Tag Archives: course preparation

Teaching an Integrated Human Anatomy and Physiology Course: Additional Lessons Learned and Online Course Adjustments
Jennifer Ann Stokes, PhD
Assistant Professor of Kinesiology
Southwestern University

In my previous blog post, I outlined the lessons learned in my first run teaching a year-long integrated upper-division human anatomy and physiology course. It has been about a year and a half since the original post and after having taught the course for a second time I will review and add to my list of initial lessons learned. Additionally, this spring semester brought new challenges with a very swift move to online coursework due to COVID-19, so I will also comment on the resulting course alterations. As a reminder, this course sequence (A&P I and II) is an upper-division junior and senior level course at my college and class sizes are very small (20-24 students) allowing for maximum time for interaction, questions, and instructor guidance both in lecture and lab.

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First, I will review the previous lessons learned and add additional commentary based on what I learned in my second year. If you haven’t yet, I would check out the previous blog for the initial notes.

1) Use an integrative textbook.

My textbook of choice is still Physiology: An Integrated Approach by Dee U. Silverthorn. For anatomy, I continued to supplement the anatomy information, such as the specifics of the skeletal system and joints, muscles, histology, etc., through the use of models and other reference material in hands-on lab activities. One addition made in the second year was the use of AD Instrument’s Lt online learning platform.  I discuss the addition of Lt in more detail later in this post, but I think it is important to note here too since the Lt lessons directly complemented the textbook material and helped bridge the gap between lecture and lab for the students.

2) Start building and assessing students’ A&P knowledge from the ground up, and build incrementally.

Laying the foundation for the core concepts is critical to the student’s understanding, application, and mastery of the complex integrative content that this course builds. I took this foundation building more seriously the second time around and, in the end, I did not have to spend more time on the basic content but instead I provided more formative assessment opportunities. This helped the students who did not have as strong a background or understanding of the basic material to recognize that they needed additional assistance. In addition to the weekly homework assignments which were graded for completion only, I added weekly low-stake quizzes using our learning management system (LMS). At first I thought the students would dislike the extra work, but an end-of-the-year survey indicated that they appreciated the extra practice and that the quizzes helped them feel better prepared for the exams.

3) Create a detailed course outline, and then be prepared to change it.

This lesson holds true for just about any course, but I found it especially true for an integrated A&P course – even when teaching it a second time. And it is even more important when you have to switch to online delivery. In the second year, I learned to appreciate that no two cohorts of students are the same and what took the previous cohort a day to master took the next cohort up to two days in some cases. Having the “flex days” at the end of each section was crucial for concept review and content integration. These are days where no new content is introduced, but instead we review and practice together.

4) Constantly remind your students of the new course format.

I cannot emphasize this enough: students will want to revert back to what they are comfortable with and what has worked for them in the past. I constantly remind students that their “cram and forget” method will not serve them well in this course and provide them with ample opportunity to practice this both on the formative and summative assessments. In the second year I continued the individual meetings with each student after their first exam to discuss study strategies and new ways to approach this material, but I also implemented additional check-ins throughout the year particularly with those students who were struggling. I continued to remind the students that the course content not only builds throughout the entire semester but also the entire year! I hammered this point home a bit more with the addition of “retention” quizzes which were delivered unannounced throughout the year and tested major core concepts and application.

5) Solicit student feedback.

Students can be brutally honest, so use that to your advantage. A lot of the new things I added in my second year teaching this course came from the first year-student feedback. I send out my own surveys with specific questions throughout the year which the students fill out anonymously. I find that students are happy to help, especially when they can see a course alteration mid-semester which was based on their feedback.

6) Be prepared to spend a lot of time with students outside of the classroom.

Still very true, but that’s probably my favorite part of this job. Even when we switched to online course delivery the virtual office hours were busy and students took advantage of the extra review and time to ask questions. 

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In this second section, I will add additional lessons learned in my second year of teaching this course and comment on the changes made when the course moved online mid-way through the second semester.  

7) Over-communication.

One of the things I am known for with my students is consistent and clear communication, probably to the point of over-communication. I also emphasize that communication is a two-way street, so just as I am constantly communicating information to them, I expect them to do the same to me, including any accommodations, sports travel, or general course questions. I model this behavior with regular use of our LMS announcement page and I use the start of each class to review important deadlines and open the floor for questions. The move to online instruction only made this over-communication even more important. Early on in the transition period I checked in often to let them know the new plan and opened discussion pages to allow them to ask questions and express any concerns. I checked in multiple times a day using the LMS announcement page, posted a “live” course schedule and tables of new homework and quiz due dates all in one central location, and I added silly memes to the discussion boards to up engagement. I also added resource pages on the basics of Zoom and how to be an online student since this was very new territory for them (and me). Looking back this was a lot of information that was constructed and disseminated very quickly, but an end-of-the-year survey indicated they appreciated the information and that it told them that I was prepared and willing to help them during the transition.

