Tag Archives: classroom culture

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

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

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

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

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

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

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

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

So, what is a stereotype threat?

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

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

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

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

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

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

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

References:

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

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

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

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

1. Staying online after the class has ended.

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

2. Integrating video/audio into online discussion boards.

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

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

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

4. Holding “unofficial” hours.

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

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

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

Physiology Bumper Stickers for Teaching and Learning
Alice R. Villalobos, BS, PhD
Texas Tech University

As teachers we hope students remember and apply all the physiology they learned in our class.  However, many undergraduate students hope simply to get through this semester of physiology and their other courses.  They dread the amount of material and that ‘so many things go on in the body at one time.’  I asked myself what could be integrated into lecture or lab to help students better learn material in class, study more effectively on their own and ideally, improve recall when taking exams.  Around this time, I attended a teaching workshop focused on short activities and simple tools that could be incorporated into lectures to facilitate learning and recall.  One tool was the ‘bumper sticker’. 

Similar to an actual bumper sticker, the teaching bumper sticker is a short memorable phrase or slogan that encapsulates a thought, principle, or concept.  In this case, a bumper sticker helps students learn and remember a concept or principle.  In all areas of life, we use short sayings or one-liners often of unknown derivation that convey a profound or funny, classic or clever, instructional or encouraging thought.  ‘Righty tighty, lefty loosey.’ means turn the screw to right to tighten and left to loosen.  “I before E except after C.” with the addendum, “… and in words, such as protein or weight.”  Could bumper stickers work in a physiology course?  I already borrowed “Water follows sodium; sodium doesn’t follow water.” from my undergraduate professor.  We all develop short phrases while working on lectures, reading physiology papers and books, or on the fly during lecture.  

Recently, I began using bumper stickers in a more organized manner.  I took a sheet of lined paper, wrote ‘Bumper Stickers for A&P-II’ on the top, and made plenty of copies.  On the first day of class I discussed tips to improve learning and study habits.  I explained the bumper sticker was a teaching/learning tool and gave each student a sheet.  I admitted it was an experiment, but my intention was to give them short phrases to refer to and contemplate when studying on their own or spark a memory on an exam.  That very day we started glycolysis.  The first bumper sticker was “You must spend an ATP to make ATP.”  I explained the first step in glycolysis is phosphorylation, using a phosphate from ATP.  Despite some initial skepticism, bumper stickers caught on and helped many students. 

Rather than repeating your explanation verbatim, students must accurately explain concepts to themselves and others in their own words.  When students study with a partner or in groups, they can refer back to the bumper sticker along with lecture notes, diagrams and textbook to explain the respective concept to each other in their own words and peer-correct.  When students are teaching each other, they are truly ‘getting it’.  Granted, it is essential that students use more exact and scientific vocabulary to describe a mechanism or concept, as is true for any discipline.  For most students this won’t happen the very first time they explain the concept.  Learning physiology or any subject is a process; developing the vocabulary is part of that process.  A memorable bumper sticker is a prompt for stimulating discussion – verbal communication in the context of learning a given physiological mechanism and developing the vocabulary of physiology. 

There is no established technique for the initial delivery of a bumper sticker phrase.  However, its two-fold purpose as a teaching/learning tool is to help students understand and remember a concept; thus, the phrase and initial proclamation must be memorable.  Based on my hits and misses, here are several tips.  First, keep it short, ideally 10 words or less.  Second, timing is key.  Similar to a joke, timing is important but varies with topic and teaching style.  Some use the phrase as a teaser to introduce a topic; others use it to summarize key points.  Third, be as direct as possible and capture students’ full attention.  Some write the phrase on the board or slide and make an announcement, “Listen up.  Write this down.”  Fourth, look directly at your students and state the phrase clearly with meaning, effective voice inflection, dramatic tone, appropriate pause, facial expression, hand gesturing, and/or a little physical comedy.  Fifth, use accurate and scientific terms to explain the meaning of the phrase as it applies to the physiological concept.  This is absolutely critical.  Left to interpretation, students might misunderstand the actual physiological concept.

Bumper stickers for better study and testing strategies

*Use common sense at all times, especially on test day.* At times, students forget obvious and intuitive things.  For example, when applying Boyle’s Law to respiration, don’t forget to breathe.  I remind students that lung volume and intrapulmonary pressure will change such that when we inhale air flows in, and when we exhale air flows out.  Physical laws applied to physiological mechanisms explain relationships among different components of a mechanism, e.g., the pressure of a quantity of gas to its volume.  I assure them, they can and will learn the fundamental physics on which Boyle’s law is based, but keep it simple and remember – when you inhale air flows in, when you exhale air flows out. 

            *Understand the question, before you answer it.* My PhD advisor shared this pearl of wisdom before my qualifying exam.  I encourage students to calmly, slowly and deliberately read the entire question.  On any multiple choice or essay exam, they must be certain of what is being asked, before answering a question.  Do not stop reading the question until you come to a period, question mark or exclamation point.  Students are concerned about wasting precious time.  Slowing down just a bit to answer correctly is worth the time and decreases the odds of second guessing or having to go back to the question.  I make another pitch for reading the text book.  It is a way to practice reading calmly and deliberately and catching differences in font or formatting, e.g., print style, italics, bold, underline, that may indicate key terms for an exam question. 

