Introducing… the HAPS Anatomy Learning Outcomes!

In the early 2000s, the HAPS Curriculum and Instruction (C&I) committee embarked on a multi-year project that resulted in the development of HAPS Anatomy & Physiology (A&P) learning outcomes.  These learning outcomes were developed for 2-semester human A&P courses, and served as a benchmark for instructors who are currently teaching A&P courses, or as a guide for those individuals developing new A&P courses.  These learning outcomes were well received, and many publishers have since adopted or incorporated these outcomes into their own learning materials.  In addition, the HAPS Comprehensive A&P exam questions were developed by mapping to these learning outcomes.

Unfortunately, the A&P learning outcomes are not as useful for those of us who teach stand-alone anatomy (or stand-alone physiology) courses.  A new set of learning outcomes needed to be developed for each of these stand-alone courses.  With that in mind, the HAPS Testing Committee embarked on a multi-year project to create and develop the HAPS Anatomy Learning Outcomes.

Why the HAPS Testing committee and not the C&I committee, you ask?  We quickly realized that anatomy-specific learning outcomes needed to be developed by individuals who teach stand-alone anatomy courses – and most of the C&I members did not teach such a course, whereas many members of the HAPS Testing committee did.  In addition, the HAPS Testing committee also has the goal of creating a HAPS anatomy-specific comprehensive exam – but before an exam could be created, the learning outcomes needed to be fleshed out.

The process of creating anatomy-specific learning outcomes involved multiple revision cycles involving members of the Testing Committee as well as members of the Anatomy Testing task force (experts charged with the task of developing the HAPS anatomy exam, under the purview of the HAPS Exam Program).  We used the HAPS A&P learning outcomes as a template, but ensured the learning outcomes were written with a stand-alone anatomy course in mind.  We greatly appreciate the assistance of ADInstruments, as they helped fund several off-site meetings with the task force in order to finalize these learning outcomes.  We completed our task in early 2018 and introduce to you all – the HAPS anatomy learning outcomes!  Please visit the website to learn more and download the outcomes.

As with the A&P learning outcomes, the HAPS Anatomy learning outcomes are to serve as a guide and benchmark only.  We do not expect all anatomy instructors to cover every single learning outcome, they may address the learning outcomes in whatever order they like, and they are welcome to include additional learning outcomes in their own courses.

We hope you find these learning outcomes of use in your anatomy courses! Many thanks to the HAPS testing committee members and the HAPS anatomy exam panel for their hard work in this effort.

Go to the Anatomy Learning Outcomes now

HAPS Exam Demonstrates Comparability Across Teaching Modalities

This week's post comes from HAPSter Susan McDonald.
Meet HAPSter Susan McDonald of Western Iowa Tech Community College.

Administrators and faculty have questioned the effectiveness of online, hybrid and dual credit sections of a course as opposed to a traditional face to face section.  The opinion voiced most often is that the online and dual credit sections cannot begin to equal the learning in a traditional face to face classroom.  Indeed, in our era of transparency in education, this question has arisen amongst state and federal education agencies as well as the administrative offices of colleges and universities.  Studies have been conducted to compare modalities of delivery effects on student satisfaction, student retention, GPAs, as well as other parameters.

To address this question, Western Iowa Tech Community College Science Department in Sioux City, IA implemented a common assessment requirement for Human Anatomy & Physiology I and II.  Initially the A&P common assessment consisted of an in-house exam created by full-time A&P Instructors.  When HAPS re-created the comprehensive final exam and piloted A&P I and A&P II versions of the exam in 2014, WITCC students participated in the pilot.  WITCC’s choice for separate A&P I and II exams was based on the observation that not all students complete their 2 semesters sequentially.  Occasionally students begin their study of Anatomy & Physiology while to complete coursework during their wait to be admitted.  Occasionally a student is accepted into their program more quickly than expected resulting in the withdrawal of the student from the second semester to focus more completely on their program specific courses.  

