Tag Archives: student preparation

Building a Conceptual Framework to Promote Future Understanding

For most of my career, I taught physiology and genetics to medical students and graduate students.  My experiences with many students who had difficulty succeeding in these courses led me to the realization that the way high school and college students learn the biological sciences does not translate to effective physiology learning and understanding at the graduate level.

Medical students, by virtue of their admission to medical school, have, by definition, been successful academically prior to matriculation and have scored well on standardized exams.  They are among the best and brightest that our education system has to offer.  Yet, I have always been amazed at how many medical students truly struggle with physiology.  It is considered by many students to be the most difficult discipline of the basic medical sciences.  Most students come into medical school as expert memorizers but few have the capacity or motivation to learn a discipline that requires integration, pattern recognition, and understanding of complex mechanisms.  My overall conclusion is that high school and college level biological science education does not prepare students to succeed in learning physiology at the graduate level.  Furthermore, I believe if students were prepared to better appreciate and excel in basic physiology at earlier grade levels, the pipeline for graduate education in the physiological sciences would be significantly increased.

Over the past 5 years, it has become a passion of mine to promote a new way of teaching biology and physiology: one that helps students make connections and that lays a conceptual framework that can be enhanced and enriched throughout their educational careers, rather than one that promotes memorization of random facts that are never connected nor retained.  I recently joined the Center for Biomolecular Modeling at the Milwaukee School of Engineering (MSOE CBM) in order to focus on developing materials and activities to promote that type of learning and to provide professional development for K-16 teachers to help them incorporate this type of learning into their classrooms.

One of my first projects was to develop resources to allow students to study the structure-function relationships of a specific protein important in physiology and use that understanding to relate it to relevant physiology/pathophysiology concepts.  The program is called “Modeling A Protein Story” (MAPS) and, so far, I have developed resources for 3 different project themes: aquaporins, globins, and insulin.

The overall concept is for the students to build their understanding slowly and incrementally over time, usually as part of an extracurricular club.  They start by understanding water and its unique properties.  Then they learn about proteins and how they are synthesized and fold into specific 3D conformations in an aqueous environment based largely on their constituent amino acids and how they interact with water.  Eventually they progress to learning about the unique structure of their protein of interest and how it is related to its function.  Once they have developed a solid understanding of that protein, they work in teams to choose a specific protein story that they will develop and model.  This includes finding a structure in the Protein Data Bank, reading the associated research paper to determine what was learned from the structure, designing a model of the structure in Jmol, an online 3D visualization software, and 3D printing a physical model of the protein that helps them tell their story.  Stories can be anything related to the theme that the students find in their research and consider interesting.  For example, student-developed aquaporin stories have ranged from AQP2 in the kidney to AQP4 in the brain to the use of AQP proteins to develop biomimetic membranes for water purification in developing countries.  By choosing projects that students are interested in, they more readily accept the challenge of reading primary research literature and trying to piece together a confusing puzzle into an understandable “story”. 

In the past year, I have used the insulin theme resources and piloted an active learning project-based curriculum at the undergraduate, high school, and middle school levels on insulin structure-function, glucose homeostasis, and diabetes mellitus.  The type of learning environment in which this curriculum was introduced has varied.  Middle school level children participated in the active learning environment as part of a 2-week summer camp.  High school students from an innovative charter school in downtown Milwaukee were introduced to the project-based curriculum as a 9-week seminar course, and the activity was taught to freshman biomolecular engineering students at the Milwaukee School of Engineering as a team project in their first quarter introductory course.

Some of the activities utilized materials that we have developed at the MSOE CBM and were subsequently produced for distribution by our sister company, 3D Molecular Designs.  Others utilize resources that are readily available online such as those available at the Protein Data Bank at their educational site, PDB-101.  Finally, still other resources have been developed by us specifically for this curriculum in order to help the students move between foundational concepts in an attempt to help them make important connections and to assist them in developing their conceptual framework. 