8) More assessments. More practice. More activity.

In my second year, I assigned more practice problems from the textbook to help the students prepare for the exams and held problem sessions outside of class for review. This additional time and practice was well received even when it was a greater time commitment for the students. With the move to online instruction I was thankful that I had already established a fairly homework-heavy course as these assignments became even more important. The assigned “lecture” time was switched to virtual problem solving sessions and the course moved even more toward a flipped-classroom model. Since the switch to online occurred after I had already built a pretty solid reputation with this class (about a semester and a half) they were used to reading and problem solving before class, even if that class was now online. All homework and quizzes moved online which allowed for quicker feedback to the students on their progress and, thus, more time for questions before the exams. The switch to fully online homework and quizzes I plan to keep even when the course moves back to in-person as the quick feedback for the students and less time spent hand-grading by me is worth the extra time it takes to set-up the online modules.

9) Utilization of LMS Discussion Forums.

Honestly, the use of the LMS discussion forums did not start until the course moved online, but their quick success made me question why I had not taken advantage of this tool earlier. When the course moved online I added discussion pages with titles such as “What is going on?!? General course questions.” and “What I am most nervous about with the course moving online is…” The goal was to provide an outlet for students to ask questions and share their concerns. I always started the discussion myself, giving them a sort of “jumping off” point and an example. These discussion pages were utilized by almost all members of the course and were rated very highly in the end. Students could comment any time of day enhancing the accessibility of the discussion. I will modify these to be used in my courses moving forward for both in-person and online courses.

10) Online presence for both lecture and lab.

I actually increased my A&P online presence prior to the mandatory switch to online coursework with the implementation of AD Instruments Lt learning platform in the fall semester. My students received free access to both the anatomy and physiology modules thanks to an award from the American Physiological Society. The Teaching Career Enhancement Award supported a year-long study assessing the use of the ADInstruments Lt learning platform and its interactive and immersive lessons aimed at enhancing knowledge, retention, and practical application of the integrative course content. The Lt platform was fully customized to the course material and was used both in the lecture classroom and in the lab. In the lab, students were able to interact with a data acquisition system that is more “game-like” and familiar, while still collecting high-level human physiology data. Lt also allowed for the creation of new lessons that engaged students with the use of embedded questions in multiple formats, including drag-and-drop labeling, drawing, short answers, and completion of tables. These lessons were used in many ways: for pre-lab preparation, in-lab and post-lab assessment, and for active learning activities in the classroom. Lessons were completed individually or in small groups, and questions were set up with hints, immediate feedback, multiple tries, and/or automatic grading.

These modules were also incorporated in the active-learning lecture component of the course, providing additional exposure and practice with the content. The Lt lessons directly complemented the textbook material and helped bridge the gap between lecture and lab for the students. When the course moved fully online I was incredibly thankful that Lt was already in use in my course and that the students were already comfortable and familiar with the platform. I used Lt exclusively for the online labs and supplemental lecture content for the remainder of the spring semester. Just as before, the lessons and modules were customized by me to fit my course learning objectives and prepare the students for their new online assessments. Students could complete the online coursework at their leisure and stop by the virtual office hours for help or post questions on the discussion boards for feedback. Student feedback indicated that the addition of Lt to this course enhanced accessibility of the course content, provided extra practice and exposure to the material, and overall was rated highly by the students.  

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And just as I did before, now I turn the conversation over to the MANY seasoned educators who read this blog. What did you learn in your quick move to online coursework? Did you implement any new pedagogical tools which you will continue to use even with in-person instruction? Please share!

Jennifer Ann Stokes is a soon-to-be Assistant Professor of Kinesiology at Southwestern University in Georgetown, TX, after spending the last three years at Centenary College of Louisiana. Jennifer received her PhD in Biomedical Sciences from the University of California, San Diego (UCSD) and following a Postdoctoral Fellowship in respiratory physiology at UCSD, Jennifer spent a year at Beloit College (Beloit, WI) as a Visiting Assistant Professor of Biology to expand her teaching background and pursue a teaching career at a primarily undergraduate institution. Jennifer’s courses include Human Anatomy and Physiology (using an integrative approach), Nutritional Physiology, Exercise Physiology, Medical Terminology, and Psychopharmacology. Jennifer is also actively engaged with undergraduates in basic science research (www.stokeslab.com) and in her free time enjoys cycling, hiking, and yoga.

