Tag Archives: classroom content

Building bridges: Medical physiology teaching in China
Ryan Downey, Ph.D.
Assistant Professor
Co-Director, Graduate Physiology Program
Team Leader, Special Master’s Program in Physiology

Department Pharmacology and Physiology
Georgetown University Medical Center
Washington, D.C.

The Chinese Society of Pathophysiology hosted the 2019 Human Functional Experiment Teaching Seminar and the Second Human Physiology Experimental Teaching Training Course 25-27 October. Across two and a half days, educators from across China met at Jinzhou Medical University in the province of Liaoning to discuss and workshop the latest ideas in active learning and interactive teaching techniques. In many ways, especially in terms of the esteem in which this meeting is held by its attendees, this meeting was not dissimilar from the APS Institute on Teaching and Learning, which will hold its next biennial meeting this coming June in Minneapolis. For the 2019 meeting, the organizers decided to invite an international speaker, which is how I found myself on a plane headed to China. As part of my visit, not only did I get to attend the workshop hosted at Jinzhou Medical University, but also I was hosted by several of the meeting organizers at their home institutions to see their facilities. In this writeup, I will reflect on some of the observations that I made during the many different conversations that I had with the educators participating in the meeting.

The most common question that I got from my hosts was, “What kinds of technology do you use in your classrooms and labs and how do you use them?” What surprised me the most about this question wasn’t the actual question itself, but the perception that many of the educators at the meeting held that they were lagging behind in the implementation of using technologies as   teaching and learning tools. The large majority of teaching spaces that I visited were equipped with much the same technology as any classroom or lecture hall that I would find in an American university: computers, projectors, large-screen LCD displays, and power at every seat to accommodate student personal electronic devices. While there was the occasional technological oddity, such as a computer here or there that was still running Windows XP, the technology available to these educators was very much on par with the technology I would expect at any modern university, which is why I was surprised that the educators had the perception that they were behind in implementing different technologies. In my conversations with them, I discussed the use of audience response systems like iClicker and PollEverywhere as well as interactive elements like gamification through websites such as Kahoot!, but my emphasis in these conversations was exactly the same as I have with educators at home: we need to make sure that there is a sound pedagogical basis for any engagement we use with our students and that the technology doesn’t matter. I can use 3×5 colored  index cards to create an audience response system that functions as well as (or sometimes even better!) than clickers because no one has any problems with the WiFi while using a 3×5 card. The technology facilitates our instruction and should never drive it for the sake of itself.

A common thread of many discussions was the use of internet technologies in teaching. While there is much to be said about the limitations of the ‘Great Firewall’ of China and the amount of government regulation that occurs over their communications, it’s important to note how little these limitations affect the day-to-day activities of the majority of citizens. There are Chinese versions of almost every single internet convenience that we would take for granted that function at least as well as our American versions. Their social media system has grown to the point that many international users are engaging on their platforms. There are food delivery apps and the local taxi services have all signed on to a common routing system (at least in Beijing) that functions in a similar way to Uber or Lyft. In a side-by-side comparison between my phone and one of the other meeting participants, there is near feature parity on every aspect. From an educational standpoint, however, there are some notable differences. The lack of access to Wikipedia is a notable gap in a common open resource that many of us take for granted and there is not yet a Chinese equivalent that rivals the scope or depth that Wikipedia currently offers. Another key area in which internet access is limited is their access to scholarly journals. This lack of accessibility is two-fold, both in the access to journals because of restrictions on internet use as well as the common problem that we are already familiar with of journal articles being locked behind paywalls. The increasing move of journals to open access will remove some of these barriers to scholarly publications, but there are still many limits on the number and types of journal articles that educators and learners are allowed through Chinese internet systems.

The most common request that I received while attending the educators meeting was, “Tell me about the laboratories you use to teach physiology to your medical students.” I think this is the largest difference in teaching philosophy that I observed while in China. The teaching of physiology is heavily based on the use of animal models, where students are still conducting nerve conduction experiments with frogs, autonomic reflex modules with rabbits, and pharmacological studies in rats. These are all classic experiments that many of us would recognize, but that we rarely use anymore. One key area of the workshops were modules designed to replace some of these classic animal experiments with non-invasive human-based modules, such as measuring nerve conduction velocities using EMG. My response that the majority of our physiology teaching is now done through lecture only was met with a certain degree of skepticism from many of them because the use of labs is so prevalent throughout the entire country. Indeed, the dedication of resources such as integrated animal surgical stations runs well into the hundreds of thousands of dollars per laboratory room set up, and to facilitate the entirety of students each year, there are multiple labs set up at each university. As the use of non-invasive human experiments expands, an equal amount of space and resources are being given to setting up new learning spaces with data acquisition systems and computers for this new task. In this area, I think that we have much to gain from our Chinese counterparts as many of the hardest concepts in physiology are more easily elucidated by giving students the space to self-discover in the lab while making physiological measurements to fully master ideas like ECG waves and action potential conduction.

