Category Archives: Science Content

Down the custom path: Adaptive learning as a tool for instruction and assessment in science education

The spread of COVID-19 via the SARS-CoV-2 virus led colleges and universities around the world to close on-campus instruction for the safety of students, faculty and staff.  This left many instructors, specifically those in the sciences, struggling to find effective methods to present information to students in a manner that both encouraged learning and allowed for assessment of knowledge attainment.  Non-traditional colleges and universities, those that offer most or all of a degree to students in the online environment, were poised to transition easily; continuing to use the tools available in the virtual world to both guide students and assess learning.  As institutions wrestle with the decision to move courses back to the on-campus setting, this blog implores those in higher education, even science education, to consider adaptive learning as a vital component of curriculum.

Prior to my appointment as Lead Faculty at Colorado Technical University, I taught a variety of science courses in on-campus class and laboratory settings.  Both exams and laboratory practica could be cumbersome, both in prep and in grading.  While the questions could be mapped back to unit and/or course learning outcomes, this would require input of each student’s response to each question into a data sheet for analysis.  Even with online administration of exams, assessment methods were limited and instructors like myself were reliant on continuous creation of lectures, worksheets, activities, and online simulations to present course materials.  When it came time to transition to online, students would navigate through a learning management system and open a variety of files, videos, interactive activities, practice sheets, and practice quizzes for one unit in a course.  There had to be a better way to incorporate all the things we know drive student inquiry into one area while allowing assessment of their knowledge, right?  There was.

Enter adaptive learning technology.  Colorado Technical University relies upon Intellipath™ to deliver content to students in the asynchronous classroom in a variety of subjects, including natural sciences, math, engineering, nursing, and health studies.  I entered into teaching and managing faculty as a novice in this tool, and now I want to sing its praises to anyone who will listen. Adaptive learning does just as the title suggests.  It adapts based on the student’s knowledge, adding questions in areas where they need additional practice and allowing those already determined to have a certain understanding of topics to skip on to new materials.  Once these lesson nodes are designed, they can be used over and over again and questions can be delivered in a variety of ways to assess the same outcome. Gone is the need to continuously upload materials as they are all housed within the adaptive learning platform.  Instructors have the ability to see how a student is doing not just in terms of their progress through the unit but also their mastery of a specific topic.  Students have the ability to earn high marks when they demonstrate competency in the subject on their first attempt but are able to improve their score when they didn’t do as well as they had hoped.

The system rolls instruction, interaction, and formative and summative assessments all in together in one data rich place.  Instructors can tailor their outreach and additional instruction to specific students or overall trends within a specific cohort.  Those tasked with the assessment of effectiveness portion of curriculum can pull these data to discern what outcomes are being met.  In modern higher-ed, what students know is important but how we know they know what they know is also a priority.  We have to be able to paint a quantitative picture that our curriculum is effective.

Students are re-evaluating their choices for universities and it is wise of all of us to consider our options for content delivery and knowledge assessment.  I think many educators in colleges or universities have attended at least one meeting at this point to discuss the decline in the number of “traditional” college students and some of us may have even been tasked with figuring out what to do about it.  More and more students are faced with the dilemma of needing to manage being caregivers, members of the workforce, or other life challenges while also attaining a degree.  This is our time to be bold and innovative in the classroom and really personalize a student’s experience.  Will there always be “traditional” college classes?  Only time will tell.  I cannot predict where we will be as educators in a decade but I can say that it will be my goal to evolve to meet the demands of the profession.  Science leads us to advances and adaptations so shouldn’t we be advanced and adaptive in science education?

Dr. Tiffany Halfacre (she/her) earned undergraduate degrees from Berea College (Biology) and Saint Petersburg College (Funeral Services), an MSMS from Morsani College of Medicine at the University of South Florida, and a DHSc from A.T. Still University College of Graduate Health Studies.

