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.

Flipping A & P: Synergy

Weight Lifter
I WISH this was me!

I work out.  I don’t particularly enjoy it, but I make myself do it for my own good. Sound in mind and body, that sort of thing.

So I was in the college fitness center, using the strength training equipment, when I noticed the weight machine listed the names and locations of the muscles I was using to do that particular exercise. Every machine there did.  That got me thinking about how my students have such problems with muscle locations and names because they don’t seem to associate them with joint movements.  They study each system separately as if they are unrelated.  Hmm, maybe I could use the weight machines to help the students connect the two.

In the past I have tried to help my students connect joint movements and muscle actions by having them tell me all the muscles necessary to do things like ‘Dance the Twist’. (I wish I had a video of those lab days. Very amusing!) But I felt the assignment left something wanting.

Coincidentally, there has been a very interesting conversation about this very topic recently on the HAPS listserv  and that gave me the idea to expand the activity to the skeletal system.  We don’t normally require our students to learn origin and insertion for all the muscles for this course, but they do learn most of the bone features. So last week I gave them a list of joint movements and I had them all follow me over to the fitness center.  Each group had to find a machine that strengthens the muscles that perform each joint movement.  And then they had to do at least 5 reps on it.  I’m hoping the burn will help them remember the location of those muscles.  After that they had to write down the muscles used and their locations, conveniently displayed right on the machines.  Lastly I asked them to tell me the shape of the joint moved and the bone features involved in the joint, tying together the different systems.  The lab practicals will show whether this exercise (literally!) worked or not.  The class was certainly active and engaged.

This activity was possible because of flipping.  This is the best part of flipping, the active learning during class. The students already had the background information so I didn’t have to stand in front of a projector or a white board talking.  Instead we could take our little field trip.

The fitness center supervisor certainly appreciated it.  Many students were unaware the college even had a fitness center and, hopefully, some will sign up for fitness classes.  Sound in mind and body, you know.

Flipping A & P: The Benefit of the Second Chance

Typewriter Eraser by Claes Oldenburg and Coosje van Bruggen
Typewriter Eraser by Claes Oldenburg and Coosje van Bruggen
National Gallery of Art, Washington

I really want my students to understand Anatomy and Physiology, not just memorize the terms and some factoids.  So I try to design assignments that challenge them to connect ideas, delve into ramifications and apply information in new ways.  When my students complete these group assignments I hope that they have a deeper understanding of the concepts covered.  At least on the questions they got right.  The missed questions are a different story.

Students rarely asked why they got a question wrong or what the correct answer was.    I could write insightful comments to guide them and it would mostly be a waste of ink. I handed back these assignments only to have the grade glanced at and then the paper stuffed into a binder, never to be looked at again.  I thought “If they would just go back over these missed questions, they would learn so much more.”

Of course, the only sure way to get students to do something is to attach points to it.  So I borrowed an idea from mastery learning, and started to allow students to resubmit work for a higher grade.  Unlike mastery, I only allow an assignment to be resubmitted once. When given unlimited attempts, I find that students just start guessing, hoping to hit the right answer eventually.

My students work in groups of 3-4, so re-grading work isn’t as daunting for me as it may sound.  Don’t get me wrong, I do a considerable amount of grading, but I have really seen a benefit from the “redo”.

The biggest benefit is the clearing up of misunderstandings for the students. For example, on a recent protein synthesis assignment, students were confusing amino acids with codons. Because they went back and tried again, they realized the difference. Ideally, they won’t have the same confusion on the exam.

You may not want to let your students resubmit every assignment you give them, but consider trying it for an assignment that they find especially difficult.  I find a little extra grading pays big dividends.


Flipping A & P: The Drama of Collaboration

Image by Colleen Roxas

It’s that time of the semester again, group assessment time.  I’m hoping it will resolve some of the group drama that I’ve been pulled into.

When I first started flipping my classes, I decided that my students would work collaboratively in groups.  I had been having trouble getting the students to participate in classroom discussions with me and I was hoping they would be more willing to talk to each other.  Boy, do they!  It can get very loud in my class sometimes.  As long as they’re mostly talking about Anatomy and Physiology, that’s a great thing.

During my first flipped semester I formed student groups based on where the students were sitting in one class and randomly in another class.  I would like to be able to say I did this on purpose to see which worked better, but it just happened by coincidence.  I thought that grouping students by where they sat would be random.  I know better now.  And it quickly became clear that a true random assortment worked much better than student selected groups.

Students sat with their friends and the classroom was segregated by type of student.  Students in the front row were go-getters and the back corners were filled with students trying not to be noticed.  I ended up with several super-groups and several flailing groups. Surprisingly to me, the self-selected groups had little drama.  They quietly excelled or quietly floundered.  The randomly formed groups had all kinds of drama.  I was worried about this in the beginning, but I came to realize that groups with issues were passionate and passion is good.

