Tag Archives: student preparation

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.
Mentoring Mindsets and Student Success

There are numerous studies showing that STEM persistence rates are poor (especially amongst under-represented minority, first-generation, and female students) (1-2). It is also fairly broadly accepted that introductory science and math courses act as a primary barrier to this persistence, with their large class size. There is extensive evidence that first-year seminar courses help improve student outcomes and success, and many of our institutions offer those kinds of opportunities for students (3). Part of the purpose of these courses is to help students develop the skills that they need to succeed in college while also cultivating their sense of community at the university.  In my teaching career, I have primarily been involved in courses taken by first-year college students, including mentoring others while they teach first-year courses (4). To help starting to build that sense of community and express the importance of building those college success skills, I like to tell them about how I ended up standing in front of them as Dr. Trimby.

I wasn’t interested in Biology as a field when I started college. I was going to be an Aerospace Engineer and design spaceships or jets, and I went to a very good school with a very good program for doing exactly this. But, college didn’t get off to the best start for me, I wasn’t motivated and didn’t know how to be a successful college student, so my second year of college found me now at my local community college (Joliet Junior College) taking some gen ed courses and trying to figure out what next. I happened to take a Human Genetics course taught by Dr. Polly Lavery. At the time, I didn’t know anything about Genetics or have a particular interest, I just needed the Natural Science credit. Dr. Lavery’s course was active and engaged, and even though it didn’t have a lab associated with it we transformed some E. coli with a plasmid containing GFP and got to see it glow in the dark (which, when it happened almost 20 years ago was pretty freaking cool!). This was done in conjunction with our discussions of Alba the glow-in-the-dark rabbit (5). The course hooked me! I was going to study gene therapy and cure cancer! After that semester, I transferred to Northern Illinois University and changed my major to Biology.

So, why do I bring this up here? When I have this conversation with my undergraduate students, my goal is to remind them that there will be bumps in the road. When we mentor our students, whether it be advisees or students in our classes, it is important to remind them that failure happens. What matters is what you do when things do go sideways. That is really scary for students. Many of our science majors have been extremely successful in the lead up to college, and may have never really failed or even been challenged. What can we do to help our students with this?

First of all, we can build a framework into our courses that supports and encourages students to still strive to improve even if they don’t do well on the first exam. This can include things like having exam wrappers (6)  and/or reflective writing assignments that can help students assess their learning process and make plans for future assessments. Helping students develop self-regulated learning strategies will have impacts that semester (7) and likely beyond. In order for students to persevere in the face of this adversity (exhibit grit), there has to be some sort of hope for the future – i.e. there needs to be a reasonable chance for a student to still have a positive outcome in the course. (8) This can include having a lower-stakes exam early in the semester to act as a learning opportunity, or a course grading scale that encourages and rewards improvement over the length of the semester.

Secondly, we can help them to build a growth mindset (9), where challenges are looked forward to and not knowing something or not doing well does not chip away at someone’s self-worth. Unfortunately, you cannot just tell someone that they should have a growth mindset, but there are ways of thinking that can be encouraged in students (10).

Something that is closely tied to having a growth mindset is opening yourself up to new experiences and the potential for failure. In other words being vulnerable (11). Many of us (and our students) choose courses and experiences that we know that we can succeed at, and have little chance of failure. This has the side effect of limiting our experiences. Being vulnerable, and opening up to new experiences is something important to remind students of. This leads to the next goal of reminding students that one of the purposes of college is to gain a broad set of experiences and that for many of us, that will ultimately shape what we want to do, so it is okay if the plan changes – but that requires exploration.