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.

How to motivate students to come prepared for class?

The flipped classroom is a teaching method where the first exposure to the subject occurs in an individual learning space and time and the application of content is practiced in an interactive guided group space. Freeing up class time by shifting traditional lecture outside of class allows the instructor more time for student-centered activities and formative assessments which are beneficial to students. The flipped teaching model has been shown to benefit students as it allows self-pacing, encourages students to become independent learners, and assists them to remain engaged in the classroom. In addition, students can access content anytime and from anywhere. Furthermore, collaborative learning and peer tutoring can be integrated due to freed-up class time with this student-centered approach. Given these benefits, the flipped teaching method has been shown to improve student performance compared to traditional lecture-based teaching. Compared to the flipped classroom, the traditional didactic lecture is considered a passive type of delivery where students may be hesitant to ask questions and may omit key points while trying to write or type notes.

There are two key components in the flipped teaching model: pre-class preparation by students and in-class student-centered activities. Both steps involve formative assessments to hold students accountable. The importance of the pre-class assessment is mainly to encourage students to complete their assignments and therefore, they are better prepared for the in-class application of knowledge. In-class activities involve application of knowledge in a collaborative space with the guidance of the instructor. Although the flipped teaching method is highly structured, students still come to class unprepared.

Retrieval practice is yet another powerful learning tool where learners are expected to recall information after being exposed to the content. Recalling information from memory strengthens information and forgetting is less likely to occur. Retrieval of information strengthens skills through long-term meaningful learning. Repeated retrieval through exercises involving inquiry of information is shown to improve learning.

The use of retrieval strategy in pre-class assessments is expected to increase the chance of students completing their pre-class assignment, which is often a challenge. Students attending class without having any exposure to the pre-class assignment in the flipped classroom will drastically affect their performance in the classroom. In my flipped classroom, a quiz consisting of lower level of Bloom’s taxonomy questions is given over the pre-class assignment where the students are not expected to utilize any resources or notes but to answer questions from their own knowledge. Once this exercise is completed, a review of the quiz and the active learning portion of the class occurs. I use a modified team-based learning activity where the groups begin answering higher order application questions. Again, no resources are accessible during this activity to promote their preparation beforehand. Since it is a group activity, if one student is not prepared, other students may fill this gap. The group typically engages every student and there is a rich conversation of the topic being discussed in class. The classroom becomes a perfect place for collaborative learning and peer tutoring. For rapid feedback to the students, the group answers to application questions are discussed with the instructor prior to the end of the class session.

Student preparation has improved since the incorporation of the flipped teaching model along with retrieval exercises in my teaching, but there are always some students who are not motivated to come prepared to class. It is possible that there are other constraints students may have that we will not be able to fix but will continue to be searching for and developing newer strategies for helping these students maximize their learning.

Dr. Gopalan received her PhD in Physiology from the University of Glasgow, Scotland. After completing two years of postdoctoral training at Michigan State University, she began her teaching endeavor at Maryville University where she taught Advanced Physiology and Pathophysiology courses in the Physical Therapy and Occupational Therapy programs as well as the two-semester sequence of Human Anatomy and Physiology (A&P) courses to Nursing students. She later joined St. Louis Community College where she continued to teach A&P courses. Dr. Gopalan also taught at St. Louis College of Pharmacy prior to her current faculty position at Southern Illinois University Edwardsville where she teaches Advanced Human Physiology and Pathophysiology for the doctoral degrees in the Nurse Anesthetist and Nurse Practitioner programs. Besides teaching, she has an active research agenda in teaching as well as in the endocrine physiology field she was trained in.
My First Run at Teaching an Integrated Physiology Course: Lessons Learned

One of the primary factors that attracted me to my current position, a tenure-track Assistant Professor of Biology at a small teaching-intensive liberal arts college, was the fact that my new department gave me the freedom to update and, in the end, completely overhaul the existing Anatomy and Physiology (A&P) curriculum. This position allowed great academic freedom, especially to a new professor, and department support for trying new teaching strategies and activities was, and still is, very high. So as a new entrant into the field of physiology education, and as someone who is interested in pedagogical research, this opportunity and level of freedom excited me.

