Category Archives: Teaching Strategies

Why demonstrating and embracing uncertainty should be a learning objective, especially in uncertain times?

Uncertainty.  We have all heard that word quite frequently lately.  It tends to carry negative connotations and feelings of uneasiness.  It seems the answer to every question these days is, “well, it depends”.  As physiology educators, this is not new to us.  How many times have we answered a student’s broad question with this same phrase?    Regardless of how much active learning is accomplished in the classroom, students at all levels are tasked with preparing for and taking standardized tests.  My children started taking assessments in preschool, multiple choice tests for grading purposes in kindergarten, and state assessment tests in 3rd grade.  Then there will be standardized tests for admissions to college, graduate admissions, and licensing.  It’s no wonder that some students are conditioned to study ‘to the test’ instead of having the goal of truly learning the material, and are hesitant to express when they don’t know something.   I spent the first decade of my career teaching science at the undergraduate level and have spent the last five years teaching in the professional school setting, including medical, dental, and podiatry students.  I have found that these health professions students in particular become especially aware of uncertainty when they start gaining experience with clinical cases and with patients.  I also notice that they are uneasy with uncertainty even from the interactions in the classroom – they are high achieving students and don’t want to be wrong, to be perceived as not knowing an answer or a concept, of maybe feeling like they don’t belong.  In truth, many students have the same questions, and the same feelings, but are hesitant to express them.   It is known that dealing with uncertainty and ambiguity, especially in professions where people are serving patients whose health is at stake, can result in the experience of stress, anxiety, depression, and burnout (1).  Wellness is an important consideration, especially in a climate where things seem to be changing day-to-day and we are provided limited information and answers.  How one deals with uncertainty can lead to life and professional decisions including which career or specialty to pursue.  While this concept is not novel, actually teaching students how to tolerate or even embrace uncertainty is a relatively new concept, one which I think should be made a more purposeful objective in our courses.   What if instead of shying away from admitting we don’t know something, we learn how to accept it, and how to approach the problem to find the most effective answer?  How do we best learn to tolerate uncertainty, and train our students how to cope with and learn from uncertainty?  What are the benefits of embracing uncertainty?   

Bring uncertainty into the classroom Thoughtfully and purposely embedding uncertainty into activities in the classroom does several things.  First, it allows students to learn that not every question has an absolute answer.  Students need help shifting their mindset.  This also encourages students to work with material at higher levels of Bloom’s taxonomy, like evaluation and application.   Additionally, this helps create a culture in the classroom where asking questions and admitting to what we don’t know is a good thing, and brings value to classroom discussions.  This allows students to bring in their own experiences in an attempt to work through a problem and arrive at an answer, enhancing students’ learning.  Students can build their confidence as they find value in embracing the unknown as they learn to navigate the process to find the answers to their questions.   The learning theory constructivism suggests that students build their own learning, that knowledge is built upon knowledge, and that it works best in context (2). This encourages students to bring their own experiences to the learning process, and the result is that each student may bring a different perspective and answer (3).  These principles match well with the intention of teaching how to manage uncertainty.  A goal is for students to be engaged and motivated in an active learning environment, allowing them to share ideas and build their knowledge based on their prior knowledge and experiences.  

Leading to deeper learning To further expand the idea of students building their mental models, activities designed to allow for more open-ended thinking or answers, which build upon each other, can be utilized.  For example, in the cardiovascular physiology component of our medical course, we build on the basic concepts in a series of small group sessions which encourage students to work in their teams to answer questions pertaining to these concepts.  We may start with the principles of hemodynamics but eventually work our way to the integration of cardiac function and vascular function.  These sessions require students to not only recall knowledge, but also apply information in a manner which may lead to uncertainty.  They learn to question the severity of perturbations, the balance of factors which interact, and the cause and effect.  We find students may become frustrated with the “it depends” answer, but they learn how to view the nuance and ask the appropriate questions.  This type of exploration and learning transitions well to more clinical sessions, where students need to know which questions to ask, which tests to order, and which colleagues to consult.    

Demonstrate uncertainty as educators and professionals In addition to our basic science session, I spend a lot of time teaching with clinical colleagues in the pre-clerkship medical classroom.  We have a small cohort of core educators who participate in a special type of small group learning we call Clinical Reasoning Conferences.  The core educators are either basic scientists or clinicians and come from different disciplines, bringing different experiences and expertise to each session. We are always joined by content experts in our sessions with the students as well.  This means that we are likely to be in a session where we are not the content expert, but have immediate access to one. This gives us an opportunity to demonstrate uncertainty in the classroom, to students who feel constant pressure to know everything and to perform at the highest level.  To be honest, it took a while for us to get comfortable with telling the students, “I don’t know”, but that “I don’t know” was, in reality, “I don’t know but let’s get the answer”, which gave us the opportunity to demonstrate how we get the answer.  It could be a reference from the literature, a clinical resource, or a colleague.  Students not only benefit from getting perhaps a more comprehensive answer to their questions, but also knowledge that no one can know everything or even how much is still unknown.  It is imperative in medicine that they learn and practice how to find appropriate information in order to make the most informed decision when it comes to patient care.  These practices have also been shared by other medical educators (1).  Clinical Reasoning Sessions also include students teaching the material to their colleagues, and we make it clear in our expectations that we much rather they describe their process and maybe come up with an incorrect conclusion than have short, although correct, answers which do not demonstrate process and reasoning.  Another goal is to allow the students plenty of chances to practice answering questions of a clinical nature posed by faculty, and allow them to become comfortable asking faculty questions, well before they start their clerkships.    

