Tag Archives: science

The Teaching of Basic Science as a Necessity in the Doctor in Physical Therapy Clinical Curriculum

There is an ever increasing need to train evidenced-based clinicians among all the health disciplines. This is particularly true in the relatively young profession of physical therapy, where the educational standards have shifted from entry level bachelor’s degree requirements to clinical doctorate training. The increase in educational standards reflect the growth of the discipline, with an effort to increase the depth of knowledge and level of skill required to be a physical therapist while moving from technician to an independent direct access practitioner. This evolution also marks a shift in standards of evidenced-based practice from clinical observation to an ability to provide mechanistic understanding which includes fundamental scientific insights and transforms clinical practice. The profession also recognizes the need to advance the profession through research that provides a scientific basis validating physical therapy treatment approaches. As a result, there is an expanding, yet underappreciated role, for the basic science researcher / educator in Doctor of Physical Therapy (DPT) programs.

Strategies to integrate and infuse the basic science into practice:

1. Faculty training:

Big Four Bridge in Louisville, KY

How to bridge the gap between basic science and clinical education?  As dual credentialed physical therapist and basic scientist these influence Sonja’s teaching approach, to serve as a “bridge” between foundational science content and clinical application.  Teaching across broad content areas in a DPT curriculum provides opportunities to “make the connection” from what students learn in the sciences, clinical courses, and relate these to patient diagnosis and therapeutic approaches.

While dual training is one approach, these credentials combined with years of ongoing contemporary clinical practice, are rare and impractical to implement in an academic setting. Most often DPT programs rely on PhD trained anatomists, neuroanatomists, and physiologists to teach foundational courses, often borrowed from other departments to fulfill these foundational teaching needs. Thus, Chris’s approach is through crosstalk between scientist/physiologist and clinician to serve as a role model and teach the application of discoveries for identifying best evidence in clinical decision making. By either approach, we have become that key bridge teaching and demonstrating how foundational science, both basic and applied impact clinical decision making.

2. Placement of foundational science courses (physiology, neuroscience, anatomy):

Traditional curricular approaches introduce foundational sciences in anatomy, neuroscience, and physiology in the first year of the DPT curriculum, followed by clinical content with either integrated or end loaded clinical experiences over the course of remaining 2.5-3 years. Our current program established an alternative approach of introducing foundational sciences after the introduction of clinical content and subsequently followed by a full time clinical clerkship/ education. Having taught in both models, early or late introduction of foundational sciences, we recognized either partitioned approaches lead to educational gaps and makes bridging the knowledge to application gap challenging for students.

Regardless, the overall message is clear and suggestive of the need for better integration of foundational/scientific content throughout the curriculum. These challenges are not unique to physical therapy, as this knowledge to clinical translation gap is well documented in medicine and nursing and has been the impetus for ongoing curriculum transformations in these programs. These professions are exploring a variety of approaches on how to best deliver /package courses / and curriculum that foster rapid translation into clinical practice. Arena, R., et al., 2017; Fall, L.H. 2015; Newhouse, R.P. and Spring, B., 2010; Fincher et al., 2009.

Recently, new curricular models have emerged within the doctoral of physical therapy curriculum that complement the academic mission to train competent evidenced based clinicians Bliss et al., 2018, Arena R. et al. 2017. These models leverage the faculty expertise of physiologist/scientist, research, and clinical faculty to create integrative learning experiences for students. These models include integrated models of clinical laboratory learning and/ or classroom-based discussion of case scenarios, that pair the basic scientist and the clinical expert. It is our belief, that teaching our clinical students through these models will lead to enhanced educational experience, application of didactic course work, and the appreciation for high quality research both basic and applied.

3. Appreciation and value of foundational sciences through participation in faculty led research:

Capstone experiences are common curricular elements for the physical therapy profession. This model is believed to 1) prepare future physical therapy generations to provide high-quality clinical care and, 2) provide research needed to guide evidence-based care, and 3) foster the appreciation for evidence and advances in the field. We believe these pipeline experiences could allow for advanced training incorporating strong foundational (science) knowledge that is relevant to the field, which can be applied broadly and adapted to integrate the rapidly growing knowledge base. Such models may assist in integrating the importance of scientific findings (basic and applied) while facilitating the breakdown of barriers (perceived and real) that silo clinical and foundational content (Haramati, A., 2011).