As an educator who was primarily trained in discipline-specific content addressing some of these changes to teaching can be daunting. Fortunately there are many resources available out there. Some of them I cited previously, but additional valuable resources that have been helpful to me include the following:

  • Teaching and Learning STEM: A Practical Guide. Felder & Brent Eds.
    • Covers a lot of material, including more information of exam wrappers and other methods for developing metacognitive and self-directed learning skills.
  • Cheating Lessons: Learning from Academic Dishonesty by Lang
    • Covers a lot relating to student motivation and approaches that can encourage students to take a more intrinsically motivated attitude about their learning.
  • Rising to the Challenge: Examining the Effects of a Growth Mindset – STIRS Student Case Study by Meyers (https://www.aacu.org/stirs/casestudies/meyers)
    • A case study on growth mindset that also asks students to analyze data and design experiments, which can allow it to address additional course goals.

 

  1. President’s Council of Advisors on Science and Technology. (2012). Engage to excel: Producing one million additional college graduates with degrees in science, technology, engineering and mathematics. Washington, DC: U.S. Government Office of Science and Technology.
  2. Shaw, E., & Barbuti, S. (2010). Patterns of persistence in intended college major with a focus on STEM majors. NACADA Journal, 30(2), 19–34.
  3. Tobolowsky, B. F., & Associates. (2008). 2006 National survey of first-year seminars: Continuing innovations in the collegiate curriculum (Monograph No. 51). Columbia: National Resource Center for the First-Year Experience and Students in Transition, University of South Carolina.
  4. Wienhold, C. J., & Branchaw, J. (2018). Exploring Biology: A Vision and Change Disciplinary First-Year Seminar Improves Academic Performance in Introductory Biology. CBE—Life Sciences Education, 17(2), ar22.
  5. Philipkoski, P. RIP: Alba, The Glowing Bunny. https://www.wired.com/2002/08/rip-alba-the-glowing-bunny/. Accessed January 23, 2019.
  6. Exam Wrappers. Carnegie Mellon – Eberly Center for Teaching Excellence. https://www.cmu.edu/teaching/designteach/teach/examwrappers/ Accessed January 23, 2019
  7. Sebesta, A. and Speth, E. (2017). How Should I Study for the Exam? Self-Regulated Learning Strategies and Achievement in Introductory Biology. CBE – Life Sciences Education. Vol. 16, No. 2.
  8. Duckworth, A. (2016). Grit: The Power of Passion and Perseverance. Scribner.
  9. Dweck, C. (2014). The Power of Believing that you can Improve. https://www.ted.com/talks/carol_dweck_the_power_of_believing_that_you_can_improve?utm_campaign=tedspread&utm_medium=referral&utm_source=tedcomshare
  10. Briggs, S. (2015). 25 Ways to Develop a Growth Mindset. https://www.opencolleges.edu.au/informed/features/develop-a-growth-mindset/. Accessed January 23, 2019.
  11. Brown, B. (2010). The Power of Vulnerability. https://www.ted.com/talks/brene_brown_on_vulnerability?language=en&utm_campaign=tedspread&utm_medium=referral&utm_source=tedcomshare
Christopher Trimby is an Assistant Professor of Biology at the University of Delaware in Newark, DE. He received his PhD in Physiology from the University of Kentucky in 2011. During graduate school he helped out with teaching an undergraduate course, and discovered teaching was the career path for him. After graduate school, Chris spent four years teaching a range of Biology courses at New Jersey Institute of Technology (NJIT), after which he moved to University of Wisconsin-Madison and the Wisconsin Institute for Science Education and Community Engagement (WISCIENCE – https://wiscience.wisc.edu/) to direct the Teaching Fellows Program. At University of Delaware, Chris primarily teaches a version of the Introductory Biology sequence that is integrated with General Chemistry and taught in the Interdisciplinary Science Learning Laboratories (ISLL – https://www.isll.udel.edu/). Despite leaving WISCIENCE, Chris continues to work on developing mentorship programs for both undergraduates interested in science and graduate students/post-docs who are interested in science education. Chris enjoys building things in his workshop and hopes to get back into hiking more so he can update his profile pic. .
Creating Unique Learning Opportunities by Integrating Adaptive Learning Courseware into Supplemental Instruction Sessions