Manage expectations In my experience, students appreciate the ability to give feedback and share their expectations of their courses and programs.  They also align these with their own expectations of themselves.  Faculty and course directors work to resolve the students’ expectations with their own, and to assist students in forming and revising their expectations of and their role and responsibilities within the course.  Educating during a pandemic has shined a light on and challenged the way we manage these expectations. A word I have heard my colleagues use lately is grace; we should extend grace to our students, to ourselves, and ask for grace from others.  This is another way we can demonstrate how we deal with uncertainty, which can hopefully serve as a soft teaching point for our students.    

Outside of the science classroom Developing skills to help us manage uncertainty extends to outside of our classroom.  We hope that students will take the lessons and continue to use them in other classes, or outside of school altogether.  Medical schools often offer electives, some of which are tied to wellness or extracurricular subjects.  For example, some of our electives include Artful Thinking, in which students hone their skills of observation, application, and context, and Fundamentals of Improv, so that students can work on skills of listening, support, creativity, and quick thinking and response.  Other schools and programs offer similar experiences for students (4,5).  The narrative medicine program emphasizes skills of reflective writing to focus on the human side of medicine, reminding why we’re here in the first place (6).  

Challenging ourselves and encouraging our creativity One of the most important lessons I learned in the transition to remote and hybrid education over the past six months was to face the uncertainty with planning, reflection, and flexibility.  I am the type to have a backup plan to my backup plan, which I realized gave me the flexibility to be more creative in my course design and preparation.  I feel that my courses benefitted from my ability to challenge myself, because of uncertainty, and I intend to continue to reflect and employ what I consider my ‘best practices’ even when we move back into the in-person classroom in the future.   We are exposed to uncertainty every day.  How we choose to frame our mindset, to help our students and ourselves tolerate or even embrace uncertainty can bring benefits both in and outside of the classroom.  

References and further reading Twelve tips for thriving in the face of clinical uncertainty, accessed 8/28/20  https://www.tandfonline.com/doi/pdf/10.1080/0142159X.2019.1579308 What is Constructivism?, accessed 8/28/20 https://www.wgu.edu/blog/what-constructivism2005.html Inviting Uncertainty into the Classroom, accessed 8/28/20 http://www.ascd.org/publications/educational-leadership/oct17/vol75/num02/Inviting-Uncertainty-into-the-Classroom.aspx Teaching Medical Students the Art of Uncertainty, accessed 8/28/20 https://www.cuimc.columbia.edu/news/teaching-medical-students-art-uncertainty The Alda Method, Alda Center for Communicating Science, accessed 9/4/20 https://www.aldacenter.org/alda-method Narrative Medicine Program, Accessed 9/4/20 https://medicine.temple.edu/education/narrative-medicine-program The Diagnosis, Prognosis, and Treatment of Medical Uncertainty https://www.jgme.org/doi/pdf/10.4300/JGME-D-14-00638.1 The Ethics of Ambiguity: Rethinking the Role and Importance of Uncertainty in Medical Education and Practice https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC5497921&blobtype=pdf Helping Students Deal with Uncertainty in the classroom https://www.edutopia.org/blog/dealing-with-uncertainty-classroom-students-ben-johnson Learning: Theory and Research http://gsi.berkeley.edu/media/Learning.pdf          


Rebecca Petre Sullivan, Ph.D.
Associate Professor of Physiology
Lewis Katz School of Medicine at Temple University
Dr. Rebecca Petre Sullivan earned her Ph.D. in Physiology from the Lewis Katz School of Medicine at Temple University and completed a Post-Doctoral Fellowship in the Interdisciplinary Training Program in Muscle Biology at the University of Maryland School of Medicine.  She taught undergraduate biology courses at Ursinus College and Neumann University.  As an Associate Professor of Physiology and a Core Basic Science Educator, she is currently course director in the Pre-Clerkship curriculum at LKSOM and at the Kornberg School of Dentistry; in addition to teaching medical and dental students, she also teaches physiology in Temple’s podiatry school and in the physician assistant program.  She is a member of Temple University’s Provost’s Teaching Academy.  She was the recipient of the Mary DeLeo Prize for Excellence in Basic Science Teaching in 2020 and a Golden Apple Award in 2017 from LKSOM, and the Excellence in Undergraduate Teaching Award from Neumann University in 2012.
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.

Physiology Educators Community of Practice (PECOP) Webinar Series

The American Physiological Society (APS) is pleased to announce a new webinar series focused on our educator community. The monthly series includes live webinars focused on education best practices, synchronous and/or asynchronous teaching, establishing inclusive classrooms and publishing. Educator town halls will also be featured as we strive to support and engage the educator community throughout the year.

Starting this month, take advantage of the educator webinar series by visiting the events webpage on the APS website. Register for each webinar, learn about speakers and their talks today!