She has a varied background as an educator spanning over 10 years.  She has taught courses in general biology, human biology, anatomy, physiology, pharmacology, and health sciences in addition to interdisciplinary work in medical humanities.  She has been involved in course development, programmatic and institutional accreditation, and institutional research and effectiveness.  Her research and service interests include exploring health and nutrition literacy as they relate to geographical and socioeconomic differences. Outside of the classroom, she has been involved in chapel series lectures including one on “Truth in Grief” and was awarded the Excellence in Academic Advising award during her tenure at Carson-Newman University for her work advising pre-health professions students.  Dr. Halfacre currently serves as a Lead Faculty and an Assistant Professor of Health Studies at Colorado Technical University where she not only focuses on faculty preparation and support but also initiatives to retain and encourage success in first year and first generation college students.

Her hobbies include anything outdoors, running, amateur photography, and enjoying various arts, specifically music.
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.

Do You Want To Be On TV?

Last summer, some colleagues and I published a paper on how high school students can communicate their understanding of science through songwriting.  This gradually led to a press release from my home institution, and then (months later) a feature article in a local newspaper, and then appearances on Seattle TV stations KING-5 and KOMO-4.

It’s been an interesting little journey.  I haven’t exactly “gone viral” — I haven’t been adding hundreds of new Twitter followers, or anything like that — but even this mild uptick in interest has prompted me to ponder my relationship with the news media. In short, I do enjoy the attention, but I also feel some responsibility to influence the tone and emphases of these stories. In this post, I share a few bits of advice based on my recent experiences, and I invite others to contribute their own tips in the comments section.

(1) Find out how your school/department/committee views media appearances.  In April, I was invited to appear on KING’s mid-morning talk show, which sounded cool, except that the show would be taped during my normal Thursday physiology lecture!  My department chair and my dean encouraged me to do the show, noting that this sort of media exposure is generally good for the school, and so, with their blessing, I got a sub and headed for the studio.

(2) Respect students’ privacy during classroom visits.  After some students were included in a classroom-visit video despite promises to the contrary, I realized that I needed to protect their privacy more strongly. I subsequently established an option by which any camera-shy students could live-stream the lecture until the TV crew left.

(3) Anticipate and explicitly address potential misconceptions about what you’re doing.  I’ve worried that these “singing professor” pieces might portray the students simply as amused audience members rather than as active participants, so, during the classroom visits, I’ve used songs that are conducive to the students singing along and/or analyzing the meaning of the lyrics. (Well, mostly. “Cross-Bridges Over Troubled Water” wasn’t that great for either, but I had already sung “Myofibrils” for KING, and KOMO deserved an exclusive too, right?)

(4) Take advantage of your institution’s public relations expertise.  Everett Community College’s director of public relations offered to help me rehearse for the talk show — and boy am I glad that she did!  Being familiar with the conventions and expectations of TV conversations, Katherine helped me talk much more pithily than I normally do. In taking multiple cracks at her practice question about “how did you get started [using music in teaching]?” I eventually pared a meandering 90-second draft answer down to 30 seconds. She also asked me a practice question to which my normal response would be, “Can you clarify what you mean by X?” — and convinced me that in a 4-minute TV conversation, you don’t ask for clarifications, you just make reasonable assumptions and plow ahead with your answers.

(5) Ask your interviewers what they will want to talk about. Like a novice debater, I struggle with extemporaneous speaking; the more I can prepare for specific questions, the better.  Fortunately, my interviewers have been happy to give me a heads-up about possible questions, thus increasing their chances of getting compelling and focused answers.

Readers, what other advice would you add to the above?

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Gregory J. Crowther, PhD has a BA in Biology from Williams College, a MA in Science Education from Western Governors University, and a PhD in Physiology & Biophysics from the University of Washington. He teaches anatomy and physiology in the Department of Life Sciences at Everett Community College. His peer-reviewed journal articles on enhancing learning with content-rich music have collectively been cited over 100 times.

The Large Lecture: Minor Adjustments, Major Impacts

Large lecture courses are hard, for both students and faculty alike, and while an exhaustive body of Scholarship of Teaching & Learning (SOTL) research boasts benefits of smaller classes (Cuseo, 2007), budgetary and a myriad of other restrictions leave many higher education institutions with few options for reducing class sizes.  Accordingly, many instructors are forced to figure out a way to best serve our students in this unideal setting.