Bumper stickers for general principles in physiology

*Enough, but not too much.* Many students think every physiological end point is maintained at a constant value.  I explain that various parameters are regulated such that they gently fluctuate within a narrow range.  Plasma sodium must be ‘enough’; if it drops too low osmolarity decreases.  If sodium is ‘too much’, osmolarity increases; plasma volume increases; blood pressure increases.  If an endpoint falls below range, regulatory mechanisms bring it back up into range; should it increase above normal range, regulatory mechanisms bring it back down into range.  

*It’s not a mathematical equation; it’s a relationship.* Many students confess they are ‘really bad at math’ or ‘hate math’.  CO, MAP, renal clearance, alveolar ventilation rate – all math.  Understanding and passing physiology requires math.  I tell students math describes physiological relationships between different factors that regulate or dictate a given endpoint, similar to interactions and relationships among friends or a team.  Actual equations represent precise relationships, e.g., CO = HR x SV.  In that case, cardiac output will increase and decrease in direct proportion to heart rate and stroke volume.  Then there is Poiseuille’s Equation.  Students are not required to memorize that equation, but they must learn and apply the principles of the equation: F α DP, F α 1/R and F α r4.  I clarify the α symbol means ‘in proportion to’, not equals.  I repeat, ‘It’s not a mathematical equation; it’s a relationship.”  I suggest they view a as a hug, and embrace the dependence of blood flow on the pressure gradient, vascular resistance, and the luminal radius.  The 4 means when radius changes even just a little, flow changes a lot!  I provide a more technical explanation of how blood flow can decrease significantly with gentle vasoconstriction and increase with gentle vasodilation; this showcases the essential regulatory role of vascular smooth muscle.  This particular bumper sticker serves to remind them math is critical to our understanding of physiology and hopefully, ease their anxiety.  More math awaits in respiratory physiology, and they revisit and apply F α DP, F α 1/R and F α r4 to air flow.

*Know what abbreviations mean, and don’t make up abbreviations.* I explain the names of hormones, especially, are rich in information.  These names indicate source, stimulus for release, and mechanism of action.  For example, atrial natriuretic peptide, ANP, is a peptide hormone secreted from atrial tissue when plasma volume increases that increases urine output (-uretic) and sodium (natri-) excretion.  Not too creative, but self-explanatory.  Couple it with “Water follows sodium …”; problem solved.  

Bumper stickers for chronological order or sequence

For many cellular and organ mechanisms, there is a strict chronological order of events.  During the cardiac cycle, there is a distinct chronological order for each of several different phenomena that occur simultaneously and interdependently.  I use bumper stickers to teach a basic concept of cardiac physiology that help students learn the cardiac cycle – the electrical~mechanical relationship.  First, I show the entire Wiggers diagram and explain it tracks the series of interrelated electrical and mechanical events as they occur in the same timeline of one heartbeat.  I assure them we will take one panel at a time and pull it altogether at the end.  I start with the relationship of the ECG to the 4 ventricular phases, using a set of bumper sticker phrases that I write on the board.  We review the electrical events of P (atrial depolarization), QRS (ventricular depolarization) and T (ventricular repolarization) deflections.  Then, I say, “Pay attention.  Write down each phrase.”

*Electrical then mechanical.* I explain emphatically that first an electrical signal is transmitted and received, then the atrial or ventricular muscle responds.  In the cardiac cycle, electrical events P, QRS, and T each precede atrial or ventricular responses.  

*Depolarizeàcontract.  Repolarizeàrelax.* I explain depolarization triggers contraction; repolarization leads to relaxation.  P wave signals atrial contraction; QRS complex signals ventricular contraction; T wave signals ventricular relaxation.

*Depolarizeàcontractàincrease pressure.  Repolarizeàrelaxàdecrease pressure.*  I remind them changes in pressure gradients across the atrioventricular and semilunar valves determine whether valves open or close and consequently, whether blood flows into or out of the ventricle.  Depolarization leads to ventricular contraction and in turn, an increase in pressure; repolarization leads to ventricular relaxation and in turn, a decrease in pressure. 

*The AV valve is the fill valve; the semilunar valve is the ejection valve.*  A student thought of this phrase!  She explained, “When the AV valve – tricuspid or mitral – is open during diastole, the ventricle fills with blood from the atrium.  When the semilunar valve – pulmonary or aortic – is open during systole, blood is ejected.”  In that moment I thought my work as a teacher was done; my student is teaching herself and others.  I give her full credit, but use her bumper sticker.  I further explain when the ventricle relaxes and pressure drops below the atrial pressure, the AV valve will open, and blood enters the ventricle; when it contracts ventricular pressure exceeds atrial pressure and the AV valve closes; as it continues to contract, eventually ventricular pressure exceeds aortic pressure, the aortic valves opens, and blood is ejected into the aorta. 

Bumper stickers might not be the right tool for every teacher, student, or topic, or be appropriate for undergraduate versus graduate course.  If you decide to implement this tool, you might not have a bumper sticker for every basic or general physiology concept or mechanism or a set of bumper stickers for every organ system.  You might only use a bumper sticker phrase once or twice in a whole semester.  When used appropriately, they truly can make a difference.  On the other hand – if how you teach is working just fine and your students are getting it – then all I have to say is, “If it ain’t broke, don’t fix it!”