My predecessor, while a fantastic educator, had built the year-long A&P sequence in the traditional form of one to two weeks on a specific topic (e.g. histology, the skeletal system, or the respiratory system) and an exam every so often that combined the previously covered topics. Both the topics covered and the exams could very much stand on their own, and were more like separate units. This course design was exactly the way I took the A&P course, longer ago than I care to admit, although at a different institution. In fact, most of my college courses were taught this way. And while that may be appropriate for some fields, the more I was reading and learning about teaching A&P the more I was starting to convince myself that I wanted teach A&P in an integrated fashion as soon as I got the chance.

So here I was, the bright-eyed and bushy-tailed newly minted Assistant Professor of Biology, with the academic freedom to teach A&P in the best way that I saw fit. One important thing to note: this course sequence (A&P I and II) is an upper-division junior and senior level course at my college, and class sizes are very small (20-24 students) allowing for maximum time for interaction, questions, and instructor guidance both in lecture and lab. (That latter point is key, but we’ll talk more about that in a minute.)

I entered the 2017-2018 academic year with a brand-new, shiny, exciting, and most importantly, integrated A&P course plan and a lot of enthusiasm. Along the way I took meticulous notes on what worked, what didn’t work, and the areas that needed improvement. Now in the 2018-2019 academic year I’m teaching this integrated course sequence for the second time, all while taking those same meticulous notes and comparing student feedback. Below I’ve compiled what I deem (so far) to be some of the most important lessons that I learned along the way:

 1) Use an integrative textbook.

This I was fortunate to do from the start. While this is an A&P course (not just P), I decided to use Physiology: An Integrated Approach by Dee U. Silverthorn as my primary text. Not only is the book already designed to be used in an integrative fashion, but there is ample introductory material which can be used to remind students of previous course material that they need to know (see lesson #2 below) and there are entire chapters dedicated to the integration of multiple systems (e.g. exercise). The assessment questions in the text are also well organized and progressive in nature and can be assigned as homework for practice or pre-reading assignments. Anatomy information, such as the specifics of the skeletal system and joints, muscles, histology, etc., was supplemented through the use of models and other reference material in hands-on lab activities.

2) Start building and assessing students’ A&P knowledge from the ground up, and build incrementally.

There are two important parts to this lesson: A) previous course knowledge that is applicable to this upper-division A&P course, and B) the new A&P material itself.

In my initial run of the course I made the mistake of starting out at a bit too advanced of a content level. I assumed more knowledge was retained from previous courses by the students than actually was. I learned very quickly that I needed to take a step back, but not too far. Instead of re-teaching introductory chemistry, biology, and physics, I took the opportunity to remind them of the relevant key principles (e.g. law of mass action) and then pointed them to pages in the text or provide additional material where they could review.

I applied this same philosophy as we progressed through new material. Lower-order Bloom’s principles should be assessed and mastered first, before progressing to the higher-order skills for each new section. In my second iteration of the course I implemented low-stakes (completion-based grade) homework assignments to be completed before the class or lab period, which were aimed to get a head-start on the lower-order skills. Then in class we reviewed these questions within the lecture or lab and added on with more advanced questions and/or activities. This format of pre-class homework was very well received by the students, and even though it is more work for them, they said that it encouraged them to keep up with the reading and stay-on track in the class. As the class progressed, I added in more advanced homework problems that integrated material from previous chapters. Obviously, if you are going to teach in an integrated fashion then you will need to assess the students in the same way, but a slow-build up to that level and ample low-stakes practice is key.

3) Create a detailed course outline, and then be prepared to change it.

This lesson holds true for just about any course, but I found it especially true for an integrated A&P course. As an instructor, not only did I need to be well versed in A&P, but I also needed to see the big picture and connect concepts and ideas both during the initial course construction and as the course progressed. I went into the course with an idea of what I wanted (and needed) to cover and during the course students helped guide what topics they struggled with and/or what they wanted to learn more about. So while still sticking to covering the basics of a course, I was still able to dive a bit deeper into other topics (such as exercise) per student interest. This also helped boost motivation for student learning when they feel they have some agency in the material.

Another aspect of the lesson is the addition of what I call “flex days”. Students will find this style of teaching and learning challenging and some will need more time and practice with the material. I found it very helpful to add in a “flex day” within each unit where no new material was covered, but instead time was dedicated to answering questions and additional practice with the concepts. If a full class day can’t be dedicated, even 30 minutes can be put to great use and the students really appreciate the extra time and practice.

