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).
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.
Have you taught those boring muscles lately? And those dreaded origins and insertions?
And when students get to the exam they are frazzled and sad? Why do we do the same things over and over and wonder why students don’t recall what we teach them? Muscles are one of the most dynamic tissues of the body so let’s teach them dynamically!
Working in healthcare for the past decade has taught me that patient “buy in” usually leads to better outcomes. Interestingly enough, students are the same way. So why not let them pick some of the muscles they have to learn? They can choose based on personal or occupational interest. For example, if your group is interested in occupational therapy, focus on muscles that are involved in activities of daily living. Are they mostly nursing students? Include muscles commonly strained by nurses in their daily practice from poor lifting mechanics or improper conditioning. This could incentivize strengthening to prevent future injuries. Student buy in may develop into personal investment, which enhances their compliance and advances their outcomes. Follow this formula, and see what happens!
Formula 1: Buy in > Personal Investment > Compliance > Improving Outcomes
It is also important to think about the breadth of material to cover. It’s not essential that students learn every specific muscle and attachment, and an operational method may enhance recall. Consider the following four step process starting with motion and ending with the muscle. First, focus on the motion desired. Second identify the plane of motion and axis of rotation. Third, isolate the line of action. Fourth, label the primary movers. A possible fifth addition could be offering an everyday example.
Formula 2: Motion Desired > Plane of Motion/Axis of Rotation > Line of Action > Primary Mover
If students have difficulty identifying the plane of motion and axis of rotation, have them poke a pencil through the middle of a large index card. Then place the index card in the plane of motion desired. If the body part contacts the card while going through the full range of motion, they’re in the wrong plane. The axis of rotation will automatically be perpendicular to the plane of motion for easy identification.
Next, they overlay a piece of string to identify a logical line of action across the joint.
String can help students identify the logical line of action across a joint.
Using this method, students can isolate the muscles in that region responsible for the action. As a bonus, they can suggest an example of how that muscle is used in everyday life.
If you have the students pick a few of their own muscles too, be sure they are able to complete the process despite the muscle’s obscurity. I have always included a few interesting muscles for their action, shape or function. For example, the gluteus medius not only performs hip abduction, but also executes hip internal rotation due to its line of action. The temporalis not only functions in mandibular elevation but also retraction. The piriformis, besides being a cute pennant shaped muscle, is the only gluteal muscle with a sole proximal attachment on the sacrum. If you have some high level students, dare them to discover how the gluteus maximus can perform knee extension! How else could a patient with an above knee amputation negotiate stairs in a reciprocal fashion? And if that’s not fun enough, challenge them to identify the motion that occurs if one muscle attachment is fixated and the other is not. For instance, if the distal end of the Biceps Brachii is fixated, by placing the hand under a table, then the trunk will flex forward (unfixed). Try it with other muscles too! Muscles are dynamic and should be taught that way. Because in the end, we want our students to look like this!
John Zubek is a Doctor of Physical Therapy and is an Assistant Professor of Physiology at Michigan State University.
It’s likely that at this point I do not need to convince most of you that active learning can be highly beneficial to student learning. There is a multitude of resources, including HAPS Educator articles, which discuss successful active learning in a variety of classroom settings. But here’s the thing. With so many great ideas at our finger tips, where are we supposed to begin if we want to implement active learning in our own courses?
First, step back from the swarm of ideas swirling in your mind and reflect on your goals. What are the goals of your course (which may or may not be content-related)? Your goals should shape the type of active learning exercise(s) you implement. Here’s what the participants at my workshop at the HAPS Annual Conference in May had to say about their goals with active learning:
To ensure your efforts are manageable, start with just one or two sessions. Upon successful implementation of the initial activity, you can build off it, or incorporating additional methods. Allow enough time to develop the activity, implement it in class, and give yourself time afterward to assess and for providing student feedback if necessary. Some (or all) of these steps can take a lot of time!