Alice Villalobos received her Bachelors of Science in biology from Loyola Marymount University and her PhD in comparative physiology from the University of Arizona-College of Medicine.  For the past several years, she has taught Anatomy & Physiology-II and Introduction to Human Nutrition in the Department of Biology at Blinn College and guest lectured at Texas A&M University on the topics of brain barrier physiology and heavy metal toxicology.  She recently relocated to Texas Tech University to join the Department of Kinesiology & Sport Management where she teaches Physiological Nutrition for Exercise.

Fostering an Inclusive Classroom: A Practical Guide

Ah, the summer season has begun! I love this time of year, yes for the sun and the beach and baseball games and long, lazy summer reading, but also because it gets me thinking about new beginnings. I’ve always operated on a school-year calendar mindset, so if you’re like me, you’re probably reflecting on the successes and shortcomings of the past year, preparing for the upcoming fall semester, or maybe even launching into a new summer semester now. As campuses become more diverse, fostering an inclusive learning environment becomes increasingly important, yet the prospect of how to do so can be daunting. So where to start?

First, recognize that there is not just one way to create an inclusive classroom. Often, the most effective tactics you use may be discipline-, regional-, campus-, or classroom-specific. Inclusive teaching is a student-oriented mindset, a way of thinking that challenges you to maximize opportunities for all students to connect with you, the course material, and each other.

Second, being proactive before a semester begins can save you a lot of time, headaches, and conflict down the road. Set aside some dedicated time to critically evaluate your course structure, curriculum, assignments, and language choices before ever interacting with your students. Consider which voices, perspectives, and examples are prominent in your class materials, and ask yourself which ones are missing and why. Try to diversify the mode of content representation (lectures, videos, readings, discussions, hands-on activities, etc.) and/or assessments types (verbal vs. diagrammed, written vs. spoken, group vs. individual, online vs. in-class, etc.). Recognize the limits of your own culture-bound assumptions, and, if possible, ask for feedback from a colleague whose background differs from your own.

Third, know that you don’t have to change everything all at once. If you are developing an entirely new course/preparation, you’ll have less time to commit to these endeavors than you might for a course you’ve taught a few times already. Recognize that incremental steps in the right direction are better than completely overwhelming yourself and your students to the point of ineffectiveness (Trust me, I’ve tried and it isn’t pretty!)

Below, I have included some practical ways to make a classroom more inclusive, but this list is far from comprehensive. As always, feedback is much appreciated!

Part 1: Course Structure and Student Feedback

These strategies require the largest time commitment to design and implement, but they are well worth the effort.

  • Provide opportunities for collaborative learning in the classroom. Active learning activities can better engage diverse students, and this promotes inclusivity by allowing students from diverse backgrounds to interact with one another. Furthermore, heterogeneous groups are usually better problem-solvers than homogeneous ones.
  • Implement a variety of learning activity types in order to reach different kinds of learners. Use poll questions, case studies, think-pair-share, jigsaws, hands-on activities, oral and written assignments, etc.
  • Select texts/readings whose language is gender-neutral or stereotype-free, and if you run across a problem after the fact, point out the text’s shortcomings in class and give students the opportunity to discuss it.
  • Promote a growth mindset. The language you use in the classroom can have a surprising impact on student success, even when you try to be encouraging. How many of us have said to our students before a test, “You all are so smart. I know you can do this!”? It sounds innocent enough, but this language conveys that “being smart” determines success rather than hard work. Students with this fixed mindset are more likely to give up when confronted with a challenge because they don’t think they are smart/good/talented enough to succeed. Therefore, when we encourage our students before an assessment or give them feedback afterwards, we must always address their effort and their work, rather than assigning attributes (positive or negative) to them as people.
  • Convey the same level of confidence in the abilities of all your students. Set high expectations that you believe all students can achieve, emphasizing the importance of hard work and effort. Perhaps the biggest challenge is maintaining high expectations for every student, even those who have performed poorly in the past. However, assuming a student just can’t cut it based on one low exam grade may be as damaging as assuming a student isn’t fit due to their race, gender, background, etc.
  • Be evenhanded in praising your students. Don’t go overboard as it makes students feel like you don’t expect it of them.

Part 2: Combating Implicit Bias

Every one of us harbors biases, including implicit biases that form outside of our conscious awareness. In some cases, our implicit biases may even run counter to our conscious values. This matters in the classroom because implicit bias can trigger self-fulfilling prophecies by changing stereotyped groups’ behaviors to conform to stereotypes, even when the stereotype was initially untrue. Attempting to suppress our biases is likely to be counterproductive, so we must employ other strategies to ensure fairness to all our students.

  • Become aware of your own biases, by assessing them with tools like the Harvard Implicit Association Test (https://implicit.harvard.edu/implicit/takeatest.html) or by self-reflection. Ask yourself: Do I interact with men and women in ways that create double standards? Do I assume that members of one group will need extra help in the classroom – or alternatively, that they will outperform others? Do I undervalue comments made by individuals with a different accent than my own?
  • Learn about cultures different than your own. Read authors with diverse backgrounds. Express a genuine interest in other cultural traditions. Exposure to different groups increases your empathy towards them.
  • Take extra care to evaluate students on individual bases rather than social categorization / group membership. Issues related to group identity may be especially enhanced on college campuses because this is often the first time for students to affirm their identity and/or join single-identity organizations / groups.
  • Recognize the complexity of diversity. No person has just one identity. We all belong to multiple groups, and differences within groups may be as great as those across groups.
  • Promote interactions in the classroom between different social groups. Even if you choose to let students form their own groups in class, mix it up with jigsaw activities, for example.
  • Use counter-stereotypic examples in your lectures, case studies, and exams.
  • Employ fair grading practices, such as clearly-defined rubrics, anonymous grading, grading question by question instead of student by student, and utilize activities with some group points and some individual points.