One of the activities that helps them try to make sense of the connection between glucose and insulin is this “cellular landscape” painting by Dr. David Goodsell at Scripps Research Institute and available at PDB-101.

They learn the basic concept that when blood glucose increases after a meal, insulin is released from the pancreas and allows glucose to be taken up and stored by the cells.  But how?  When they are given this landscape and minimal instructions, they must look closely, connect it to what they already know and try to make sense of it.  They work together in a small group and are encouraged to ask questions.  Is this a cell?  If so, where is the plasma membrane and the extracellular/intracellular spaces?  What types of shapes do they see in those spaces?  What is in the membrane?  What are those white dots?  Why is one dot in one of the shapes in the membrane?  Why are there yellow blobs on the outside of the cell but not on the inside?  Eventually they piece together the puzzle of insulin binding to its receptor, leading to trafficking of vesicles contain glucose transporter proteins to the plasma membrane, thereby allowing the influx of glucose into the cell.  By struggling to make detailed observations and connections, a story has been constructed by the students as a logical mechanism they can visualize which is retained much more effectively than if it had been merely memorized.

In other activities they learn how insulin in synthesized, processed, folded, stored, and released by the pancreatic beta cells in response to elevated blood glucose.  They use a kit developed by MSOE CBM that helps them model the process using plastic “toobers” to develop an understanding of how insulin structure is related to its function in regards to the shape and flexibility required for receptor binding but also related to its compact storage in the pancreas as hexamers and the importance of disulfide bonds in stabilizing monomers during secretion and circulation in the blood.  

As the students build their understanding and progress to developing their own “story”, the depth of that story depends on grade level and the amount of time devoted to the project.  Undergraduate students and high school students who have weeks and months to research and develop their story tend to gravitate to current research into protein engineering of insulin analogs that are either rapid-acting or slow-release, developed as type 1 and type 2 diabetes medications, respectively.  The basic concepts behind most of these analogs are based on the structure-function relationships of hexamer formation.  Rapid-acting medications usually include amino acid modifications that disrupt dimer and hexamer formation.  Slow-release medications tend to promote hexamer stability.  Middle school students or high school students with limited time to spend on the project may only focus on the basic properties of insulin itself.  The curriculum is driven by the students, so it is extremely flexible based on their capabilities, time, and motivation.  Students ultimately use their understanding of insulin structure-function to design and 3D-print a physical model that they highlight to show relevant amino acid modifications and other details that will help them to present the story they have developed based on their learning progression and research. 

In conclusion, we have found that this type of open-ended project-based active learning increases learning, retention, and motivation at every educational level  with which we have worked.  Students are initially frustrated in the process because they are not given “the answer” but they eventually learn to be more present, make observations, ask questions, and make connections.  Our hope is that introduction of this type of inquiry-based instruction in K-16 biological sciences education will eventually make the transition to graduate level physiology learning more successful.

Diane Munzenmaier received her PhD in Physiology studying the role of the renin-angiotensin system on skeletal muscle angiogenesis. This was followed by postdoctoral study of the role of astrocytes in stroke-induced cerebral angiogenesis. She joined the faculty of the Department of Physiology at the Medical College of Wisconsin in 1999 and the Human and Molecular Genetics Center in 2008. As Director of Education in the HMGC, Dr. Munzenmaier lectured and developed curriculum for medical and graduate school physiology and genetics courses. She developed an ACGME-accredited medical residency curriculum and Continuing Medical Education (CME) courses for physician education. She also enjoyed performing educational outreach to K-12 classrooms and the lay public. She is passionate about education and career mentoring for students of all levels. Her specific interests in biomedical science education are finding engaging ways to help clarify the link between structure and (dys)function in health and disease.

