What is the HAPS Exam?

Take Rational Course Design with Margaret Weck!
HAPS President Emeritus Margaret Weck, shares some history about the HAPS Exam.

From the founding of the Human Anatomy and Physiology Society (HAPS) as an organization in 1989, there has been a general agreement that many of our students find the study of Human Anatomy and Physiology to be difficult.  For some there is the difficulty in the sheer volume of new words to process and for most there is also a difficulty in conceptualizing the body as a set of integrated organ systems with interdependent processes necessary to sustain the life of the whole person.  Partially to counteract grade inflation pressures on individual campuses, partially to justify requests for baseline prerequisite courses, and partially just for our own reference, there has been an ongoing desire for more “objective’ ways to know how well our students are doing.  Out of this impulse the “HAPS Comprehensive Exam” was born in first draft around 1992 and piloted in June of 1993. I have great familiarity with the exam as I took over scoring the exam from Chris Farrell (Trivecca Nazerene University) and did all the central scoring of paper and pencil exams from the summer of 2007 through the spring of 2015, when the paper and pencil version was discontinued.

The exam has undergone several major revisions through time and has migrated from the original mail order, self-scored, paper and pencil form to a secure on-line testing environment.  The HAPS Exam Program continues to write new questions and refine the scoring algorithm.  Some questions (up to 20 per administration) are being tested for validity and reliability before being permanently added into the master question database.  The exam has costs associated with the maintenance of the database, validation of new questions, test administration, and data analysis of the results.  Consequently the exam is offered on a per-test fee basis to faculty and administrators at accredited institutions of higher education.

The HAPS exam is now a secure 100+ item test correlated to the HAPS Learning Outcomes for Undergraduate Anatomy and Physiology.  It is currently the only validated means for obtaining comparison data across textbooks and publishers to help benchmark the performance of your students against the performance of other A&P students across the North American continent.

The HAPS Exam is now a computerized assessment.
The HAPS Exam is now a computerized assessment.

There are now several versions of the exam including the combined exam and subsets for A&P I only and A&P II only.  Neither the complete exams nor the individual items contained in the exams are, or have ever claimed to be, perfect or without flaws.  The HAPS exam is not an exhaustive examination of everything that your students actually know or even theoretically should know.  The HAPS exam is not a substitute for a final exam targeted to your student population and your particular course.  The HAPS exam score by itself in isolation is not a total representation of your students’ learning or the quality of your course(s).  But in this era of assessment and accountability the HAPS Exam remains the only nationally normed and somewhat standardized examination over the content and concepts of Human Anatomy and Physiology.

What makes the HAPS Exam valuable?

The HAPS exam data is very useful in accreditation reports to validate efficacy of curriculum changes that have been made or to provide leverage to support requests for proposed changes.  Sequentially administered test results over several years is a potentially powerful data source for answering the question, “How do you know it works?”  Although administrators often find this the most compelling reason to justify the annual expense of the exam, I have found, personally, that the ability to gain perspective on my students’ performance to be of even more value.

I have found that the HAPS exam gives us at the St. Louis College of Pharmacy the opportunity to step back away from our local concerns and get a bit of perspective on how our students are actually doing.  They may not be mastering the nervous system in the way we would like, but guess what?  Turns out that many students across North America are struggling with that system.  This doesn’t mean that we give up or quit trying.  It just means that we have a more realistic sense of the challenge we are facing – not just at our school but across all of HAPS.  If we are all having difficult in getting our students to deeply engage with a particular topic or system, I know I can go to the HAPS listserv (I still call it that) and ask around for what others are doing to address the issues we are facing.  It is very empowering to know that neither I, nor my colleagues, nor my students as a group, are necessarily failing, even when I can see room for improvement in my students’ development of meaningful understanding of A&P.  Perspective taking can be very powerful.

And if my/our students do particularly well in one area compared to the normed average?  Well then I/we have the perfect topic/technique/workshop to share at the next HAPS annual meeting, or an article for HAPS Ed, or other publication!  I can feel especially confident in offering my thoughts, suggestions and materials to others because I have evidence that what I and my colleagues are doing is helping our students meet not only our expectations, but allowing achievement at or above the national norm.