Part 3: Day-to-Day Classroom Culture

These suggestions fall under the “biggest bang for your buck” category. They don’t require much time to implement, but they can go a long way to making your students feel more welcome in your classroom.

  • Use diverse images, names, examples, analogies, perspectives, and cultural references in your teaching. Keep this in mind when you choose pictures/cartoons for your lectures, prepare in-class or take-home activities, and write quiz/test questions. Ask yourself if the examples you are using are only familiar or relevant to someone with your background. If so, challenge yourself to make it accessible to a wider audience.
  • Pay attention to your terminology and be willing to adjust based on new information. This may be country-, region-, or campus-specific, and it may change over time (e.g. “minority” vs. “historically underrepresented”). When in doubt, be more specific rather than less (e.g. “Korean” instead of “Asian”; “Navajo” instead of “Native American”).
  • Use inclusive and non-gendered language whenever possible (e.g. “significant other/partner” instead of “boyfriend/husband,” “chairperson” instead of “chairman,” “parenting” instead of “mothering”).
  • Make a concerted effort to learn your students’ names AND pronunciations. Even if it takes you a few tries, it is a meaningful way to show your students you care about them as individuals.
  • Highlight the important historical and current contributions to your field made by scientists belonging to underrepresented groups.
  • Limit barriers to learning. You will likely have a list of your own, but here are a few I’ve compiled:
    • Provide lecture materials before class so that students can take notes on them during class.
    • Use a microphone to make sure all students can hear you clearly.
    • Consider using Dyslexie font on your slides to make it easier for dyslexic students to read them.
    • Speak slowly and limit your use of contractions so that non-native-English speakers can understand you more easily.
    • Write bullet points on the board that remain there for the whole class period, including the main points for that lecture, important dates coming up, and key assignments.
    • Be sensitive to students whose first language is not English and don’t punish them unnecessarily for misusing idioms.

As a final parting message, always try to be mindful of your students’ needs, but know that you don’t have everything figured out at the outset. Make time to reevaluate your approach, class materials, and activities to see where improvements can be made. Challenge yourself to continually improve and hone better practices. Listen to your students, and be mindful with the feedback you ask them to give you in mid-semester and/or course evaluations.

For more information, I recommend the following resources:

  1. Davis, BG. “Diversity and Inclusion in the Classroom.” Tools for Teaching (2nd Ed). San Francisco: Jossey-Bass, A Wiley Imprint. p 57 – 71. Print.
  2. Eredics, Nicole. “16 Inclusive Education Blogs You Need to Know About!” The Inclusive Class, 2016 July 27. http://www.theinclusiveclass.com/2016/07/16-inclusive-education-blogs-you-need.html
  3. Handelsman J, Miller S, Pfund C. “Diversity.” Scientific Teaching. New York: W. H. Freeman and Company, 2007. p 65 – 82. Print.
  4. “Instructional Strategies: Inclusive Teaching and Learning.” The University of Texas at Austin Faculty Innovation Center. https://facultyinnovate.utexas.edu/inclusive

Laura Weise Cross is an Assistant Professor of Biology at Millersville University, beginning in the fall of 2019, where she will be teaching courses in Introductory Biology, Anatomy & Physiology, and Nutrition. Laura received a B.S. in Biochemistry from the University of Texas and a Ph.D. in Molecular and Cellular Pathology from the University of North Carolina. She recently completed her post-doctoral training in the Department of Cell Biology & Physiology at the University of New Mexico, where she studied the molecular mechanisms of hypoxia-induced pulmonary hypertension. Laura’s research is especially focused on how hypoxia leads to structural remodeling of the pulmonary vessel wall, which is characterized by excessive vascular smooth muscle cell proliferation and migration. She looks forward to engaging undergraduate students in these projects in her new research lab.

Do You Want To Be On TV?

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

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

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

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

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

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

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

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

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.

It was Just a Bag of Candy, but Now It’s a Lung – Don’t Be Afraid to Improvise When Teaching Physiology

Many of us have been teaching the same course or the same topic in a team-taught course for many years.  I have been teaching the undergraduate Anatomy and Physiology-II (AP-II) course at a community college for four years.  People often ask, “Doesn’t it get old?  Don’t you get bored, teaching the same topic?”  Without hesitation, I answer, “No.” Why?  First, on-going research continually brings new details and insight to nearly every aspect of cell and integrative physiology.  You’re always learning to keep up with the field and modifying lectures to incorporate new concepts.  Second, you truly want your students to learn and enjoy learning and continually seek out ways to teach more effectively.  You try new approaches to improve student learning.  However, the third reason is truly why teaching physiology will never get old or dull.  No two students and no two classes are alike; individual and collective personalities, career goals, academic backgrounds and preparedness, and learning curves vary from class to class.  About half my students have not taken the general biology or chemistry courses typically required for AP-I or AP-II (these are not required by the college).  The unique combination of characteristics in each group of students means that on any given day I will need to create a new makeshift model or a new analogy for a physiological mechanism or structure-function relationship to help students learn.  Thus, even if all physiological research came to complete fruition, the teaching of physiology would still be challenging, interesting, and entertaining.  Many of my peers share this perspective on teaching physiology.