 

4) Constantly remind your students of the new course format.

Students will want to revert back to what they are comfortable with and what has worked for them in the past. They will forget that information needs to be retained and applied later in the course. I found that I needed to constantly remind students that their “cram and forget” method will not serve them well in this course. But, simply telling them is not enough, so I allowed for practice problems both in and outside of class that revisited “older” material and prepared them for the unit exams with integrative questions which combined information from different chapters. I even listed the textbook chapters at the end of the question so that they would know where to find the material if needed.

Along with this, I found that tying material back to central themes in physiology (e.g. structure-function, homeostasis, etc.) also helped the students connect material. I am fortunate that the entry level biology courses at this college teach using the Vision and Change terminology, so the basic themes are not new to them, making integration at least on that level a bit more approachable.

 

5) Solicit student feedback.

Students love to be heard and they love to know that their input matters. And in the design of a new course I want to know what is working and what is not. I may think something is working, but the students may think otherwise. Blank notecards are my best friend in this instance. I simply have a stack at the side of the room and students can or cannot fill them out and drop them in a box. I often ask a specific question and solicit their input after an activity or particularly challenging topic. Of course, the second part of this step is actually reading and taking their input seriously. I’ve often made some last minute changes or revisited some material based on anonymous student feedback, which also ties back to lesson #3.

 

6) Be prepared to spend a lot of time with students outside of the classroom.

Some students are great about speaking up in class and asking questions. Other students are more comfortable asking questions outside of class time. And of course, I found that students of both flavors will think that they know a particular concept, and then find out, usually on an exam, that they do not (but that is probably not unique to an integrative course). So, after the first exam I reached out to every student inviting them to meet with me one-on-one. In these meetings we went through not only the details of the exam, but study skills. Every student needed to be reminded and encouraged to study a little bit every day or at least every other day to maximize retention and success. This also helped create an open-door policy with students who needed and wanted more assistance, increasing their comfort level with coming to office hours and asking for help.

 

As you may have inferred, teaching this type of course takes a lot of time. I’ll be honest and say that I wasn’t necessarily mentally or physically prepared for the amount of time it took to design and run this course, especially in my first year of teaching, but I made it work and I learned a lot. During this process I often discussed course ideas with department colleagues and A&P instructors at other universities. I perused valuable online resources (such as LifeSciTRC.org and the PECOP Blog) for inspiration and guidance. I also found that I spent a lot of time reflecting on just about every lecture, activity, and lab to ensure that the content connections were accurate, applicable, and obtainable by the students. And while I know that the course still has a ways to go, I am confident in the solid foundation I have laid for a real integrative A&P course. And, just as I am doing now with its second iteration, each run will be modified and improved as needed to maximize student learning and success, and that is what makes me even more excited!

Now I turn the conversation over to the MANY seasoned educators that read this blog. Do you have experience designing and teaching an integrated A&P course? What advice do you have for those, like me, that are just starting this journey? Please share!

Jennifer Ann Stokes is an Assistant Professor of Biology at Centenary College in Shreveport, LA. She received her PhD in Biomedical Sciences from the University of California, San Diego (UCSD). Following a Postdoctoral Fellowship in respiratory physiology at UCSD, Jennifer spent a year at Beloit College (Beloit, WI) as a Visiting Assistant Professor of Biology to expand her teaching background and pursue a teaching career at a primarily undergraduate university. Now at Centenary College, Jennifer teaches Human Anatomy and Physiology I and II (using an integrative approach), Nutritional Physiology, Medical Terminology, and Psychopharmacology. Jennifer is also actively engaged with undergraduates in basic science research (www.stokeslab.com) and in her free time enjoys cycling, hiking, and yoga.
Medical Physiology for Undergraduate Students: A Galaxy No Longer Far, Far Away

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

 

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

 

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

 

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

Jeffrey L. Osborn, PhD is a professor of biology at the University of Kentucky where he teaches undergraduate and graduate physiology. He currently serves as APS Education Committee chair and is a former medical physiology educator and K12 magnet school director. His research focuses on hypertension and renal function and scholarship of teaching and learning. This is his first blog.
Course Preparation for a First Timer – Tips and Example Steps to Take

 


idea		 This summer has been a uniquely exciting time for me as I prepare to teach my very first course, Human Physiology! What are the steps you take for preparing your courses? If it is your first time teaching, preparation seems overwhelming, and a challenge to figure out where to even begin. In this blog, I will be describing the steps I’ve taken to get ready for teaching my first course at our nearby minority-serving community college this fall. Full disclosure — I am definitely not an expert in course preparation, but I’ve included some tips and resources for what has worked for me.

