10- What if Students Don’t Flip?

Sometimes The Flip flops…

One of the most common questions I field about flipping my classes relates to handling the non-flippers.  I had a conversation with a colleague the other day about strategies for dealing with students who don’t flip course content before attending class.  She is a speech teacher and as we talked, I realized how LUCKY I am to teach Anatomy and Physiology.  My students often demonstrate an intense level of intrinsic motivation to understand the material, because most of the course content relates directly to the careers they are choosing to pursue.  So when she asked what I do when my students don’t flip, I hesitated.  Because the fact is, I do nothing.  If my students fail to come to class prepared, they will be fundamentally confused by the activities we are doing in class.  Most of my students don’t like this.  Additionally, the questions asked by the non-flippers (if they dare ask any) often reveal that they didn’t adequately prepare for class. I try to be kind when I tell them that I covered their question in detail during the video lecture and gently remind them that in a flipped class, they should probably watch the lecture BEFORE coming to class.  I’ve had some students confide in me that they DIDN’T watch the online lecture…ONCE.  And they were so lost and confused that they never repeated that mistake.  But this is in a class full of really motivated students.  So how can instructors ensure students come to class prepared?

I’ve been playing with the idea of making my clicker questions count for real points.  Right now, I give students 100% of their clicker points just for showing up to class and participating. (Clicker points count for 5% of their total course grade.)  Honestly, the idea of holding students accountable for correct answers on these clicker questions makes me really tired, because in addition to being very motivated to understand the material, my students are also very motivated to collect every single possible point, even if it means fighting to the death with their exhausted instructor (that would be me).  I find that my clicker questions (mostly multiple choice) often initiate extremely interesting debates and I gain insights into the thinking that guides their decision making.  I also get to vet my questions–and my students are excellent critics.  I’m not sure I could handle the bookkeeping drama that would accompany a change in my clicker policy.

Other instructors require quizzes or other pre-class assessments to “prove” students flipped the content.  I also think this would be an amazing thing to do…but only if I had the time to build really meaningful, interactive, and challenging assessments that easily fed into my LMS and required no grading.  Ahem.

I think one of the best things to do is to simply facilitate activities during class time that are so engaging and interesting that students really WANT to come to class prepared.  I’d say I get a C- in this area right now…which I suppose just means I have lots of room to improve!

9- Blood Pressure

Image of an alarm clock (in the public domain)
This device is not my friend.

It is late.  We lost an hour this morning, which means my alarm clock is going to be particularly vile when it cheerfully erupts in about 6 hours.  And I can’t go to bed quite yet, because I am still preparing for my physiology class on Blood Pressure in the morning.  I started my preparations by reviewing my flipped video lecture on the topic.  This was a painful task, as I quickly found about 62 improvements I would LOVE to make to that set of video lectures.  (This is an unfortunate aspect of the flip: improving one’s lectures requires a significant input of time that is usually unavailable during the semester.)

As I watched my lecture with steadily increasing disgruntlement, I decided to look for interesting activities to engage students in my  morning class.  I turned to the APS Archive for inspiration and when I resurfaced an hour later, I had about 62 new activities that I was really excited to try (out of 151 hits on my very broad “blood pressure” search).  (This is another unfortunate aspect of the flip: developing/vetting activities to replace “lecture” requires a significant input of time that usually is subtracted from the sleep column.)

While it is highly unlikely that I will be able to pull any of these activities together for class in 7 hours, I thought I’d share the WEALTH that is OUT THERE for you flippin’ crazies who are trying to add more active learning to your lecture time.  Here are three of the 151 hits on my “blood pressure” search.

  1. Laboratory activity: This article from Advances in Physiological Education describes a medical school’s efforts to replace a cardiovascular physiology lab that made use of anesthetized critters with one that makes use of fully conscious med students instead.
  2. Flow diagrams: This resource contains complex flow diagrams that are visually interesting and informative.  I have a very VISUAL brain and I love the idea of students building flow diagrams like these.
  3. Case study: This case focuses on neural control of the cardiovascular system.  It is extremely comprehensive and describes a scenario with a pregnant mama going into labor.

This is just a smattering of the amazing resources cataloged in the Archive of Teaching Resources.  Anyone else out there interested in adding MORE hours to each day?  Ahhhh, one can dream.  Enjoy the week!

