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Conference Report
Faculty of Medicine University of Sydney Sydney, NSW 2006, Australia Chair, Commission for Teaching International Union of Physiological Sciences
Abstract
The very successful workshop (San Jose, Costa Rica, November 16–18th, 2000) was attended by 70 participants from 19 countries, Central and South America, with some additional expertise from Australia, Canada, Costa Rica, New Zealand, and the USA. The organization was very capably undertaken by staff of la Universidad de Iberoamerica (UNIBE). The local arrangements for the workshop were excellent, and all the participants would wish to record their appreciation to UNIBE for its foresight and for the substantial support that it provided. Discussion was very lively both in the plenary sessions and in the interactive workshops. It was particularly pleasing to see that local students contributed actively. Simultaneous translation (Spanish/English) of the formal presentations and some of the discussion sessions greatly assisted communication and ensured the free exchange of ideas.
A number of important themes emerged from the formal presentations, the ensuing discussions, and the workshops.
Educational Change
The major recurring theme throughout the workshop was the issue of educational change itself, because the workshop had been established to introduce current trends in physiology education. Many of the sessions included ideas that were new to at least some participants, ensuring a high level of interest and debate. There was an emphasis on the need for student-centered learning, which shifts the focus from the teacher to the learner. It was repeatedly acknowledged that student learning must be active. All speakers introduced ideas and stimulated thinking on various alternatives to the traditional didactic lectures and repetitive "cook-book" practicals. Obviously the effective management of educational change is crucial, but there was overall a willingness to explore the possibilities, despite cultural and traditional barriers to change. For some, too, such new approaches represent significant threats to the authority of the teacher, but many warmly embraced the ideas and debated a variety of strategies that would assist students to control their own learning.
Related to this theme, issues of the management of resources (staff , finance, and equipment) recurred. Many were concerned with locating resources to support newer methods of teaching and learning physiology. Others questioned how to determine priorities for change and how to balance competing demands in the face of limited resources.
George Somjen, in his introductory talk, emphasized the variety of ways in which programs in physiology are constructed across the world. Physiology is a core subject for students in many programs. The variety of approaches he reported demonstrates that there is certainly no single or "ideal" curriculum in place because of the needs of disparate student groups and local priorities. Both the relative time allocations and the order of presentation of topics are highly variable. He highlighted the need for staff development and for mentoring of new staff, both obviously crucial, particularly in a context of change. Orlando Morales offered some stimulating insights (intriguingly based on Newton’s Laws of Motion) on the difficulties of initiating and implementing change in educational practices.
Collaborative Learning
Much discussion centered on ways of encouraging students to work together. In that way, active learning occurs in the classroom; students are able to test ideas and rehearse their growing understanding. The theme of students working together actively in groups was introduced first in the context of problem-based learning (Bill Galey and Ann Sefton). It recurred in the context of students tutoring each other in working through computer programs in scheduled tutorial classes (Joel Michael and Rob Kemm). Teamwork also featured in discussions of student practical sessions (Dee Silverthorn). The challenge for teachers is to develop ways for students to collaborate in different teaching settings. In that way, the students’ communication skills are enhanced, their use of professional language is developed, and their understanding of concepts is subjected to the critical questioning of fellow students as well as staff.
Problem-Based Learning
There was considerable interest in the issues raised by two speakers on problem-based learning (Bill Galey and Ann Sefton). The method clearly reflects a commitment to a student-centered approach and represents one form of active learning. Students faced with a problem presented to them in a group situation must work together to identify the issues and find a resolution to the problem (in the health sciences, usually a clinical problem) that is presented to them. The communication skills of the group are enhanced, and students learn to work cooperatively in a team. For many health professional programs, the method supports clinical reasoning, the use of appropriate biomedical language, and the early introduction of clinical experience. It may be implemented across a whole program, integrating different discipline areas, or remain more restricted in scope within a single discipline or subject.
There was considerable interest in the method, although it is not yet implemented widely in Central and South America. In discussion, although many had heard of the method, some participants were very knowledgeable about the details, whereas to others, it was a new and perhaps daunting concept.
The Use of Computers in Teaching Physiology
Considerable interest was aroused in the various ways in which the learning of physiology can be enhanced with the wise use of computers.
Joel Michael provided an excellent introduction to the use of computers by small groups of students to stimulate their discussion, test their understanding, and to "tutor" each other. The particular focus was on "putting ideas together" to understand physiological systems when they are perturbed. Enthusiastic groups in workshops had the opportunity to explore his programs and to consider their usefulness in their own home universities; most expressed strong interest in using the materials. Rob Kemm illustrated the use of well-designed computer programs to help students construct their own conceptual models of various physiological mechanisms.
