Category Archives: Teaching Strategies

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.   

Lighting the Spark: Engaging Medical Students in Renal Physiology
Jessica Dominguez Rieg, PhD
Department of Molecular Pharmacology and Physiology
University of South Florida Morsani College of Medicine

Recently, I spent some time reflecting on the way we teach physiology at my institution. One thing that kept coming to my mind- why does renal physiology get such a bad reputation? We often hear medical students commenting that renal physiology was the hardest topic of the first year, that there’s too much math involved, and concepts like acid-base and electrolyte disorders are too difficult to grasp. Does a negative attitude about renal physiology really matter in the long run? If the students can successfully pass USMLE Step 1, can I rest easy knowing they are competent in understanding how the kidneys function? Or can I, a basic science faculty, make a bigger impact on how these students view the renal system?

Chronic kidney disease is a growing public health concern in the United States, affecting roughly 40 million adults. Given the increasing burden of disease, an aging population, and modern medicine that is keeping patients with end-stage kidney disease alive longer, we need a robust workforce in nephrology. However, the field of nephrology is in the middle of a major crisis, and there is significant concern that there will not be an adequate workforce to meet the healthcare needs of patients afflicted with kidney disease. Only 62% of available nephrology fellowship positions were filled in the 2019 National Resident Matching Program match and less than 45% of positions were filled by U.S. MD graduates, making nephrology one of the least competitive subspecialties1. When does the waning interest in nephrology begin? Many think it starts early in a medical student’s academic journey.

I recently surveyed our medical students at the University of South Florida Morsani College of Medicine (250 respondents) and found that 60% of students agreed or strongly agreed that the topic of nephrology is interesting and yet close to one-third of them agreed or strongly agreed that renal pathophysiology is too complex and challenging for them. When asked what makes the biggest impact on their future career choice, 60% indicated that having role models and mentors in the specialty field was high impact; however, less than half of the students felt they had been exposed to encouraging role models or mentors in nephrology. Students ranked rotations during clerkships as having the highest impact in career choice; and yet our students are first exposed to nephrology during their Internal Medicine clerkship in their 3rd year, which only last 8 weeks. Not surprisingly, students ranked didactics in the preclinical years as having the lowest impact on career choice. What if we can change that? Perhaps there is too little done too late- and we just can’t get enough momentum going to gain a critical mass of students interested in nephrology. Is there anything that we, as medical physiology educators, can do to help? We can light the spark!

1. Make it matter. The complexity of renal physiology must be taught with meaningful clinical context. Students need to understand the clinical importance of what they are learning or there is a high chance they will get turned off from the very beginning. One of the best ways I have found to make it matter, is to work closely with my clinical colleagues. Not only can they provide (and co-teach) examples of how to

2. Make it digestible. Students often get overwhelmed by the level of detail that is expected in the renal block. We must ensure we are giving them the important content in bite-sized pieces so they have time to think about it, apply it, and understand it. I give our students a blank nephron map2 at the beginning of the renal block and ask that they work together to fill it out. On the last day of the renal block, we go through the maps together as a summary of renal function. Students like having all the transporters, hormones and key characteristics about each region of the nephron in one place. It helps them organize their knowledge and also gives them something to refer to in Year 2 and beyond.

3. Make it relatable. At our institution, students get renal physiology at the end of Year 1, so they’ve had all other organ systems besides reproductive physiology. I use many analogies throughout the renal system and always to try to highlight the similarities with the intestinal tract, which they are more familiar with at that point in time. After all, the nephron is like a “mini-intestine”, with similar histological features and transporter profiles. By relating the new renal content to something they’ve seen before, it can help make it a little easier to understand (and allows them to make systemic connections).

4. Make it stick. Students struggle with grasping acid-base disturbances. Consistent repetition and practice problems is key! Many times, students learn multiple ways to approach interpreting acid-base disturbances (different formulas, different values for expected compensatory responses, etc.) depending on who is teaching. This can be frustrating and confusing for students. We have found that having all faculty that teach some aspect of acid-base balance use a single resource, a step-by-step guide to interpreting acid-base disturbances3, has been very helpful in ensuring consistency in what we teach. Students also work through many practice problems in interpretation of arterial blood gases, starting in Year 1, again in Year 2, and again during the clerkships. The result is that students have gone from scoring less than 50% on NBME acid-base questions, to close to 90%- it’s sticking!