Contributing to the barriers are that relatively few of the basic sciences and translational studies are being conducted by rehabilitation experts. Furthermore, like medicine disciplines, it is unlikely that DPT faculty will be experts as both a clinician and scientist. Rather these emerging models promote teams of scientists and clinical faculty who work together to promote scientific, evidence-based education (Polancich S. et al., 2018; Read and Ward 2017; Fincher et al., 2009). Implementation of these education models requires “buy in” from administration and faculty who must recognize and value a core of outstanding clinician-educators, clinician-scientists, and basic scientists, and reward effective collaboration in education (Fincher 2009).

Although these models are flowering in research intensive universities, the challenges of integrating the basic sciences are greater in programs embedded within smaller liberal arts institutions that lack the infrastructure and administrative support for creating teaching-science-clinical synergies. Often these programs are heavily weighted towards clinical education faculty who emphasize clinical teaching and development of clinical skills, with a less integrated emphasis on the fundamental science in clinical decision making. Our own experience, having taught foundational (physiology and neuroscience) sciences, are that faculty in these programs are more reluctant to embrace and value foundational sciences. A possible explanation may be the limited exposure to and unrecognized value of contributions to the field from such basic and translational approaches. It is frequently implied if it works, it may not be necessary to understand mechanistically how it works. While this might suffice for today’s practice approach, this will not be enough for future clinicians in a rapidly evolving clinical environment. Programs that may not foster scientific curiosity, may be missing the opportunity to instill lifelong learning. We agree with other educators that the integration of basic science is critical for the student progress toward independence and essential competence, and that health science educators should support the teaching of basic science as it aids in the teaching of how to solve complex clinical scenarios even if clinicians may not emphasize the basic science that underlies their reasoning (Pangaro, 2011).

Concluding Thoughts:

Physical therapy departments particularly those within major academic centers housing a mix of research, education, and clinically focused faculty can successfully operate a curriculum able to synergize education, research, and clinical initiatives. Creating synergies early in a curriculum by pairing clinical specialists with science trained faculty will facilitate connections between clinical practice and science (Bliss, et al., 2018). While curricular change can be challenging, programs that implement a collaborative model where faculty with a shared area of expertise (e.g., orthopedics, neurology, cardiopulmonary, pediatrics and geriatrics) and unique complementary skill sets (i.e., research, education, and clinical practice) come together to transform student educational experiences – completing that bridge between basic science and clinical practice.

Stacked Stone Arch

 

References:

Arena, R., Girolami, G., Aruin, A., Keil, A., Sainsbury, J. and Phillips, S.A.,

Integrated approaches to physical Therapy education: a new comprehensive model from the University of Illinois Chicago, Physiotherapy Theory and Practice, 2017, 33:5, 353-360, doi: 10.1080/09593985.2017.1305471.

Bliss, R., Brueilly, K. E., Swiggum, M. S., Morris, G. S., Williamson, E.M., Importance of Terminal Academic Degreed Core Faculty in Physical Therapist Education, Journal of Physical Therapy Education. 2018, 32(2):123-127, doi: 10.1097/JTE.0000000000000054.

Fall, L.H., The Collaborative Construction of the Clinical Mind: Excellence in Patient Care through Cognitive Integration of Basic Sciences Concepts into Routine Clinical Practice, Med.Sci.Educ. 2015, 25(Suppl 1): 5, doi: 10.1007/s40670-015-0192-9.

Fincher, M., Wallach P., and Richardson, W.S.,  Basic Science Right, Not Basic Science Lite: Medical Education at a Crossroad, J Gen Intern Med. 2009, Nov; 24(11): 1255–1258, doi: 10.1007/s11606-009-1109-3

Haramati, A., Fostering Scientific Curiosity and Professional Behaviors in a Basic Science Curriculum, Med.Sci.Educ. 2011, 21(Suppl 3): 254, doi: 10.1007/BF03341720.

Newhouse, R.P. and Spring, B., Interdisciplinary Evidence-based Practice: Moving from Silos to Synergy, Nurs Outlook. 2010, Nov–Dec; 58(6): 309–317, doi: 10.1016/j.outlook.2010.09.001.