7- Active Learning Makes Me Happy

Sometimes my class is a party…

Maybe you are starting to get a sense of this, but I like it when my students are happy. I often use their satisfaction as evidence that a technique or lesson is “successful.”  I understand that happiness may or may not correlate with LEARNING, but I can’t seem to shake the drive to make my students happy (though I am unwilling to give them extra credit or “easy” exams to accomplish this.)  My push to make happy students isn’t linked to the external requirement for positive student evaluations; I am still technically a part-time instructor and we are officially evaluated ONCE every THREE YEARS. But I still find my pedagogy revolves around what students LIKE.  While I think there are some very important reasons to stay true to this intention, I had an interesting experience this week that might provide an important nudge away from the “do what it takes to make students happy” camp.

We began the skeletal system in Human Anatomy on Tuesday.  This lab is notorious on our campus for being the point at which quantity of content PLATEAUS.  The labs prior to the bone lab are progressively more challenging, but none of the labs after the bone lab are MORE difficult (though they certainly are not easier!)  I always note that if you can master the bone lab, you are ready to handle the rest of the course.

Because of the notorious difficulty of the lab, I came up with a task for students to carry out during their three hour lab period.  I divided our bones into 6 stations (skull, superior limbs, pelvis, etc), provided groups with sticker tags, and asked them to create a practical quiz for their assigned station.  I then gave them about 20 minutes to create the quiz for their station, complete with an answer key, and then I had them move through the stations and take each others’ quizzes.  I found the experience a little exhausting in my morning lab, because there was a general undercurrent of disgruntlement about the activity that just made me tired.  So when the afternoon lab came in, I ended up giving them a CHOICE: they could do my activity, or study on their own.  All of the students in the afternoon lab chose to study on their own and the general mood was much more pleasant.

And then I graded their quizzes, which were given to each group at the end of their lab sessions.  Ready?

The early lab (who DID the activity) scored an average of 1.2 points higher on their 10 point quiz when compared to the late lab (who studied on their own).  Now these are students who FIGHT to the DEATH about one point on a 100 point exam…so this difference will be perceived as ENORMOUS for my team.  Of course, I wondered if perhaps my afternoon students were always…more challenged than the early group, so I compared the averages for the two previous quizzes.  One quiz had the early lab leading by 0.2 points and the other quiz had the late lab leading by 0.1 points.  That counts as a wash in Wendy-land.

...and sometimes not.
…and sometimes it isn’t.

This was a “moment” for me. I won’t ever ditch the idea that happy students learn more and I really believe that the ability to motivate students is a powerful teaching tool.  But I do think I need to follow my instincts and require my students to do the same, whether they are happy, or not.

6- Case Studies

The National Center for Case Study Teaching in Science Logo
The National Center for Case Study Teaching in Science is an absolute treasure trove of interesting cases!

After spending nearly a year recording video lectures for my flipped classes, I have finally arrived at a semester in which MOST of the lectures have been recorded (for better or worse) and I am able to focus my time on improving the quality of the ACTIVITIES we do during class time.  Although I am painfully critical of the quality of my existing video lectures, I am grateful to finally have more time to work on the class activities.

I am always intrigued by case studies and if you haven’t taken a look at the National Center for Case Study Teaching in Science, you really need to check it out.  This resource is included in the APS Archive and it is literally a gold mine of interesting cases.  I’ve signed up for their email listserv and receive monthly updates describing new cases they’ve recently posted.  When I get these emails, I usually end up wishing I taught more classes, because the topics are so engaging.  I was particularly interested in checking out a relatively recent case about Colony Collapse Disorder in honeybees.

The group also facilitates an annual summer workshop where participants explore different kinds of case studies, and then write and deliver their own cases to a guinea pig group of undergrads who offer feedback on the experience.  Someday, when I figure out how to squeeze 48 hours out of each 24, I would LOVE to participate in this conference.   But there are other sources of case studies for use in the flipped classroom.  One of my favorite workshops at the HAPS Annual Conference last year in Las Vegas was Cherie McKeever’s workshop on writing your own case studies.  She also offers an online summer class on how to write and implement fun cases.

I am going to experiment with a clicker-based case study on hearing loss this week in Human Physiology.  I will keep you posted!