What to do on the First Day of Class: Insights From Physiology Educators?
July 23, 2020
12 p.m. EDT

Join in the discussion about how to greet students on the first day of class and set the tone for the rest of the course.

Speakers:

  • Barbara E. Goodman, PhD from the Sandford School of Medicine, University of South Dakota (Vermillion)
  • Dee Silverthorn, PhD from the University of Texas at Austin

A successful semester: Applying resilient and inclusive pedagogy to mitigate faculty and student stress
August 20, 2020
2 p.m. EDT

As we head into an uncertain academic year, spend an hour with us to consider strategies which will help you and your students navigate our changing academic, professional, and personal lives. Participants will work through pragmatic and concrete strategies they can transition into their own work to promote student learning and minimize stress.

Speakers:

  • Josef Brandauer, PhD from Gettysburg College (Penn.)
  • Katie Johnson, PhD from Trail Build, LLC (East Troy, Wisc.)

Writing & Reviewing for Advances
September 17, 2020
12 p.m. EDT

This session will be a chance to encourage all who have adapted their teaching during the COVID-19 pandemic to share their work. This topic also ties in to the Teaching Section featured topic for EB 2021.

Speaker:

  • Doug Everett, PhD from National Jewish Health (Denver, Colo.)

A Framework of College Student Buy-in to Evidence-Based Teaching Practices in STEM: The Roles of Trust and Growth Mindset
October 22, 2020
12 p.m. EST

This topic is relevant to building trust, which goes hand-in-hand with inclusion and diversity. Trust is essential for the different modalities of teaching which educators and students will experience in the fall.

 

Educators Town Hall
November 19, 2020
12 p.m. EST

A chance to talk about what happened during the fall semester and also plan for the upcoming year

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Reference:

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

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

Cultivating a growth mindset for the work of diversity and inclusion
Lisa Carney Anderson, PhD
Associate Professor
Department of Integrative Biology and Physiology
University of Minnesota
Minneapolis, MN

I live in Minnesota and work at the University of Minnesota.

I’m sure you have read and heard about the Twin Cities in the news.  George Floyd was murdered by a police officer in Minneapolis. In addition, in the past few years, members of the Minneapolis Police have killed other Black citizens.  Consequently, a large number of people of all ages, colors and creeds poured into the streets to protest police brutality.  I am a White cis woman with privilege. Though I feel confident about my abilities as a physiologist and an educator, I’m not confident about the work of diversity and inclusion. Nonetheless, I am trying to figure out how I can use my privilege to provide a better learning and life experience for my students of color.

In 2018, at the Institute on Teaching and Learning, Katie Johnson of Trail Build, gave a powerful presentation on diversity and inclusion (2).  In her talk, she met us where we all lived.  She started by saying that she was a scientist and teacher.  If it was her job to be objective, what could she possibly do to promote diversity and inclusion?  Then she said something amazing.

We as physiologists ask our students to think in new ways.  We ask them to learn a lot of new terms: homeostasis, contractility, permeability, peristalsis and clearance.  Then we ask them to learn a lot of concepts.  Negative feedback mechanisms can maintain the cellular environment. Increased intracellular calcium increases the strength of a cardiac contraction.  Permeability is related to the number of open ion channels in a membrane. Peristalsis is a wave like contraction that moves contents along the gut lumen. Clearance is defined in terms how much plasma per unit of time is cleaned of a given substance.  Then we ask our student to put the terms and concepts into a framework that explains how the body works.  And we don’t ask students to do this sequentially, we ask them to accomplish this simultaneously.  Holy Smokes. That is hard work.  We ask our students to struggle with physiology.

So here is the amazing part.  If we ask our students to think in new ways to learn physiology, then we, as faculty, should be willing to think in new ways to address racism and equity in science and education. 

Dr. Johnson also gave us insight into the student experience.  For example, cold calling students is not a fair classroom practice.  I’ve learned that this is where small group discussion or Think-Pair-Share exercises (3) can be very helpful. If students have a chance to try out their ideas on a peer, then they may gain confidence to share an idea with the whole class. 

For example, I’ve also learned to be intentional when I set up student groups.  Here in very White Minnesota, I might have a few students of color.  I look at my class list and I look at the students’ pictures and try to make sure there are at least two students of color in a group even if that means some groups are all White. My process for assigning groups is far from perfect because, I may not recognize that a student identifies as non-white.  I don’t assume to know the comfort level of my students but my sense is that this practice addresses at least some of the stress of being the only person of color in a small group.  I have a colleague that calls imperfect classroom interventions like this, “filling in the gaps when a systemic solution is not available to address stereotype threats.”

So, what is a stereotype threat?

Before Mr. Floyd was murdered, I read the book, Whistling Vivaldi: how stereotypes affect us and what we can do, by Claude M. Steele (4).  From his work I have learned universities are power structures that can be very intimidating for students.  Through rigorous experimentation, Dr. Steele demonstrated how stereotype threat, or the stress of feeling marginalized interferes with a student’s performance. The burden of constantly feeling like you don’t belong is exhausting.  As I read this book, I thought back on my own experience as an undergraduate, first-generation, female. I was the only female in physics lab.  I felt like no one wanted to be my lab partner and no one wanted me there.  The lab teacher made jokes at my expense. I got Cs in physics.  Was it because I’m bad at physics?  Was it because I felt marginalized?  Is this how my students of color feel?