Computers also offer new opportunities for recording data in practical experiments, an issue demonstrated and discussed by Bridget McMillan, Michael McKnight, and Alexey Putvinsky. Ingenious experiments were demonstrated in "hands-on" sessions, and the PowerLab system provided an opportunity for participants to see what could be achieved in their own practical classrooms. The notion of capturing data for later teaching sessions was also demonstrated. The generous provision of the computers and PowerLabs allowed individuals to explore and test ideas, a strong feature of the workshop.
Rob Kemm and Ann Sefton illustrated different uses of web-based technology, for stimulating student discussion of difficult concepts and for supporting problem-based learning, respectively. Issues related to the use of the internet were debated in lively workshop discussion sessions. Concerns were expressed about equity of access by students and staff and the lack of expertise and confidence of many staff. Many participants discussed ways to become familiar with online searching and using the technology. Thus the need for staff development and for support for the infrastructure were both recognized as critical issues. The value of computers in distance education was acknowledged, although the particular difficulties of access and equity at a distance were recognized. The ubiquity of English on the internet was noted, and disparate views were expressed. Some argued that all students need to be able at least to read English in order to remain current in their practice after graduation, whereas others argued equally strongly for translation into Spanish.
Groups actively debated the issue of providing learning materials for staff and students on the web. All agreed that access to high-quality teaching and learning resources was a high priority. There was a strong consensus that the American Physiological Society (APS) was the logical organization to offer leadership, and there was strong support for that organization to continue to provide good quality resources. Adequate descriptions of materials and appropriate tagging for identification were both considered to be essential so that teachers can locate relevant material. In addition, it was agreed that evaluation was crucial, not only before materials are posted in order to ensure quality, but also later, so that those who found items useful (or not) in enhancing student learning in specific settings could contribute views. Issues of intellectual property rights, copyright, and acknowledgement clearly need to be resolved. Although some felt that an educational website should be managed by the international body [International Union of Physiological Sciences (IUPS)], the leadership of the APS with its present initiatives in this direction was acknowledged.
Practical Classes
Dee Silverthorn presented ideas for practical classes, focusing on good experimental design and the effective use of groups to ensure that students engage intellectually with the class. One principle message was that if the objectives of the program can only be met with experimental work, then it must be included. She presented examples of useful strategies, including the use of prediction of responses, an approach also used in Joel Michael’s programs. Successful classes more closely model experimental research. She also described the imaginative use of invertebrate preparations that can be used for hands-on experience.
In later discussion, it appeared that for many participants, animal rights was not a major social or political issue but that some individual students expressed objections to working with animals. Overall, there was a feeling that the use of animals in classroom experiments was declining. When considering replacing live experiments with computer models, the students present expressed strong opposition, arguing that the experience of handling live tissue was valuable.
Disseminating Advances in Teaching and Learning
Penny Hansen presented information on the educational literature. She highlighted issues in publishing and disseminating educational ideas and developments, encouraging those with an interest in teaching to evaluate their work and publish. In smaller group discussion, it was apparent that participants were aware of, and read, Advances in Physiology Education as well as other educational journals in the health sciences. They were less confident about identifying what might represent an appropriate educational innovation worthy of publication, and some felt that their skills in English were weak.
International Collaborations
Participants expressed the strong wish to develop a collaborative Central American group to support both research and teaching in physiology in the region. A letter of intent will be passed on to the IUPS. The establishment of a regional educational committee would be welcomed by the Teaching Commission of IUPS, and the regional chair will be invited to join the IUPS Commission for Teaching. The group was also interested in the possibility of linkages with universities elsewhere for staff and student exchanges as well as collaborations in teaching and research.
SELECTED ABSTRACTS
Student Researches with PowerLab
A. Putvinskiy
UNIBE-Universidad de Iberoamérica, Apartado 11870, San José 1000, Costa Rica
One of the best ways to stimulate the interest of students is to get them to feel as though they are performing real research. With the right encouragement, and given a framework, students can design an experiment, implement the protocols, and evaluate the results. Modern computer-based systems can turn the classroom into a real research laboratory. PowerLab is a computer-based data-acquisition system which is simple enough to put in the hands of students but is the same tool that is used by researchers world wide. A good teacher can excite the imagination of students with suggestions like "you would get a Nobel Prize if you could work out how to..." Students can then perform an analysis of the literature (the Internet is a good resource), and start to work out the methods, including the PowerLab hardware and software settings required, and the analysis techniques. Interpretation of the experimental results can trigger creative group discussions. Young researchers always like to see the results of their experiments and are happy to work on the presentation of their data in the form of a journal article, a lecture with a slide show, or a practical demonstration the experiment. To experience the exhilaration of performing new research, is equally important to your students regardless of whether they are destined to become research scientists or medical doctors, and this can be achieved with the use of a PowerLab system. Examples of student researches and developments are presented.