Irrespective of one’s mastery of integrative physiology, as teachers we must be ready and willing to think creatively on our feet to answer questions or clarify points of confusion.  A common mistake in teaching is to interpret the lack of questions to mean our students have mastered the concept we just explained, such as the oxygen-hemoglobin dissociation curve.  Despite the amazing color-coding of green for pH 7.35, red for pH 7.0 and blue for pH 7.5 and perfectly spaced lines drawn on that PowerPoint slide, your Ms./Mr. Congeniality level of enthusiasm, and sincerest intentions – you lost them at “The relationship of oxygen saturation of hemoglobin to the partial pressure of oxygen is curvilinear.”  You know you lost them.  You can see it in their faces.  The facial expression varies: a forehead so furrowed the left and right eyebrows nearly touch, the cringing-in-pain look, the blank almost flat stare, or my favorite – the bug-eyed look of shock.  Unfortunately, it will not always be obvious.  Thus, it is essential we make an effort to become familiar with the class as a group and as individuals, no matter how large the class.  Being familiar with their baseline demeanor and sense of humor is a good start.  (I have students complete ‘Tell Me About Yourself’ cards on the first day of class; these help me a great deal.)  During lecture, we make continual and deliberate eye contact with the students and read their faces as we lecture and talk to them, rather than at them.  In lab we work with and talk to each group of students and even eavesdrop as a means to assess learning.  Time in class or lab is limited, which tempts us to overlook looks of confusion and move on to the next point.  However, when students do not accurately and confidently understand a fundamental concept, they may have even greater difficulty understanding more integrated and complicated mechanisms.  You must recognize non-verbal, as well as subtle verbal cues that students are not following your logic or explanation.  In that immediate moment you must develop and deliver an alternative explanation.  Improvise.

As per Merriam-Webster, to improvise is to compose, recite, play, or sing extemporaneously; to make, invent, or arrange offhand; to fabricate out of what is conveniently on hand.  What do you have on hand right now to create or develop a new explanation or analogy?  Work with what you have within the confines of the classroom.  These resources can be items within arm’s reach, anything you can see or refer to in the classroom.  You can also use stories or anecdotes from your own life.  Reference a TV commercial, TV show, movie, song, or cartoon character that is familiar to both you and your students.  Food, sports, and monetary issues can be great sources for ideas.  I cook and sew, which gives me additional ideas and skills.  Play to your strengths.  Some people are the MacGyvers of teaching; improvisation seems to be a natural born gift.  However, we all have the basic ability to improvise.  You know your topic; you are the expert in the room.  Tap into your creativity and imagination; let your students see your goofy side.  Also, as you improvise and implement familiar, everyday things to model or explain physiological or structure-function relationships you teach your students to think outside the box.  Students learn by example.  My own undergraduate and graduate professors improvised frequently.  My PhD and post-doc advisors were comparative physiologists – true masters of improvised instrumentation.

Improvise now, and improve later.  Some of my improvised explanations and demonstrations have worked; some have fallen flat.  In some cases I have taken the initial improvised teaching tool and improved the prototype and now regularly use the demonstration to teach that physiological concept.  Here are three examples of improvisational analogies I have used for the anatomy of circular folds in the intestine, the opening and closing of valves in the heart, and the role of alveoli in pulmonary gas exchange.  Disclaimer:  These are not perfect analogies and I welcome comments.

Surface area in the small intestine.  Students understand that the surface area of a large flat lab table is greater than the surface area of a flat sheet of notebook paper.  A sheet of paper can be rolled into a tube, and students understand that the surface area of the ‘lumen’ is equal to the surface area of the paper.  In AP-I, students learned that microvilli increase the surface area of the plasma membrane at the apical pole of an epithelial cell, and many teachers use the ‘shag carpet’ analogy for microvilli.  Similarly, they understood how villi increase surface area of the intestinal lumen.  However, some students did not quite understand or cannot envision the structure of circular folds.  As luck would have it, I was wearing that style of knit shirt with extra-long sleeves that extend just to your fingertips.  I fully extended the sleeve and began to explain. “My sleeve is the small intestine – a tube with a flat-surface lumen (my arm is in the lumen) – no circular folds.  This tube is 28 inches long and about 8 inches around.  As I push up my sleeves as far as I can, and the fabric bunches up.  These messy folds that form are like circular folds.  And, now this 6 inch tube with all these circular folds has the same surface area as the 28-inch plain tube.”  (I sew; I know the length of my own arm and am great at eyeballing measurements.)