Pangaro, L., The Role and Value of the Basic Sciences in Medical Education: The Perspective of Clinical Education -Students’ Progress from Understanding to Action. Medical Science Educator. 2010, Volume 20: No. 3. 307-313.

Polancich, S., Roussel, L., Graves, B.A., O’Neal, P.V., A regional consortium for doctor of nursing practice education: Integrating improvement science into the curriculum. J Prof Nurs. 2017, Nov – Dec;33(6):417-421, doi: 10.1016/j.profnurs.2017.07.013.

Read C.Y., Ward L.D., Misconceptions About Genomics Among Nursing Faculty and Students. Nurse Educ. 2018, Jul/Aug;43(4):196-200, doi: 10.1097/NNE.0000000000000444.

 

 

Chris Wingard completed his BA in Biology form Hiram College a MS from University of Akron and PhD from Wayne State University. He has served in physiology departments at University of Virginia, Medical College of Georgia and East Carolina University during his career and has most recently joined the Bellarmine University College of Health Professions as Professor teaching in the Physical Therapy, Accelerated Nursing and Biology Programs.  His interests are in the impacts of environmental exposures on the function of the cardiovascular pulmonary systems.
Sonja Bareiss received a BS in Biology and Master’s in Physical Therapy from Rockhurst University. She completed her PhD in Anatomy and Cell Biology at East Carolina University. Dr. Bareiss was a faculty member at East Carolina University Department of Physical Therapy and Department of Anatomy and Cell Biology before joining the DPT program at Bellarmine University. Her areas of teaching span foundational sciences (neuroscience and anatomy) to clinical content (electrical modalities). Her most recent efforts have been to develop and implement a pain mechanisms and management course into physical therapy curriculum with emphasis on interdisciplinary learning. In addition to her academic experience, Dr. Bareiss has over 8 years of full-time clinical experience where she specialized in treating patients with chronic pain syndromes. Her research and clinical interests have been dedicated to understanding mechanisms of neural plasticity related to the development and treatment of pain and neurodegenerative disease and injury and integrating undergraduate Biology Honors and DPT students into the work.
Teaching High Level Learning Goals in Science Classes: A Lesson from Librarians

Bloom’s Taxonomy provides a way to classify learning outcomes into lower order and higher order goals. On the lower end of the spectrum we ask students to remember, understand, and apply by doing tasks such as define, list, explain, and interpret. On the higher end of the spectrum, we want students to analyze, evaluate, and ultimately create by doing tasks such as organize, compare, critique, and design (1). As educators, we all want to push our students toward the highest levels of Bloom’s Taxonomy, but how do you teach someone to create? It feels like a daunting task. I don’t think anyone ever attempted to directly teach me these higher-level skills, but instead I somehow learned them in graduate school by trial and error (in the form of a lot of red writing on drafts that I submitted to my thesis advisor). This is why I was so excited to discover the synthesis matrix. A synthesis matrix is a table that is set up to extract relevant information from sources, which can include non-scholarly, scholarly, and even student generated data. It provides a way to organize research that allows for easy comparison of the key information from many sources (3, 4, 5). I first learned about the synthesis matrix when I was teaching First Year Seminar (FYS) at Dickinson College. Learning outcomes for FYS include the ability to critically analyze information from multiple perspectives and use that information to create clear academic writing (2). Using class time to teach these skills was very different from what I typically do in my biology classes where it is a struggle just to keep up with the vast amount of content. Therefore, it is an understatement to say that I was out of my element teaching FYS. Fortunately, each FYS class at Dickinson is assigned to librarians. I was fortunate to have Dickinson librarians Nick Lonergan and Jessica Howard help design assignments and teach methods that help students achieve the FYS learning goals. Nick and Jessica designed a synthesis matrix assignment to help students find relevant non-scholarly and scholarly sources and extract information from the sources to help them compare viewpoints on different concepts found in each reference. In this case, the synthesis matrix was used as a homework assignment to prepare students to organize and synthesize information from multiple references in future writing assignments. The power of the synthesis matrix immediately hit me as I realized that this is what experts do in their heads. Many years of reading and analyzing both the work of others and our own research leads to the formation of a mental synthesis matrix that we can pull from as needed in our respective fields. I think my life would have been a lot easier if I knew about the concept of a paper synthesis matrix in graduate school. Since my discovery of the synthesis matrix in FYS, I have used it in different ways in all of the biology classes I teach at Dickinson College including Introductory Biology (Biology 132), Physiology (Biology 333), and Molecular Pathophysiology, which is a research and writing intensive class (Biology 433). Some ways I have used it include:

 

  • Homework assignment: On the simplest level, the synthesis matrix can be used to assess student ability to find appropriate references and extract relevant information from those references. An example of this is described above for FYS and I can easily see this working well in Introductory Biology classes. I have also done this in Molecular Pathophysiology (Biology 433) as a homework assignment prior to assigning a literature review writing assignment.

 

  • Classroom Activity: In Physiology (Biology 333), I have lab groups (6 groups of 4 students each) find a primary publication on a topic related to an upcoming lab project and analyze it for specific information related to research methods and results. In order to avoid overlap and make sure they found the right type of paper, I have the students email the paper they found for approval. If two groups found the same paper or if it is not the right type of source (for example, some students will try to use a review), I will ask them to find another paper. In lab I draw a synthesis matrix on the board and distribute blank handouts of the same synthesis matrix. We then go around the room and as students report their findings, I fill in the synthesis matrix. When it is done, I demonstrate how to use the matrix to synthesize the results of multiple references to come to overarching conclusions and design new experiments. We use this to guide the design of a class research project and in future writing assignments.

 

  • Model Creation: The most complex way I have used the synthesis matrix is in Molecular Pathophysiology (Biology 433). As a research based Writing in the Discipline (WID) class, we focus all of our attention on analyzing primary literature and doing novel experiments in lab. Throughout the semester, I encourage students to draw their own textbook style models of what data show. This can be done by synthesizing results from a single primary publication (if the authors did not already generate a model), multiple primary publications (as seen in review articles), and even by incorporating student lab results with published results. The synthesis matrix can be set up to accommodate all of these approaches. For example, instead of labeling columns by reference #, columns can be labeled by figure # for a single primary publication. Similarly, a column for class lab results can be added to incorporate class results (Figure 1). This is my favorite way of using the matrix. It is so powerful for students to see how one small experiment they did fits in with the big picture of what others have published.

Of all the teaching methods I have tried over the years, the synthesis matrix is the closest I have come to teaching students how to think like an expert. It has also allowed me to do a better job of breaking the research and writing process down into component parts. If you tell a college senior to write a one page introduction section of a scientific paper with 5 references, many of them think they can produce one page of writing in a couple of hours (I know I thought that as a senior in college!). However, if you force them to do a synthesis matrix that includes analysis of the relevant information in 5 primary papers prior to writing about them, they quickly realize how much work is involved.

 

Ultimately, the most important lesson I learned though all of this is that teaching in science classes can benefit greatly from methods used in classes outside of our discipline. If you Google “synthesis matrix”, it is a commonly used method promoted on Library, Academic Coaching, and Writing Center websites at many colleges and universities (3, 4, 5). However, I never heard of it until librarians introduced me to it while teaching FYS. Interacting with scholars outside of my discipline has helped me to integrate the teaching of higher level learning goals alongside lower level learning goals related to content in my classes.

 

References

  1. Vanderbilt University, Center for Teaching, Bloom’s Taxonomy. https://cft.vanderbilt.edu/guides-sub-pages/blooms-taxonomy/. 2018 Vanderbilt University, Accessed December 28, 2018.
  2. Dickinson, First-Year Seminar. https://www.dickinson.edu/homepage/99/first_year_seminars . Accessed December 28, 2018.
  3. Ashford University, Synthesis Matrix. https://writingcenter.ashford.edu/synthesis-matrix . 2017 Bridgepoint Education. Accessed December 28, 2018.
  4. Johns Hopkins Sheridan Libraries, Write a Literature Review. http://guides.library.jhu.edu/lit-review/synthesize . 2017 Johns Hopkins Sheridan Libraries. Accessed December 28, 2018.
  5. Academic Coaching and Writing, A Synthesis Matrix as a Tool for Analyzing and Synthesizing Prior Research. https://academiccoachingandwriting.org/dissertation-doctor/dissertation-doctor-blog/iii-a-synthesis-matrix-as-a-tool-for-analyzing-and-synthesizing-prior-resea . 2018 Academic Coaching and Writing LLC. Accessed December 28, 2018.