Upon returning home, I have been asked by nearly everyone about my travel experiences, so I think it may be worth a brief mention here as well. I cannot overstate the importance of having a good VPN service setup on all of your electronic devices before traveling. Using a VPN, I had near-normal use of the internet, including Google and social media. My largest problem was actually trying to access local Chinese websites when my internet address looked like I was outside of the country. I have had good experience with NordVPN, but there are several other very good options for VPN service. Carrying toilet paper is a must. There are lots of public restrooms available everywhere in the city, but toilet paper is either not provided or available only using either social media check-ins or mobile payments. For drinking water, I traveled with both a Lifestraw bottle and a Grayl bottle. This gave me options for using local water sources and not having to rely on bottled water. The Lifestraw is far easier to use, but the Grayl bottle has a broader spectrum of things that are filtered out of the water, including viruses and heavy metals, which may be important depending on how far off the tourist track you get while traveling. My final tip is to download the language library for a translator app on your mobile device for offline use so that you can communicate with others on the streets. When interacting with vendors and others not fluent in English, it was common to use an app like Google Translate to type on my device, show them the translated results, and they would do the same in reverse from their mobile device.

One of the themes across the meeting was building bridges — bridges between educators, bridges between universities, bridges across the nation and internationally. I’m glad to have had the opportunity to participate in their meeting and contribute to their conversation on building interactive engagement and human-focused concepts into the teaching of physiology. Overall, the time that I spent talking to other educators was useful and fantastic. Everyone I met and interacted with is enthusiastic and excited about continuing to improve their teaching of physiology. I left the meeting with the same renewed energy that I often feel after returning from our ITL, ready to reinvest in my own teaching here at home.

Ryan Downey is an Assistant Professor in the Department of Pharmacology & Physiology at Georgetown University. As part of those duties, he is the Co-Director for the Master of Science in Physiology and a Team Leader for the Special Master’s Program in Physiology. He teaches cardiovascular and neuroscience in the graduate physiology courses. He received his Ph.D. in Integrative Biology from UT Southwestern Medical Center. His research interests are in the sympathetic control of cardiovascular function during exercise and in improving science pedagogy. When he’s not working, he is a certified scuba instructor and participates in triathlons

How do you feel about sharing with the world? The Open Educational Resources (OER) phenomenon.

Joann May Chang, PhD
Professor of Biology & Director for the Center for Instructional Excellence at Arizona Western College
Yuma, Arizona

I recently attended a training on Open Educational Resources (OER) and what it truly means to offer an OER course.  What is an OER course?  If you offer a course that uses an e-text with other content found on the web to supplement without costing the student any money, this would be defined as being free of costs and not truly an OER course.  Why? That leads to the key question Matthew Bloom, OER Coordinator for Maricopa Community Colleges, posed to our group during the training: “How do you feel about sharing with the world?” 

OER has become a prominent topic in higher education to save students on textbook costs, but also a movement in building high quality accessible teaching materials for educators without being tied to a publishing company.  In a 2017 blog post by Chris Zook, he provided infographics of data associated with the increase in textbook prices that have outpaced inflation, medical services, and even new home costs. [attached graphic 1 & 2]  As Chris Zook also noted, community college students are two times more likely to purchase textbooks with their financial aid than four-year college students which increases their financial burden to complete their degree.  When faculty build OER courses, they can decrease this burden and share their course content with others who are working towards giving equal access to higher education.

OER is at the forefront of Arizona Western College because it is an integral part of our institution’s strategic planning goals to make higher education more accessible for our student population where the average yearly salary is only $38,237.    We are a year into this goal with our first formal OER training taking place in June 2019.  When Matthew first asked us if we share our teaching materials, most of us said “Sure! We share with our colleagues often.”  But then he followed that up with “How willing are you to share your developed content with the world?”  And that is the difference between a free versus an OER course.  If a faculty member develops open course content and licenses it under the Creative Commons License, the material can be retained, reused, revised, remixed, and redistributed (known as the 5R activities) by others.  The creator of the open content can control how their material is used with the different Creative Commons licenses. [Creative Commons License gif] With the shared content, the OER movement aims to provide quality teaching materials that can be used in an open creative and collaborative manner while benefitting students in reducing textbook costs.

I did not realize the importance of Matthew’s question until I started my search for OER content with Creative Commons Licensing for our OER transitioning Anatomy and Physiology courses.  We will be using the OpenStax A & P textbook starting this Fall and even though Matthew gave us some good starting points to search for open resources that follow the 5R activities, it has been difficult finding pictures and diagrams that can be used in lecture and activities.  I have been able to find various posts to labs, power point slides, videos, and open textbooks that can be used for A&P.  The most common issue is the lack of quality science pictures or diagrams offered as open content, which I have also heard is a problem from other colleagues transitioning to OER. 