First of all, I’ve learned from Dr. Steele in Whistling Vivaldi and Dr. Johnson from Trail Build that there are things I can do to help my students with stereotype threats.  I can help them practice affirmation.  I’ll share with you how I do this in my Clinical Physiology Class.  This is a two-course series in which students from nursing anesthesia, biomedical engineering, physiology, kinesiology and other biological sciences come together to learn about pathophysiology and clinical physiology.  I assign the students to interdisciplinary groups such that representatives from all majors are distributed as evenly as possible throughout the groups.  I try to balance genders and make sure that no student of color is alone in a group of White students.  Then I encourage them in their discussions to think about the assets they bring to the conversation: leadership, math ability, problem solving, biochemistry knowledge, clinical experience, research experience, practicality, being a peacemaker and so on.  Because, as the American humorist, Will Rogers, is reported to have said, “We are all ignorant, only on different subjects.” I try to get them to see that they have knowledge their peers don’t have and that is why it is important for them to be present.

Second, I try to help my students have an incremental mindset rather than a fixed mindset.  This comes from the work of Carol Dweck (1) also described in Whistling Vivaldi. An incremental mindset is one in which a student might think “today, not possible but tomorrow, POSSIBLE.”  I tell my students that physiology is a way of thinking and you have to practice it.  No one is born knowing physiology and just because physiology is hard does not mean it is the wrong field for them. I want my students to realize I have had failures but they don’t define me. For example, I tell my students about the first time I took biochemistry when I was a senior in college.  I got a D and not because I didn’t work hard. I spent many lonely hours going over my notes but when it came time for the test, and I just couldn’t remember a single glucose molecule.  Then in graduate school, I took biochemistry again.  I got some large pieces of butcher paper.  I drew molecules and pathways and enzymes.  I drew them over and over from memory.  While I rode the bus, I reflected on how the pathways were related.  For fun I would predict what would happen if a particular enzyme did not work.  I used retrieval, mental models and reflection (though at the time I did not realize that’s what they were called).  I learned a lot of biochemistry, I earned a lot of confidence, and I got a good grade.  Now people call me Dr. Anderson.  Not because I’m a genius but because I know it is possible to grow into goals and aspirations.

Leading a classroom with an incremental mindset (also called a growth) mindset, in my opinion, is a powerful way for me to promote equity in my educational mission.  If I am honest with them about the struggles I’ve had, they might be willing to come into office hours and get some help. If students know that I went from a D to an A, they might think that they can do it too. Instead of seeing a poor grade on a test as the limit of their knowledge, they might see it as room to grow and work they need to do.  If they stay in the class, they can realize that improvement; if they drop the class, they are behind in completing their program and behind financially. If I can keep a student of color from dropping the class and help them with study skills, then that is one small step for equity.

Finally, as we make our way towards the fall, it is important to acknowledge that some of our students, especially our students of color and our Black students may have experienced trauma in their lifetimes.  They are traumatized by the isolating effects of the pandemic. They are traumatized by seeing repeated airings of the murder of George Floyd in Minneapolis and Rayshard Brooks in Atlanta. They are traumatized due to societal inequities that value their lives and bodies and education less than others. We must acknowledge their experience.

Two weeks ago, one of my medical physiology students invited me to a rally at the St. Paul State Capitol as part of “White Coats for Black Lives.”  At first, I didn’t want to go. I was scared of getting exposed to the Covid-19 virus.  But nonetheless I found myself typing in an email, “How can I participate?” My student invited me so I had to be part of the solution. So, I put on my black mask and my white coat and I headed to the State Capital.  I spoke to my students, and they offered me a sign. “SILENCE IS COMPLICITY.”  I found my spot on the lawn and I held up my sign. The lawn was full of health care providers and educators from all over the Twin Cities.   I listened to an inspiring student-led protest in favor of providing health care access for all, increasing the diversity of student and faculty bodies and ending race-based medicine.  I was deeply moved by the experience and I was glad I came.  Our students of color and their allies are demanding more of us as faculty, departments and institutions.

I’m getting comfortable with being uncomfortable. I’m ready to listen because I am not an expert in anti-racism and I’m ready to work even though I might make some mistakes along the way.  I’m hoping to cultivate a growth mindset around issues of racism and spending my time listening to experts, reading on my own and learning. We ask this of our students every day and we as faculty can do no less.

References:

  1. Claro S, Paunesku D, Dweck CS. Growth mindset tempers the effects of poverty on academic achievement. Proc Natl Acad Sci U S A. 2016;113(31):8664-8668.
  2. Johnson, K.M.SInclusive Practices for Diverse Student Populations. Plenary. APS Institute on Teaching and Learning, Madison, WI, June 18-22, 2018.
  3. Lyman, F. “The responsive classroom discussion.” In Anderson, A. S. (Ed.), Mainstreaming Digest. College Park, MD: University of Maryland College of Education, 1981.
  4. Steele, C.S. Whistling Vivaldi: how stereotypes affect us and what we can do, W.W Norton & Company: New York, 2010.