Can the Flipped Classroom Method of Teaching Influence Students’ Self-Efficacy?
Chaya Gopalan, PhD, FAPS
Associate Professor
Departments of Applied Health, Primary Care & Health Systems
Southern Illinois University Edwardsville

Self-efficacy is the belief in one’s ability to succeed in a specific situation or accomplish a specific task (Bandura, 1977). Students with high self-efficacy have higher motivation to learn and, therefore, are able to reach higher academic goals (Honicke & Broadbent, 2016). Gender, age, and the field of study are some factors that are known to affect self-efficacy (Huang, 2013). Genetics plays a significant role (Waaktaar & Torgersen, 2013). Certain physiological factors such as perceptions of pain, fatigue, and fear may have a marked, deleterious effect on self-efficacy (Vieira, Salvetti, Damiani, & Pimenta, 2014). In fact, research has shown that self-efficacy can be strengthened by positive experiences, such as mastering a skill, observing others performing a specific task, or by constant encouragement (Vishnumolakala, Southam, Treagust, Mocerino, & Qureshi, 2017). Enhancement of self-efficacy may be achieved by the teachers who serve as role models as well as by the use of supportive teaching methods (Miller, Ramirez, & Murdock, 2017). Such boost in self-efficacy helps students achieve higher academic results.

The flipped classroom method of teaching shifts lectures out of class. These lectures are made available for students to access anytime and from anywhere. Students are given the autonomy to preview the content prior to class where they can spend as much time as it takes to learn the concepts. This approach helps students overcome cognitive overload by a lecture-heavy classroom.  It also enables them to take good notes by accessing lecture content as many times as necessary. Since the lecture is moved out of class, the class time becomes available for deep collaborative activities with support from the teacher as well as through interaction with their peers. Additionally, the flipped teaching method allows exposure to content multiple times such as in the form of lecture videos, practice questions, formative assessments, in-class review, and application of pre-class content. The flipped classroom therefore provides a supportive atmosphere for student learning such as repeated exposure to lecture content, total autonomy to use the constantly available lecture content, peer influence, and support from the decentered teacher. These listed benefits of flipped teaching are projected to strengthen self-efficacy which, in turn, is expected to increase students’ academic performance. However, a systematic approach measuring the effectiveness of flipped teaching on self-efficacy is lacking at present.

References:

Bandura, A. (1977). Self-efficacy: toward a unifying theory of behavioral change. Psychological review84(2), 191.

de Moraes Vieira, É. B., de Góes Salvetti, M., Damiani, L. P., & de Mattos Pimenta, C. A. (2014). Self-efficacy and fear avoidance beliefs in chronic low back pain patients: coexistence and associated factors. Pain Management Nursing15(3), 593-602.

Honicke, T., & Broadbent, J. (2016). The influence of academic self-efficacy on academic performance: A systematic review. Educational Research Review17, 63-84.

Huang, C. (2013). Gender differences in academic self-efficacy: A meta-analysis. European journal of psychology of education28(1), 1-35.

Miller, A. D., Ramirez, E. M., & Murdock, T. B. (2017). The influence of teachers’ self-efficacy on perceptions: Perceived teacher competence and respect and student effort and achievement. Teaching and Teacher Education64, 260-269.

Vishnumolakala, V. R., Southam, D. C., Treagust, D. F., Mocerino, M., & Qureshi, S. (2017). Students’ attitudes, self-efficacy and experiences in a modified process-oriented guided inquiry learning undergraduate chemistry classroom. Chemistry Education Research and Practice18(2), 340-352.

Waaktaar, T., & Torgersen, S. (2013). Self-efficacy is mainly genetic, not learned: a multiple-rater twin study on the causal structure of general self-efficacy in young people. Twin Research and Human Genetics16(3), 651-660.

Dr. Chaya Gopalan received her PhD in Physiology from the University of Glasgow, Scotland. Upon completing two years of postdoctoral training at Michigan State University, she started her teaching career at St. Louis Community College. She is currently teaching at Southern Illinois University Edwardsville. Her teaching is in the areas of anatomy, physiology, and pathophysiology at both undergraduate and graduate levels for health science career programs. Dr. Gopalan has been practicing evidence-based teaching where she has tested team-based learning and case-based learning methodologies and most recently, the flipped classroom. She has received several grants to support her research interest.

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.