Tag Archives: student preparation

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.


  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?





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.



Putting More Physiology into A & P

thinker-28741_640It’s tough being an undergrad student nowadays.  It’s expensive. State funding has cut into the budgets that used to go to offset tuition, and buildings for new classrooms have been on hold forever. Still they keep coming, paying higher and higher fees and tuition, crowded into larger and larger classroom sizes, getting shut out of labs: these are just the surface to larger problems in general. What kind of education are students getting now?  I ponder this as I teach A & P again after teaching physiology at a medical school for the last six years and A & P in smaller class sizes four years before that at universities and community colleges. Things have changed, and not for the better.  I’ll toss around some ideas that may or may not resonate with you, but these are things I feel we need to improve upon.


  1. How can we get class sizes smaller so we can teach and communicate? The depth of what students know goes not far beyond binge and purge. We can have small group discussion, more TBL and other models for active learning (if they read the pre-class material) and we’ll always have the good students, but for many lectures have become something to avoid. I get students who ask for my PPTs beforehand and use them as note templates, yet many rely on those as a sole source. The chances to integrate material become less frequent as we teach to the room and decrease the amount of material students can absorb. The long term rewards to learning are not being reinforced. I have students submit corrections for points in paragraph form, making them compose answers.


  1. Students need learning skills. Something I learned the hard way, but even in the prehistoric 1970’s note taking was essential. I implore students to do this as a way to create schemas even providing handouts with study skills that I have collected over the last thirty years. Of course the good students use this info, while the middle of the packers might but only after the first exam. We have more students who are being advised that health professions are good careers but not telling them how steep the competition is and how much is expected. Do I want an ED nurse who might forget that NaCl is not the same as KCl? Maybe I don’t have to weed them out, but I want their expectations to be parallel to the challenge and this should be considered the beginning of their career.


  1. Lastly, I propose perhaps a new approach to A & P; let’s separate the classes. Some institutions do this having advanced anatomy and general physiology classes for exercise science, why not do these for pre-health majors as well? The texts nowadays for A & P are humongous, with tons of information that skims the surface without enough integration. Let’s teach physiology with a chance to do more hands-on experiments and not have lab just being anatomy. I poll my students about whether they have seen frog muscle or heart experiments or any Mr. Wizard styled presentations. Few have, maybe from the more affluent secondary schools, therefore descriptions of diffusion or tetanus become an abstraction without the physical connection. They do ECGs and FEV1s in the second half of A & P, why not have that be the whole year?


Personally my career in physiology began when I walked into a behavioral neuroscience lab and ran my own independent study experiments for undergrad credit, all the while learning about the other research going on. I was happy that one of my biology students worked over the summer on an Integrative and Organismal NSF summer fellowship (that I know from my APS Porter Committee membership go underutilized) because statistics show that these students will go on in science.  I’d like to see our future caregivers have that depth as well.





William Johnson received his Master degree in Education from Johns Hopkins University in 1990. After teaching high school on the Dine reservation, he then pursued and obtained his PhD in Biology from Northern Arizonan University, studying angiotensin in desert anurans. After teaching physiology at University of South Florida Colleges of Public Health and Medicine, William has returned to his alma mater to teach anatomy and physiology and human physiology, as well as being involved in the summer program for Journey for Underrepresented in Medical Professions HRSA grant at NAU.