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

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

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

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

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

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

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

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

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

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

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

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

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

Carol Britson received her B.S. from Iowa State University and her M.S. and Ph.D. from the University of Memphis. She has been in the Department of Biology at the University of Mississippi for 22 years where she teaches Vertebrate Histology, Human Anatomy, Introductory Physiology, and Human Anatomy and Physiology I and II. In 2018 she received the University of Mississippi Excellence in Teaching award from the PLATO (Personalized Learning & Adaptive Teaching Opportunities) Program supported by the Association of Public and Land-Grant Universities and the Bill and Melinda Gates Foundation.
A Fork in the Road: Time to Re-think the Future of STEM Graduate Education

“Rather than squeeze everyone into preordained roles, my goal has always been to foster an environment where the players can grow as individuals and express themselves creatively within a team structure” –Phil Jackson (1)

Recently, I was reading the PECOP blog “Paradigm Shifts in Teaching Graduate Physiology” by Dr. Andrew Roberts.  His discussion focused on how we need to change the way physiology is taught to graduate students as technology has evolved.  But, one particular line caught my eyes as I was preparing my blog:  “if it was good enough for Galileo, it is good enough for me.”   Many university faculty members believe the “If it was good enough for Galileo, it is good enough for me” approach is the major issue with the current biomedical graduate student training system, which stands at a crossroad and is threatening its own future if appropriate corrections are not made (2, 3).

The document I read for this blog, Graduate STEM Education for the 21st Century (4) is an updated version of the report published in 1995 (5).  It is rather large (174 total pages) and contains information on various topics about the current status of STEM graduate education and a call for systematic change. I will limit my discussion to the current status of the PhD training system and recommendations for changes in the programs.

Issues at the heart: Gap between the Great Expectation and Hard Reality

Both the 1995 and the current documents list several issues associated with the STEM graduate training programs in the U.S.  However, the common thread that runs through both documents is associated with the gap between how our graduate students are trained and what has been happening in the job market.  The current STEM graduate program still is designed with the general expectation that students will pursue a career in academia as a tenure-track faculty member at a research institution.  However:

  1. The majority of growth in the academic job market has come from part-time positions, adjunct appointments, and full-time non-tenure-track positions (i.e. instructors, lecturers, research associates) rather than tenure-track positions in research-intensive institutions.
  2. The employment trend for STEM PhDs is shifting away from academia to non-academic positions.

The gap in the expectation of the training programs and the reality of job market creates several problems, including:

  1. Those who wish to pursue a career in academia often require a longer time to secure permanent employment and often work in positions that under-employ them (i.e. part-time, non-tenure track) and/or under-utilize their training (i.e. positions that do not require a PhD).
  2. Graduates who pursue non-academic positions, especially in the private sector, lack adequate preparation to enter their positions and become successful.

Many non-academic employers have voiced concerns that current STEM education is no longer acceptable for the current job market, as it does not provide sufficient training to make students more attractive and versatile to be employed outside of academia, which is becoming more international and diverse.  In particular, employers are concerned that current STEM graduates lack skills in areas such as:

  1. Communication
  2. Teaching and mentoring
  3. Problem solving
  4. Technology application
  5. Interdisciplinary teamwork
  6. Business decision making
  7. Leadership
  8. The ability to work with people from diverse backgrounds in a team setting

Changes needed for the system: Let students discover their destiny

The major change needed in the current STEM education system is that we need to let students figure out which career path is for them and provide appropriate training opportunities, rather than trying to force them to fit into one mold. Phil Jackson, whom I quoted earlier, writes: “Let each player discover his own destiny. One thing I’ve learned as a coach is that you can’t force your will on people.” (1). Jackson goes on to say: “On another level, I always tried to give each player the freedom to carve out a role for himself within the team structure.  I’ve seen dozens of players flame out and disappear not because they lacked talent but because they couldn’t figure out how to fit into the cookie-cutter model of basketball that pervades the NBA.”   We need to foster a graduate training environment that encourages each student to discover their role without any pressure, stigma, or discouragement.