Lisa Carney Anderson is an Associate Professor and Director of Education in the Department of Integrative Biology and Physiology at the University of Minnesota. She completed her doctoral training in muscle physiology at the University of Minnesota. She directs the first-year medical physiology course. She also teaches nurse anesthesia students, dental students and undergraduates. She is the 2012 recipient of the Didactic Instructor of the Year Award from the American Association of Nurse Anesthesia.  She co-authored a physiology workbook called Cells to Systems: Critical thinking exercises in Physiology, Kendall Hunt Press. Dr. Anderson’s teaching interests include encouraging active learning through retrieval and assessment of student reflection.  She has joined the APS Teaching Section Steering Committee as Secretary.

Keeping the Connection Alive During Remote Instruction
Candace Receno, PhD
Assistant Professor, Exercise Science & Athletic Training
Ithaca College

As a first year Assistant Professor, making the shift to remote learning during COVID-19 was certainly a gamechanger. As many previous blog posts have highlighted, the way we needed to look at instruction changed and forced both students and faculty to rapidly adapt. There were so many things that needed to be considered when making the transition. How flexible can our students be, now that some have become primary caretakers or have fallen ill or need to seek employment? How do instructors tackle making significant changes to their course, now that they are also dealing with similar issues? How do both groups create and participate in a high-quality course experience with fewer resources and a very short amount of time to adjust? Many of the insightful blogs posted have really highlighted how to keep these considerations in mind in order to create online courses that still meet course objectives and foster a high-quality learning experience. I have learned so much through reading these posts, in addition to numerous resources provided to our community. Through integration of these resources into my own courses, I found myself also trying to think of ways that I could keep the courses inherently “me”. Engaging and connecting with students on a personal level has always been something that I found helpful to my own teaching, but becomes hard when the mode of communication has shifted. This can also be difficult when some classes must be delivered asynchronously, in an effort to accommodate the changing lifestyles of our students. Perhaps just as important to a high-quality learning experience as shifting our instruction methods, is finding new ways to create the human connection that is much easier developed with on-campus learning. Here, I highlight some of the methods I found to be successful in making sure that I was able to keep my students engaged in the course while miles apart. While these may sound like really simple ideas, I’ll admit that I didn’t realize how important they were to the student experience until I had reflective conversations with many students after the Spring semester. With times of uncertainty still ahead, I plan to continue using these methods in the future.

1. Staying online after the class has ended.

This is probably the simplest of the suggestions to integrate, but really seemed to make a difference in getting the students more comfortable opening up over the computer screen. For my synchronous courses, I always ended class time by reminding the students I would stay in the virtual classroom to answer any questions or just to chat. I found that once students realized I would be sticking around for a few minutes regardless of if anyone else stayed, they were more willing to hang around and ask questions they might not have felt comfortable asking in front of other students or e-mailing me about. This also gave me another opportunity to reflect on how I was constructing my online course materials. Hearing what points students needed extra clarification on forced me to consider how topics that were ordinarily well understood in the physical classroom needed to be shifted with remote instruction.

2. Integrating video/audio into online discussion boards.

I needed to teach asynchronously for a particular course where students had concerns about internet availability and meeting other personal obligations, which came with completely different issues from my synchronous course. Posting notes in addition to pre-recorded lectures allowed me to successfully get course material across, but it was still missing the personal component that is fostered via in class discussion. The use of discussion boards where both the students and I posed questions to one another helped with that. Importantly, I asked students to record their questions/answers for the discussion board via video or audio whenever possible. Students continually reported that it was nice to actually hear and see one another even though live sessions were not possible. Moreover, they described how it was nice to laugh and share with one another, as responses did not have to be rehearsed and could closely mimic what might have happened in the physical classroom. 

3. Holding several office hours, varying in day and time.

Disclaimer: This may be harder to implement for some individuals because with COVID-19 comes a host of additional responsibilities and stresses that need to be attended to. But, if possible even for one day, I highly recommend it. The traditional times for which we hold office hours may not be feasible when we take into account the added responsibilities of needing to stay at home. So, why not hold office hours at different times that lend themselves to our new schedules? I found that holding office hours much later than I normally would resulted in many more students coming to them. Moreover, similar to my first suggestion, I made sure that students knew I’d be in the meeting room for my virtual hours regardless of if students signed up or not. Previously, I had always had an “open door policy” where students knew they could stop by my office without prior notice as long as my door was physically open. The new virtual office hours I held helped to mimic that. By having drastically different hours on different days, I tried to make sure that students could stop in whenever suited them. An important memory that stuck with me about this particular method was an instance when I was available at 7 pm on a Tuesday night. I had a student who showed up just wanting to talk, and stated, “I figured I wasn’t bothering you since you were on here anyway.”  Prior to COVID-19, she often stopped in to talk about how things were going. Through our virtual conversation, I learned that this student wasn’t seeking any help related to the class, but just wanted to talk because it helped things feel “normal” again. Even if you can’t hold a large variety of office hours, I truly think that doing something that helps mimic the ways you previously interacted with your students is so helpful during this time.