Heart valves open and close as dictated by the pressure difference across the valve.  This is integral to ventricular filling, ejection of blood into the lung and aorta, and the effect of afterload.  Heart valves are one-way valves.  A few students heard ‘pressure difference’ and were lost.  Other students had trouble understanding how stroke volume would decrease with an increase in afterload.  What can I use in the room?  There’s a big door to the lab, and it has a window.  It opens in one direction – out, because of the doorframe, hinges and door closure mechanism; it only opens, if you push hard enough.  I ran over to the door.  “The lab door is a heart valve.  It’s the mitral valve, the lab is the atrium, and the hallway is the ventricle.  The door only opens into the hall – the mitral valve only opens into the ventricle.  When it closes, it stops once it sits in the frame.”  I asked a student about my size to go outside the room, and push against the door closed – but let me open it; she could see and hear me through the window.  “As long as I push with greater force than she applies to keep it shut, the door or valve will open.”  The student played along and made it challenging, but let me open the door.  ‘Blood flows from the atrium into the ventricle, as long as the valve is open.  But, as soon as the pressure in the ventricle is greater than the pressure in the atrium the valve closes.”  The student forcefully pushed the door shut.  They got it!  Now, afterload …?  Back to the lab door.  “Now the lab door is the aortic valve, the lab is the left ventricle, and the hall is the aorta.  This valve will open and stay open as long as the pressure in the ventricle is greater than the pressure in the aorta.  The longer the valve is open, the greater the volume of blood ejected from the ventricle.  The volume of blood ejected from the ventricle in one beat is the stroke volume.  The pressure that opposes the opening of the aortic valve is afterload.  What happens with afterload?”  I then asked the tallest, strongest student in class to play the role of Afterload; he too got into the role.  “Afterload has now increased!  The pressure that opposes the opening of the valve has increased.  Will I or won’t I have to push harder to open the door – now that afterload has increased?”  The student is very strong; I can barely push the door open.  “I not only have to push harder, but I can’t keep the door or valve open for very long.  Look.  Even though the ventricle pressure is greater, the valve is open for a shorter period – so less blood is ejected and stroke volume decreases.”

Alveoli increase the surface area for gas exchange.  Students see the lungs as 2 large sacs, and the surface area available for gas exchange between air and blood is simply the inner lining of each sac.  However, each lung is made of millions of tiny air sacs or alveoli into which air flows.  How this anatomical arrangement greatly increases surface area for gas exchange is not intuitively obvious.  The overall size of the lung does not increase, so why would the surface area increase?  As luck would have it, it was Halloween.  I had brought a big bonus bag of individually wrapped bite-size candies to class.  “One lung is like this bag.  If we cut open the bag and measure the sheet of plastic, it would be about 18 inches by 12 inches or 216 square inches.  But if we completely fill it with candy, it might hold at least 150 pieces of candy.”  I quickly unwrapped one piece of candy, held up the wrapper, and estimated a single wrapper was 4 square inches.  “If we fill one bag with 150 pieces of candy, we then have 600 square inches of surface area.  Which would provide greater area for gas exchange: one big lung or millions of alveoli?”  I revised this particular improvised explanation using scissors, a ruler and two 11-oz bags of Hershey’s® kisses.  I carefully opened both bags and transferred kisses from one bag to the other, until it was completely full, i.e., 112 kisses, and taped it shut.  I then fully opened up the other bag; it was 10 inches x 8 inches or 80 square inches.  An individual kiss wrapper is 4 square inches; all 112 individual wrappers are 448 square inches.

My improvised analogies are not perfect, but they have served as great teaching tools.  If you can improve upon these, please do.  Share any suggestions you have and lastly, share your improvised explanations and analogies.  Thanks.

Alice Villalobos received her B.S.in biology from Loyola Marymount University and her PhD in comparative physiology from the University of Arizona-College of Medicine.  She has been in the Department of Biology at Blinn College for 4 years where she teaches Anatomy and Physiology II and Introduction to Human Nutrition.  She guest lectures in undergraduate courses at Texas A&M University on the topics of brain barrier physiology and the toxicity of heavy metals.
Creating Unique Learning Opportunities by Integrating Adaptive Learning Courseware into Supplemental Instruction Sessions

Teaching a large (nearly 400 students), introductory survey course in human anatomy and physiology is a lot like trying to hit a constantly moving target. Once you work out a solution or better path for one issue, a new one takes its place. You could also imagine a roulette wheel with the following slots: student-faculty ratios, student preparation, increasing enrollments, finite resources, limited dissection specimen availability (e.g., cats), textbook prices, online homework, assessment, adaptive courseware, core competencies, learning outcomes, engagement, supplemental instruction, prerequisites, DFW rates, teaching assistants, Dunning Kruger effect, open educational resources, GroupMe, student motivation, encouraging good study habits, core concepts, aging equipment … and the list goes on.

If the ball lands on your slot, are you a winner or loser?

Before getting ahead of myself, I need to provide an overview of A&P at the University of Mississippi. Fall semesters start with 390 students enrolled in A&P I within one lecture section, 13 lab sections at 30 students each, anywhere from 10-13 undergraduate teaching assistants, 2 supplemental instruction (SI) leaders, and at least six, one-hour SI sessions each week. The unusual class size and number of lab sections is the result of maxing out lecture auditorium as well as lab classroom capacities. I am typically the only instructor during the fall (A&P I) and spring (A&P II) terms, while a colleague teaches during the summer terms. The two courses are at the sophomore-level and can be used to fulfill general education requirements. There are no prerequisites for A&P I, but students must earn a C or better in A&P I to move on to A&P II. Approximately one-third of the students are allied health (e.g., pre-nursing) and nutrition majors, one-third are exercise science majors, and the remaining one-third of students could be majoring in anything from traditional sciences (e.g., Biology, Chemistry, etc.) to mathematics or art.

The university supports a Supplemental Instruction program through the Center for Excellence in Teaching and Learning (https://cetl.olemiss.edu/supplemental-instruction/). The SI program provides an extra boost for students in historically demanding courses such as freshman biology, chemistry, physics, accounting, etc. SI leaders have successfully passed the courses with a grade of B or better, have been recommended to the program by their professors, agree to attend all lectures for the courses in which they will be an SI leader, and offer three weekly, one-hour guided study sessions that are free to all students enrolled in the course. SI leaders undergo training through Center for Excellence in Teaching and Learning and meet weekly with the course professor. Students who regularly attend SI sessions perform one-letter grade higher than students who do not attend SI sessions.