 

Tiffany Frey is an Assistant Professor of Biology at Dickinson College in Carlisle, PA. She received her Ph.D. in Molecular Medicine from Johns Hopkins University School of Medicine and also has a certificate in Adult Learning from Johns Hopkins University School of Education. She teaches Introductory Biology, Physiology, and Molecular Pathophysiology at Dickinson College. Her research interests are focused on understanding the cellular and molecular basis of autoinflammatory disease and incorporating and assessing the effects of scholarly teaching methods in her courses. Outside of work, she enjoys spending time with her family (husband, 2 children, and dog Charlie), reading, participating in exercise classes, and running in local races.
Scientific Literacy: A Challenge, a Task, a Poem

Scientific literacy allows citizens to get involved in issues and ideas related to science as a reflective citizen[1]. A scientifically literate person can:

  1. Recognize, offer and evaluate explanations for a variety of scientific and technological phenomena
  2. Describe and evaluate scientific research and propose ways to answer questions and solve problems following the scientific method
  3. Analyze and evaluate data, concepts and arguments in a variety of contexts, reaching appropriate conclusions for the data received[1]

 

The challenge

Quality education is the key to achieving literate societies. Unfortunately, scientific literacy is generally very low in most developing countries. Results of the PISA tests, for example, reveal that competencies in mathematics and sciences in developing countries are below the average of the countries evaluated[2]. This has enormous consequences for the communities by negatively impacting their political, economic and social decision-making.

 

Figure 1. Performance in mathematics and science of different countries in the 2015 Pisa tests. Images Taken from http://www.oecd.org/pisa/.[2]

The task

It is very important to open spaces for the general community in developing countries to learn about the practice of science. Many scientific organizations develop training activities that are usually directed at specialized audiences. For this reason, it is important to highlight the task of scientific associations that are concerned with bringing science to the general community such as the American Physiological Society through events such as PhUn week. In the particular case of Colombia, the Colombian Association for the Advancement of Science (ACAC) organizes every two years a very large science fair “Expociencia” that is visited by more than 40,000 elementary, middle and high school students.

 

These science fairs have several objectives:

  1. Allow students to present the results of scientific projects. Students are exposed to an essential component of science, sharing and communicating research. In addition, they have the opportunity to learn from their peers and receive feedback from more experienced researchers.
  2. Open the doors of academic, governmental or industry laboratories to the community. Visitors have the opportunity to know what scientists do, interact with them, expose their visions about science. In addition, visitors can express doubts they have about different concepts, and sometimes they can find answers to their questions.
  3. Generate academic spaces so that researchers can discuss how to work with the community, address their most pressing needs and communicate their results to the public.

Figure 2. Participation of students in academic activities at Expociencia 2018. Images courtesy of Deiryn Reyes, ACAC.

Recently with the support of the Faculty of Medicine of the Universidad de los Andes, I had the opportunity to participate in Expociencia[3]. It was gratifying to see how the children ran from one side to the other having the opportunity to learn about electronics, physics, programming, biology, medicine and anthropology. These children are like sponges that quickly absorb the information they receive and are willing to ask questions without filtering them through mechanisms that adults have learned. In addition, Expociencia promotes spaces for university students to share their experiences and for a moment to be role models for school students. I believe that many lives are changed thanks to the experience of living science.

 

The poem

In the nineteenth century lived a poet who wrote and translated from other languages several of the best-known stories that are known by children and adults in Colombia. His influence on Colombian literature is similar to that of the Grimm brothers in Europe. The name of this writer was Rafael Pombo. A few weeks ago, thanks to my son, I had the opportunity to learn that he also wrote about the importance of knowledge and science. On this occasion I want to share a personal translation of one of Rafael Pombo´s poems, that can be used to discuss with small children and adults the importance of science in our lives.

 

THE CHILD AND THE OX

Rafael Pombo (1833-1912)

The boy

 

-What do you think about all day

Lying on the grass?

You seem to me a great doctor

Enraptured in his science.

 

The ox

-The science, dear child

It is not what feeds me;

That is the fruit of study,

With what God gives humans.

 

Out thinking for me,

Poor animal, hard enterprise;

I prefer to make thirty furrows

Before learning two letters.