4. Holding “unofficial” hours.

This was a tip that I originally learned from a colleague, and adapted to fit my own subject matter. This colleague would host “unofficial”  hours, where she would sporadically e-mail students to let them know she would be in an online meeting room partaking in some fun activity. For example, on a random weeknight, she e-mailed students and said they could join in on her quest to make enchiladas. Several students took her up on that offer, and she used it as a time for the class to come together without any defined learning expectations. This gave her students the opportunity to connect as they would have previously, in a class that was now asynchronous during remote learning. She began to take sessions one step further, and would ask her students to describe ingredients in her cooking sessions in the context of her speech language pathology lectures. In an effort to take her advice and put my own spin on it, I began asking students to join me when I would participate in online workouts. It became a great way to have students connect with their classmates using an activity that we all had some interest in. With students in my pathophysiology course, I’d sneak in questions about how students felt after participating in a particular exercise and how this might impact the clinical populations they work with, giving me a way to reiterate what they had learned in a real-world context. 

In my experience, a large part in keeping students engaged was understanding that the human component to a course has the potential to impact student learning irrespective of how well we can pivot our course formats to meet remote instruction needs. No matter how it’s done, showing the students that you are still on the other side of that WiFi signal is an important consideration for all of us. I hope that my experience helps to identify other ways you might do this, and I’d appreciate you sharing your own ways to cultivate the student-instructor relationships via online methods.

Candace Receno is an assistant professor in the Exercise Science & Athletic Training department at Ithaca College in Ithaca, NY. She earned her PhD in Science Education from Syracuse University and served as a Post-Doctoral Fellow in the Biological Sciences department at Le Moyne College for two years. Candace just completed her first year as an Assistant Professor at Ithaca College, where her undergraduate and graduate courses include Advanced Exercise Physiology, Cardiopulmonary Assessment for Exercise, Pathophysiology, and Foundations of Human Performance and Wellness. She also hopes to continue engaging undergraduates in research related to exercise performance in special populations.

Evolution of Teaching Physiology and Accommodating Social Distancing
Andrew M. Roberts, M.S., Ph.D., FAPS
Associate Professor
Department of Physiology
University of Louisville School of Medicine
Louisville, KY

Our graduate physiology courses at the University of Louisville School of Medicine evolved from a lecture-based format supplemented by recitation sessions and modules for each topic.  Students work in groups to identify learning issues and discuss concepts needed to understand and solve assigned questions.  They present their findings to the class and respond to questions from faculty and students.  We found this to be an important forum whereby students gain experience applying their physiological knowledge. 

An additional step that fostered student understanding was problem-based learning modules where student groups discussed and answered exam type questions.  For the “pre-test” component, each group discussed and chose their answers together.  This was followed by a “post-test” with different but, similar questions answered by each student individually.  Our metrics clearly indicated students’ ability to apply their knowledge increased significantly.

Another component which bolstered student performance and encouraged use of multiple resources for information was online quiz questions for each learning module.  Questions were made available on “Blackboard” and answered according to a schedule.  Students received notification whether they answered correctly and could change their answer choices within an allotted time.  Team-based learning with activities that encouraged students to incorporate multiple information sources improved students’ grasp of physiological concepts and mechanisms.

In summary, we developed ways to effectively engage our students who have diverse educational backgrounds and learning preferences.  It is important to note that the classroom environment, with face to face instruction, provides the opportunity to teach and motivate students through interactions with faculty members and fellow students.  However, other types of activities work well to augment and encourage student learning.

In the last year, our faculty has been discussing the possibility and usefulness of supplementing our program with online course options that could enhance students’ academic backgrounds whether they were on or off campus.  Online learning has become prevalent as another teaching tool for a diverse student group and accommodates a variety of learning preferences.  It offers flexibility whether used to supplement a “classroom” physiology course, or course taught exclusively online.  Over the last year, our experience with online learning platforms indicated instructors could teach to an entire class simultaneously. 

Students can be divided into discussion groups for problem-based learning and instructors can virtually interact by “joining” the groups.  In addition, the platforms allow everyone to be seen and to be heard.  Furthermore, it is easy to link slide as well as video presentations and record class sessions.  Traditionally, we posted lecture notes and supplemental material on “Blackboard” for students to read before class and provided access to recorded lectures.  There also is a forum for students to interact with each other and faculty members. 

Educational methods are ever changing and can go forward and back again.  With this in mind, online learning is not necessarily a replacement for face-to-face learning but, can be an additional learning tool.  Even faculty less familiar with online learning have found the latest learning platforms to be relatively easy to use and actually to enhance their teaching styles.  A key ingredient to the success of our program, is having designated faculty members and staff available as teaching resources!  With the necessity for implementing social distancing during the COVID- 19 pandemic, online learning and video conferencing allowed us to continue and sustain our courses and academic program during this difficult time hopefully without jeopardizing student lifelong learning.

Andrew M. Roberts, MS, PhD, FAPS is an Associate Professor in the Department of Physiology at the University of Louisville School of Medicine in Louisville, Kentucky.  He received his PhD in Physiology at New York Medical College and completed a postdoctoral training program in heart and vascular diseases, as well as, a Parker B. Francis Fellowship in Pulmonary Research at the University of California, San Francisco at the Cardiovascular Research Institute.  His research focuses on cardiopulmonary regulatory mechanisms with an emphasis on neural control, microcirculation, and effects of local endogenous factors.  Current studies include microvascular responses altered by inflammatory diseases and conditions, which can lead to acute respiratory distress syndrome.  Additional studies include obstructive sleep apnea.  He teaches physiology to graduate, medical, and dental students and has served as a course director as well as having taught allied health students.