This can be tough. Students will sometimes resist the unfamiliar (i.e. not a standard lecture). Be transparent. Explain the goals of the activity, and if appropriate, share evidence to support the activity. Ensure students that it is of the appropriate difficulty level for them and that you’re there to guide them. Considering giving credit for participation, especially if it’s a regular part of class. For more on this topic, check out the Cavannagh, et al. (2016) article or this blog post from Bryn Lutes at Washington University.
Classroom Assessment Techniques: A Handbook for College Teachers by Angelo and Cross is a book that will walk you through identifying your goals, selecting appropriate activities for those goals, and it gives you a detailed guide for implementation of the activities and assessment. Assessment is a critical part of scholarly teaching! How else will you know if the original goals were accomplished?
Technology. A simple, yet effective means of incorporating small snippets of active learning into a lecture can be interactive questions. Similar to “clicker” questions, there are many web-based platforms which enable faculty to easily incorporate interactive questions (multiple formats) into lectures. It’s an opportunity to give the students practice retrieving informing, as well as allowing instructors to see where students are in their understanding of the material.
Low-tech options. In lieu of all of the apps and high-tech options out there we sometimes forget that a marker board, or pen and paper can be effective tools. Drawing or writing out a process in a way that is meaningful to students (and maybe incorporating a drawing) is an effective means to promote learning. Get creative with other materials too! Pull ‘n’ Peel Twizzlers make a great model of vascular supply, and playdoh, pipe cleaners, paper, etc. can be used to model many different body parts.
While this is by no means an exhaustive list of resources available for us to use in teaching, I hope it helps you get started. Establish your goals. Pick an activity to meet those goals. Plan well, and don’t forget to include assessment! Happy teaching!
Cavanagh, A.J., Aragón, O.R., Chen, X., Couch, B.A., Durham, M.F., Bobrownicki, A., Hanauer, D.I., & Graham, M.J. (2016). Student buy-in to active learning in a college science course. CBE Life Sci Educ 15(4).
Michael, J. (2006). Where’s the evidence that active learning works? Adv Physiol Educ 30: 159-167.
Pierce, R., J. Fox. (2012). Vodcasts and active-learning exercises in a “flipped classroom” model of a renal pharmacotherapy module. American Journal of Pharmaceutical Education 76(10): 1-5.
Audra Schaefer is an Assistant Professor of Anatomy and Cell Biology who teaches neuroanatomy and histology to first year medical students. She oversee multiple systems-based integrated courses that are part of the first two years in the medical curriculum. She also conducts educational research, with interests in metacognition, study skills and remediation.
Muscles and bones, bones and muscles. How many times have my students learned the deltoid tuberosity in the bone unit, only to complain that they have to learn all these bone names as part of their muscle attachments?! Many of my students come in thinking they are going to simply learn the names of the bones, having little understanding that there is a whole world of terms for bone landmarks. To help my novice students become proficient, I have made two changes.
Historically, my labs followed a 2 week period of appendicular and then axial bones, followed by a 2 week period of appendicular and then axial muscles. My students scraped an average of around 67% on their weekly practical quizzes. They always did slightly better with their bones, and then much worse with their muscles in part due to that muscle attachment component. I wanted more, so I flipped to appendicular bones one week, followed by appendicular muscles the next week. Their averages went up to 78% for the unit, but I still got a little of the whining related to bone landmarks. Their scores were higher on bone weeks and lower on muscle weeks, so I switched to regional study of the body, bones and muscles of the leg one week, the arm the next and so forth. For the last three years, my averages for this unit have settled around 75%, but the students are making the connections between bone landmarks and their muscle attachments.