 

Chewing well, I care more

that a lesson at school.

With the teeth, I chew,

You, child, with your head.

 

But if you want to be wise

Hopefully seeing me you´ll learn

To ruminate, and ruminate a lot,

Every bit of science.

 

Digesting, not eating,

It is what the body takes advantage of,

And the soul, invisible body,

has to follow such a rule.

 

Without ruminating it well, do not swallow

Not a line, not a letter;

The one who learns like a parrot,

Ignorant parrot stays.

 

References

  1. National Academies of Sciences, E., and Medicine., Science Literacy: Concepts, Contexts, and Consequence. 2016.
  2. OECD. Results by Country. [cited 2018 November 4th]; Available from: http://www.oecd.org/pisa/.
  3. Ciencia, A.C.p.e.A.d.l. Expociencia 2018. 2018 [cited 2018 October 31st]; Available from: https://expociencia.co/home/.
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.

 

 

 

The Real World – A Philosophical Analysis?

Silhouette of coming businessman in doorway with shadow

“The world is too much with us; late and soon,

Getting and spending, we lay waste our powers”—thus, Wordsworth over two centuries ago, bemoaned man’s disconnect from the natural world and meaningful lives. Universities these days are exhorted to prepare students for the “real world”. But what that “reality” is, puzzles me.

 

In one sense, there is a depressing soul-numbing banality to our daily lives. As the Fool told Jacques, “From hour to hour, we ripe and ripe/And then, from hour to hour, we rot and rot;/And thereby hangs a tale.” Surely we do not need Universities to teach students to cope with that tedium—picking out the best buys from a selection of toilet paper or tooth pastes, parking cars, changing diapers, filing tax forms and other drearies (to coin a word). The ‘real world” is one where many trudge through their working days longing for the weekends when they can begin to live. We always ask people how their weekends went, not their week. Do we need courses in coping with tedium or preparing for the weekend?

 

We could of course, prepare them for other realities. Beyond death and taxes, there are other certainties, the “resonant lies” that Auden warned us about in his Ode to Terminus. That our students will find themselves in a thicket of lies in the real world is more than certain. We can prepare them well by giving them the right tools. In the sciences, much is made of critical appraisal where students are taught to assess peer-reviewed articles and analyze publications. That is all well and good, but the more dangerous lies have rarely been subject to peer review. They lie buried elsewhere in the minutes of Committee meetings, confidential reports etc. I think it was David Halberstam in his brilliant analysis of the Kennedy administration, who noted the significance of selective “minuting” in skewing decisions. Perhaps an interdisciplinary or trans-disciplinary mandatory course in “Institutional Lying” can be very useful.

 

Philip Larkin found himself in a church where he mused on what would become of such sacred spaces, “In whose blent air all our compulsions meet/ Are recognized, and robed as destinies.”  To me, the University much like a church, is a sacred space, where one melds the richness of the past with the exuberance of the future. It is that richness of the real world that we can pass on to our students, not just its banalities.

 

I am a basic biologist and most, though not all, of my courses deal with biological mechanisms that underly the very marrow of our existence, the stuff we are made of, so to speak. The words and concepts, I use, (receptors, inverse agonists, G-proteins, allosteric modulators, constitutive activities etc.), may seem a trifle arch but these can, and have, made their way from bench to boardroom and beyond. In addition, our daily lives, loves, behaviors, misbehaviors stem from responses to such molecules.

 

None of what I teach may help my students deal directly with their quotidian vicissitudes; in a deeper sense though, they may realize that underlying all their actions, their fears, hopes, loves and despairs are molecular interactions whose mysteries have been probed and defined by their own species adding to the rich tapestry of human expression and creativity. We are, ourselves, part of that wonderful world that Wordsworth wanted us to be in touch with.  Truly the unknown psalmist got it right when he said “Oh Lord, How manifold are Thy works! In Wisdom has thou made them all: the earth is full of thy riches”

What better way for a university to fulfill its role than opening the windows to their students to that wonderful world, the REAL one?