Three years ago, in my first year as a full time faculty member, I found myself teaching one of these large lecture classes.  There were ~250 students, split across two sections, piled into an outdated auditorium.   The setting was intimidating for me, and if one thing was certain, it was that however intimidated I felt, my students felt it even harder (and as an aside, three years later, I still find myself, at times, intimidated by this space).  So, in a high-stakes, pre-requisite course like Anatomy & Physiology that is content-heavy and, by nature, inherently intense, what can be done in a large lecture hall to ease the tension and improve student learning?

When looking to the SOTL research for evidence-based recommendations on student engagement and active learning ideas in high-enrollment courses such as mine, I quickly became overwhelmed with possibilities (not unlike a kid in a candy store).  Before I knew it, finding meaningful ways to reshape my class in the best interest of the student became defeating – how was I supposed to overhaul my course to integrate best-practice pedagogy while still juggling the rest of my faculty responsibilities?

Thankfully, last year a colleague introduced me to a book, Small Teaching: Everyday Lessons from the Science of Learning, by James Lang.  Admittedly – I still have not finished this book (rest assured – I am currently in a book club studying this book, so I WILL finish it!); that being said, Lang’s powerful message about the significance of small changes resonated with me pretty early on in the text.  Minor, thoughtful adjustments to the daily classroom routine are capable of eliciting substantial impacts on student learning.  In other words, I did not need to reinvent the wheel to better serve my students; instead, I set a goal for myself to try out one or two small, reasonable adjustments per semester.  While I am still navigating best-practice teaching and experience a healthy dose of trial-and-error, here is what I have found useful thus far:

 

1. Learning names. This is perhaps the most straightforward, obvious classroom goal, but when you have a large number of students, something as simple as learning student names can quickly slip through the cracks.  Now, I appreciate that implementing this goal takes considerable time and intention, and depending on the structure of your high-enrollment course, it may or may not be feasible.  In my course, for example, it is a two-part series, which means I have the same students for an entire academic year rather than one semester.  Moreover, in addition to lecture, I have all of my students in smaller lab sections.  Accordingly, I have plenty of opportunity to interact with students and pay attention to names.

From a purely anecdotal observation, if and when a student musters up the courage to ask a question in the large auditorium, addressing them by name appears to increase the likelihood of the student asking again.  Moreover, it seems to have an impact on other students in the classroom, too; anecdotally, I have noticed in lectures where I address student questions using student names, the number of different students asking questions appears to increase.  Overall, addressing students by name seems to communicate a message that students in our classrooms are not simply a body in a seat or a number in the system, but they are a member of a learning community.

2. Finding an inclusive platform for voicing questions. Despite reaching a point in the academic year where everyone knows each other by name, some students will never feel comfortable enough raising their hand to ask questions in the big lecture hall. Knowing this, along with the notion that student confusion rarely exist in isolation, this semester I made it a point to explore alternative platforms for asking questions during lecture.  Cue in the Google Doc: this handy, online word-processing tool gave me a platform for monitoring student questions in real time during lecture.  On the logistical end, it is worth noting that I have a TA monitoring our Google Doc during lecture, so that when a stream of questions comes through, common themes in questions are consolidated into one or two questions.  A few times during the lecture, I will check in with our TA and address questions.  It is also worth mentioning that the document has been set up such that student names are linked to their comments; this was implemented as a measure to keep comments appropriate and on track.  So far, this has turned out to be a great platform, not only for students asking lecture questions in real time, but also for facilitating some really great discussion amongst students.