The more schools and students who participate, the more meaningful the results become.  If you have not done so before, think about the HAPS exam this year.

Study Abroad: Human Anatomy in Poland

Student-interactive activities at the Public Higher Medical Professional School in Opole.
Student-interactive activities at the Public Higher Medical Professional School in Opole.

Two years of planning, many discussions, and revisions of the program’s agenda and it finally happened!

On May 29, 2017, a wonderful group of CCBC (Community College of Baltimore County) biology students and faculty left for an exciting 10-day adventure, dubbed Human Anatomy in Poland.  The human anatomy and education parts of the program included a visit to the Anatomy Museum at the Jagiellonian University Medical College in Krakow (the oldest university in Poland), the Criminal and Forensic Medicine Museum at the Wrocław Medical University, the unforgettable experience of visiting and attending a workshop at the world-famous Plastinarium in Guben, and student-interactive activities at the Public Higher Medical Professional School in Opole.

Workshop at the Plastinarium in Guben, Germany.
Workshop at the Plastinarium in Guben, Germany.

This anatomy focused experience was intermingled with touring the cities of Wroclaw, Opole, Krakow and Warsaw. The participants learned about Polish history, culture, and architecture by visiting many sites registered on the UNESCO World Cultural and Natural Heritage List, including the Centennial Hall in Wroclaw, the Old Town in Krakow, the Nazi German concentration camp Auschwitz-Birkenau, the Salt Mine in Wieliczka, and the Historic Centre in Warsaw.

Description of the study abroad program would not be complete without adding that the participants were enthralled with Polish food, enjoying all varieties of pierogi (commonly confused with “pierogis”). Some are even still experiencing “lody (ice cream) withdrawal”. I was asked on multiple occasions throughout the study abroad by the participants whether the program will be repeated; I share this enthusiasm and hope it isn’t the last of its kind!

It was a fantastic trip!
It was a fantastic trip!

Ewa Gorski is a biology professor at the Community College of Baltimore County in Maryland where she has been teaching human anatomy & physiology and physiological pathology courses for about twenty years. The majority of her students are preparing for careers in nursing and mortuary science. Ewa has been HAPS member since 2002.

Meet a HAPSter- Quelly from Brazil!

This post describes Quelly Shaive’s anatomy program in Manaus, Brazil.

Anatomy for Medicine is a class which emphasizes the application of anatomy knowledge within a clinical anatomy model.  The approach of Anatomy for Medicine is topographic, where we explore each segment, structure or organ in great detail . This course is divided into 2 parts: Anatomy I and II. This course consists of teaching the anatomy itself as well as pertinent clinical correlations to facilitate student learning and to prepare them for further clinical and surgical education. Students are responsible for presenting seminars where they demonstrate their understanding of anatomy within a clinical case format.

The aims of Human Anatomy I (given in the first period) and Human Anatomy II (given in the second period) are to know the main aspects of regional anatomy and the relationships with the clinical diagnosis of major diseases that affect humans.  Students also have guidance on anatomical dissection practices and the technical notion of invasive procedures, both diagnostic and therapeutic.

Our topographical approach focuses on the regional division of the human body and incorporates in its discussions the medical/surgical importance and applied anatomical knowledge.  This provides students of medicine good learning conditions to study the subjects that are prerequisite: Medical Propedeutics, Neuropsicoimunologia and Operative Technique and Experimental Surgery.

We have 8 teachers and we count on the help of Teacher’s Assistants, who are selected through written test. These Teacher’s Assistants give us support in practical classes, help students in extra class schedules, organize symposiums and events in anatomy and perform the anatomoclinical sessions. The Teacher’s Assistants also participate in events outside the state of Amazonas, such as Brazilian Medical Education Congress.