5- The Dead Rats: Success!

In contrast to my first attempt with Dead Rat fun times a year ago, Endocrine Rats lab activity last week was very popular with my students.  I ended up recording a brief lecture to help guide them through the process of determining which rats were treated with which hormones, and also made a few changes to my own lab handout for the next time I use it.  Overall, it was a much more successful experience, judging solely by classroom climate.

I am very aware that just because my students “liked” it, doesn’t mean they learned anything.  To that end, I have to make tonight’s post particularly brief because I am in the middle of writing exams for both my classes (ouch).   On nights like this, I usually conclude that sleep is overrated and then I load up on caffeine and keep going.  However, after Valerie’s email to the HAPSters on the list-serv on Thursday, requesting a HAPS liaison to participate in the National Sleep Foundation’s task force, I realize that perhaps I should revise my general approach to sleep:

You_can_sleep_when_you're_dead!Ahhhh, ok.  Short post it is.

4- APS Archive Activity: The Dead Rats

Reinforce student understanding of the endocrine system by using “Virtual Rats”! This activity is described in a journal article posted in the APS Archive of Teaching Resources.

I wonder how many Physiology students dropped my class this semester when they saw the “Dead Rats” activity on the course schedule.  There certainly have been many who tentatively ask me about that particular activity.  After briefly traumatizing them with visions of dead rats piled high to the ceiling, I inform them that the activity actually makes use of PAPER dead rats.  I can SEE that great sigh of relief as it exits their lungs!

I found this activity through the APS Archive of Teaching Resources.  It simulates an actual physiology lab in which students treat rats with various hormones, then kill the rats and weigh their organs to learn more about how the hormones affect different body systems.  The activity eliminates the need to kill rats (for which I am extremely grateful) and also adds a bit of authentic mystery into the mix, because the students in the scenario forgot to label the hormones before treating the rats.  My students are then tasked with figuring out which hormone was used to treat each rat.

This activity works fantastically in the flipped class.  My students will watch their lecture on the endocrine system and complete the lab handout based on the article from the Archive, all before coming to class on Wednesday.  Then they will get into groups and examine their packets of “dead rats.”  There are many skills students use in this activity.  First, they have to have a working understanding of each hormone and the different ways the hormones affect each other and body organs.  I do not require them to memorize these interactions or details, YET.  I just want them to be able to APPLY what they’ve learned about the hormones to help them understand the dead rats. One of the most challenging things for them involves HOW they organize their data.  This is tricky and I have to be careful about giving them instructions that are too specific, because then the activity becomes an exercise in following a recipe, instead of an opportunity to practice critical thinking skills.

I piloted this activity in my class a year ago, and perhaps because it was done so early in the semester, students found the open structure of it quite frustrating.  I am used to this kind of frustration when I try something new, mostly because I don’t yet understand the pitfalls they will tumble into.  In class tomorrow, I will warn them about the importance of effectively preparing for the activity by watching the lecture AND completing the lab handout.  I will also remind them to make sure their brains are optimally engaged as they study and prepare.

Finally, I’d love to say I have a sophisticated assessment planned to accompany this activity…but unfortunately, I do not.  That, however, is one of the GREAT things about teaching…I get to constantly improve my craft.  Adding a rock-star quality assessment into the mix will be my goal NEXT semester.

Flipping A & P: Hi, my name is Elaine and I’m a K+ ion!

Painting of neurons
Pepto Bismol Nerves by mochaloda

I’m always getting crazy ideas.  Sometimes they’re crazy good ideas, sometimes just plain crazy.

This week’s crazy idea came out of my frustration with teaching cell membrane potentials.  It’s a very difficult… no, that’s too negative…challenging concept for students.  A series of pictures in a textbook is hard to visualize.  A video or animation is better, but students still have a hard time internalizing the concepts of resting membrane potentials, local potentials and action potentials.

My crazy idea was to borrow a page from Miss Silvers play book.  Miss Silvers was my kids’ science teacher at Science Hill Middle School (yes, our town is really named Science Hill).  She retired a few years ago and was one of the best teachers I have ever known.  The students all dreaded taking her because she was so demanding, but my kids still remember lessons they learned in her class over eight years ago.  (I’m happy if my students remember lessons from the previous semester.)  My daughter says that the science she learned in Miss Silver’s classes carried her all the way through high school and part way through her college science classes.  My daughter can still vividly remember lessons in Miss Silver’s classroom because they were so active.  Miss Silver’s always had them up and moving, acting out processes, testing themselves against each other, and learning by doing.