WITCC’s results for semesters where all A&P students were tested included traditional face to face classes, hybrid sections where the students are provided an hour of lecture and 2 hours of lab per week, league classes which are dual credit high school students where the high school instructor is also the college instructor, hybrid league classes where there is both a college instructor and a high school instructor, and online students from WITCC only.    Below is a graph of all of the data for the modalities  demonstrating the comparability of instruction between the modalities.  In addition to the scores and test statistics, users of the exams are provided statistics for all of the exams twice a year in June and again in December.  These statistics are provided by school type such as 4-year college, 2-year college, technical college, etc.  It is helpful to be able to compare my student performance with that of the students in other colleges similar to mine.2-12-18

The effects of course delivery modality on student satisfaction and retention and GPA in on-site vs. hybrid courses 

A Comparison of Teaching Modalities for Student Success

Comparing Student Performance in Online and Face-to-face Delivery Modalities

The HAPS Standardized Exam, Course Performance and Subsequent Professional School Performance

In 2014, when I was teaching at a school of nursing, I was asked to develop a Human Anatomy and Physiology course sequence for undergraduates at our university who were interested in pursuing a degree in nursing.  Human Anatomy and Physiology was required for admission to our school, and we were interested in attracting more undergraduates from our university.  We wanted to make these undergraduates more aware of nursing as a possible career path, particularly bright students who already expressed an interest in science.  Additionally, we were seeing that many students who matriculated into our traditional BSN program (to obtain a first bachelor’s degree) either were not well prepared, or seemed to have forgotten a significant portion of their basic science coursework.  A colleague and I developed a pilot course that combined Human Anatomy and Physiology II (a common nursing prerequisite course) with Health Assessment (a course that is often offered early in the professional nursing curriculum) into a novel course that we called Physical Assessment:  Normal Human Form and Function.  Students in this novel course would take the traditional Human Anatomy and Physiology II lecture but would have a separate lab where the Health Assessment skills would be taught.  We got approval from our university’s IRB, and also from our School’s curriculum committee.  We obtained funding through a small grant from our university’s Center for Faculty Development and Excellence, and funds from the Center for Science Education.  Our pilot course launched in the spring of 2016 with 10 students.

Our hypothesis was that students who participated in the pilot offering of this novel course would demonstrate improved learning of the basic anatomy and physiology concepts, as well as better retention of these concepts, than students who did not participate in the innovative pilot course.  We used the HAPS standardized exam as a pre-test / post-test to measure students’ improvement from the beginning of the course sequence (August 2015) to the end (May 2016).   We found that all students had significantly improved post-test scores on the HAPS exam when compared to the pre-test scores.  We did see that participants in our pilot study did outscore non-participants in terms of exam scores, overall course scores and HAPS exam scores.  These students appeared to be more satisfied with their overall experience.  Further, participants also appeared to have stronger course scores in Pathophysiology, the first science course they encountered as professional nursing students, than non-participants.  We noted a correlation between the learning gains on the HAPS exam and scores in Pathophysiology – this may be the first observation of correlation of pre-professional coursework performance with professional performance.  Our pilot course experience resulted in a poster presentation at the 2017 annual HAPS meeting in Salt Lake City.

The biggest limitation of our study was the small sample size – our pilot cohort was 10 students.  We chose the students in this cohort carefully for this first iteration in an attempt to minimize the potential disruption to their entry and progression through a professional nursing curriculum (ie, we chose students that appeared likely to be successful).  Thus, we cannot generalize our results widely to pre-nursing students, and we cannot rule out the possibility that the participants would have out-scored their non-participant counterparts in any case.  

There were several challenges specifically associated with the HAPS exam we faced as we developed this course.  One challenge was the cost of the HAPS exam – about $10 per student.  Since we opted to use the exam as a pre-test / post-test assessment, we needed $20 per student to obtain this data.  Funding from the CFDE / Center for Science Education covered the cost of the exams.  Another challenge in the use of the HAPS exam was that it is completely online.  One required element in administering the exam is a professionally-supported computer lab.  Students were not allowed to use their own computers, and there is no compatibility with any “lock-down browser” mechanisms that would prevent students from accessing online resources during the exam.  While our school of nursing still had a computer lab, many schools have stopped supporting these in lieu of having students provide their own computers.  Some students taking the HAPS exam at the beginning of the academic year expressed their anxiety when viewing their scores, and some dropped the course shortly afterward.  Additionally, we did not include an incentive for students to perform to their best ability on either the pre-test or the post-test, which may have indicated that their HAPS exam score was not important.