Something I didn’t expect happened in the random groups. These groups would have one or two successful students and several mediocre students.  The mediocre students began to look to the good students for help and the good students were happy to give it.  They became role models to the struggling students.  They shared good study techniques and would keep the group focused.  The drama would start when students felt they were working harder than others in the group or someone was too controlling.  The temptation for me was to step in and separate the warring parties.  But I knew that one of the benefits of working in groups is to learn to resolve problems on your own.  I gave advice and asked them to stick it out one more week.  For several groups it took two weeks and more advice and not a few tears, but the groups would resolve their issues or at least come to a truce.  Interestingly, the groups with the most drama at the beginning usually ended up being the best groups by the end.  They fought because they cared.

I’ve since discussed my early group experience with faculty friends in the Communications department and they just nodded knowingly.  They gave me a lot of great advice and I have implemented two suggestions so far. The first one is to form the groups more purposefully.  I now create teams based on student preparedness for the class.  I’ll elaborate on that process in my next blog post.  The other idea is to assign peer assessments.  Each student must evaluate every other student in the group, including themselves, using a rubric.  They assign points to each other that represent how much they feel that student has contributed to the group.  The average of the points counts as one of their group work grades.  The most helpful aspect of this assessment is the constructive (but polite) comments they make about each other anonymously.  The students receive all the assessment information as feedback and the comments may be the most helpful to counter the drama.  Student cohesion really improves after the assignment.  I’m hoping it works this semester so I can hang up my mediator hat for a while.

Collaborative learning may be noisy and like a soap opera sometimes, but I think it has been the most successful part of my classroom flip.


Image by Colleen Roxas, http://www.simplyaesthetic.net

Flipping A & P: Can’t Create, Curate!

Content-Curation-feature-image“Flipping sounds great, but I don’t have time to make all those videos.”  That was my thought when I first heard about flipping the classroom.  If this thought is keeping you from flipping, there is another way to test the water.

If you have no time or desire to make your own videos: curate!  When I first started flipping, good videos were hard to find.  It may have taken me just as long to gather good quality videos as it would have to make them. Many videos I found were inaccurate, boring, way too long, or of really poor quality.  There were few repositories of videos then and searching was tedious.  I shudder to remember how many horrible videos I watched before finding an acceptable one.

Thank goodness this is no longer true.  There are now many free (FREE!) resources for professional quality videos to offer to your students.  Some videos have embedded quizzes to increase student interactivity and reinforce the lesson.  The best videos meet Universal Design (ADA) standards with captions or a transcript, which is important because all videos required for courses at my college must be accessible by disabled students.  A few video recording software programs, such as Camtasia, attempt to auto caption your voice, but are usually pretty poor at this.  I’m not sure which takes longer, correcting the auto captioning or just making them from scratch.

If you would like to dip your toe into flipping, you might start at one of the websites below.  Start with just one video and see how the water feels.

If you know of another good site for Anatomy and Physiology videos, please post them in the comments.

Happy Flipping!


Flipping A&P: Flipped Day

ImageYesterday, September 6, was Flip Your Classroom Day: A Global Initiative.  The event was sponsored by the Flipped Learning Network. Educators worldwide pledged to flip a class yesterday (or any day).  In honor of Flipped Day, I decided to start my new blog series on Flipping Anatomy and Physiology.  Wendy Riggs has been blogging about flipping her A&P courses for a while and you might be wondering why I would blog about the same subject.  The beautiful thing about flipping is that there is no single right way to do it.  She and I have different approaches and I think our blogs should complement each other nicely.

My name is Elaine Kohrman and I have been flipping my Anatomy and Physiology courses for a little over a year.  I’m an Assistant Professor of Biology at Somerset Community College in Kentucky and teach Anatomy and Physiology courses to Allied Health students.  SCC’s campuses are in the foothills of the Appalachian Mountains and serve some of the poorest regions in the United States.  Our students are often underprepared and many are the first in their family to ever attend college.

For my first five years I taught using the standard lecture format.  I enjoyed sharing my knowledge of the subject immensely, but many students could not master the material.  If I spent extra time explaining a concept to help every student succeed, I would run out of time at the end of the semester to cover all the content.  Many students would memorize the facts without ever really understanding the concepts.

For the next few years I tried inserting discussion questions into my lectures to improve the depth of learning and engagement of my students.  That didn’t work out as well as I had hoped, because the students who needed to be more engaged were not joining the discussions.

I started hearing about the concept of Flipping the Classroom and researched the topic extensively.  Flipping seemed the perfect answer to improve student interaction with the material.  I “drank the Kool-Aid” and completely converted my Anatomy and Physiology I class to a Flipped classroom.  Now I’ve converted my Anatomy and Physiology II class as well and couldn’t be happier.  I’ll never stop tweaking my classes, but I’m never returning to the old lecture format.

Over the next few months, I’ll share my version of flipping and I look forward to hearing your ideas.