I was worried at first that college students would find these kinds of activities too hokey.  They were adults, not kids!  I shouldn’t have been surprised to find that most students like fun, even if it is hokey. A few semesters ago I started putting smiley faces on assignments and quizzes with perfect grades.  Hokey, I know.  Kindergarten stuff.  Students LOVE them!  God forbid that I should forget to put a smiley face on a paper.  Now I announce “Smiley Face!” when I hand back those papers and those students cheer and beam.  Hokey is obviously not a barrier.

So I decided I would disrupt the daily class routine and instead of having our usual clicker question session we would ‘Be an Action Potential’! We moved the desks into the shape of a neuron (as best we could).  I handed out signs to the students identifying them as ions, voltage gated ion channels, ligand gated ion channels, Na+/K+ pumps, acetylcholine (2 students, of course), acetylcholinesterase, and all the other components of neurons.

We started by building the cell membrane with ion channels and Na+/K+ pumps. The pump/students established the resting membrane potential by moving student ions between the desks to be on the correct side of the membrane.  Then we created a local potential by opening ligand gates in the dendrites and letting the students labeled ‘Na+ ion’ into the neuron.  As we discussed the movement of ions during an action potential, the students moved around and became the action potential.  We ended with the release of acetylcholine into the synaptic cleft and then the removal of acetylcholine by acetylcholinesterase.

The students were certainly attentive during the activity.  It’s hard to be distracted by a text message when you might have to repolarize the membrane.  With any luck, ‘Being an Action Potential’ will be as memorable as one of Miss Silver’s classes.  Or maybe I’m just crazy.

Flipping A&P: Going All The Way

 “V"J day in Times Square” inspired by Alfred Eisenstaedt's famous photo.
“V”J day in Times Square” inspired by Alfred Eisenstaedt’s famous photo.

I’ve been in a relationship with Flipping for over a year now.  I think it’s time to take this relationship to the next level.  It’s time to ‘Go All The Way’.  That’s right, Flipped Mastery.

I really love flipping my class.  I feel that my students have the chance to obtain a deeper understanding of the course material with this instructional method.  Students work WITH the material and don’t just memorize it.  Unfortunately, this is not true for all my students.  Some participate too little in their groups and generally these students do poorly.  But there isn’t really a way to FORCE them to be actively involved.  This has led me to consider the next step: Mastery.

With Mastery, every student would have to be actively learning.  They would have to master a subject before they could move on.  No one is struggling to keep up.  And on the other end of the spectrum, no one is bored waiting for the next topic.  Unhappily, this will probably mean even more grading for me.  Instead of eight group worksheets every day, I might have as many as thirty two individual worksheets to grade.  But I’d rather grade more, but better, assignments than fewer, worse assignments.

I feel that I could help students even more by letting them make choices about their education.  Most students are more active in my classes now, but they still do what I say when I say to do it, at least during class.  I’m hoping that students will be more motivated to complete their work when it is their choice of which assignments to do and in which order.  Why do students need to study topics in the same order as the book?  Is it necessary to study the Integumentary system before the Muscular system?  As long as topics are scaffolded, I don’t see why students can’t choose their own path through the material.  The coursework can become a tree with multiple branches, rather than a rigid linear path.

It will also take a bit of work to come up with a menu of assignments for each topic, but I think that grading a variety of assignments will make grading more interesting for me, too.  It is so tedious to grade the same assignment over and over and over.

The one thing that has held me back from taking the plunge is the loss of group interaction.  If all the students are working at their own pace, no one will be working together.  The gurus of Flipping, Aaron Sams and John Bergmann, say in their book Flip your Classroom: Reach Every Student in Every Class Every Day that students will automatically organize themselves into learning groups.  I hope that this is true of my students because I have seen a real benefit to student collaboration.

I don’t think I’m ready to fully commit in all my classes, but I think I’ll take a deep breath and jump in with both feet into at least one course.  I just hope that ‘Going All the Way’ doesn’t end in tears.

