Category Archives: Undergraduate Physiology

Teaching for Learning: The Evolution of a Teaching Assistant

An average medical student, like myself, would agree that our first year in medical school is fundamentally different from our last, but not in the ways most of us would expect. Most of us find out that medical school not only teaches us about medicine but it also indirectly teaches us how to learn. But what did it take? What is different now that we didn’t do back in the first year? If it comes to choosing one step of the road, being a teaching assistant could be a turning point for the perception of medical education in the long run, as it offers a glimpse into teaching for someone who is still a student.

At first, tutoring a group of students might seem like a simple task if it is only understood as a role for giving advice about how to get good grades or how to not fail. However, having the opportunity to grade students’ activities and even listen to their questions provides a second chance at trying to solve one’s own obstacles as a medical student. A very interesting element is that most students refuse to utilize innovative ways of teaching or any method that doesn’t involve the passive transmission of content from speaker to audience. There could be many reasons, including insecurity, for this feeling of superficial review of content or laziness, as it happened for me.

There are, in fact, many educational models that attempt to objectively describe the effects of educating and being educated as active processes. Kirkpatrick’s model is a four-stage approach which proposes the evaluation of specific aspects in the general learning outcome instead of the process as a whole (1). It was initially developed for business training and each level addresses elements of the educational outcome, as follows:

  • Level 1- Reaction: How did learners feel about the learning experience? Did they enjoy it?
  • Level 2- Learning: Did learners improve their knowledge and skills?
  • Level 3- Behavior: Are learners doing anything different as a result of training?
  • Level 4- Results: What was the result of training on the business as a whole?

Later, subtypes for level 2 and 4 were added for inter-professional use, allowing its application in broader contexts like medicine, and different versions of it have been endorsed by the Best Evidence in Medical Education Group and the Royal College of Physicians and Surgeons of Canada (1) (2).  A modified model for medical students who have become teachers has also been adapted (3), grading outcomes in phases that very closely reflect the experience of being a teaching assistant. The main difference is the inclusion of attitude changes towards the learning process and the effect on patients as a final outcome for medical education. The need for integration, association and good problem-solving skills are more likely to correspond to levels 3 and 4 of Kirkpatrick’s model because they overcome traditional study methods and call for better ways of approaching and organizing knowledge.

Diagram 1- Modified Kirkpatrick’s model for grading educational outcomes of medical student teachers, adapted from (3)

These modifications at multiple levels allow for personal learning to become a tool for supporting another student’s process. By working as a teaching assistant, I have learned to use other ways of studying and understanding complex topics, as well as strategies to deal with a great amount of information. These methods include active and regular training in memorization, deep analysis of performance in exams and schematization for subjects like Pharmacology, for which I have received some training, too.

I am now aware of the complexity of education based on the little but valuable experience I have acquired until now as a teacher in progress. I have had the privilege to help teach other students based on my own experiences. Therefore, the role of a teaching assistant should be understood as a feedback process for both students and student-teachers with a high impact on educational outcomes, providing a new approach for training with student-teaching as a mainstay in medical curricula.

References

  1. Roland D. Proposal of a linear rather than hierarchical evaluation of educational initiatives: the 7Is framework. Journal of Educational Evaluation for Health Professions. 2015;12:35.
  2. Steinert Y, Mann K, Anderson B, Barnett B, Centeno A, Naismith L et al. A systematic review of faculty development initiatives designed to enhance teaching effectiveness: A 10-year update: BEME Guide No. 40. Medical Teacher. 2016;38(8):769-786.
  3. Hill A, Yu, Wilson, Hawken, Singh, Lemanu. Medical students-as-teachers: a systematic review of peer-assisted teaching during medical school. Advances in Medical Education and Practice. 2011;:157.

The idea for this blog was suggested by Ricardo A. Pena Silva M.D., Ph.D. who provided guidance to Maria Alejandra on the writing of this entry.

María Alejandra is a last year medical student at the Universidad de Los Andes, School of Medicine in Bogota, Colombia, where she is has been a teaching assistant for the physiology and pharmacology courses for second-year medical students. Her academic interests are in medical education, particularly in biomedical sciences.  She is interested in pursuing a medical residency in Anesthesiology. Outside medical school, she likes running and enjoys literature as well as writing on multiple topics of personal interest.
In Defense of the “Real” Thing

Society has moved into the age of virtual reality.  This computer-generated trend has wide-sweeping implications in the classroom.  Specific to anatomy, impressive 3D modeling programs permit students to dissect simulated bodies pixel by pixel.  It is exciting and often more cost-effective.  Virtual dissection, without doubt, can play a significant role in the current learning environment. However, as stated by Rene Descartes, “And so that they might have less difficulty understanding what I shall say about it, I should like those who are unversed in anatomy to take the trouble, before reading this, of having the heart of a large animal with lungs dissected before their eyes (for it is in all respects sufficiently like that of a man)”. This idea leads me to my argument; there is no replacement for the real thing.

 

We as teachers must incorporate a variety of learning tools for a student to truly understand and appreciate anatomical structure. Anatomical structure also needs to be related to physiological function. Is there anyone reading this that has not repeated the mantra “form determines function” hundreds or thousands of times during their teaching?  The logistical and financial restrictions to human cadavers, necessitates the frequent incorporation of chemically preserved specimens into our laboratory curriculum. Course facilitators often employ a cat or a pig as a substitute for the human body. I am not advocating against the use of preserved specimens or virtual programs for that matter (and kudos to my fellow facilitators who have learned the arduous techniques required to dissect a preserved specimen). However, it is my opinion that it is a time consuming assignment with limited educational end points. Not to mention the rising specimen costs and limited vendor options. The cost of a preserved cat is now ~$40, while the average cost of a live mouse is only ~$5. Two very important components necessary to understand the concept that form determines function are missing from preserved specimens (even cadavers). These two components are: texture and color. With respect to color, the tissues of preserved specimens are subtle variations of gray, completely void of the Technicolor show of the living organism. Further, texture differences are extremely difficult to differentiate in a preserved specimen. Compare this to a fresh or live specimen and the learning tools are innumerable. You might argue that mice are much smaller, but dissecting microscopes can easily enhance the dissection and in my experience far outweigh the noxious experience of dissecting a chemically preserved organism.

 

To further convince you of the value of dissecting fresh tissue I would like to present a couple of examples. First, why is the color of tissue important? One of the most important bodily pigments is hemoglobin. Hemoglobin, as we all know, is the pigment that gives blood its red color. Therefore the color of a tissue often reflects the level of the tissue vascularity and often (but of course not always) in turn the ability of that tissue to repair or regenerate. Simply compare the color of the patellar tendon (white) to the red color of the quadriceps. Muscles being highly vascularized have a much greater ability to regenerate than non-vascular connective tissue such as the patellar tendon. In addition, muscles contain myoglobin, a red protein very similar to hemoglobin. Two clear examples of teaching opportunities that would be missed with the traditional use of preserved specimens.

 

Texture is completely lost with chemical preservation as tissues become hardened and rubbery. My students are always blown away by the fact you can completely eliminate the overall structure of the brain by pressing it between their two fingers. The tactile experience of holding the delicate brain allows students to explore how form begets function begets pathology. Traumatic brain injury (TBI) has become a hot topic in our culture. We no longer see children riding bicycles without helmets, the National Football League has new rules regarding tackle technique and my 8-year-old soccer player is penalized for headers during game play. What better way to educate a new generation of students just how delicate nervous tissue is than by having them “squash” a mouse brain? Regardless, of the amazing skull that surrounds the brain and the important fluid in which it floats, a hit to the head can still result in localized damage and this tactile experience emphasizes this in a way no virtual dissection could ever accomplish.