This post comes from Dr. Ann Massey, PhD, Senior Lecturer for the Department of Cellular Biology at The University of Georgia.

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.

Transferability: Giving Credit Where Credit is Due

In general, students take our A&P courses in preparation for a future career in healthcare or the sciences. It is critical to our students that our courses are accepted; either for transfer or as a prerequisite by other institutions and programs. National guidelines, such as the HAPS learning goals and outcomes, provide a common reference point for instructors and administrators to compare and evaluate courses. 

As an online science educator, one of my challenges is to make my courses as robust and defensible as possible when it comes to transfer. Unfortunately, a bias against online science courses still exists at some institutions. Some students are challenged or even denied credit for transfer or acceptance as a prerequisite simply because they took their course online. I agree that not all online science courses are equal and designed with the same rigor. However, the same can be said of on-campus courses, yet they are not held to the same level of scrutiny. 

In preparing this post, I went back to the HAPS-L Discussion Group archives to review the history of our discussions on the topic of transferability. Not familiar with the HAPS discussion groups? Visit the HAPS Discussion Groups page for additional information on how HAPS members can subscribe to the discussion groups and access the archives. 

In December 2015, we had a discussion on “Transfer credit for purely online A&P courses.” Wendy Riggs noted that at her institution, the teaching modality of the course was not allowed to be a factor when considering transfer. As long as the course had the appropriate number of credits, contained a laboratory component, and came from an accredited institution, it would be accepted for transfer. Both Wendy and Jon Jackson highlighted the important difference between focusing on the instructional method and achieving the learning outcomes. Jon Jackson made the point that asking if courses are equivalent is the wrong question. The appropriate question is how well the student in the course masters the material. 

Instructors and administrators can use the following questions to help guide their evaluation. Ideally, the syllabus should contain the answers to these questions:

Does the syllabus reference state or national standards? One of the goals of the HAPS Guidelines for Undergraduate Instruction of Human Anatomy And Physiology was to “help establish equivalency between anatomy & physiology courses at different institutions, easing many of the problems associated with the process of transferring credits.” A statement of course alignment to state or national standards can be very helpful during the evaluation process. References to articulation agreements may also provide an additional data point for comparison. 

Does the course use a commonly recognized textbook or course materials? The use of commonly recognized textbooks and course materials provides some confidence that the common body of anatomy & physiology knowledge has been covered in the course. This question becomes increasingly important as the use of Open Educational Resources (OER) becomes more common.

What was included in the lab? The HAPS Guidelines describe the expectations for hands-on laboratory experiences and hours of laboratory activity per week of the course. It is important to note that the HAPS Guidelines and the Distributed Learning Position Statement support A&P instruction at a distance. 

Does the course or department utilize the HAPS exams? Use of the HAPS exams provides a direct measure of student learning referenced to the HAPS learning outcomes. Even if individual student scores are not available, use of the HAPS exams for programmatic assessment is an indicator that the institution is attempting to evaluate student performance relative to the HAPS outcomes.

Is the institution regionally accredited? This may require investigation beyond the syllabus, but can be easily answered using the institution’s public website. Regional accreditation (HLC, SACS, etc.) provides an indication of overall institutional quality independent of instructional modality. 

Students can also be proactive and be prepared for potential questions:

Keep a copy of the syllabus. This is the most important document (besides the transcript) a student will need in order to demonstrate the scope and activities in our course.

Keep copies of their work. This is especially useful in courses where students are creating original lab reports or assignments. In my A&P courses, students create written and video-based lab reports. I encourage my students to keep copies of their assignments so that they can share them with institutions if there are questions. My institution also uses a commercial publicly viewable online portfolio platform which students can use to display their work. 

In summary, we can help all of our students with respect to transfer through quality course design and clear documentation in the syllabus. In terms of evaluating science courses for transfer, we need to take the time, request a syllabus, and give credit where credit is due.

Dave Brashinger is an assistant professor and director of the natural sciences program at American Public University System.