5. Make it fun! One of the notoriously challenging lectures in our preclinical years is integration of acid-base, volume, and electrolyte disorders. Traditionally, it was a lecture given by a nephrologist and was very technical and clinically oriented. However, students were lost and overwhelmed. So, I partnered with an internal medicine physician and we revamped the session into a fun, interactive series of cases where we co-facilitated discussion. Students were introduced to the 14th book of Lemony Snicket’s A Series of Unfortunate Events: The Hazardous Hospital, where they were asked to investigate the mysterious health issues of Sir Cornelius. The cases we presented were challenging and framed with very relevant basic science concepts, and students loved it! Not only did they have fun while learning, but they really appreciated having a basic scientist and clinician teaching together.

In conclusion, renal physiology is challenging and may be contributing to a lack of interest in a career in nephrology. As medical physiology educators, we have the ability to work with our clinical colleagues and revamp how we teach the renal system. We can get students engaged and excited about renal physiology by making the content clinically relevant, digestible, relatable and fun. After all, there needs to be a spark to light the fire!

References:

  1. National Resident Matching Program, Results and Data: Specialties Matching Service 2019 Appointment Year. National Resident Matching Program, Washington, DC. 2019
  2. Robinson PG, Newman D, Reitz CL, Vaynberg LZ, Bahga DK, Levitt MH. A large drawing of a nephron for teaching medical students renal physiology, histology, and pharmacology. Advances in Physiology Education. 42:2, 192-199, 2018.
  3. DeWaay D, Gordon J. The ABC’s of ABGs: teaching arterial blood gases to adult learners. MedEdPORTAL. 2011;7:9038.

Dr. Dominguez Rieg is a faculty member in the Department of Molecular Pharmacology & Physiology at the University of South Florida Morsani College of Medicine. She is the Course Director for the Gastrointestinal, Endocrine, Renal and Reproductive Systems block and the Physiology Integration Director that is responsible for mapping physiology content objectives across the entire curriculum. She teaches endocrine, renal and reproductive physiology and renal pathophysiology in multiple courses in the pre-clerkship years. She received her PhD in Physiological Sciences from the University of Arizona. Her research interests are kidney-intestine crosstalk and intestinal function in the context of systemic diseases such as obesity and diabetes. When she’s not at work, she is enjoying time with her young daughter and four German Shepherds.

Can the Flipped Classroom Method of Teaching Influence Students’ Self-Efficacy?
Chaya Gopalan, PhD, FAPS
Associate Professor
Departments of Applied Health, Primary Care & Health Systems
Southern Illinois University Edwardsville

Self-efficacy is the belief in one’s ability to succeed in a specific situation or accomplish a specific task (Bandura, 1977). Students with high self-efficacy have higher motivation to learn and, therefore, are able to reach higher academic goals (Honicke & Broadbent, 2016). Gender, age, and the field of study are some factors that are known to affect self-efficacy (Huang, 2013). Genetics plays a significant role (Waaktaar & Torgersen, 2013). Certain physiological factors such as perceptions of pain, fatigue, and fear may have a marked, deleterious effect on self-efficacy (Vieira, Salvetti, Damiani, & Pimenta, 2014). In fact, research has shown that self-efficacy can be strengthened by positive experiences, such as mastering a skill, observing others performing a specific task, or by constant encouragement (Vishnumolakala, Southam, Treagust, Mocerino, & Qureshi, 2017). Enhancement of self-efficacy may be achieved by the teachers who serve as role models as well as by the use of supportive teaching methods (Miller, Ramirez, & Murdock, 2017). Such boost in self-efficacy helps students achieve higher academic results.

The flipped classroom method of teaching shifts lectures out of class. These lectures are made available for students to access anytime and from anywhere. Students are given the autonomy to preview the content prior to class where they can spend as much time as it takes to learn the concepts. This approach helps students overcome cognitive overload by a lecture-heavy classroom.  It also enables them to take good notes by accessing lecture content as many times as necessary. Since the lecture is moved out of class, the class time becomes available for deep collaborative activities with support from the teacher as well as through interaction with their peers. Additionally, the flipped teaching method allows exposure to content multiple times such as in the form of lecture videos, practice questions, formative assessments, in-class review, and application of pre-class content. The flipped classroom therefore provides a supportive atmosphere for student learning such as repeated exposure to lecture content, total autonomy to use the constantly available lecture content, peer influence, and support from the decentered teacher. These listed benefits of flipped teaching are projected to strengthen self-efficacy which, in turn, is expected to increase students’ academic performance. However, a systematic approach measuring the effectiveness of flipped teaching on self-efficacy is lacking at present.