The Federal University of Amazonas (UFAM) offers the discipline of Anatomy for various courses in the health area, which is offered according to the needs of each course as shown in the table below:

Degree in Sciences: Chemistry and Biology Anatomy and Physiology 60 H
Dentistry Fundamentals of Human Anatomy 90 H
Natural Sciences, Physical Education, Biological Sciences and Psychology Fundamentals of Human Anatomy 60 H
Pharmacy Human anatomy 90 H
Physiotherapy Fundamentals of Human Anatomy

Functional Anatomy Neuroanatomy

90 H

120 H

60 H

It is noteworthy that these subjects offered by UFAM are not exactly the same for all federal universities in Brazil; however, there is equivalence of the nomenclature, workload and content approach.  The Ministry of Education and Culture (MEC) is the institution which determines accreditation and coordination for all public and private universities.

Some studies published in Brazil show that anatomical teaching in our country began on 18 February 1808 by Decision No Régia. 2, D. João VI, the Bahia School of Surgery, was formed in Salvador, and over the years, other medical schools were opened in Brazil until today.

The Anatomy courses are divided into theoretical and practical classes. For lectures, we make use of Power Point and whiteboard. The classes are held in laboratories with real human specimens without using any advanced technology, such as 3D Dissection Tables. The human cadaver parts used for dissection are preserved in formaldehyde, alcohol and glycerine. When anatomical variations are found they are cataloged and published in appropriate journals.

The importance of the use of cadaver dissection is appreciated for providing a faithful model of the future student reality. UFAM has adopted these practices to help students of anatomy, favoring the development of teamwork, respect for the body, familiarization with the body, application of practical skills, integration of theory and practice and preparation for clinical work

To improve my performance in class, I participated for the first time in the 30th HAPS Annual Conference in May 2016 in Atlanta, Georgia. As a member of HAPS, I receive messages daily about novelties in anatomy, clinical discussions of best books tips, applications, websites and videos that is of great value to improve my knowledge in the area. I have a long way to go in higher education, and I know I can count on the support of HAPS and my fellow members to improve my teaching of one of the oldest arts in the world: Anatomy.

Quelly Shiave, in her Anatomy Laboratory – UFAM.  Painting the background made by a former student of Medicine.

Quelly Shiave is a professor of anatomy at the Federal University of Amazonas (UFAM) in Manaus, Brazil.

RAAS – Glug Glug Glug…

When I teach endocrinology students our unit on the adrenal gland cortical hormones, I always post a PowerPoint slide which depicts a Wikipedia image of the renin-aldosterone-angiotensin-system (RAAS).

This image is licensed CC-BY-SA 3.0 by A. Rad. Accessed on 12/4/17.

Its author does an elegant job of elaborating angiotensin II’s targets and responses, which include increases in sympathetic nervous system activity, tubular Na+ reabsorption and K+ excretion and H2O retention, adrenal cortex release of aldosterone, arteriolar vasoconstriction with a concomitant increase in blood pressure, and posterior pituitary release of ADH (arginine vasopressin) leading to reabsorption of H2O by the collecting duct. Overall there is an increase in the perfusion of the juxtaglomerular apparatus (JGA), which offers the negative feedback signal to reduce renin output by the JGA.

I point out to students this elegant, multiple-organ defense of falling blood pressure: the kidney (for renin release), liver, lung, adrenal cortex, hypothalamus (for both CRH and ADH), and kidney (for elevated perfusion) is all automatic. But when I show diagrams from multiple sources, including texts, I offer this question, “What is missing from these images?” I do prompt them with a clue about loss of perspiration during  workouts, but the ‘lights don’t go on’ until I reveal a PowerPoint shape with this on it, “Glug, glug, glug” – then they smile …. because they realize that drinking fluids provides the fastest return from hypovolemia…

Be thorough. Connect the dots.

Post comes from Robert S. Rawding, Ph.D., Professor in the Department of Biology at Gannon University in Erie, PA.

“I Was Too Embarrassed”

Exploring the Reasons Students Don’t Engage with Instructors to Improve Performance

“I was too embarrassed. He would think I was stupid,” replied my private tutoring client. This was her only response to why she did not meet with her professor after failing every exam the first time she took A&P 2 at a nearby university. I told her that most professors I know don’t assume that you are unintelligent if you’re struggling to understand material. The startling part of this exchange was her response to my reassurance, which was to ask, “Really?” She was genuinely surprised to hear that he would not assume she was an incapable student.