Flipping A & P: Taking a Hit


I’m so glad that my Associate Dean warned me about the hit I would take on my student evaluations when I decided to flip my courses. Without that warning, I would have been devastated by the response after my first flipped semester. It still stung a bit.

Now, I have never been voted “favorite teacher” by students. I teach a difficult subject, I don’t bend the rules laid down in the syllabus and those rules are pretty strict about due dates and make up work. I have also expected my students to be able to think critically and not just memorize the material. In other words, I’m “hard”. Even so, my evaluations were always pretty good. Then, I flipped.

Some students enjoyed the new format. Here are some direct quotes from their anonymous course evaluation comments.

“I greatly enjoy Prof Kohrman’s class. She keeps class interesting and I enjoy everything she is doing.”

“I’ve enjoyed this class because it requires me to think critically and put forth a lot of effort. I have learned a lot!”

Others weren’t as enthusiastic, to put it mildly. These are excerpts; their full comments were usually MUCH longer. Some accompanied by suggestions that I should be fired.

“Ms. Kohrman is a good teacher, however I do not like her teaching style. She does not lecture at all. It is the weirdest format I have ever seen in a college class, however I am doing well in it.”

“I think that it would help the students if the instructor would lecture in the class, instead of always just doing clicker questions, group work, and handouts.”

“I believe Kohrman has the potential to be an effective teacher but her methods of teaching are non-learnable. I am in class to be taught not to be questioned on material I studied before I came to class but was never taught.”

“By far the very worst instructor I have ever had! I am well aware that anatomy is not an easy subject to begin with but when you have an instructor that doesnt teach, it makes it even harder.”

I’m always amused by comments that the student had to “learn everything themselves”, as if information is just downloaded to their brains during lectures. But I do take student evaluations seriously and I have made some changes based on comments I have received. I do a lot of mini-lectures now during clicker questions, especially when the students don’t seem to understand a specific topic. I also make charts and drawings on the white boards to help organize material. I think the balance is better between lecturing and flipping now.

I am very lucky to be at a community college that is really interested in student learning and not just enrollment numbers or completion rates. I haven’t been fired. In fact, I received a merit bonus award and was the recipient of the Somerset Community College Faculty Award of Excellence for 2013.*

*Your results may vary.

16- Student Thoughts on the Riggs-Style External Brain

Mayb I be excused?  My brain is full.
Whose brain gets tired when studying Anatomy?!

At the beginning of every class this semester, I ask my students to answer two questions.  First, I ask them how much “flippin'” work they did to prepare for class.  To get a “3” (out of 5), they have to watch the flipped video lecture, complete the External Brain assignment (which often is a rather vague list of suggested questions to think about), and also prep for lab.  To get a 4 or 5, they need to spend additional hours studying.  Their responses are all self-reported…I have no way to verify accuracy, though I implore them to be honest as their feedback informs decisions I make about my pedagogy.  I then ask them to assess the completeness of their External Brain assignment by thinking about how close the document is to where they want it, for use on the External Brain exam.

Now, keep in mind that my students are a highly motivated bunch and with this comes a bit of grade-obsession.  They work hard and they want their grades to reflect their efforts (though we all know “effort” doesn’t always correlate with “understanding”).  So one such motivated student approached me after class the other day and expressed frustration with having to assess his External Brain BEFORE class began.  His complaint, which I found really interesting, was that there was no way his External Brain was complete before class began, no matter how much time he spent working on it.  Lecture and lab always informed improvements and additions he would make to his document, and knowing this, he felt like he had to report a poor grade on the “How complete is your External Brain?” self-assessment. This, of course, didn’t make him happy and he wanted me to know that just because he was reporting a low “readiness” number at the beginning of class, it didn’t mean he wasn’t using the External Brain in the way I was intending it to be used.

His concern made me think about how I am using the External Brain, and I think I agree with him.  For me, the External Brain serves the purpose of MOTIVATING students to prepare adequately for my flipped class.  But really, none of us should expect the External Brain to be a complete and polished document at the beginning of class, because students will be making revisions and additions based on the things that HAPPEN during class and lab.  I think this is a positive thing, because it indicates that not only do the students value the activities that happen during class, but they value their External Brains too.