 

3. Holding students accountable for in-class activities.  I quickly realized in my large lecture class that students were generally unmotivated to participate in any in-class activity unless I collected it and assigned points (which, by the way, can be a logistical nightmare with 250 students).  Yet, as I learned in Making it Stick: The Successful Science of Learning, by Brown, Roediger, and McDaniel (a previous book club endeavor of mine), engaging students in activities like 5 minute recall exercises is widely supported as an effective tool for long-term learning and retention.  So, I decided to piggy back off my previous idea of the Q&A Google Doc, and open up an entire classroom folder where, in addition to our Q&A doc, students had daily folders for submitting in-class activities (again, in real time).  As of now, the way that it works is as follows: upon completing the short recall exercise, or other in-class activity, students will snap a photo of their work and upload it to our Google drive.  Then, I choose a piece of student work to display as we review the activity prompt, which has proven to be a great method for maintaining student accountability (I disclosed to the students that I will randomly choose a few days in the semester to award extra credit for those who submitted during class).  Additionally, this provides quick feedback to me (in real time) regarding student comprehension and common misunderstandings; in fact, I will occasionally choose to review a student submission that represents a common mistake to highlight and address a common problem area.

In summary, implementing these small changes has offered realistic approaches to improving my students’ experience and creating community in an otherwise challenging setting: the large lecture.  While I retain other long-term teaching goals that require more of a time commitment, Lang’s sentiment that small ≠ insignificant provides a solid ground for improvement in the present.

References:

Brown, PC, Roediger, HL, and McDaniel, MA (2014). Making it Stick: The Successful Science of Learning.  Cambridge, MA: Harvard University Press.

Cuseo, Joe. (2007). The empirical case against large class size: Adverse effects on the teaching, learning, and retention of first-year students. Journal of Faculty Development: 21.

Lang, James (2016).  Small Teaching: Everyday Lessons from the Science of Learning. San Francisco, CA: Jossey-Bass.

 

Amber Schlater earned her B.S. from the University of Pittsburgh in Biological Sciences, and her M.S. and Ph.D. from Colorado State University in Zoology; she also completed a two-year post-doctoral fellowship at McMaster University.  Currently, Amber is an Assistant Professor in the Biology Department at The College of Saint Scholastica in beautiful Duluth, MN, where she teaches Human Anatomy & Physiology, Super Physiology (a comparative physiology course), and mentors undergraduate research students.  Outside of work, Amber enjoys hiking, biking, camping, canoeing, and doing just about anything she can outside with her family.
The Teaching of Basic Science as a Necessity in the Doctor in Physical Therapy Clinical Curriculum

There is an ever increasing need to train evidenced-based clinicians among all the health disciplines. This is particularly true in the relatively young profession of physical therapy, where the educational standards have shifted from entry level bachelor’s degree requirements to clinical doctorate training. The increase in educational standards reflect the growth of the discipline, with an effort to increase the depth of knowledge and level of skill required to be a physical therapist while moving from technician to an independent direct access practitioner. This evolution also marks a shift in standards of evidenced-based practice from clinical observation to an ability to provide mechanistic understanding which includes fundamental scientific insights and transforms clinical practice. The profession also recognizes the need to advance the profession through research that provides a scientific basis validating physical therapy treatment approaches. As a result, there is an expanding, yet underappreciated role, for the basic science researcher / educator in Doctor of Physical Therapy (DPT) programs.

Strategies to integrate and infuse the basic science into practice:

1. Faculty training:

Big Four Bridge in Louisville, KY

How to bridge the gap between basic science and clinical education?  As dual credentialed physical therapist and basic scientist these influence Sonja’s teaching approach, to serve as a “bridge” between foundational science content and clinical application.  Teaching across broad content areas in a DPT curriculum provides opportunities to “make the connection” from what students learn in the sciences, clinical courses, and relate these to patient diagnosis and therapeutic approaches.

While dual training is one approach, these credentials combined with years of ongoing contemporary clinical practice, are rare and impractical to implement in an academic setting. Most often DPT programs rely on PhD trained anatomists, neuroanatomists, and physiologists to teach foundational courses, often borrowed from other departments to fulfill these foundational teaching needs. Thus, Chris’s approach is through crosstalk between scientist/physiologist and clinician to serve as a role model and teach the application of discoveries for identifying best evidence in clinical decision making. By either approach, we have become that key bridge teaching and demonstrating how foundational science, both basic and applied impact clinical decision making.