 

Finally, I would like to discuss a topic close to my heart that does require a non-preserved large animal specimen. The function of arteries and veins is vastly different based on the structure of elastic or capacitance vessels, respectively. For example, the deer heart allows easy access to the superior or inferior vena cava (veins that are thin and easily collapsed) and the aorta (thick and elastic artery) permitting valuable teaching moments on vessel structural variability for divergent physiological function. These structures on a preserved specimen are usually removed just as they enter the heart making them very difficult to evaluate.

 

These are just some elementary examples. Numerous concepts can be enhanced with the added illustrations of texture and color. When presented with both options, my students always choose the fresh tissue!  The wonder and excitement of handling fresh tissue has become a hallmark of our Anatomy and Physiology course and is regularly mentioned as student’s favorite example of hands-on learning in the classroom.

 

I have to end this with a special shout-out to my dear lab adjunct Professor Elizabeth Bain MSN, RN. Liz has made access to deer heart and lungs an easy task for me.

April Carpenter, PhD is an Assistant Professor in the Health and Exercise Physiology Department at Ursinus College. She received her PhD in Molecular and Cellular Physiology at Louisiana State University Health Sciences Center and completed two postdoctoral fellowships at the Hospital for Special Surgery in New York and Cincinnati Children’s Hospital Medical Center. Her research interests include the molecular regulation of endothelial function and its impact on all phases of skeletal muscle injury.  Dr. Carpenter currently teaches Anatomy and Physiology, Research Methods and a new Pathophysiology course.
What if your students went to a lecture . . . and a concert broke out?

In June I attended the American Physiological Society’s Institute on Teaching and Learning (ITL) for the first time.  It was a fantastic week of presentations, workshops, and networking, from the opening keynote address on “Student-instructor interactions in a large-group environment” by Prem Kumar (University of Birmingham, UK) to the closing plenary talk on “Inclusive practices for diverse student populations” by Katie Johnson (Beloit College).

 

The week is hard to summarize concisely, yet I can easily identify my most memorable moment.  That occurred on Wednesday morning (June 20th).  Robert Bjork, a UCLA psychologist, had just delivered a fascinating plenary talk on learning, forgetting, and remembering information.  He had reviewed several lines of evidence that the memorization process is more complicated than tucking facts into a mental freezer where they persist forever.  Instead, the timing and context of information retrievals can profoundly affect the success of subsequent retrievals.

 

At the end of the lecture, I stood up with a question (or possibly a monologue masquerading as a question). “It seems that maintaining long-term memories is a really active, dynamic process,” I said. “The brain seems to be constantly sorting through and reassessing its memory ‘needs,’ somewhat like the way the kidney is constantly sifting through the plasma to retain some things and discard others. Is that a reasonable analogy?”

 

“Yes it is,” he answered politely.  “Perhaps,” he added, “you could write a paper on the ‘kidney model’ of how the brain learns.”

 

“I can do even better than that,” I said.  “Here’s a song I wrote about it!”  And I launched into an impromptu a cappella rendition of “Neurons Like Nephrons” (http://faculty.washington.edu/crowther/Misc/Songs/NLN.shtml).

 

The audience clapped along in time, then erupted with wild applause!  That’s how I prefer to remember it, anyway; perhaps others who were there can offer a more objective perspective.

 

In any case, singing is not just a mechanism for hijacking Q&A sessions at professional development conferences; it can also be done in the classroom.  And this example of the former, while unusual in and of itself, hints at several useful lessons for the latter.

 

  1. Unexpected music gets people’s attention. In truth, I have no idea whether most ITL attendees found my song fun or helpful. Still, I’m quite sure that they remember the experience of hearing it.  Now think about your own courses.  Are there any particular points in the course where you desperately need students’ undivided attention?  Unexpected singing or rapping is amazingly effective as an attention-grabber, even (especially?) if the performer is not a gifted musician.  Don’t be afraid to use this “nuclear option.”

 

  1. Music is not just for “making science fun” and memorizing facts. Many teachers and students who support the integration of music into science courses do so because they think it’s fun and/or useful as a mnemonic device. Both reasons are legitimate; we do want our courses to be fun, and our students do need to memorize things.  But music can be much more than an “edutainment” gimmick.  “Neurons Like Nephrons” (http://faculty.washington.edu/crowther/Misc/Songs/NLN.shtml), for example, develops an analogy between the way that the brain processes information and the way that the kidney processes plasma.  It’s not a perfect analogy, but one worthy of dissection and discussion (https://dynamicecology.wordpress.com/2016/11/14/imperfect-analogies-shortcuts-to-active-learning/).  Songs like this one can thus be used as springboards to critical thinking.

 

  1. The effectiveness of any musical activity is VERY context-specific. After my musical outburst at ITL, I was flattered to receive a few requests for a link to the song. I was happy, and remain happy, to provide that. (Here it is yet again: http://faculty.washington.edu/crowther/Misc/Songs/NLN.shtml.)  But here’s the thing: while you are totally welcome to play the song for your own students, they probably won’t love it.  To them, it’s just a weird song written by someone they’ve never heard of.  They won’t particularly care about it unless the production quality is exceptional (spoiler: it’s not) or unless they are going to be tested on the specific material in the lyrics.   Or unless you take other steps to make it relevant to them – for example, by challenging them to sing it too, or to explain what specific lines of lyrics mean, or to add a verse of their own.

 

 

In conclusion, music can function as a powerful enhancer of learning, but it is not pixie dust that can be sprinkled onto any lesson to automatically make it better.  As instructors, for any given song, you should think carefully about what you want your students to do with it.  That way, when the music begins, the wide-eyed attention of your incredulous students will be put to good use.

Gregory J. Crowther, PhD has a BA in Biology from Williams College, a MA in Science Education from Western Governors University, and a PhD in Physiology & Biophysics from the University of Washington. He teaches anatomy and physiology in the Department of Life Sciences at Everett Community College.  His peer-reviewed journal articles on enhancing learning with content-rich music have collectively been cited over 100 times.
Medical Physiology for Undergraduate Students: A Galaxy No Longer Far, Far Away

The landscape of medical school basic science education has undergone a significant transformation in the past 15 years.  This transformation continues to grow as medical school basic science faculty are faced with the task of providing “systems based” learning of the fundamental concepts of the Big 3 P’s: Physiology, Pathology & Pharmacology, within the context of clinical medicine and case studies.  Student understanding of conceptual basic science is combined with the growing knowledge base of science that has been doubling exponentially for the past century.  Add macro and microanatomy to the mix and students entering their clinical years of medical education are now being deemed only “moderately prepared” to tackle the complexities of clinical diagnosis and treatment.  This has placed a new and daunting premium on the preparation of students for entry into medical school.  Perhaps medical education is no longer a straightforward task of 4 consecutive years of learning.  I portend that our highest quality students today, are significantly more prepared and in many ways more focused in the fundamentals of mathematics, science and logic than those of even 30 years ago.  However, we are presenting them with a near impossible task of deeply learning and integrating a volume of information that is simply far too vast for a mere 4 semesters of early medical education.

 

To deal with this academic conundrum, I recommend here that the academic community quickly begin to address this complex set of problems in a number of new and different ways.  Our educators have addressed the learning of STEM in recent times by implementing a number of “student centered” pedagogical philosophies and practices that have been proven to be far more effective in the retention of knowledge and the overall understanding of problem solving.  The K-12 revolution of problem-based and student-centered education continues to grow and now these classroom structures have become well placed on many of our college and university campuses.  There is still much to be done in expanding and perfecting student-centered learning, but we are all keenly aware that these kinds of classroom teaching methods also come with a significant price in terms of basic science courses.