References:

Bandura, A. (1977). Self-efficacy: toward a unifying theory of behavioral change. Psychological review84(2), 191.

de Moraes Vieira, É. B., de Góes Salvetti, M., Damiani, L. P., & de Mattos Pimenta, C. A. (2014). Self-efficacy and fear avoidance beliefs in chronic low back pain patients: coexistence and associated factors. Pain Management Nursing15(3), 593-602.

Honicke, T., & Broadbent, J. (2016). The influence of academic self-efficacy on academic performance: A systematic review. Educational Research Review17, 63-84.

Huang, C. (2013). Gender differences in academic self-efficacy: A meta-analysis. European journal of psychology of education28(1), 1-35.

Miller, A. D., Ramirez, E. M., & Murdock, T. B. (2017). The influence of teachers’ self-efficacy on perceptions: Perceived teacher competence and respect and student effort and achievement. Teaching and Teacher Education64, 260-269.

Vishnumolakala, V. R., Southam, D. C., Treagust, D. F., Mocerino, M., & Qureshi, S. (2017). Students’ attitudes, self-efficacy and experiences in a modified process-oriented guided inquiry learning undergraduate chemistry classroom. Chemistry Education Research and Practice18(2), 340-352.

Waaktaar, T., & Torgersen, S. (2013). Self-efficacy is mainly genetic, not learned: a multiple-rater twin study on the causal structure of general self-efficacy in young people. Twin Research and Human Genetics16(3), 651-660.

Dr. Chaya Gopalan received her PhD in Physiology from the University of Glasgow, Scotland. Upon completing two years of postdoctoral training at Michigan State University, she started her teaching career at St. Louis Community College. She is currently teaching at Southern Illinois University Edwardsville. Her teaching is in the areas of anatomy, physiology, and pathophysiology at both undergraduate and graduate levels for health science career programs. Dr. Gopalan has been practicing evidence-based teaching where she has tested team-based learning and case-based learning methodologies and most recently, the flipped classroom. She has received several grants to support her research interest.

Backward planning of lab course to enhance students’ critical thinking
Zhiyong Cheng, PhD
Food Science and Human Nutrition Department
The University of Florida

Development of critical thinking and problem-solving skills hallmarks effective teaching and learning [1-2]. Physiology serves as a fundamental subject for students in various majors, particularly for bioscience and pre-professional students [1-8]. Whether they plan on careers in science or healthcare, critical thinking and problem-solving skills will be keys to their success [1-8].

Backwards course design is increasingly employed in higher education. To effectively accomplish specific learning goals, instructions are to begin course development with setting learning objectives, then backwardly create assessment methods, and lastly design and deliver teaching and learning activities pertaining to the learning objectives and assessment methods. In terms of development of critical thinking and problem-solving skills, a lab course constitutes an excellent option to provide opportunities for instructors and students to explore innovative paths to their desired destinations, i.e., to accomplish specific learning goals.

In a traditional “cookbook” lab setting, detailed procedures are provided for the students to follow like cooking with a recipe. Students are usually told what to do step-by-step and what to expect at the end of the experiment. As such, finishing a procedure might become the expected goal of a lab course to the students who passively followed the “cookbook”, and the opportunity for developing critical thinking skills is limited. In a backwards design of a lab course; however, the instructor may engage the students in a series of active learning/critical thinking activities, including literature research, hypothesis formulation, study design, experimental planning, hands-on skill training, and project execution. Practically, the instructor may provide a well-defined context and questions to address. Students are asked to delve into the literature, map existing connections and identify missing links for their project to bridge. With the instructor’s guidance, students work together in groups on hypothesis development and study design. In this scenario, students’ focus is no longer on finishing a procedure but on a whole picture with intensive synthesis of information and critical thinking (i.e., projecting from generic context to literature search and evaluation, development of hypothesis and research strategy, and testing the hypothesis by doing experiments).