Dr. Keith Yamamoto from the University of California San Francisco says that graduate training needs to be student-centered so that graduates can find their roles and meet the needs of the society (3). Faculty mentors have the responsibility of training students so that students become successful in what they choose to do.  Faculty mentors, academic departments, and institutions also need to make a concerted effort to provide opportunities for students to develop additional skills necessary to become successful in what they choose to do.  This includes teaching, especially if they want to work in a teaching-intensive institution (like the one in which I work). Faculty mentors may fear that allowing students to work on skills unrelated to the research area may hinder student success.  They may also fear that students serving as graduate teaching assistants may extend the time needed to complete their degree.  However, students need opportunities to develop these other skills, along with discipline-specific skills to become competitive in the job market and competent employees.  Again, the focus needs to be on the students and what they want to pursue, as well as what is needed for them to succeed after they walk out of the laboratory.  And, we need to trust students that they will find their paths on their own.  Dr. Yamamoto concludes his seminar by saying: “Inform/empower students to make appropriate career decision…. Students will get it right.” (3)

References and additional resources:

  1. Jackson P, Delehanty H (2013). Eleven Rings: The Soul of Success (Penguin, New York).
  2. Alberts B, Kirschner MW, Tilghman S, Vermus H (2014) Rescuing US biomedical research from its systemic flaw. Proc Natl Acad Sci USA 111(16):5773-5777.
  3. Yamamoto K (2014) Time to rethink graduate and postdoc education. https://www.ibiology.org/biomedical-workforce/graduate-education/
  4. The National Academies of Science, Engineering, and Medicine (2018) Graduate STEM Education for the 21st Century (The National Academics Press, Washington DC).
  5. The National Academies of Science, Engineering, and Medicine (1995) Reshaping the Graduate Education of Scientists and Engineers (The National Academics Press, Washington DC).
Yass Kobayashi is an Associate Professor of Biological Sciences at Fort Hays State University in Hays, KS.   He teaches a human/mammalian physiology course and an upper-level cellular biology course to biology majors, along with a two-semester anatomy and physiology sequence to nursing and allied health students.   He received his BS in agriculture (animal science emphasis) with a minor in zoology from Southeast Missouri State University in 1991.  He received his MS in domestic animal reproductive physiology from Kansas State University in 1995.  After a brief stint at Oklahoma State University, he completed his Ph.D. at the University of Missouri-Columbia in domestic animal molecular endocrinology in 2000.  He was a post-doctoral research associate at the University of Arizona for 2 years and at Michigan State University for 4 years before taking an Assistant Professor of biology position at Delta State University in Cleveland, MS in 2006.  He moved to Fort Hays State in 2010 and has been with the institution ever since.
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.
BOOK REVIEW: Teach Students How to Learn: Strategies you can incorporate into any course to improve student metacognition, study skills, and motivation

I recently had a conversation with my son who teaches high school math and computer science at a Catholic college-prep girls high school in San Jose, CA about how his students did not realize that they were learning from his innovative standards-based teaching approach.  We had already discussed how mindset has a big impact on student learning at an early age; how K-12 students are not taught appropriate study skills for future educational experiences; and how students do not understand how they learn.  Thus, I went out looking for resources to help him deal with these learning issues.  By searching on Amazon, I found the book Teach Students How to Learn:  Strategies You Can Incorporate Into Any Course to Improve Student Metacognition, Study Skills, and Motivation by Saundra Yancy McGuire with Stephanie McGuire (ISBN 978-1-62036-316-4) which seemed to be just what we wanted.  Dr. McGuire taught chemistry and has worked for over 40 years in the area of support for teaching and learning.  She is an emerita professor of chemical education and director emerita of the Louisiana State University Center for Academic Success.  Her daughter Stephanie is a Ph.D. neuroscientist and performing mezzosoprano opera singer who lives in Berlin, Germany.