 

It is my contention that we must now expand our time frame and begin preparing our future scientists and physicians with robust undergraduate preprofessional education.  Many of our universities have already embarked upon this mission by developing undergraduate physiology majors that have placed them at the forefront of this movement.  Michigan State University, the University of Arizona and the University of Oregon have well established and long standing physiology majors.  Smaller liberal arts focused colleges and universities may not invest in a full majors program, but rather offer robust curricular courses in the basic medical sciences that appropriately prepare their students for professional medical and/or veterinary education.  Other research 1 universities with strong basic medical science programs housed in biology departments of their Colleges of Arts and Sciences may be encouraged to develop discipline focused “tracks” in the basic medical sciences.  These tracks may be focused on disciplines such as physiology, pharmacology, neuroscience, medical genetics & bioinformatics and microbiology & immunology.  These latter programs will allow students to continue learning with more broad degrees of undergraduate education in the arts, humanities and social sciences while gaining an early start on advanced in depth knowledge and understanding of the fundamentals of medical bioscience.  Thus, a true undergraduate “major” in these disciplines would not be a requirement, but rather a basic offering of focused, core biomedical science courses that better prepare the future professional for the rigors of integrated organ-based medical education.

 

In the long term, it is important for leaders in undergraduate biomedical education to develop a common set of curriculum standards that provide a framework from which all institutions can determine how and when they choose to prepare their own students for their post-undergraduate education.  National guidelines for physiology programs should become the standard through which institutions can begin to prepare their students.  Core concepts in physiology are currently being developed.  We must carefully identify how student learning and understanding of basic science transcends future career development, and teach professional skills that improve future employability.  Lastly, we must develop clear and effective mechanisms to assess and evaluate programs to assure that what we believe is successful is supported by data which demonstrates specific program strengths and challenges for the future.  These kinds of challenges in biomedical education are currently being addressed in open forum discussions and meetings fostered by the newly developed Physiology Majors Interest Group (P-MIG) of the APS.  This growing group of interested physiology educators are now meeting each year to discuss, compare and share their thoughts on these and other issues related to the future success of our undergraduate physiology students.  The current year will meet June 28-29 at the University of Arizona, Tucson, AZ.  It is through these forums and discussions that we, as a discipline, will continue to grow and meet the needs and challenges of teaching physiology and other basic science disciplines of the future.

Jeffrey L. Osborn, PhD is a professor of biology at the University of Kentucky where he teaches undergraduate and graduate physiology. He currently serves as APS Education Committee chair and is a former medical physiology educator and K12 magnet school director. His research focuses on hypertension and renal function and scholarship of teaching and learning. This is his first blog.
Beyond Content Knowledge: The Importance of Self-Regulation and Self-Efficacy

You can lead students to knowledge, but you can’t make them understand it …

Undergraduate physiology education has been steadily morphing from a traditionally instructor-centered, didactic lecture format to a more inclusive array of practices designed to improve student engagement and therefore motivation to learn.  Many excellent resources are available regarding the theory and practice of active learning (4) as well as guidelines specific to teaching physiology (2).  Common questions instructors ask when redesigning courses to be student-centered, active learning environments are often along the lines of:

  1. What specific content areas should I teach, and to what depth?
  2. What active learning strategies are most effective and should be included in course design? Common methodologies may be in-class or online discussion, completion of case studies, team-based learning including group projects, plus many others.
  3. How do I align assessments with course content and course activities in order to gauge content mastery?
  4. How do I promote student “buy-in” if I do something other than lecture?
  5. How do I stay sane pulling all of this together? It seems overwhelming!

These last two questions in particular are important to consider because they represent a potential barrier to instructional reform for how we teach physiology– the balance between student investment and responsibility for their learning versus time and effort investment by the instructor.  All parties involved may exhibit frustration if instructor investment in the educational process outweighs the learner’s investment.  Instructors may be frustrated that their efforts are not matched with positive results, and there may be concerns of repercussions when it comes time for student course evaluations.  Students may perceive that physiology is “too hard” thus reducing their motivation and effort within the course and possibly the discipline itself.

To improve the likelihood of a positive balance between instructor and student investment, perhaps we should add one additional question to the list above: What is the learner’s role in the learning process?   

Students often arrive to a class with the expectation that the instructor, as the content expert,  will tell them “what they need to know” and perhaps “what they need do” to achieve mastery of the factual information included as part of course content.  This dynamic places the responsibility for student learning upon the shoulders of the instructor.  How can we redefine the interactions between instructors and students so that students are engaged, motivated, and able to successfully navigate their own learning?

 

Self-Regulated Learning: A Student-Driven Process

Self-regulated learning is process by which learners are proactive participants in the learning process.  Characteristics associated with self-regulated learning include (4):

  • an awareness of one’s strengths and weaknesses broadly related to efficacious learning strategies (e.g., note-taking)
  • the ability to set specific learning goals and determine the most appropriate learning strategies to accomplish goals
  • self-monitoring of progress toward achieving goals
  • fostering an environment favorable to achieving goals
  • efficient use of time
  • self-reflect of achievement and an awareness of causation (strategies à learning)

The last characteristic above, in particular, is vitally important for development of self-regulation: self-reflection results in an appreciation of cause/effect with regard to learning and mastery of content, which is then transferrable to achievement of novel future goals.  Applied to undergraduate physiology education, students learn how to learn physiology.

At one point recently I was curious about student perceptions of course design and what strategies students utilized when they had content-related questions.  The following question was asked as part of an anonymous extra credit activity:

The results of this informal survey suggest that, at least in this cohort , undergraduate students generally did have a strategy in place when they had content-related questions—utilization of online resources, the textbook, or the instructor via e-mail to review how others have answered the question.  The good news (if we can call it that) is that only one student reported giving up and did not attempt to find answers to questions.  However, it is interesting to see that only 14% of respondents reported using critical thinking and reasoning to independently determine an explanation for their original question.  Extrapolating to a professional setting, would I want my health care provider to be proficient at looking up information that correlates with signs and symptoms of disease, or would I prefer my health care provider capable of synthesizing a diagnosis?  Thus, self-regulation and having an action plan to determine the answer for a particular question (or at least where to find an answer) may only be part of the learning process.

 

Self-Efficacy: A Belief in One’s Ability to Achieve a Defined Goal

While self-regulation refers to a collection of self-selected strategies an individual may use to enhance learning, self-efficacy is the confidence that the individual possesses the ability to successfully apply them.

Artino (1) has posed the following practices associated with building self-efficacy in medical education.

  • Help students with the goal-setting process, which could be related to learning or the development of skills and competencies; facilitate the generation of realistic and achievable goals
  • Provide constructive feedback, identifying specific areas for which students are demonstrating high performance and areas for improvement
  • Provide mechanisms to compare self-efficacy to actual performance; this could take the form of instructor feedback, metacognitive strategies, self-assessments, and self-reflections
  • Use peer modeling and vicarious learning; best practices would be to use peers at a similar level of competence who are able to demonstrate successful achievement of a learning goal

I am interested in the relationships between self-regulated learning, self-efficacy, how students learn physiology, and tangentially student perceptions of my role as the instructor.   Thus, here is another example of a self-reflection activity that was offered in an online class-wide discussion forum as extra credit (Hint: extra credit seems to be a sure-fire way to promote student engagement in self-reflection).  Once students responded to the prompt shown below, they were able to review other student’s responses.  Following the due date, I diplomatically consolidated all responses into a “peer suggestions for how to learn physiology” handout.

Three outcomes were in mind when creating this activity:

  1. To encourage students to think about the control they have over their own learning and recognize specific practices they can utilize to empower learning; also peer modeling of learning strategies
  2. To set reasonable expectations for what I can do as the instructor to foster learning, and what I cannot do (I would make it easy to understand all physiological processes, if only I could…)
  3. To plant the seed that course activities build content knowledge applicable to a future career goal, which hopefully translates into increased motivation for active participation in course activities

 

Beyond Content Knowledge: Integration of Self-Regulation and Self-Efficacy into Course Design

Incorporation of activities to build self-regulation and self-efficacy can be included along with content knowledge in the active learning classroom environment.  Moving away from didactic lecture during class time to a more flexible and dynamic active learning environment provides opportunities to discuss and model different learning strategies.  If incorporated successfully, students may experience increased self-efficacy and self-confidence, setting the precedent for continued gains in academic achievement and subsequently the potential for professional success.