 

pkr

 

 

P.K. Rangachari is currently Professor (Emeritus) of Medicine at McMaster University. Depending on the emphasis placed, that word emeritus could imply he has much merit, none whatsoever or only in cyberspace. He has a medical degree (M.B.B.S. 1966) from the All-India Institute of Medical Sciences, New Delhi, India and a Ph.D. (Pharmacology) from the U. of Alberta (1972). He drifted into medical school due to a bureaucratic blunder that derailed his efforts to become an organic chemist. However he was lucky. He had great teachers in the basic sciences and so after graduation, he left his stethoscope behind and began a peripatetic existence moving from lab to lab in several continents, finally landing up at McMaster University in Canada, some thirty plus years ago.
P.K. Rangachari’s experimental research focused on the effects of inflammatory mediators on ion transport in smooth muscles and epithelia. He has taught students in undergraduate science, liberal arts, nursing, medicine, physiotherapy and pharmacy. He has sought to bridge the two cultures (the sciences and the humanities) by designing interdisciplinary courses or encouraging students to express their learning through more creative outlets such as framing conversations, writing reviews and plays. He is blessed that he is blissfully ignorant so he can wake up each day convinced that there is so much more to learn. His students fortunately help him in that regard.

 

 

Acknowledging race in the science classroom

thinking“I don’t teach about race. Leave it to the social scientists. They are trained to talk and teach about this stuff. I wouldn’t even know where to start.” I am embarrassed to admit it, but there were times in my life I thought this, and I know I am not alone.

As a science educator, it is easy to stick close to our training as scientists. Scientists teaching science is normalized, largely unquestioned, and safe. Early in my career as an educator, with every institutional equity initiative announcement, I easily convinced myself that I supported my students in other ways. “Leave diversity to the experts.”

What about my expertise? Diabetes is a topic I know well after more than 15 years of training, research, and teaching. It was easy to incorporate this topic into all of my courses. In fact, I teach my entire introductory biology course using humans as a model and diabetes as a way to connect many of the systems. Most students know someone with diabetes. Their personal experience with the disease, complemented by a continuous barrage of hands-on, inquiry-based laboratory activities in this intro course, completely hooks the students! They succeed, with very low drop or fail rates (<5%). At the conclusion of the course, students are enthusiastic about taking more biology courses (Johnson & Lownik, 2013). Things seem to be going well. Why worry?

During the introductory biology course, we spend days going over CDC data about the trends and risk factors for diabetes (CDC, 2015). Are the relationships correlations or causations? How can we use population data to think about the biological mechanism of diabetes? These are great questions for introductory students, and they totally buy in.

However, something funny happens when we start looking at these data. Diabetes is a disease that affects black and Latinx populations at a vastly higher rate than white populations (CDC, 2015). Why would I talk about that? Let’s talk about the science. I know the science. I have spent years studying how hormones regulate glucose (i.e. “the science”).

Frankly, I was scared to stray from my training. The students of color really engage the topic of diabetes, intrigued by the data indicating racial differences.  Many students of color speak of their beloved grandparents’ struggle with diabetes. What if students started asking me questions about race? As a white professor, how could I answer their questions? I know how hormones act to change glucose levels; I don’t know why certain racial and ethnic groups are more susceptible to diabetes. Students want answers about their own risk, and I didn’t know how to help them.

Looking back now, in response to my fear, I deliberately avoided discussions of race disparities. During the introductory biology course, we talked about socioeconomic factors, cultural factors, obesity, and food availability, but in vague and general terms. I might put up a graph to demonstrate disparities, but we never “had time” to engage the topic. We never really talked about why these disparities exist.

As a researcher, I would never intentionally ignore a major contributing factor to a disease. Would we ever ignore smoking as a risk factor for lung cancer? Why completely avoid race as a risk factor for diabetes, even though some individuals are almost twice as likely to develop the disease (CDC, 2015)?

 

By ignoring race and ethnicity as risk factors for diabetes in my course, I taught my students:

  1. Only traditional aspects of disease are worthy of investigation and emerging or relatively newly identified risk factors do not deserve attention.

Potential long-term impact: Reinforcing old practices comes at the expense of new findings and approaches. Focusing exclusively on the role of hormones in diabetes ignores other potential mechanisms, specifically those related to race, limiting the scope and creativity of questions investigated in my classroom and the scientific community.