2. Placement of foundational science courses (physiology, neuroscience, anatomy):

Traditional curricular approaches introduce foundational sciences in anatomy, neuroscience, and physiology in the first year of the DPT curriculum, followed by clinical content with either integrated or end loaded clinical experiences over the course of remaining 2.5-3 years. Our current program established an alternative approach of introducing foundational sciences after the introduction of clinical content and subsequently followed by a full time clinical clerkship/ education. Having taught in both models, early or late introduction of foundational sciences, we recognized either partitioned approaches lead to educational gaps and makes bridging the knowledge to application gap challenging for students.

Regardless, the overall message is clear and suggestive of the need for better integration of foundational/scientific content throughout the curriculum. These challenges are not unique to physical therapy, as this knowledge to clinical translation gap is well documented in medicine and nursing and has been the impetus for ongoing curriculum transformations in these programs. These professions are exploring a variety of approaches on how to best deliver /package courses / and curriculum that foster rapid translation into clinical practice. Arena, R., et al., 2017; Fall, L.H. 2015; Newhouse, R.P. and Spring, B., 2010; Fincher et al., 2009.

Recently, new curricular models have emerged within the doctoral of physical therapy curriculum that complement the academic mission to train competent evidenced based clinicians Bliss et al., 2018, Arena R. et al. 2017. These models leverage the faculty expertise of physiologist/scientist, research, and clinical faculty to create integrative learning experiences for students. These models include integrated models of clinical laboratory learning and/ or classroom-based discussion of case scenarios, that pair the basic scientist and the clinical expert. It is our belief, that teaching our clinical students through these models will lead to enhanced educational experience, application of didactic course work, and the appreciation for high quality research both basic and applied.

3. Appreciation and value of foundational sciences through participation in faculty led research:

Capstone experiences are common curricular elements for the physical therapy profession. This model is believed to 1) prepare future physical therapy generations to provide high-quality clinical care and, 2) provide research needed to guide evidence-based care, and 3) foster the appreciation for evidence and advances in the field. We believe these pipeline experiences could allow for advanced training incorporating strong foundational (science) knowledge that is relevant to the field, which can be applied broadly and adapted to integrate the rapidly growing knowledge base. Such models may assist in integrating the importance of scientific findings (basic and applied) while facilitating the breakdown of barriers (perceived and real) that silo clinical and foundational content (Haramati, A., 2011).

Contributing to the barriers are that relatively few of the basic sciences and translational studies are being conducted by rehabilitation experts. Furthermore, like medicine disciplines, it is unlikely that DPT faculty will be experts as both a clinician and scientist. Rather these emerging models promote teams of scientists and clinical faculty who work together to promote scientific, evidence-based education (Polancich S. et al., 2018; Read and Ward 2017; Fincher et al., 2009). Implementation of these education models requires “buy in” from administration and faculty who must recognize and value a core of outstanding clinician-educators, clinician-scientists, and basic scientists, and reward effective collaboration in education (Fincher 2009).

Although these models are flowering in research intensive universities, the challenges of integrating the basic sciences are greater in programs embedded within smaller liberal arts institutions that lack the infrastructure and administrative support for creating teaching-science-clinical synergies. Often these programs are heavily weighted towards clinical education faculty who emphasize clinical teaching and development of clinical skills, with a less integrated emphasis on the fundamental science in clinical decision making. Our own experience, having taught foundational (physiology and neuroscience) sciences, are that faculty in these programs are more reluctant to embrace and value foundational sciences. A possible explanation may be the limited exposure to and unrecognized value of contributions to the field from such basic and translational approaches. It is frequently implied if it works, it may not be necessary to understand mechanistically how it works. While this might suffice for today’s practice approach, this will not be enough for future clinicians in a rapidly evolving clinical environment. Programs that may not foster scientific curiosity, may be missing the opportunity to instill lifelong learning. We agree with other educators that the integration of basic science is critical for the student progress toward independence and essential competence, and that health science educators should support the teaching of basic science as it aids in the teaching of how to solve complex clinical scenarios even if clinicians may not emphasize the basic science that underlies their reasoning (Pangaro, 2011).