It is also important to consider that what we do in the classroom, in a single course, is just one piece of the undergraduate educational experience.  Currently there is a call for undergraduate physiology programmatic review and development of cohesive curricula to promote knowledge of physiology as well as professional/transferrable skills and competencies directed toward a future career (3).

If the overarching goal of an undergraduate education is development of knowledge, skills, and abilities transferrable to a future career, as well as life-long learning, it is vitally important that discussion of self-regulated learning and self-efficacy are included within the curriculum.   Although this seems a daunting task, it is possible to purposefully design course structure, and indeed programmatic structure, with appropriate activities designed to enhance learning and self-efficacy.  One key suggestion is to make the inclusion of knowledge, skills, and competencies transparent to boost awareness of their importance, throughout the educational experience.  Here is one example of what this could look like:

 

Students frequently focus upon content knowledge, and subsequently their grade as the primary outcome measure, rather than seeing the “big picture” for how the sum total of course activities most likely directly relate to their professional goals.

A second key component to building well-prepared and high achieving undergraduates is to involve your colleagues in this process.  It takes a village, as the saying goes. Talk to your colleagues, decide which course/s will emphasize specific attributes, and also be a united front.  If students hear the same message from multiple faculty, they are more likely to recognize its value.

Finally, course or curricular reform is time-consuming process.  Don’t expect the process to be complete within one semester.  There are many excellent resources related to backward course design, core concepts of physiology as conceptual frameworks for student learning, student-centered activities, etc.  Be purposeful in selecting 1-2 areas upon which to focus at a time.  Try it out for a semester, see how it goes, and refine the process for the next time around.

 

Jennifer Rogers, PhD, ACSM EP-C, EIM-2 received 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, student response activities, 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.

Dr. Rogers is a Lecturer in the Health & Human Physiology Department at The University of Iowa.  She is the course supervisor for the Human Physiology lecture and lab courses.  Jennifer also teaches Human Anatomy, Applied Exercise Physiology, and other health science-focused courses such as Understanding Human Disease and Nutrition & Health.

  1. Artino AR. Academic self-efficacy: from educational theory to instructional practice. Perspect Med Educ 1:76–85, 2012.
  2. Michael J, Cliff W, McFarland J, Modell H, Wright A. The Core Concepts of Physiology: A New Paradigm for Teaching Physiology. Published on behalf of The American Physiological Society by Springer, 2017.
  3. Wehrwein EA. Setting national guidelines for physiology undergraduate degree programs. Adv Physiol Educ 42: 1-4, 2018.
  4. Zimmerman BJ. Becoming a self-regulated learner: an overview. Theory Into Practice, 41(2): 64-70, 2002.
The Undergraduate Physiology Lab – A New Shine on a Classic Course

The evolution of the workplace in the twenty-first century has created the need for a workforce with a skill set that is  unlike that needed by previous generations.  The American Physiological Society recognized this need  over a decade ago and with the assistance of  Association of Chairs of Departments of Physiology created  a set of professional skills needed by physiologists in the workplace (1).  This effort was echoed by the AAMC, the  STEM Innovation Task Force, and professional organizations  as they composed a  set of core competency or workplace  skills (2, 3).  Subsequent surveys of US employers across multiple industrial sectors indicated that students entering the technical workforce lacked these  critical skills.  Higher education has since been  tasked to provide students with training experiences in workplace skills, as well as content knowledge.

What are these workplace or employability skills?  The APS Professional Skills are a diverse set of skills, however the generally accepted workplace skills are a subset of this group and can be distilled into the list below.

Students entering the workplace should be able to:

  1. Work in a team structure
  2. Solve problems and think critically
  3. Plan, organize, and prioritize time
  4. Manage projects and resources
  5. Work with technology and software
  6. Communicate in oral or written formats
  7. Obtain and process information
  8. Pursue lifelong learning

Many of these skills have been embedded in the program objectives of the bachelor’s  degree.  Educators have found it difficult to insert skill training experiences into the traditional lecture classroom but most can be readily embedded into a lab curriculum such as the undergraduate physiology lab.

Let us consider these skills individually and examine how they can be found in a physiology  lab.

 

Students entering the workplace should be able to work in a team structure.

This skill is easily adapted to the physiology lab curriculum because lab partners are essential in most physiology lab courses.  The workload, experimental design, or timing of the protocol demands collaboration to accomplish tasks and complete the experiment.  The question that arises is, “How can we  train students to be productive team members in the workplace?”

Let’s think about the characteristics of good team work.  First and foremost good teamwork means completing assigned tasks promptly and responsibly.  It is easy to address this on an individual level in any course through graded assignments but it can be a challenge on a team level.   In labs however individual responsibility to the team can be addressed by assigning each team member a job that is essential to completion of the experiment.

There are also a set of interpersonal skills that promote good teamwork and these translate into practices that are important in any workplace.

  • Respect your team members and their opinions.
  • Contribute feedback, criticism, or advice in a constructive manner.
  • Be sensitive to the perspectives of different
  • When a conflict arises approach the dialog with restraint and respect.

These ideas  aren’t novel but when an instructor reviews them in class they not only provide students with guidelines  but they also communicate the instructor’s expectations for team behavior.

Finally, by using the common direction “Now show your partner how to do it.” or the well-known adage “see one, do one, teach one” an instructor promotes a subtle suggestion of responsibility for one’s team members.

Students entering the workplace should be able to solve problems and think critically. 

This objective has been a long-standing cornerstone of undergraduate life science education (4, 5).  Many instructors think that a bachelor’s degree in science is de facto a degree in critical thinking causing some instructors neglect this objective in curricular planning.  After all, if you are ever going to understand physiology, you have to be able to solve problems.  However in the workplace a physiologist will encounter many kinds of problems, challenges, puzzles, etc., and the well-prepared student will need experience in a variety of problem solving techniques.

Let’s review some problem solving practices and look at  how they occur  in the lab.

  • Use troubleshooting skills: Labs are a perfect place to teach this aspect of problem solving because it shows up so many times.  Consider the situation where a student asks  “Why  can’t I see my pulse, ECG, EMG, ….  recording on the screen?”  A typical instructor response might be, “Have you checked the power switch, cable connections, gain settings, display time..?”  only to find that the students has not thought to check any of these.  Ideally we want students to progress to the point where they can begin to troubleshoot their own problems so that their questions evolve to, “I have checked the power switch, cable connections, gain settings, display time and still don’t see a  recording on the screen.  Can you help me?”
  • Identify  irregular results:  This practice is similar to troubleshooting and again,  labs are a good place to learn about it.   Consider the situation where a student asks “My Q wave amplitude is 30.55 volts.  Does it look right to you?”  Be the end of the course the instructor hopes that the student will be able to reframe the question and ask “My P wave amplitude is 25.55 volts and I know that that is 10 fold higher than it should be.  Can you recheck my calculations?”
  • Use appropriate qualitative approaches to research problems: In the workplace a physiologist may be using this skill to ask a questions like “How can our lab evaluate the effect of Compound X on escape rhythm?”  but in the physiology lab students will learn a variety of experimental techniques and on the final exam must be able answer a less complex question like “How could you identify  third degree heart block?”
  • Use quantitative approaches to express a problem or solution: While physiology labs are rich in sophisticated  quantitative analyses it seems that it is simple calculational mechanics can often perplex and confound, students.  For example, students can readily calculate heart rate from an R-R interval when given an equation but without the equation some students may struggle to remember whether to divide or multiply by 60 sec.  Instructors recognize that the key is not to remember how to calculate rates but rather to understand what they are and be able to transfer that knowledge to problems in other areas of physiology  and ultimately be able to create their own equation for any rate.  The ability to use qualitative skills for problem solving in the workplace relies on making this transition.
  • Supporting a hypothesis or viewpoint with logic and data; Critically evaluating hypotheses and data:    In many ways these two problem solving skills are mirror images of each other. Physiology lab students get a lot of experience in supporting a hypothesis with logic and data, particularly as they write the discussion section of their lab reports.  However, the typical student gets little opportunity to critically evaluate untested or flawed hypotheses or data, a practice they will use frequently in their careers as they review  grants, manuscripts, or project proposals.  One solution might be engage students in peer review in the lab.