I didn’t think too much about this again until I picked up another student who also failed A&P 2 at a nearby community college. The story was the same, with a few added details. Despite failing 4 exams, no attempt was made to meet with the professor to discuss strategies for improvement. I asked her why. “Probably because I was embarrassed I did so poorly. I didn’t want to face my professor. Also, I didn’t think it would be helpful to go back and look, because reading the correct answers doesn’t really help matters if you don’t understand the content to begin with, so why make myself look stupid?” Now my curiosity was peaked. Is this how most students who don’t want to review and discuss their performance feel? Do they assume that they will either be judged, or that there’s nothing to be learned from seeing their mistakes? This might be especially true when exams are not cumulative. They may assume it’s better to just move on, in which case they are likely to repeat the same mistakes in preparing for the next assessment. It is easy to assume that only the students who are struggling will make appointments to review their performance, but from my experience, t’s usually the students hitting close to the average that view their exams, and the high and low scoring cohorts stay silent. The question then remains: Why would embarrassment stop a student from discussing their performance? Wouldn’t the desire to avoid more failure, or repeating a course, outweigh the risk?

Let’s assume for simplicity’s sake that you have created a supportive environment, you make yourself available, and when students do come, you provide constructive feedback that leaves them more confident and better prepared moving forward. However, the students who are struggling still don’t reach out. What else can, or should, an instructor do, for a student afraid of judgment? It is all too easy to write this off as a “silly” emotion, especially if you are a friendly, enthusiastic instructor (and I’ve never met a HAPSter who wasn’t!). However, after my experiences with the tutoring students over the summer, I decided to change up the language I used when I invited exams this academic year. I stressed the importance of failure in success.  I shared stories of my own academic struggles with students, stressing that some topics came naturally, and others were very hard to grasp, and took many hours of self-study outside the classroom to finally take hold. Finally, and what I feel made the biggest difference, I added the simple statement “please do not feel embarrassed to meet with me and review your exam” to my class email. The result? The number of my A&P students who came to review their midterms this year tripled from the five previous years.

For students, it does not always go without saying that we won’t judge their intelligence or ability. Say it. It takes almost no time, but you may see it make a big difference in the number of students who reach out for help. Do the easy things to get them in the door, and they may leave more self-directed, confident students. It may be hard for those of us who work in education to imagine letting embarrassment prevent us from getting better grades, but I’m sure that if we were all honest with ourselves, we could identify something we avoid because of fear of judgement. Students ultimately have to help themselves, but we can certainly help them get out of their own way.

Dr. Krista Rompolski is an Assistant Teaching Professor at Drexel University. 

Nominate Someone for the HAPS/Thieme Excellence in Teaching Award!

Do you know a great teacher,  someone you feel inspires student success in anatomy and physiology?  If you do (and we all do), please consider nominating him or her for the HAPS/ Thieme Excellence in Teaching Award for 2018.  HAPS is honored to team with Thieme Publishers to offer this opportunity to recognize one of our own for efforts in the classroom or laboratory.

Nominated instructors:

  • Must be teaching anatomy and physiology during this academic year, with an expectation that they will continue,
  • Must be HAPS members, and
  • Must be exemplary teachers

To qualify to nominate an instructor, you must be an instructor or administrator at an accredited institution in the United States or Canada, have at least two years of experience, and be able to explain why the nominee deserves the award.

HAPS expresses its thanks to Thieme Publishing for support in the establishment and continuation of this award.

The award includes a $1500 cash honorarium and waiver of fees for the HAPS Annual Conference.  The recipient will present the “HAPS/Thieme Award for Excellence in Teaching Workshop” during the Annual Conference Workshop Sessions in 2018.  We had terrific workshops at the 2015, 2016 and 2017 conferences.  This year’s recipient will join an illustrious group that includes Terry Thompson, Mary Tracy Bee and Mark Nielsen.

Nomination forms and details on award criteria can be found on the HAPS webpage. Deadline for nominations is December 1st, 2017.

Don Kelly
HAPS Grants and Scholarships Committee