The book has interesting and self-explanatory chapters about Dr. Saundra McGuire’s own evolution as a teacher (and as a chemistry major I could really relate to her story), discussions about why students don’t already know how to learn when they come to college, what metacognition can do for students to help them become independent learners, how to introduce Bloom’s taxonomy and “the study cycle” to students, how to address student growth vs. fixed mindset status, and how both faculty and students can boost motivation, positive emotions, and learning.  The study cycle learning strategy proposed and used by Dr. McGuire over the years involves five steps for the students: preview before class, attend class and take meaningful notes, review after class, study by asking “why, how, and what if” questions in planned intense study sessions and weekend reviews, and assess their learning by quizzing or planning to teach it to others.  Especially helpful for teachers are the actual presentations as three online slide sets and a sample video lecture (styluspub.presswarehouse.com/Titles/TeachStudentsHowtoLearn.aspx), and a handout summarizing the entire process that Dr. McGuire uses to introduce her learning strategies to groups of students in as little as one 50-minute class period.  Throughout the book, there are summary tables, examples, activities, and success stories about students who have incorporated the learning strategies.

In Appendix D of the book (pp. 176-177), Dr. McGuire includes a handout entitled “Introducing Metacognition and Learning Strategies to Students: A Step-by-Step Guide” for the 50 minute session.

An abbreviated version of the 15 steps are repeated here:

  1. Wait until the students have gotten the scores of their first test back.
  2. Don’t tell the class in advance that there will be a presentation on learning strategies.
  3. Evaluate student career goals by clickers or show of hands at beginning of session.
  4. Show before and after results from other students.
  5. Define metacognition.
  6. Use exercise to show the power of various learning strategies.
  7. Ask reflection questions, like “What is the difference between studying and learning?
  8. Introduce Bloom’s taxonomy.
  9. Introduce the study cycle as way of ascending Bloom’s.
  10. Discuss specific learning strategies like improving reading comprehension (active reading) and doing homework as formative assessment.
  11. Discuss reasons students in the class may or may not have done well on the first test.
  12. Ask students how different the proposed learning strategies are to the ones that they have been using.
  13. Ask students to commit to using at least one learning strategy for the next few weeks.
  14. Direct students to resources at your campus learning center.
  15. Express confidence that if students use the learning strategies they will be successful.

Currently all of the students that I teach are either advanced undergraduate students planning to go to professional schools or graduate students, so that my current students do not have mindset or motivational issues and have mostly learned how they study best.  However after sharing this book review with you, I have convinced myself that I cannot give up my book to my son when he comes to visit next month and I will need to go and buy another one.  I hope that this book will help you facilitate the learning of your students too!

Barb Goodman received her PhD in Physiology from the University of Minnesota and is currently a Professor in the Basic Biomedical Sciences Department of the Sanford School of Medicine at the University of South Dakota. Her research focuses on improving student learning through innovative and active pedagogy.
Beyond Content Knowledge: The Importance of Self-Regulation and Self-Efficacy

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

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

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

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

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

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

 

Self-Regulated Learning: A Student-Driven Process

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

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

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

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

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

 

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

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

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

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

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

Three outcomes were in mind when creating this activity:

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

 

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

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

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

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

 

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

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

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

 

Jennifer Rogers, PhD, ACSM EP-C, EIM-2 received her PhD and post-doctoral training at The University of Iowa (Exercise Science).  She has taught at numerous institutions ranging across the community college, 4-year college, and university- level  higher education spectrum.  Jennifer’s courses have ranged from  small, medium, and large (300+ students) lecture courses, also online, blended, and one-course-at-a-time course delivery formats.  She routinely incorporates web-based learning activities, lecture recordings, student response activities, and other in-class interactive activities into class structure.  Jennifer’s primary teaching interests center around student readiness for learning, qualitative and quantitative evaluation of teaching  strategies, and assessing student perceptions of the learning process.