Students entering the workplace should be able to plan, organize, and prioritize time.  Students entering the workplace should be able to manage projects and resources.

These two skills representing personal organization and project organization often go together.  They are fundamental to any workplace but a lab is a special environment that has its own organizational needs and while they are idiosyncratic they provide experience that can be transferred to any workplace environment.  For a lab scientist  these skills can be characterized as being able to prioritize project tasks, identify needed resources, plan a project timeline, and track a projects progress.

Let’s consider some organizational and planning practices and examine on how they are used  in the lab.

As students read an experimental protocol they may ask themselves “What should do I do first – collect my reagents or start the water bath?” ,  “What is Type II water and where can I get it?” or “Can I finish my part of the data analysis and get it to my lab partner by Friday?”  How can instructors teach this?  As we look for an answer, let’s consider the realities of teaching a lab course.  Often in an effort to facilitate a lab session and enable students to complete the experiment on time, an instructor will complete some of the protocol like preparing buffers, pre-processing tissue, doing preliminary stages of dissection in advance  of the lab.  How can this instructional altruism help students learn about prioritizing tasks, identifying needed resources, or planning a project timeline.  There is no clear  or obvious answer.  Lab instructors routinely juggle learning objectives with time and content restraints  but  recognizing  that these skills are a fundamental part of professional practice makes us pause and think about  when and if  we can fit them in.

Students entering the workplace should be able to work with technology

This is clearly where lab courses can provide experiences and training that lecture courses cannot but it can be difficult for undergraduate institutions to equip labs with the most recent iteration in technology.   This does not diminish the significance of the course because physiology labs support an additional programmatic goal.  They train students to work with and use technology in ways that complement and extend their knowledge of physiology.

Let’s look at how these ideas show up in the lab.  Consider the situation where a student raises their hand during the lab and says,  “I can’t see anything on my recording but a wavy line.”  The instructor goes over to their experiment, surveys it and shows the student how to adjust the gain or display time.  Voila their data returns!

Or, consider the situation where a student raises their hand and says, “I know I am  recording something but it doesn’t look like my  ECG, pulse, etch”.  The instructor goes over to the experiment, surveys it and shows the student how to apply a digital filter.   Voila their data recording returns! Instructors recognize these situations as ‘aha!” moments where the lab has a tremendous impact on the student learning  but these experiences also provide students with  a long-term value – an appreciation  for knowing how to manage the technology they use.

Students entering the workplace should be able to communicate in an oral and written format

Many of the writing skills that are valued in the workplace are fundamental pieces of the physiology lab, particularly the physiology lab report.  Students are expected to organize their ideas, use graphics effectively, write clear and logical instructions in their methods, and support their position(s) with quantitative or qualitative data.

Let’s consider how writing skills are taught  in the lab report.  Instructors encourage and reinforce these skills by inserting marginal comments like “make the hypothesis more specific”,  “discuss and explain your graph”,  “discuss  how your results can be explained by homeostasis, cardiac output, etc.….” in the lab report.  Students, in the interest of  in getting a better grade on that next lab report, will ask their instructor “How can I make my hypothesis clearer?”, “I thought that I discussed that graph – what more do I need?”, or “  “I thought that I wrote about how the baroreceptor reflex explained my results – what should I have done instead?”  The typical instructor then gives their best explanation and grades the next lab report accordingly.

Some communication skills are embedded in the a lab course in a less transparent manner.  For example, one of the valued professional skills is the ability to convey complex information to an audience.  Instructors observe this in practice regularly as a student asks their lab partner “Show me how you did that?”

Finally there are some communication skills that are not so readily inserted into the lab curriculum and require a special effort on the part of the instructor.  One example of this is the ability to write/ present a persuasive argument which is a part of every  physiologists career in the preparation of  project proposals, contract bids, or project pitches.

Students entering the workplace should be able to obtain and process information

As physiologists we understand how critical it is to have these skills because much of our career is spent pursuing information or processing it.  There are however, multiple steps to becoming proficient.  One needs to be able to recognize  the what they need to know, identify resources to find it, be able to converse with experts to gain it, and finally be able to compile and process it in order to create learning or new knowledge.

The first step of this process, “knowing what you don’t know”, is the hardest for students because they often pursue and learn all the information available rather than focusing on what they don’t know or need to know.  This dilemma is faced by all undergraduate students at some point in their education and a lab course like many other courses tests them on this skill at least once or twice during the term.   The second step to proficiency is  identifying the resources needed to find information.   College libraries in collaboration with faculty inform students about institutional resources available for information gathering however they key to learning this skill is practice.  The physiology lab provides opportunities for practice each time an instructor asks a student to  “include 3 relevant  references in your lab report”, or asks a student to “describe clinical condition X in the discussion and explain how it relates to this lab, these results, etc.”.

Finally one of the objectives of most physiology labs is to teach students how to collect and process physiological information (data)  in a way that allows it to be compiled  into useable physiological information  (inferential statistics).   Students get plenty of practice with this in lab and even though it is discipline specific the general process can be applies to many other fields.

Students entering the workplace should be able to pursue lifelong learning.

Many of us teach or have taught physiology labs at one time or another  and found that not only is this an opportunity to reinforce concepts in physiology and dispel misconceptions  but also to impart to students a true appreciation for physiology and how it makes living organisms work.  Is there better way to promote lifelong learning?

This blog was not meant to be a complete presentation of professional or workplace skills nor was it intended to suggest that these skills  are the  most important in a physiologist’s career.   It was meant to reveal that fundamental professional skills are central components of most physiology lab courses and that sometimes we teach them without realizing it.

REFERENCES

  1. APS/ACDP List of Professional Skills for Physiologists and Trainees. The American Physiological Society.   http://www.the-aps.org/skillslist.aspx  accessed 10/24/2017.
  2. AAMC Core competencies for entering medical students. American Association of Medical Colleges.   accessed 10/20/2017.  https://www.careercenter.illinois.edu/sites/default/files/Core%20Competencies%20forEntering%20Medical%20Students.pdf accessed 10/25/2017.
  3. Focus on employability skills for STEM points to experiential learning. STEM Innovation Task Force.  https://www.stemconnector.com/wp-content/uploads/2016/12/Focus-on-Employability-Skills-Paper-1.pdf   accessed 10/21/2017.
  4. Vision and Change in undergraduate biology education:  A call to action.    http://visionandchange.org/files/2011/03/Revised-Vision-and-Change-Final-Report.pdf
  5. Bio 2010 Transforming undergraduate education for future research biologists. The National Academies Press.   https://www.nap.edu/login.php?record_id=10497&page=https%3A%2F%2Fwww.nap.edu%2Fdownload%2F10497
Jodie Krontiris-Litowitz is a Professor of Biological Sciences in the STEM College of Youngstown State University.  She currently teaches Human Physiology Lab, Advanced Systems Physiology and Principles of Neurobiology and has taught Human Physiology and Anatomy and Physiology.  In her classroom research Jodie investigates using active learning to engage students in the lecture classroom.  She is a long-standing member of the Teaching Section of the American Physiological Society and has served on the APS Education Committee.  Jodie is a Biology Scholars Research Fellow and a recipient of the YSU Distinguished Professor of Teaching award.
Stress and adaptation to curricular changes

 

 

 

…there was a teacher interested in enhancing the learning process of his students. He wanted to see them develop skills beyond routine memorization. With the support of colleagues and the education team at his university, he succeeded and chose a semi-flipped classroom approach that allowed him to introduce novel curricular changes that did not generate much resistance on the part of the students.