  1. Scientists don’t “do” diversity.

Potential long-term impact: While national science education initiatives have a strong emphasis on encouraging diversity and equity, these movements have struggled to develop at the grassroots level. In my experience, most white science undergraduate students cannot articulate the importance of diversity of thought and experience in science. Students typically miss the mark when they emphasize that science is “objective,” and therefore, unbiased.  In fact, every scientist has different experiences, training, and assumptions, resulting in different approaches to asking questions and drawing conclusions. Diversifying these approaches is essential for innovation. If the importance of diversity in science continues to be misunderstood, current and future scientists will surround themselves with individuals that think and act like them, limiting new ideas, interpretations, and innovations.

  1. To ignore the concerns and questions of students of color.

Potential long-term impact: By glossing over the details of racial health disparities and not taking the time to understand them myself, I silenced the legitimate health concerns of my students of color. It should not be a surprise that many of my black and Latinx students switched their majors to public health and sociology. I was ignoring their queries and interests. They went to disciplines that addressed their questions. Mass exodus of individuals of color represents a deletion of perspectives from the scientific community. The result is a limited set of experiences that determine the scope of future research agendas; therefore, severely limiting the ability to solve large and complex scientific problems (Page, 2007).

To address these problematic gaps in my pedagogy, I continually challenge the way I think about diversity and equity in my classroom and make impactful changes. Avoiding potential harm to my students was a factor in making these changes; however, my greatest influence was students of color at my institution stating that they did not feel safe or welcome in the sciences (Johnson & Mantina, 2016).

Here are a few first steps I have taken to change the atmosphere in my classroom:

  1. We now talk about racial health disparities and investigate mechanisms related to these disparities in my courses, using CDC data or peer-reviewed scientific articles (ex. Herman, et al., 2016).
  2. I continue to educate myself about the interdisciplinary research investigating these disparities.
  3. I acknowledge publicly to students that when we discuss race and diversity, I might not get it right, might not have all the facts, and might have different personal experiences than theirs.
  4. Prior to larger class conversations about race, I collect input from students of color about how they might approach these conversations.
  5. I never ask a student to speak on behalf of their race or identity, only to speak to their own experiences. I never force a student to speak on the topic of race, period. However, reflective writing or small group discussions are helpful to bring ideas to the forefront.
  6. I avoid telling students that their experiences with racism are wrong or overblown.
  7. I use an assets-based approach to teaching science. Students develop strategies to become successful by identifying the skills and information they bring to the classroom based on their unique experiences and background.
  8. I challenge myself to continue to evolve my approaches to active learning and engaging students. For example, in my early years of teaching, to establish an interactive environment on the first day of class, students introduced themselves and talked about a summer experience to a small group. However, students that worked as day labors found this exercise intimidating when sharing with students that went on wonderful European vacations. I now prefer to ask students to describe their favorite food or dessert.

I acknowledge that issues of race, equity, and diversity are multi-faceted and nuanced, and purposefully, this description is a broad overview of the topic. I still have a lot to learn and do, but I am now a scientist that “does” diversity.

References

CDC (2015). Diabetes Public Health Resource. Available at: http://www.cdc.gov/diabetes/statistics/incidence/fig6.htm, accessed August 2, 2016.

Herman, et al. (2007). Differences in A1c by race and ethnicity among patients with impaired glucose tolerance in the diabetes prevention program. Diabetes Care, 30 (10): pp. 2453-7.

Johnson, K.M.S. and Lownik, J.C. (2013). Workshop Format Increases Scientific Knowledge, Skills, and Interest when Implemented in an Introductory Biology Course that Attracts and Retains Underrepresented Minorities.  Poster.  Experimental Biology, Boston, MA, April 20-24, 2013.  Published Abstract: FASEB J. 27:739.7

Page, S.E. (2007). The difference: how the power of diversity creates better groups, firms, schools, and societies. Princeton University Press (Princeton, New Jersey).

 

KatieJohnson

 

 

 

 

 

 

 

Katie Johnson, Associate Professor of Biology at Beloit College, evaluates the effects of active teaching practices on learning attitudes and outcomes in different student populations. She has been recognized by the American Physiological Society for her work. Her laboratory research assesses the connection between obesity and hormones that regulate glucose levels in animals. She mentors a diverse group of trainees and has numerous physiology and pedagogy publications and presentations co-authored by undergraduate researchers.