Step 1: Reflection and determining my teaching philosophy

Reflecting on my time as an undergraduate student, I realize that learning how to learn did not come easy. It took me more than half way through my undergraduate years to figure out how to do it, and it was not until I was a graduate student that I mastered that skill. Thinking about my future students, I sought training opportunities to aid me in becoming a teacher who effectively facilitates student learning. I especially am interested in teaching practices that foster learning in first-generation college students who are not yet experienced with knowing how to learn and study. I want to make sure that my teaching style is inclusive of as many diverse student populations as possible. To do this, I have to educate myself on learning theories and effective teaching methods.

Early this summer, I attended the West Coast National Academies’ Summer Institute on Scientific Teaching to educate myself on teaching methods, and went home with understanding of the practices that fit my style and my philosophy. I highly recommend others to take advantage of these types of events or workshops (such as those offered by CIRTL) to familiarize yourself with various techniques. Aside from formal workshops, informal meetings with teaching mentors or experienced teachers gives valuable insight into the kinds of things to expect, things to avoid, suggestions and tips, teaching experiences, and inspirational words of wisdom. Use your network of mentors! Overall, inward reflection, formal workshops, and informal conversations with experienced mentors are ways that have helped me formulate the teaching practices that I will use for the course.

Step 2: Book and technology selection for the course

This sounds like an easy task, however, it can be a challenge if it is the first time you learn how to deal with choosing a book and the technology for your course. Luckily, one of my teaching mentors introduced me to the publisher’s local representative who met with me for several hours to discuss various book options and the technological tools that could be combined with my order. The rep helped me register my course in their online tool (Mastering A&P) and trained me to use this technology for creating homework, quizzes, interactive activities, rosters and grading. Thus far, I’ve spent countless hours exploring and learning how to use this technology before class starts. After all, I can’t expect my students to maneuver it if I can’t do it myself!

Step 3: Creating a syllabus, alignment table, and rubrics

The most important, hence time-consuming, task thus far is selecting the major topics and level of depth for the course while deciding the most important concepts, ideas, and skills for students to take away from the course. In order for students to meet expectations and become successful learners in the course, both the instructor and students should have this information clearly written out and understood at the very start of the course. The course syllabus is the first place where overall learning goals, outcomes, and expectations for the students for this course is presented. Furthermore, the syllabus should include information about grading, and any institutional policies on attendance, add/drop deadlines, and disability services.

Fortunately, the course that I am preparing has been offered multiple times previously, and thus I do not need to completely design a new course from scratch. However, I am re-designing and modifying sections of the course to include active and interactive teaching techniques. To guide this process during the semester, creating an alignment table for the course is beneficial to effectively execute learning activities and teach key concepts, ideas and skills. The components included in this table are: course learning goals, daily learning objectives, assignments, summary of activities, and assessments for each class period.

Take note that assessments should be determined first in order to prepare the content and activities for the class period accordingly (backwards design). Assessments could include an in-class activity, post-class assignments, exam and quiz questions. Rubrics of assessments should be made without ambiguity to formally assess students and to make sure the class period addresses the major points that students will be expected to learn. Preparing each class period, with flexibility for modifications based on gauging student grasp of the material, will help the semester run more smoothly and with less difficulties.

Step 4: Preparing content presentation and materials for activities

The last step I will take for course preparation is making and uploading any PowerPoint slides, handout materials, assignments, quizzes and exams, and any other material required for activities. With an alignment table already made, this portion of preparation should be relatively easy, but it will still take a significant amount of time.

Final Tips

Overall advice, plan ahead!! At minimum, it should take an entire summer to successfully prepare for a new course. With a well-planned course ahead of time, the hope is to be able to spend more energy throughout the semester to transfer and translate faculty enthusiasm for teaching into student enthusiasm for learning physiology!

Additional resource: Course Preparation Handbook by Stanford Teaching Commons

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Angelina Hernández-Carretero is an IRACDA Postdoctoral Fellow at UC San Diego and is an adjunct faculty member at San Diego City College. She earned her Ph.D. in Cellular & Integrative Physiology from Indiana University School of Medicine. Her research interests involve diabetes, obesity, and metabolism. Angelina has a passion for mentoring, increasing diversity in STEM education and workforce, and inspiring the next generation through outreach.