The change was made. The students apparently benefited from the course. They worked in groups and learned cooperatively and collaboratively. Students evaluated peers and learned to improve their own work in the process. They not only learned the topics of the class, but also improved their communication skills.

At some point the institution asked the teacher to teach another course. He happily did so, and based on his experience introduced some of the changes of his semi-flipped classroom into the new course. The students in this course were slightly younger and had not been exposed to education in biomedical sciences. To the teacher’s surprise, the students showed a lot of resistance to change. The sessions moved slowly, the test scores were not all that good, and students did not reach the expected outcomes. It was clear that the teacher and the students were going through a period of considerable stress, while adapting to the new model. Students and teachers worked hard but the results did not improve at the expected rate.

Some time ago this was my experience and as I wandered looking for solutions, I started to question the benefits of active learning and the role of stress in educational practice.

Advantages and challenges of active learning

Evidence says that active learning significantly improves student outcomes (higher grades and lower failure rates) and may also promote critical thinking and high level cognitive skills (1, 2). These are essential components of a curriculum that attempts to promote professionalism. However, it may be quite problematic to introduce active learning in settings in which professors and students are used to traditional/passive learning (2).

Some of the biggest challenges for teachers are the following:

  • To learn about backward design of educational activities
  • To think carefully about the expected accomplishments of students
  • To find an efficient way to evaluate student learning
  • To spend the time finding the best strategies for teaching, guiding, and evaluating students.
  • To recognize their limitations. For example, it is possible that despite their expertise, some teachers cannot answer the students’ questions. This is not necessarily bad; in fact, these circumstances should motivate teachers to seek alternatives to clarify the doubts of students. At this point, teachers become role models of professionals who seek to learn continuously.
  • To learn about innovations and disruptive technologies that can improve the teacher role.

Some of the challenges for students include:

  • Understanding their leading role in the learning process
  • Working hard but efficiently to acquire complex skills
  • Reflecting on the effectiveness of their learning methods (metacognition). Usually reading is not enough to learn, and students should look for ways to actively process the information.
  • Trusting (critically) on the methods made available by the teachers to guide their learning. For example, some tasks may seem simple or too complex, but teachers have the experience to choose the right methodology. A work from our team showed that strategies that seem very simple for the student (clay modeling) have a favorable impact on learning outcomes (3).
  • Seeking timely advice and support from teachers, tutors and mentors.

Working to overcome these challenges may generate a high level of stress on students and teachers. Without emphasizing that stress is a desirable trait, I do find that some disturbance in the traditional learning process and risk taking motivate teachers and students to improve their methods.

Intermediate disturbance hypothesis and stress in education

In the twentieth century, the work of Joseph H. Connell became famous for describing factors associated with the diversity of species in an ecosystem (4). Some of his observations were presented in Charles Duhigg’s book “Smarter Faster Better” which discusses circumstances related to effective teamwork (5). Duhigg reports that Connell, a biologist, found that in corals and forests there might be patches where species diversity increases markedly. Curiously, these patches appear after a disturbance in the ecosystem. For example, trees falling in a forest can facilitate the access of light to surface plants and allow the growth of species that otherwise could not survive (5). Connell’s work suggests that species diversity increases under circumstances that cause intermediate stress in the ecosystem. In situations of low stress, one species can become dominant and eradicate other species, whereas in situations of high stress, even the strongest species may not survive. But if, an intermediate stress where to appear, not very strong and not very weak, the diversity of species in an ecosystem could flourish.

I propose that the hypothesis of the intermediate disturbance can also be applied in education. In traditional learning, an individual (ecosystem) learns to react to the challenges presented and develops a method for passing a course. In situations of low stress, memorization (evaluated at the lower levels of Miller´s pyramid) may be enough to pass a course. In high stress level situations, students may drop out or feel inadequate. However, courses that involve active learning may include moderate challenges (intermediate disturbance). These well-managed challenges can motivate the student to develop more complex skills (diversity of species) that lead to effective learning and a broader professional development.

 

 

 

 

 

 

 

 

 

Figure 1. Intermediate disturbance hypothesis in education.

 

In the book “Problem-based learning, how to gain the most from PBL”, Donald Woods describes the challenges and stresses associated with the incorporation of active learning (PBL) in a curriculum (6). He describes the stages of grief that a student (and I add, a teacher) must go through while adapting to the new system. This adaptation can take months and generally is characterized by the following phases:

  • Shock
  • Denial
  • Strong emotion (including depression, panic and anger)
  • Resistance to change
  • Acceptance and resignation to change
  • Struggle to advance in the process
  • Perception of improvement in the expected performance
  • Incorporation of new habits and skills to professional practice

 

 

 

 

 

 

 

 

 

Figure 2. Performance adjustment after curricular changes. Adapted and modified from (6).

 

Properly managing stress and finding strategies to advance in the process are rewarded by achieving better performance once the students become familiar with the new method of active learning. However, to better adapt to curricular or pedagogical changes, it is important for all the education actors to recognize the importance of deliberate work and to have clear goals. In addition, students and teachers should have access to institutional strategies to promote effective time, and anger and frustration management.

Stress is not ideal, but some stress may motivate students and teachers to reevaluate their methods and ultimately work together for a classroom focused on professional excellence. The critical question is how big is the intermediate disturbance needed to improve learning outcomes. As is commonly concluded in papers, more research is needed to answer this question, and we can learn a lot from the theories and methods from our colleagues in Biology.

References

  1. Freeman S, Eddy SL, McDonough M, Smith MK, Okoroafor N, Jordt H, et al. Active learning increases student performance in science, engineering, and mathematics. Proc Natl Acad Sci U S A. 2014;111(23):8410-5.
  2. Michael J. Where’s the evidence that active learning works? Adv Physiol Educ. 2006;30(4):159-67.
  3. Akle V, Pena-Silva RA, Valencia DM, Rincon-Perez CW. Validation of clay modeling as a learning tool for the periventricular structures of the human brain. Anat Sci Educ. 2017.
  4. Connell JH. Diversity in Tropical Rain Forests and Coral Reefs. Science. 1978;199(4335):1302-10.
  5. Duhigg C. Smarter Faster Better: Random House; 2016.
  6. Woods DR. Problem Based Learning: How to gain the most from PBL. 2nd. ed1997.
Ricardo A. Peña-Silva M.D., PhD is an associate professor at the Universidad de los Andes, School of Medicine in Bogota, Colombia, where he is the coordinator of the physiology and pharmacology courses for second-year medical students. He received his doctorate in Pharmacology from The University of Iowa in Iowa City. His research interests are in aging, hypertension, cerebrovascular disease and medical education. He works in incorporation and evaluation of educational technology in biomedical education.

He enjoys spending time with his kids. Outside the office he likes running and riding his bicycle in the Colombian mountains.

12 years of teaching technology to physiology educators

When I was approached to write a blog for PECOP I thought I could bring a slightly different perspective on classroom technology as I am not a full-time classroom educator.  My primary role for the past dozen years with ADInstruments has been to work with educators who use our products to get the most from their investment in our technology.  This has led to thousands of conversations about use and misuse of technology in the classroom and teaching laboratories.  I would like to share some of my insights here.