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

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

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

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

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

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

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

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

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

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

Examples of tasks performed.

1 – Practice exam questions

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

2 – Multiple choice questions – Quizzes

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

3 – Completing sentences or matching answers

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

4 – Filling in the gaps

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

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

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

References

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

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

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

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

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

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

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

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

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

Challenges of migrating online amid the COVID-19 pandemic
Ida T. Fonkoue, Ph.D.
Post-Doctoral Fellow, Renal Division
Emory University School of Medicine

Ramon A. Fonkoue, Ph.D.
Associate Professor, French and Cultural Studies
Michigan Technological University

The COVID-19 pandemic has led to a total and sudden reshaping of the academic landscape across the country, with hundreds of institutions moving administration entirely online and shifting to online instruction for the remainder of the spring semester or for both spring and summer. This sudden transition with practically no time to prepare has major implications for students and faculty alike, and poses serious challenges to a smooth transition as well as effective online teaching on such a large scale. Out of these challenges, two issues in particular are examined here: 

By Phil Hill, licensed under CC-BY. See URL in references.
  • the disparity in resources and preparedness for effective online teaching 
  • the implications of the migration to virtual classrooms for diversity and inclusion

Disparity in resources and preparedness for effective online teaching

Teaching an online course requires just as much, if not more, time and energy as traditional classroom courses. It also requires specific IT skills to be effective. Some teachers have managed to achieve great success engaging students online. However, many challenges remain for the average teacher. While online teaching has now been embraced by all higher education institutions and the number of classes offered online has seen a steady growth over the years, it should be noted that until now, instructors and students had the choice between brick and mortar classes and virtual ones. Each could then choose based on their personal preferences and/or circumstances. What makes the recent changes so impactful and consequential is that no choice is left to instructors or students, as the move to online classes is a mandate from the higher administration. Whether one is willing, prepared or ready is irrelevant. It is from this perspective that the question of the preparedness to migrate online is worth examining. 

With academic units ordered to move classes online, instructors who had remained indifferent to the growing trend of online teaching have had a difficult reckoning. They have had to hastily move to online delivery, often with a steep learning curve. This challenge has been compounded in some cases by the technology gap for instructors who haven’t kept their IT skills up to date as well as the school’s preparedness to support online teaching. But even instructors who had some familiarity with learning management systems (LMS) and online delivery have faced their share of challenges. We will only mention two sources of these difficulties: 

  • First, students’ expectations in a context of exclusive online teaching are different from when most online classes took place in the summer, and were attractive to students because of convenience and flexibility. With online classes becoming the norm, students in some universities are taking steps to demand that school administrators pay more attention to quality of instruction and maintain high standards to preserve teaching effectiveness. 
  • Second, instructors can no longer use LMS resources just for the flexibility and benefits they afforded, such as in blended classes or flipped classes. Moving everything online thus requires extra work even for LMS enthusiasts.

For students, there have been some interesting lessons. Until now, it was assumed that Generation Z students (raised in the boom of the internet and social media) we have in our classes have tech skills in their DNA and would be well equipped and ready to migrate online. Surprisingly, this hasn’t been the case across the board, and these first weeks have revealed real discrepancies in student IT equipment with varying consequences for online classes. Equipment failure and problems with access to high speed internet emerge as the most serious difficulties on the students’ side. Furthermore, online learning requires independence and often more self-discipline and self-motivation. Most online courses are not taught in real time, and there are often no set times for classes. While this flexibility makes online classes attractive, it can also be a drawback for students who procrastinate and are unable to follow the course pace. If left to themselves, only the most responsible students will preserve their chances of performing well. On this last point, one unexpected issue has been students who have virtually disappeared from their classes since the migration of courses online amid the COVID-19 pandemic. The current transition has thus presented major challenges for teachers and students alike. 

Implications of the migration to virtual classrooms for diversity and inclusion

The second issue we think deserves attention is the way in which educational institutions’ commitment to diversity and inclusion would play out in virtual classes. While they are now among the professed core values of all colleges and universities across the country, implementing diversity and inclusion in an online environment presents a different set of challenges for both instructors and students. In traditional classrooms, the commitment to diversity and inclusion typically translates into the following:

  • A diversity and inclusion statement from the school must be included in the course syllabus.
  • Instructors must remind students a few rules at the beginning of the course, including: recognition that the classroom is an environment where diversity is acknowledged and valued; tolerance of and respect for diversity of views in the classroom.
  • Sensitivity to and respect for diversity (gender, age, sexual orientation, etc.).
  • Students are asked to be courteous and respectful of different opinions.