Concluding Thoughts:

Physical therapy departments particularly those within major academic centers housing a mix of research, education, and clinically focused faculty can successfully operate a curriculum able to synergize education, research, and clinical initiatives. Creating synergies early in a curriculum by pairing clinical specialists with science trained faculty will facilitate connections between clinical practice and science (Bliss, et al., 2018). While curricular change can be challenging, programs that implement a collaborative model where faculty with a shared area of expertise (e.g., orthopedics, neurology, cardiopulmonary, pediatrics and geriatrics) and unique complementary skill sets (i.e., research, education, and clinical practice) come together to transform student educational experiences – completing that bridge between basic science and clinical practice.

Stacked Stone Arch

 

References:

Arena, R., Girolami, G., Aruin, A., Keil, A., Sainsbury, J. and Phillips, S.A.,

Integrated approaches to physical Therapy education: a new comprehensive model from the University of Illinois Chicago, Physiotherapy Theory and Practice, 2017, 33:5, 353-360, doi: 10.1080/09593985.2017.1305471.

Bliss, R., Brueilly, K. E., Swiggum, M. S., Morris, G. S., Williamson, E.M., Importance of Terminal Academic Degreed Core Faculty in Physical Therapist Education, Journal of Physical Therapy Education. 2018, 32(2):123-127, doi: 10.1097/JTE.0000000000000054.

Fall, L.H., The Collaborative Construction of the Clinical Mind: Excellence in Patient Care through Cognitive Integration of Basic Sciences Concepts into Routine Clinical Practice, Med.Sci.Educ. 2015, 25(Suppl 1): 5, doi: 10.1007/s40670-015-0192-9.

Fincher, M., Wallach P., and Richardson, W.S.,  Basic Science Right, Not Basic Science Lite: Medical Education at a Crossroad, J Gen Intern Med. 2009, Nov; 24(11): 1255–1258, doi: 10.1007/s11606-009-1109-3

Haramati, A., Fostering Scientific Curiosity and Professional Behaviors in a Basic Science Curriculum, Med.Sci.Educ. 2011, 21(Suppl 3): 254, doi: 10.1007/BF03341720.

Newhouse, R.P. and Spring, B., Interdisciplinary Evidence-based Practice: Moving from Silos to Synergy, Nurs Outlook. 2010, Nov–Dec; 58(6): 309–317, doi: 10.1016/j.outlook.2010.09.001.

Pangaro, L., The Role and Value of the Basic Sciences in Medical Education: The Perspective of Clinical Education -Students’ Progress from Understanding to Action. Medical Science Educator. 2010, Volume 20: No. 3. 307-313.

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Chris Wingard completed his BA in Biology form Hiram College a MS from University of Akron and PhD from Wayne State University. He has served in physiology departments at University of Virginia, Medical College of Georgia and East Carolina University during his career and has most recently joined the Bellarmine University College of Health Professions as Professor teaching in the Physical Therapy, Accelerated Nursing and Biology Programs.  His interests are in the impacts of environmental exposures on the function of the cardiovascular pulmonary systems.
Sonja Bareiss received a BS in Biology and Master’s in Physical Therapy from Rockhurst University. She completed her PhD in Anatomy and Cell Biology at East Carolina University. Dr. Bareiss was a faculty member at East Carolina University Department of Physical Therapy and Department of Anatomy and Cell Biology before joining the DPT program at Bellarmine University. Her areas of teaching span foundational sciences (neuroscience and anatomy) to clinical content (electrical modalities). Her most recent efforts have been to develop and implement a pain mechanisms and management course into physical therapy curriculum with emphasis on interdisciplinary learning. In addition to her academic experience, Dr. Bareiss has over 8 years of full-time clinical experience where she specialized in treating patients with chronic pain syndromes. Her research and clinical interests have been dedicated to understanding mechanisms of neural plasticity related to the development and treatment of pain and neurodegenerative disease and injury and integrating undergraduate Biology Honors and DPT students into the work.