An example is this lab on the physiology of fasting-feeding transitions. The transition from fasting to feeding state is associated with increased blood glucose concentration. Students are informed of the potential contributors to elevated blood glucose, i.e., dietary carbohydrates, glycogen breakdown (glycogenolysis), and de novo glucose production (gluconeogenesis) in the liver. Based on the context information, students are asked to formulate a hypothesis on whether and how hepatic gluconeogenesis contributes to postprandial blood glucose levels. The hypothesis must be supported by evidence-based rationales and will be tested by experiments proposed by students with the instructor’s guidance. Development of the hypothesis and rationales as well as study design requires students to do intensive information extraction and processing, thereby building critical thinking and problem-solving skills. Students also need to make sound judgments and right decisions for their research plans to be feasible. For instance, most students tend to propose to employ the hyper-insulinemic-euglycemic clamp because the literature ranks it as a “gold standard” method to directly measure hepatic gluconeogenesis. However, the equipment is expensive and not readily accessible, and students have to find alternative approaches to address these questions. With the instructor’s guidance, students adjust their approaches and adopt more accessible techniques like qPCR (quantitative polymerase chain reaction) and Western blotting to analyze key gluconeogenic regulators or enzymes. Engaging students in the evaluation of research methods and selection helps them navigate the problem-solving procedure, increasing their motivation (or eagerness) and dedication to learning new techniques and testing their hypotheses. Whether their hypotheses are validated or disproved by the results they acquire in the end, they become skillful in thinking critically and problem solving in addition to hands-on experience in qPCR and Western blotting.

Evidently, students can benefit from backwards planning in different ways because it engages them in problem-based, inquiry-based, and collaborative learning — all targeted to build student problem solving skills [1-8]. For a typical lab course with pre-lab lectures; however, there is only 3-6 hours to plan activities. As such, time and resources could be the top challenges to implement backwards planning in a lab course. To address this, the following strategies will be of great value: (i) implementing a flipped classroom model to promote students’ pre- and after-class learning activities, (ii) delivering lectures in the lab setting (other than in a traditional classroom), where, with all the lab resources accessible, the instructor and students have more flexibility to plan activities, and (iii) offering “boot camp” sessions in the summer, when students have less pressure from other classes and more time to concentrate on the lab training of critical thinking and problem solving skills. However, I believe that this is a worthwhile investment for training and developing next-generation professionals and leaders.

References and further reading

[1] Abraham RR, Upadhya S, Torke S, Ramnarayan K. Clinically oriented physiology teaching: strategy for developing critical-thinking skills in undergraduate medical students. Adv Physiol Educ. 2004 Dec;28(1-4):102-4.

[2] Brahler CJ, Quitadamo IJ, Johnson EC. Student critical thinking is enhanced by developing exercise prescriptions using online learning modules. Adv Physiol Educ. 2002 Dec;26(1-4):210-21.

[3] McNeal AP, Mierson S. Teaching critical thinking skills in physiology. Am J Physiol. 1999 Dec;277(6 Pt 2):S268-9.

[4] Hayes MM, Chatterjee S, Schwartzstein RM. Critical Thinking in Critical Care: Five Strategies to Improve Teaching and Learning in the Intensive Care Unit. Ann Am Thorac Soc. 2017 Apr;14(4):569-575.

[5] Nguyen K, Ben Khallouq B, Schuster A, Beevers C, Dil N, Kay D, Kibble JD, Harris DM. Developing a tool for observing group critical thinking skills in first-year medical students: a pilot study using physiology-based, high-fidelity patient simulations. Adv Physiol Educ. 2017 Dec 1;41(4):604-611.

[6] Bruce RM. The control of ventilation during exercise: a lesson in critical thinking. Adv Physiol Educ. 2017 Dec 1;41(4):539-547.

[7] Greenwald RR, Quitadamo IJ. A Mind of Their Own: Using Inquiry-based Teaching to Build Critical Thinking Skills and Intellectual Engagement in an Undergraduate Neuroanatomy Course. J Undergrad Neurosci Educ. 2014 Mar 15;12(2):A100-6.

[8] Peters MW, Smith MF, Smith GW. Use of critical interactive thinking exercises in teaching reproductive physiology to undergraduate students. J Anim Sci. 2002 Mar;80(3):862-5.