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

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

Flipped teaching is a hybrid educational format that shifts lectures out of the classroom to transform class time as a time for student-centered active learning. Essentially, typical classwork (the lecture) is now done elsewhere via lecture videos and other study materials, and typical homework (problem solving and practice) is done in class under the guidance of the faculty member. This new teaching strategy has gained enormous attention in recent years as it not only allows active participation of students, but also introduces concepts in a repetitive manner with both access to help and opportunities to work with peers. Flipped teaching paves the way for instructors to use classroom time to engage students in higher levels of Bloom’s taxonomy such as application, analysis, and synthesis. Students often find flipped teaching as busy work especially if they are not previously introduced to this teaching method. Pre-class preparation combined with a formative assessment can be overwhelming especially if students are not used to studying on a regular basis.

When I flipped my teaching in a large class of 241 students in an Advanced Physiology course in the professional year-1 of a pharmacy program almost a decade ago, the first two class sessions were very discouraging. The flipped teaching format was explained to students as a new, exciting, and innovative teaching method, without any boring lectures in class. Instead they would be watching lectures on video, and then working on challenging activities in class as groups. However, the majority of the students did not complete their pre-class assignment for their first class session. The number of students accessing recorded lectures was tracked where the second session was better than the first but still far from the actual class size. The unprepared students struggled to solve application questions in groups as an in-class activity and the tension it created was noticeable.  The first week went by and I began to doubt its practicality or that it would interfere with student learning, and consequently I should switch to the traditional teaching format. During this confusion, I received an email from the college’s Instructional Technology office wondering what I had done to my students as their lecture video access had broken college’s records for any one day’s access to resources. Yes, students were preparing for this class! Soon, the tension in the classroom disappeared and students started performing better and their course evaluations spoke highly of this new teaching methodology. At least two-thirds of the class agreed that flipped teaching changed the way they studied. This success could be credited to persistence with which flipped teaching was implemented despite student resistance.

I taught another course entitled Biology of Cardiovascular and Metabolic Diseases, which is required for Exercise Science majors and met three times per week. Although students in this course participated without any resistance, their unsolicited student evaluations distinctly mentioned how difficult it was to keep up with class work with this novel teaching approach. Based on this feedback, I set aside one meeting session per week as preparation time for in-class activities during the other two days. This format eased the workload and students were able to perform much better. This student buy-in has helped improve the course design significantly and to increase student engagement in learning. Flexibility in structuring flipped teaching is yet another strategy in improving student preparation.

While one of the situations required persistence to make flipped teaching work, the other situation led me to modify the design where one out of three weekly sessions was considered preparation time. In spite of these adaptations, the completion of pre-class assignment is not always 100 percent. Some students count on their group members to solve application questions. A few strategies that are expected to increase student preparation are the use of retrieval approach to flipped teaching where students will not be allowed to use any learning resources except their own knowledge from the pre-class assignments. Individual assessment such as the use of clickers instead of team-based learning is anticipated to increase student preparation as well.

Dr. Chaya Gopalan earned her Ph.D. in Physiology from the University of Glasgow. Upon her postdoctoral training at Michigan State University, she started teaching advanced physiology, pathophysiology and anatomy and physiology courses at both the undergraduate and graduate levels in a variety of allied health programs. Currently she teaches physiology and pathophysiology courses in the nurse anesthetist (CRNA), nurse practitioner, as well as in the exercise science programs. She practices team-based learning and flipped classroom in her everyday teaching.
The Undergraduate Physiology Lab – A New Shine on a Classic Course

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

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

Students entering the workplace should be able to:

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

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

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

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Students entering the workplace should be able to work with technology

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

REFERENCES

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