Early in my academic career I was tasked with a major overhaul of the introductory Biology curriculum at Louisiana Tech, and incorporating technology was part of this mandate. I have always been a bit of a tech geek, but rarely an early adopter.  I spent quite a bit of time and effort taking a good hard look at technology before implementing it in my classrooms.  I was fortunate enough to participate in T.H.E. QUEST (Technology in Higher Education: Quality Education for Students and Teachers). Technology was just beginning to creep into the classroom in the late nineties. Most courses were traditional, chalk and talk; PowerPoint was still a new thing, and this three-week course taught us how to incorporate this emerging technology appropriately.  PowerPoint worked better for many of us than chalk and talk, but also became a crutch, and many educators failed to use the best parts of this technology and applied it as a panacea.  Now PowerPoint has fallen out of favor and has been deemed to be “Killing Education”(1).  When used improperly, rather than curing a problem, it has backfired and reduced complex concepts to lists and bullet points.

I was fortunate enough to have been on the leading edge for a number of technologies in both my graduate and academic careers.  Anybody remember when thermocyclers were rare and expensive?  Now Open PCR can deliver research quality DNA amplification for around $500.  Other technologies became quickly obsolete; anybody remember Zip drives? Picking the tech that will persist and extend is not an easy task.  Will the Microscope go the way of the zip drive?  For medical education this is already happening (2).  While ADInstruments continues to lead the way with our PowerLab hardware and software packages for education (3); there are plenty of other options available.  Racks of very specialized equipment for recording biological signals can now be replaced with very affordable Arduino based electronics (4,5). As these technologies and their supporting software gets easier to use, almost anyone can collect quality physiological data.

One of the more interesting technologies that is evolving rapidly is the area of content delivery or “teaching and learning” platforms. The most common of these for academia are the Learning Management Systems. These are generally purchased by institutions or institutional systems and “forced” upon the faculty.  I have had to use many different platforms at different institutions. Blackboard, Desire 2 Learn, Moodle, etc. are all powerful tools for managing student’s digital records, and placing content in their “virtual” hands.  Automatic grading of quiz questions, as well as built in plagiarism detection tools can assist educators with large classes and limited time, when implemented properly.  This is the part that requires buy in from the end user and resources from the institution to get the faculty up and running (6).  While powerful, these can be cumbersome and often lack the features that instructors and students who are digitally savvy expect.  Many publisher digital tools integrate with the University LMS’s and are adopted in conjunction with, or more frequently now instead of a printed textbook.  McGraw Hill’s Connect and LearnSmart platforms have been optimized for their e-textbooks and integrate with most LMS’s (7).  Other purpose-built digital tools are coming online that add features that students expect like Bring Your Own Device applications; Top Hat is one of these platforms that can be used with mobile devices in and out of the classroom (8).

 

So what has endured?

In my almost 20 years in higher education classrooms and labs, lots of tools have come and gone.  What endures are passionate educators making the most of the technology available to them.  No technology, whether digital or bench top hardware, will solve a classroom or teaching laboratory problem without the educator.  While these various technologies are powerful enhancements to the student experience, they fall flat without the educator implementing them properly.  It’s not the tech, it’s how the tech is used that makes the difference, and that boils down to the educator building out the course to match the learning objectives they set.

 

 

 

My advice to educators can be summed up in a few simple points: 

  • Leverage the technology you already have.
    • Get fully trained on your LMS and any other digital tools you may already have at your institution. The only investment you will have here is your time and effort.
    • Check the cabinets and closets, there is a lot of just out of date equipment lying around that can be repurposed. Perhaps a software update is all you need to put that old gear back in rotation.
  • Choose technology that matches your course objectives.
    • Small and inexpensive purpose-built tech is becoming readily available, and can be a good way to add some quantitative data to the laboratory experience.
    • Top of the line gear may have many advantages for ease of use and reliability, but is not necessarily the best tool to help your students accomplish the learning objectives you set.
  • Investigate online options to traditional tools.
    • eBooks, OpenStax, and publisher’s online tools can be used by students for a lot less money than traditional texts and in some cases these resources are free.

References:

1) http://pdo.ascd.org/lmscourses/pd11oc109/media/tech_m1_reading_powerpoint.pdf

2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4338491/

3) https://www.adinstruments.com/education

4) http://www.scoop.it/t/healthcare-medicine-innovation)

5) https://backyardbrains.com/

6) http://www.softwareadvice.com/hr/userview/lms-report-2015/

7) http://www.mheducation.com/highered/platforms/connect.html

8) https://tophat.com

 

Wes Colgan III is the Education Project Manager for ADInstruments North America. He works with educators from all over the world to develop laboratory exercises for the life sciences.  He conducts software and hardware workshops across North America, training educators to use the latest tools for data acquisition and analysis. He also teaches the acquisition and analysis portion of the Crawdad/CrawFly courses with the Crawdad group at Cornell. He has been a Faculty for Undergraduate Neuroscience member since 2007, and was named educator of the year for 2014.  Prior to Joining ADInstruments, he was an assistant professor at Louisiana Tech University where he was in charge of the introductory biology lab course series.
Thinking Critically About Critical Thinking

 

A few mornings ago, I was listening to a television commercial as I got ready for work.  “What is critical thinking worth?” said a very important announcer.  “A whole lot” I thought to myself.

But what exactly is critical thinking?  A Google search brings up a dictionary definition.  Critical thinking is “the objective analysis and evaluation of an issue to form a judgement.”  The example sentence accompanying this definition is “professors often find it difficult to encourage critical thinking among their students.” WOW, took the words right out of my mouth!

Have any of you had the following conversation? “Dr. A, I studied and studied for this exam and I still got a bad grade.  I know the material, I just can’t take your tests!”  The student in question has worked hard. He or she has read the course notes over and over, an activity that has perhaps been rewarded with success in the past.  Unfortunately re-reading notes and textbooks over and over is the most common and least successful strategy for studying (4).

In my opinion, as someone who has been teaching physiology for over 20 years, physiology is not a discipline that can be memorized.  Instead, it is a way of thinking and a discipline that has to be understood.

Over the years, my teaching colleague of many years, Sue Keirstead, and I found ourselves during office hours trying repeatedly to explain to students what we meant by thinking critically about physiology.  We asked the same probing questions and drew the same diagrams over and over.  We had the opportunity to formalize our approach in a workbook called Cells to Systems Physiology: Critical Thinking Exercises in Physiology (2).  We took the tough concepts students brought to office hours and crafted questions to help the students work their way through these concepts.

Students who perform well in our courses make use of the workbook and report in student evaluations that they find the exercises helpful. But we still have students who struggle with the critical thinking exercises and the course exams.  According to the comments from student evaluations, students who struggled with the exercises report they found the questions too open ended.  Furthermore, many of the answers cannot be pulled directly from their textbook, or at least not in the format they expect the answer to be in, and students report finding this frustrating.  For example, the text may discuss renal absorption and renal secretion in general and then the critical thinking exercises asks the student to synthesize all the processes occurring in the proximal tubule.  The information is the same but the organization is different.  Turns out, this is a difficult process for our students to work through.

We use our critical thinking exercise as a type of formative assessment, a low stakes assignment that evaluates the learning process as it is occurring.  We also use multiple choice exams as summative assessments, high stakes assessments that evaluate learning after it has occurred.  We use this format because our physiology course enrollment averages about 300 students and multiple choice exams are the most efficient way to assess the class.  We allow students to keep the exam questions and we provide a key a couple of days after the exam is given.

When a student comes to see me after having “blown” an exam, I typically ask him or her to go through the exam, question by question.  I encourage them to try to identify how they were thinking when they worked through the question.  This can be a very useful diagnostic.  Ambrose and colleagues have formalized this process as a handout called an exam wrapper (1).  Hopefully, by analyzing their exam performance, the student may discover a pattern of errors that they can address before the next exam.  Consider some of the following scenarios:

Zach discovers that he was so worried about running out of time that he did not read the questions carefully.  Some of the questions reminded him of questions from the online quizzes.  He did know the material but he wasn’t clear on what the question was asking.