Dr. Cheng received his PhD in Analytical Biochemistry from Peking University, after which he conducted postdoctoral research at the University of Michigan (Ann Arbor) and Harvard Medical School. Dr. Cheng is now an Assistant Professor of Nutritional Science at the University of Florida. He has taught several undergraduate- and graduate-level courses (lectures and lab) in human nutrition and metabolism (including metabolic physiology). As the principal investigator in a research lab studying metabolic diseases (obesity and type 2 diabetes), Dr. Cheng has been actively developing and implementing new pedagogical approaches to build students’ critical thinking and problem-solving skills.

Which Level of Students are Best Suited for Flipped Learning?
Chaya Gopalan, PhD, FAPS
Associate Professor, Departments of Applied Health, Primary Care and Health Systems
Southern Illinois University Edwardsville

The flipped classroom (FC) is a student-centered teaching method that is embraced by educators in recent years for several reasons. According to Bergmann and Sams (2012), FC accommodates students’ busy schedules, helps struggling students, and allows self-pacing. In this teaching method, students are exposed to content prior to class in the form of assignments and the class time is structured to include mini-lectures so that students have opportunities to ask questions and engage with teachers. Additionally, the instructors can also administer learning activities, such as quizzes and group work so that students can gain a much deeper understanding of the content when compared to lectures alone. Khan Academy is an example of a FC that can be utilized by students ranging from elementary to high school.

A similar situation is true in the higher education arena where FC is introduced in courses ranging from community college all the way up to the graduate level courses in a wide variety of programs and professions. However, it is unclear as to which level, in particular, would benefit from the FC model the most. Ideally, college freshmen are open-minded and are able to adapt quickly to the FC approach thus being better prepared for the rest of their college years. Nevertheless, in a study conducted in China, for example, Li (2018) found that many freshmen do not utilize pre-class assignments and therefore are not prepared for in-class activities. For some freshmen, FC is not a new teaching method because they experienced it in their high schools. Introducing FC in the third and fourth years of undergraduate education, once again, could be argued as either “too late” because they have not been exposed to FC thus far, or “most ideal” because these students are more mature and do their pre-class work more reliably.   

Students’ experiences of the FC model can vary greatly. As part of an NSF-funded project, data collected from freshmen and sophomore STEM classrooms at a community college suggested that students’ perceptions, such as “learned more in the FC classroom” and “more engaged” were far less common when compared to the same level of students in a four-year institution. At the same time, when doctoral students entering a Nurse Anesthesia program were given a similar experience with FC, the response was overwhelmingly positive. On the other hand, for senior students in the Exercise Science program, their perception of FC was stronger than the freshmen-sophomore group but not as strong as that of the graduate students. Since the age of the freshmen-sophomore students at the community college varies considerably, assessing the most critical determinant can be challenging.

In summary, the students that achieve higher levels of educational experience seem to be able to utilize the FC method to the fullest extent. It must be noted that the majority of our students are experiencing FC for the very first time. Since this instructional approach demands regular study habits and time commitment while minimizing procrastination, students may take time to develop new learning strategies to be able to value their experience. Whether students respond similarly, provided they are exposed to FC classes more frequently across the curriculum, is yet to be seen.

Acknowledgements: Part of the data shared in this blog is funded by NSF-IUSE grant DUE – 1821664 “Examining Faculty Attitudes and Strategies that Support Successful Flipped Teaching”.

References

Bergmann, J., & Sams, A. (2012). Flip your classroom: Reach every student in every class every day. Eugene, Or: International Society for Technology in Education.
Li, Yi. (2018). Current problems with the prerequisites for flipped classroom teaching—a case study in a university in Northwest China. Smart Learning Environments, 5:2

Dr. Chaya Gopalan received her PhD in Physiology from the University of Glasgow, Scotland. Upon completing two years of postdoctoral training at Michigan State University, she began her teaching career at St. Louis Community College. After a short tenure at St. Louis College of Pharmacy, Dr. Gopalan joined the departments of Applied Health, Primary Care and Health Systems at Southern Illinois University Edwardsville. Her teaching is in the areas of anatomy, physiology, and pathophysiology at both undergraduate and graduate levels. Dr. Gopalan has been practicing evidence-based teaching where she has tested team-based learning methodology, case-based learning methodology and most recently, the flipped classroom. She has received several research grants in pursuing her research interests.