I remember when I took A&P, my lab instructor handed me a Rubbermaid with the bones for that week and said, “Get to it!” I had the “luxury” of having previously taken Comparative Anatomy class, so 5 of my peers worked with me to learn the material. Most of my peers left lab and were overwhelmed. So when I started teaching A&P, I tried to help the students whose strategies mimicked my classmates’, but I kept running into an almost total mental shut down the moment I handed out their term list for the week. So I made a second change. Now my labs have 6 stations and students spend about 15-20 minutes at each station. Each station has an objective, which also helps the students chunk up the material into manageable pieces.
Just what can you do at these stations? One is the dissection/prosection table with the cadaver or cat. One is a pile of bones and they have to put Humpty Dumpty back together again – recognizing left vs right and what the bone names are. Another station has a plastic skeleton with felt muscles and scotch tape to study origin, insertion, action. I have brought in Halloween skeleton decorations and asked the students to look for anatomical inconsistencies. Another table has a few bones with the goal of identifying the landmarks from their list of terms.
You may be thinking that this doesn’t get to every student, but I have noticed is I now have students who either pass their lab quiz well, or they really, really don’t pass. There aren’t so many in the middle. It tells me the students who are studying, vs not spending the time studying and I have fewer students who are all out “tanking with pride,” as I call it. It seems to be working. A student came to me yesterday and told me that she had attempted to take A&P at another institution, but she got so lost in all the material, she didn’t know where to start. She felt my lab set up helped her divide and conquer the content into manageable pieces.
It’s easy to become complacent with our students, and forget that sometimes our students need ideas presented in a way that helps them begin to categorize and learn the material. What is so simple to us may be the straw that breaks the proverbial camel’s back for them. It’s a lot of work to help our students figure out where to start and learn how to be a learner, but so rewarding when it works.
Nichole Warwick teaches biology at Clatsop Community College and is a proud member of the HAPS Communications Committee.
I found myself digging through a closet of scrap-booking goods last night in a frantic effort to find a 1 3/8” hole punch. I had been sparked by an idea that has been percolating for years, but I’ve never implemented. I wanted to build a cell with ions, channels, and charges so my students could manipulate the “players” involved in the resting membrane potential and an action potential.
This concept is particularly challenging for students. They could use chemistry, biology, and elements of physics to understand this system, but mine are woefully under prepared. Their eyes glaze over when they have to think about electrical gradients and chemical gradients working simultaneously. Add in channel types and applications to graphs that describe membrane changes in voltage, and even I’m starting to have an anxiety attack! When I teach this concept, the energy in my classroom is so thick, I could cut it with a knife. There has to be a better way.
But so far, no amount of restructuring, dividing, or attempting to present just a “snapshot” in time had worked to facilitate the connection between what is occurring with ions and how it happens. So I cut out a giant cell, a little positive and negative sign, and all the different channels, and put them in a bag. That handy scrapbook punch allowed me to make sets of 10 potassium ions and 10 sodium ions in the colors I have been trying to get my students to associate with this concept. Voila- my students will now have an intracellular space on a table that represents the extracellular space…and all the important pieces as well.
Back in the classroom, as I drew on the board a picture of each step of the electrical changes experienced by the cell, they had to manipulate their cell. Did it work dreamily well? Probably not. Some students got it and visibly relaxed. But some students didn’t get it…and remained in a state of panic. However, I did discover that my students were pretty mixed up by the concepts of “depolarization” and “repolarization.” Because they can’t see the cell, sometimes this creates a mental block.
After class, a subset of students followed me to my office, where we played more with the model and I’ll be darned if they didn’t get to the point where they could set up their cell appropriately for each of the phases of the action potential! I could ask questions like, “Can the cell be stimulated again at this point?” And the question I love more, “WHY!?!” Light bulbs started turning on and several students took pictures so they could make their own model at home to use while studying.
This week in lab we use the HHsim program to study action potentials and this time, my new models will be on the table with them and they are going to have to show me what happens to explain the graphical results they get. My hope is that time, coupled with this paper model, will help them master the concepts.
Nichole Warwick teaches biology at Clatsop Community College and is a proud member of the HAPS Communications Committee.