaching-focused, faculty spectrum. Unlike the tenure structure, there is not a strong model in place to differentiate levels of ability and professional achievement.

Is one title more representative of the job at hand than others? Should different titles be used at community colleges compared to 4-year colleges or universities?

Finally, with a significant amount of my time centered around communication and administrative-type tasks, a small part of me sometimes wonders where is the physiology? Which brings me to my next question:

Question 3: What are the opportunities for professional growth and development for non-tenure/teaching faculty?

(Hint: volunteer to write a blog or a blog post!) The obvious answer is to engage in educational research and strategies to promote student learning, since this is precisely what the job description entails. As scientists, we have a natural curiosity to explore the correlations between teaching practices and outcomes. If we have data to support the anecdotal experiences—even better! It is one way to utilize the skills developed over time in the research setting. So, this is one very viable solution to promote professional growth and development.

What are other options for remaining engaged in the study of physiology if the basic science research component is minimized by the nature of a teaching faculty position? I have come up with a handful of potential solutions, but it is my guess that many of you may have faced similar questions. What do you do to stay professionally active and engaged once the research opportunities are minimized?

In summary, I predict that teaching faculty will become more common in upcoming years, paralleling the continued evolution of the undergraduate experience (fueled by educational research regarding effective teaching strategies, of course). For now, though, there is no obvious roadmap for continued professional growth for fixed-term, non-tenure teaching faculty. Just as we invest time and energy to provide our students with the tools for success, it is important to consider how to do this with our teaching faculty colleagues.

Jennifer Rogers received her Ph.D and post-doctoral training at The University of Iowa (Exercise Science). She has taught at numerous institutions ranging across community college, 4-year college, and university settings. These varied educational experiences set the foundation for her interest in student readiness for learning and incorporation of effective teaching strategies for academic success specific to different student populations. Jennifer regularly teaches Human Physiology, Human Physiology Lab, Applied Exercise Physiology, and other health science-focused courses.