So, here’s my challenge question for you: Are you willing to share your developed content, pictures, and diagrams with the world?  If you are, please license them and share so that you can be a part of this OER movement and others can also collaborate and build that open content. Ultimately, this is about the ability to be inclusive and provide quality higher education for our students without burdening them with textbook costs.

If you are interested in this OER movement and are looking for information or content, please check out the following resources:

This list is in no way inclusive.  There are many other resources out there, they just take time to find and to search through.  I hope more of the scientific community takes part in this OER movement and can provide more resources for everyone to use or collaborate on.  It truly makes a difference to our students and their education.

Joann Chang, Ph.D. is a Professor of Biology and the Director for the Center for Instructional Excellence at Arizona Western College (AWC), a community college in Yuma, Arizona.  She currently manages the professional development for AWC and teaches A&P and Introduction to Engineering Design.  When she’s not teaching or directing, she is keeping up with her twin daughters, son, husband, three cats and one dog.  On her spare time, she is baking delicious goodies for her friends and family.

Teaching Backwards

 

Generating new ideas and cool learning experiences has always been natural and fun for me. My moments of poignant clarity often came during a swim workout or a walk with my dog as I reflect on my classes. As I visualize this activity, my students are as enthusiastic as I am and are learning. Then, reality returns as I grade the next exam and see that less than half of the class answered the question related to that activity correctly. Accounting for the students who learn despite what I do, I quickly see that I only reached a quarter of my students with this great activity. Why did this happen? What can I do about this?

Well, my life as an instructor changed the day I walked into my first session of University Center for Innovation in Teaching and Education (UCITE) Learning Fellows at Case Western Reserve University.  This program is a semester long session on how learning works where the focus is on evidence-based learning practices and provides an opportunity to discuss successes and failures in teaching with peers.  It was here that I learned about “Backwards Design”1.

What is Backwards Design?

Essentially, it is designing your course with the end in mind. I think of it as “Teaching Backwards” – that is, I visualize my students 5-10 years from now in a conversation with a friend or colleague discussing what they learned from my class. I ask myself these questions:

  1. How do I want them to describe my class? Hansen refers to this as the “Big Idea” or broad objective. An example from one of my classes is provided in Table 1.
  2. What do I want them to be able to tell their friend or colleague that they learned from the class in 5 to 10 years? Hansen has termed this as “Enduring Understanding” (see Table 1).

The next phase is to write learning objectives for each of the enduring understandings (see Table 1). We continue the journey backwards into linking learning objectives to assessment methods and developing the details of each class session. During this process, we must always take into account the student’s prior knowledge (refer to How Learning Works2).

Table 1: Example of Backwards Design Concepts for “Exercise Physiology and Macronutrient Metabolism” class.

Class: Exercise Physiology and Macronutrient Metabolism
Big Idea Enduring Understanding Learning Objective
Exercise-Body Interaction Substrate utilization during exercise depends on type, intensity, and duration of exercise. Students will be able to describe substrate utilization during exercise.
Fatigue during exercise has been associated with low glycogen levels, but scientists are not in agreement as to the underlying cause of fatigue. Students will be able to debate the theories of fatigue.

What did backwards design do for me?

Backwards design provided me focus. It allowed me to step back and ask myself: What are the key take-aways? Does that cool, creative idea I have help to achieve my end game for the course? Is there a better way to do this? Overall, the framework has helped me develop a higher quality course. With that said, I still run into exam questions where I thought I did better at teaching the material than represented by the students’ responses.  So, while there is always room for improvement, this has definitely been a step in the right direction for better learning by my students.

References:

  1. Hansen EJ. Idea Based Learning: A Course Design Process to Promote Conceptual Understanding. Sterling VA: Stylus Publishing, LLC; 2011.
  2. 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.

 

Lynn Cialdella-Kam, PhD, MBA, MA, RDN, LD joined CWRU as an Assistant Professor in Nutrition in 2013. At CWRU, she is engaged in undergraduate and graduate teaching, advising, and research. Her research has focused on health complications associated with energy imbalances (i.e. obesity, disordered eating, and intense exercise training). Specifically, she is in interested in understanding how to alterations in dietary intake (i.e., amount, timing, and frequency of intake) and exercise training (i.e., intensity and duration) can attenuate the health consequences of energy imbalance such as inflammation, oxidative stress, insulin resistance, alterations in macronutrient metabolism, and menstrual dysfunction.  She received her PhD in Nutrition from Oregon State University, her Masters in Exercise Physiology from The University of Texas at Austin, and her Master in Business Administration from The University of Chicago Booth School of Business.  She completed her postdoctoral research in sports nutrition at Appalachian State University and is a licensed and registered dietitian nutritionist (RDN).