This is a testing issue. Zach, of course, should slow down.  He should underline key words in the question stem or draw a diagram to make sure he is clear on what the question is asking.

Sarah discovers that she didn’t know the material as well as she thought she did, a problem that is called the illusion of knowing (3). Sarah needs to re-evaluate the way she is studying.  If Sarah is cramming right before the exam, she should spread out her studying along with her other subjects, a strategy called interleaving (3).  If she is repeatedly reading her notes, she should put her notes away, get out a blank piece of paper and write down what she remembers to get a gauge of her knowledge, a process called retrieval (3).  If she is using flash cards for vocabulary, she should write out learning objectives in her own words, a process called elaboration (3).

Terry looks over the exam and says, “I don’t know what I was thinking.  I saw something about troponin and I picked it.  This really frustrates me. I study and study and don’t get the grade I want.  I come to lecture and do all the exercises. I don’t know what else to do.” It is a challenge to help this student.  She is not engaging in any metacognition and I don’t claim to have any magic answers to help this student.  I still want to try to help her.

I feel very strongly that students need to reflect on what they are learning in class, on what they read in their texts, and on the activities performed in lab (3).  I have been working on a project in one of my physiology courses in which I have students take quizzes and exams as a group and discuss the answers collaboratively.  Then I have them write about what they were thinking as they approached the question individually and what they discussed in their group.  I am hoping to learn some things about how students develop critical thinking skills.  I hope I can share what I learn in a future blog posting.

  1. Ambrose SA, Bridges MW, DiPietro M, Lovett M, Norman MK. How Learning Works: 7 Research Based Points for Teaching. San Francisco CA: Jossey-Bass, 2010.
  2. Anderson LC, Keirstead SA. Cells to Systems: Critical Thinking Exercises in Physiology (3rd ed). Dubuque, IA: Kendall Hunt Press, 2011.
  3. Brown PC, Roediger HL, McDaniel MA. Make it Stick: The Science of Successful Learning. Cambridge MA: The Belknap Press of Harvard University Press, 2014
  4. Callender AA, McDaniel, MA. The limited benefits of rereading educational text, Contemporary Educational Psychology 34:30-41, 2009. Retrieved from http://ac.els-cdn.com/S0361476X08000477/1-s2.0-S0361476X08000477-main.pdf?_tid=22610e88-61b4-11e7-8e86-00000aacb35e&acdnat=1499281376_e000fa54fe77e7d1a1d24715be4bbf50 , June 22, 2016.

 

 Lisa Carney Anderson, PhD is an Assistant Professor in the Department of Integrative Biology and Physiology at the University of Minnesota. She completed training in muscle physiology at the University of Minnesota. She collaborates with colleagues in the School of Nursing on clinical research projects such as the perioperative care of patients with Parkinson’s disease and assessment of patients with spasticity. She directs a large undergraduate physiology course for pre-allied health students.  She also teaches nurse anesthesia students, dental students and medical students.  She is the 2012 recipient of the Didactic Instructor of the Year Award from the American Association of Nurse Anesthesia.  She is a co-author of a physiology workbook called Cells to Systems: Critical thinking exercises in Physiology, Kendall Hunt Press. Dr. Anderson’s teaching interests include teaching with technology, encouraging active learning and assessment of student reflection.
Report from the Inaugural Physiology Majors Interest Group Meeting

When I first heard about the Physiology Majors Interest Group at the APS Teaching Section Symposium entitled “What’s Your Major? The Rise of the Undergraduate Physiology Degree” by co-chairs Erica Wehrwein and John Halliwell at Experimental Biology in 2015, I was immediately excited.  I’m primarily an undergraduate educator and strongly identify as a ‘physiologist’ and hope some of my students do as well.  Yet, I wasn’t entirely sure.  As an assistant professor in a department of Health and Sport Science who primarily advises students in the Exercise Physiology major who want to be physician assistants and physical therapists, was I “enough” physiology?  After attending the first stand-alone conference for this group in East Lansing earlier this summer, I’m not only confident that I was right to be excited about this APS interest group but also that as Erica Wehrwein, organizer of the conference has previously reported, physiology really is alive and well at the undergraduate level.

 

What is a Physiology Major?

One of the overarching topics of discussion at the meeting, in formal sessions and during breaks revolved around this central question regarding physiology education at the undergraduate level.  From the first introductions onward, it was clear it wasn’t going to be a simple answer.  Of the 45 in attendance, a number of different departments and/or majors were represented: physiology, biology, health sciences, human biology, and kinesiology to name a few with 24 to 2274 students in these different majors.  When we talked about the students we teach, advise, and mentor, they are future physicians, nurses, physical therapists, researchers, physician assistants, and many other professions.  Still more diverse, when we compared curricula as reported in a pre-meeting survey, we saw ranges of required courses in basic sciences, anatomy, physiology, and associated laboratories.  Yet, among these differences, there were striking similarities as well.  Sessions sparked discussions of the core concepts (a topic discussed previously on this blog) of physiology we emphasize, required skills that we want our graduates to have and how we try to build these, and common employment trends when students leave our programs and the challenges this can pose for advising.  In regard to the original query of what is a physiology major, as can often be the case in our discipline, it was less about the answer itself, and more about the discussions we had along the way.

 

An integrative discipline, an integrated community

One of the most valuable aspects of the meeting was being able to spend two days with other passionate physiology professionals.  Just as I see integration of physiology and other scientific disciplines, similar to integrated body systems, I was making connections with others from large, research-intensive universities, to small, liberal arts colleges and still others that like myself, fit somewhere in the middle.  Everyone was extremely willing to share their thoughts and ideas on how to best push physiology forward and increase its value in the ever-competitive landscape of higher education.  Conversations ranged from curriculum design to specific teaching strategies and there was a free flow of information with both newer and more seasoned participants engaging in the learning process.  In a sense, the meeting modeled what we often strive to achieve in our programs and classrooms- critical thinking, grounded in evidence, with a creative application towards future improvements or development of new knowledge.

 

What does the future hold?

As the meeting ended, we went our separate ways, armed with new tools and ideas we can implement or consider in our own programs.  A sampling of the ideas I took home:

  • In teaching materials, identify the conceptual model or core principle that is being taught and ask students to do the same when completing assessments.
  • Include teaching about T-Shaped professionals in my Introduction to Health Professions course.
  • Use Khan academy YouTube videos to demonstrate to students how they can concept map while studying.
  • Help students identify transferable skills and knowledge from non-health related job (such as a cashier or server) through ONET.
  • Consider departmental membership in the American Kinesiology Association to further connect with similar programs.
  • Use and contribute to the resources I already knew about, such as Advances in Physiology Education, this LifeSciTRC, and other APS resources.

The interest group will continue, and future meetings are already being planned.  The next meeting will be held in June 2018 at the University of Arizona.  To stay in the loop, join the listserv by contacting Erica Wehrwein (wehrwei7@msu.edu).  To keep physiology education a priority, we will continue to meet, discuss, and inspire the next generation of those who identify with physiology, just as I have and will continue to.  I’m grateful to Erica and the work of the planning committee for putting together an event that focused on this important aspect of the work I do as a physiology educator.

Anne Crecelius is an Assistant Professor in the Department of Health and Sport Science at the University of Dayton.  She teaches Human Physiology and a Capstone Research course.  She returned to her undergraduate alma mater to join the faculty after completing her M.S. and Ph.D. studying Cardiovascular Physiology at Colorado State University.  Her research interest is in the integrative control of muscle blood flow.  She is a member of the American Physiological Society (APS), serving on the Teaching Section Steering Committee and the Communications Committee.