It can be as easy for an instructor to be overwhelmed by the teaching side of A&P as it is for the student to be overwhelmed by the learning side! I know that a major key to student success in anatomy and physiology courses is consistent, mental retrieval practice across multiple formats (e.g., lectures, labs, diagrams, models, dissection specimens, etc.). The more a student practices retrieving and using straightforward information, albeit a lot of it, the more likely a student will develop consistent, correct use. Self-discipline is required to learn that there are multiple examples, rather than one, of “normal” anatomy and physiology. However, few students know what disciplined study means beyond reading the book and going over their notes a few times.

To provide a model for disciplined study that can be used and implemented by all students, I developed weekly study plans for A&P I and II. These study plans list a variety of required as well as optional activities and assignments, many of which are completed using our online courseware (Pearson’s Mastering A&P) and include space for students to write completion dates. If students complete each task, they would spend approximately 10 out-of-class hours in focused, manageable activities such as:

  • Completion of active learning worksheets that correlate to learning outcomes and can be used as flashcards.
  • Practice assignments that can be taken multiple times in preparation for lecture exams and lab practicals.
  • Self-study using the virtual cadaver, photographic atlas of anatomical models, interactive animations of physiological processes, virtual lab experiments, and dissection videos.
  • Regular graded assignments aligned with course learning outcomes.

Weekly study plans are also useful during office visits with students. I can easily assess student progress and identify changes for immediate and long-term improvement. An advantage of using online courseware to support course objectives is the ability to link various elements of the courses (e.g., lecture, lab, SI sessions, online homework, group study, and self-study) with a consistent platform.

All of this sounds like a great sequence of courses, doesn’t it? Yet, the target has kept moving and the roulette wheel has kept spinning. Imagine for the story within this blog that the roulette ball has landed on “using adaptive courseware to improve supplemental instruction.”

In 2016 the University of Mississippi was one of eight universities chosen by the Bill and Melinda Gates Foundation with support of the Association for Public and Land-Grant Universities to increase the use of adaptive courseware in historically demanding general education courses. Thus, began the university’s PLATO (Personalized Learning & Adaptive Teaching Opportunities) Program (https://plato.olemiss.edu/). The PLATO grant provides support for instructors to effectively incorporate adaptive courseware into their courses and personalize learning for all affected students. Administrators of the grant were particularly supportive of instructors who could use adaptive courseware to support the SI sessions. This challenge was my personal roulette ball.

I decided to use diagnostic results from Mastering A&P graded homework assignments to prepare for weekly meetings with SI leaders. Diagnostic data on percent of University of Mississippi students correctly answering each question as well as percent of UM students answering incorrect options are compared to the global performance of all Mastering A&P users. For each question incorrectly answered by more than 50% of the students, I write a short (4-6 sentences) explanation of where students are making errors in expressing or using their knowledge and how to prevent similar errors in the future. I then searched for active learning activities and teaching tips associated with the challenging questions from the LifeSciTRC (https://www.lifescitrc.org/) and Human Anatomy and Physiology Society (HAPS; https://www.hapsweb.org/) websites. I specifically search for active learning exercises that can be conducted in a small, group setting using widely available classroom resources (e.g., white board, sticky notes, the students, etc.).

By using online courseware diagnostics, selecting focused learning activities, and communicating regularly with SI leaders, I was able to create value and unique learning opportunities for each student. The SI session format has been extremely well-received by the students and they immediately see the purpose in the study session experience. The best part is that it takes me only 30-40 minutes each week to write up explanations for the diagnostics and find the best learning activities.

I would say that we are all winners with this spin of the wheel.

Carol Britson received her B.S. from Iowa State University and her M.S. and Ph.D. from the University of Memphis. She has been in the Department of Biology at the University of Mississippi for 22 years where she teaches Vertebrate Histology, Human Anatomy, Introductory Physiology, and Human Anatomy and Physiology I and II. In 2018 she received the University of Mississippi Excellence in Teaching award from the PLATO (Personalized Learning & Adaptive Teaching Opportunities) Program supported by the Association of Public and Land-Grant Universities and the Bill and Melinda Gates Foundation.
Affective Teaching and Motivational Instruction: Becoming More Effective Educators of Science

As educators, we’re intimately familiar with learning objectives such as, “Using Fick’s principle, calculate the diffusion of a substance across a membrane.” Also, as scientists, we are familiar with technical objectives such as, “Using a micropipette, transfer 5μL of Solution A into the chromatography chamber.” In terms of learning conditions, the first is an intellectual skill and the second is a motor skill.1 One area in which we don’t often give much thought is the third type of skill that was identified by Gagné and Medsker — the affective skill. This is the area that is most often neglected by educators because it is the hardest to evaluate and quantify. We can’t explicitly say to a student, “By the end of the semester you will develop a love of physiology.” We can hope to achieve this through the semester, but as educators, the best that we can do is hope to instill these attitudes, choices, and values in our learners that persist beyond our brief time with them in the classroom.