In moving into a virtual environment, instructors have to think about the challenges of virtual classrooms and their potential impact on diversity and inclusion. For instance, the faceless nature of course participation and asynchronous delivery may make it easier for participants to disregard or neglect diversity and inclusion rules. Teachers need to reflect on ways to ensure that the virtual space of online classes remains an environment that fosters diversity and inclusion. One drawback of online classes is the potential impact of the relative anonymity on social engagement. In a traditional classroom, participants are constrained by the physical presence of their peers in the confined space of the classroom. The closed physical space of the classroom, combined with the instructor’s authority and peer pressure contribute to fostering discipline. Reflecting on the way online teaching impacts the instructor, one faculty noted: “I didn’t realize how much I rely on walking around the room and making eye contact with students to keep them engaged.” As an online teacher, one lacks the ability to connect physically with students, to read emotional cues and body language that might inform about the individuality of a student. Moreover, a good grasp of the diversity in the classroom and of students’ learning abilities is needed to plan instruction, and give each of them the opportunity to learn and succeed.

Drawing from the above considerations, here are some key questions that instructors should consider as they migrate online: What skills do instructors need to properly address diversity and inclusion online? How do instructors include diversity and inclusion requirements in online course design? How to create an inclusive online classroom? How do instructors attend to diverse students’ needs during instruction? How do they monitor behaviors and enforce diversity and inclusion rules during instruction?

While the migration might have been abrupt, instructors need not seek perfection in moving their courses online. As in traditional classes, what matters the most, from the student’s point of view, is constant communication, clear directions and support from their teachers. Students understand the challenges we all face. They also understand the rules in virtual classes, provided we emphasize them.

References

Hill, Phil (2020), Massive Increase in LMS and Synchronous Video Usage Due to COVID-19. PhilonEdTech. https://philonedtech.com/massive-increase-in-lms-and-synchronous-video-usage-due-to-covid-19/

Greeno, Nathan (2020), Prepare to Move Online (in a Hurry). Inside Higher Ed. https://www.insidehighered.com/views/2020/03/10/prepare-move-online-continuity-planning-coronavirus-and-beyond-opinion


McMurtrie, Beth (2020), The Coronavirus Has Pushed Courses Online. Professors Are Trying Hard to Keep Up. The Chronicle of Higher Education. https://www.chronicle.com/article/The-Coronavirus-Has-Pushed/248299

Dr Ida Fonkoué is a post-doctoral fellow at Emory University School of Medicine in the Laboratory of Dr Jeanie Park. She trained under Dr Jason Carter at Michigan Technological University, where she graduated with a PhD in Biological Sciences in December 2016. She teaches renal physiology classes and lead small groups in the School of Medicine. Her long-term research goal is to understand how the sympathetic nervous system, the vasculature and inflammation interplay to contribute to the high cardiovascular disease risk of patients living with chronic stress, such as those with post-traumatic stress disorder.

Dr. Ramon A Fonkoué is an Associate Professor of French and Cultural Studies and the Director of Graduate Studies in the Department of Humanities at Michigan Technological University. He is also a Visiting Scholar in the department of French and Italian at Emory University. He has been teaching online for 9 years and has experience with blended, flipped and full online classes.

Involving students in the teaching experience
Karen L. Sweazea, PhD, FAHA
Arizona State University

As faculty, we often find ourselves juggling multiple responsibilities at once. Although many of us are interested in adding hands-on or other activities to our classes, it can be difficult to find the time to develop them. This is where more advanced students who have already taken the class or graduate students can help.

A couple of summers ago I requested the help of an extra teaching assistant in my Animal Physiology course. The role of the position I was requesting was unique as I was not seeking a student to help with grading or proctoring exams. Rather, the role of this student was to help develop in-class activities that would enhance the learning experience of students taking the course.

For each lesson, the special graduate student TA was tasked with finding an existing (ex: https://www.lifescitrc.org/) or creating a new activity that could be implemented in the classroom during the last 10-20 minutes of each session, depending on the complexity of the activity. This enabled me to begin converting the course into a flipped classroom model as students enrolled in the course were responsible for reading the material ahead of time, completing a content comprehension quiz, and coming to class prepared to discuss the content and participate in an activity and/or case study. Special TAs can also assist with developing activities for online courses.

While the benefits of having such a TA for the faculty are clear, this type of experience is also beneficial to both the TA as well as the students enrolled in the course. For the TA, this experience provides an opportunity to develop their own teaching skills through learning to develop short lesson plans and activities as well as receiving feedback from the faculty and students. For the students, this is a great way to build cultural competence into the course as TAs are often closer in age to the students and may better reflect the demographics of the classroom. Cultural competence is defined by the National Education Association as “the ability to successfully teach students who come from a culture of cultures other than our own.” Increasing our cultural competency, therefore, is critical to student success and is something that we can learn to address. Having special TAs is just one way we can build this important skill.

Karen Sweazea is an Associate Professor in the College of Heath Solutions at Arizona State University. Her research specializes in diabetes and cardiovascular disease. She received her PhD in Physiological Sciences from the University of Arizona in 2005 where her research focused on understanding glucose homeostasis and natural insulin resistance in birds. Her postdoctoral research was designed to explore how poor dietary habits promote the development of cardiovascular diseases. 

Dr. Sweazea has over 40 publication and has chaired sessions and spoken on topics related to mentoring at a variety of national and local meetings. She has additionally given over 10 guest lectures and has developed 4 graduate courses on topics related to mentoring and professional development. She has mentored or served on the committees for undergraduate, master’s, and doctoral students and earned an Outstanding Faculty Mentor Award from the Faculty Women’s Association at Arizona State University for her dedication towards mentoring.