Instilling attitudes in our learners is a complex goal. This is, in part, because stating an affective goal is at times counterproductive to the goal and interferes with learning. In the example above, it is clearly ridiculous to expect that all students will leave our classrooms with a true passion for our subject matter. Some clearly will, but others will not. That will be shaped by the attitudes with which students enter our classrooms. Those attitudes consist of the knowledge that a learner has about a subject – the cognitive aspect, how the person feels about the subject — the affective aspect, and how the person behaves in response to those influences — the behavioral aspect.2 So despite our best interests to instill a care for the animal and human models we frequently use in experiments, it is completely beyond our ability to control the behavior of our learners outside of the classroom. That doesn’t mean that we shouldn’t still try because the majority of our students will come away with those lessons intact. Additionally, affective learning is difficult to assess. We can test the knowledge and skills necessary and ask about student feelings3, but at the end of the day, our students will make a choice on their behaviors on their own. For that reason, we should not make affective learning objectives part of our formal instruction plan. Because there are so many methods that depend on the affect you might want to influence, I’m going to focus on two areas that are most common: attitude and motivational instruction.

 

Katz and Stotland identified five types of attitudes.4 These types of attitudes vary with differing levels of affective and cognitive components, but the key takeaway is that individual experiences and the results and consequences of previous choices dramatically shape the attitudes with which our learners enter our classrooms. Reward for behavior not only reinforces the behavior, but also the cognitive and behavioral components that drive that behavior.1 When we focus purely on the cognitive and the motor skill aspects of learning, we can often get away with a fair amount of do-as-I-say-not-as-I-do-style instruction. The problem with this is that students look to the faculty and other instructors for role model behavior.  Thus, the more accurately that we reflect the attitudes that we want to instill in our learners, the more the students will reflect those ideals.3 One of the easiest ways to bring about these changes of attitudes are through in-class discussions.5 This positive benefit is most likely due to differences that are raised during discussion, sometimes prompting the discovery of a discrepancy between existing attitudes in a learner and new facts that are being presented. The learners then have a choice on how to adapt to the new desired attitudes. Most importantly, never underestimate group acceptance of attitudes, as immediate social reinforcement can be a powerful driver in solidifying attitudes.

 

Having discussed attitude, motivational instruction is another key area that is relevant to affective learning. No two students enter the classroom with the same motivation. One student may be enrolled in your class because of a deep passion for your subject matter while another is there simply to satisfy a requirement for their major. This mix of intrinsic and extrinsic motivations will drive the overall outcomes of affective learning. The student who is highly motivated by an intrinsic interest in your subject or the student who is extrinsically driven by the reward of a good grade (or fear of a bad grade) will generally excel in class, albeit for different reasons. The student who is there out of obligation to meet a requirement may have very little motivation to do anything beyond what is required of them to get by. To help with those students who are lacking in motivation, JM Keller broke motivational instruction into four components: attention, relevance, confidence and satisfaction.6 Gaining the attention of students through demonstrations, discussions, and other active learning techniques may help keep student motivation high. Practical application of concepts and ideas will generally inspire higher motivation than abstract or arbitrary examples.7 Keeping the material relevant will generate motivation for intrinsic learners by providing self-improvement and for the extrinsic learners by providing a reward, such as doing well on the exam. Confidence is a harder area to approach, as students must first believe they are capable of meeting the stated objectives. Making the material too easy will not lead to feelings of accomplishment, while making the material too challenging will undermine confidence in all learners.1 Finally, satisfaction can be achieved by learners of all types, regardless of motivation type when outcomes match objectives. Keeping motivation high by providing opportunities to apply learning will drive further motivation to continue learning.

Last week I completed a comprehensive review of our capstone thesis writing course, which has changed dramatically over the past year and a half while I have been the course director. Initially, the goal of the course was to have students write a literature research paper on a physiological topic of their choosing where their grade was entirely dependent upon the finished paper. The students were frequently frustrated with a lack of guidance in the course and the faculty regularly complained about the burden of reading papers of sometimes-questionable quality. Clearly there were issues with the affective components of this course from both the student and faculty side. I’ve de-emphasized the actual paper and refocused the course on the process of writing with stated learning outcomes such as: 1) Develop the language that helps us talk about science; 2) Strengthen research skills to become educated consumers of science; and 3) Gain specialized knowledge in a selected area of physiological research. Focusing the course in this way has yielded measurable results in course evaluations and faculty perceptions of paper quality from the students. By focusing on the affective components of writing and giving students more opportunities to apply their new skills, overall satisfaction has improved. Like all works of science, though, this course continues to evolve and improve. In short, to be effective teachers, we need to go beyond the intellectual and motor skills and make sure we address the affective learning of our students as well.

1 Gagné RM and Medsker LK. (1996). The Conditions of Learning. Training Applications. Fort Worth: Harcourt Brace College Publishers.

2 Baron RA and Byrne D. (1987). Social Psychology: Understanding Human interaction. 5th ed. Boston: Allyn and Bacon.

3 Dick W and Carey L. (1996). The Systematic Design of Instruction. 4th ed. New York: HarperCollins Publishers.

4 Katz D and Stotland E. (1959). A preliminary statement to a theory of attitude structure and change. In Psychology: A Study of Science. vol 3. New York: McGraw-Hill.

5 Conrad CF. (1982). Undergraduate Instruction. In Encyclopedia of Educational Research. 5th ed. New York: The Free Press.

6 Keller JM. (1987). Development and use of the ARCS model of instructional design. Journal of Instructional Development. 10;3. 2-10.

7 Martin BL and Briggs LJ. (1986). The Affective and Cognitive Domains: Integration for Instruction and Research. Englewood Cliffs, New Jersey: Educational Technology Publications.

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.
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.
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.