Test creator
E. M. Rodríguez and A. Putvinskiy
Laboratorio de Investigación, UNIBE, Costa Rica
Test Creator is a program designed specially to help university teachers in the creation, application and getting results of computer tests. The main goal of this development is to give an easy to use tool for the teachers with a simple intuitive graphic interface. With this program it is not necessary to be an experienced programmer to create a computerized test. In each one of the tests the teacher is not limited in the amount of questions and their content. Furthermore, he can insert one or more pictures, videos, sounds, texts as well as answer options for each question. The program gives the possibility of drag and drop any of the inserted objects to the preferable position. Also is possible to draw lines and arrows over the inserted pictures, this as a teachers requirement to bring out some parts of the images. When the process of creation of the test is finish the teacher obtains as a result: 1. The source files which can be used later to modify the test if necessary. 2. The installers to place ready test in student classroom, a program that doesn’t require Test Creator to run. Once the student has finished the test the program will show him/her (and the teacher) the score immediately, and also will give the student the possibility to go again over the exam looking for the right answers to failed questions. Test Creator seems to be new way to create exams more efficiently and rapidly than before with extra benefits for teachers and students.
PowerLab in physiology teaching
Bridget McMillan
ADInstruments, New Zealand
The ideal computer-based laboratory teaching system should be easy and fun to use, be flexible, and should help students learn. Although physiology principles taught worldwide are the same, the methods by which they are taught are as varied as the people teaching them. ADInstruments provides a choice of tools and resources that lets teachers customize teaching labs to best meet the needs of their students. ADInstruments produces a computer-based data acquisition system specifically designed for use in research and teaching in the biological sciences. Our hardware and software tools are ideal for recording physiological variables and for teaching both basic and advanced data acquisition and analysis skills. We supply specific teaching hardware, the PowerLab/20T, but any of our PowerLab units are suitable for teaching and can be easily customized by adding our front ends, pods, accessories, or other 3rd party hardware. The PowerLab software, Chart and Scope, can be customized to suit different levels and types of experiments. Editable menus, macros, and settings files allow automation of as little or as much of the experiment as required. Chart extensions add additional functionality to the system. For example: Playback-plays data files in real time, Sound-plays data as sound, Function Generator-generates waveforms, Export QuickTime-saves data files as QuickTime movies, Capture QuickTime-synchronizes video with data files, and Broadcaster and Listener-runs experiments over a network. To complement our teaching tools, we provide a range of teaching resources. Our Physiology Experiments Manual (PEM), and Teaching Experiments provide step by step instructions on how to perform an experiment. This material can be used "as is" with our settings files, or can be edited to suit specific requirements. Demonstrator notes, and additional written material describing more complex experimental methods, along with QuickTime movies showing experimental set ups, and data files, are also available. Our new Teaching Resources Web site contains the latest versions of our teaching material, as well as the opportunity for teachers to post their own material, view material posted by their colleagues, and participate in a PowerLab teaching Chat forum. ADInstruments is committed to working with physiologists and other biological scientists to further develop our teaching systems to ensure that they meet the requirements of modern physiology teaching.
Incorporating active learning in practical experiments for students
D. U. Silverthorn
Neurobiology Section, School of Biological Sciences, University of Texas, Austin, Texas, 78712
In recent years the emphasis on incorporating inquiry and problem-based learning has focused on the traditional lecture courses rather than practical laboratory sessions. Many faculty assume that because a laboratory is a hands-on experience, the students are actively engaged in learning during the session. In fact, this is not always true. Traditional laboratory exercises present students with a tightly scripted protocol that they are expected to follow. They collect data, analyze it, then submit a written report the following week. In this laboratory format, we have observed that if the instructor intervenes during the experiment to ask the students why they are using a particular procedure or piece of equipment, they are often unable to answer except to say that this is what the protocol instructs them to do. They may be physically engaged in the laboratory but mentally they often do not become engaged until after the session has ended, when they analyze their data and write their report. Several modifications of the laboratory format can help students participate mentally as well as physically. A simple method is to incorporate questions asking students to predict the outcome of a procedure before preforming the procedure. In one study, this technique was most effective when combined with instructor intervention that required students to explain their pre-dictions to the instructor (Modell et al., 2000). A more challenging format replaces the standard laboratory protocol with an abbreviated protocol that teaches students only the basic procedure they need to observe a particular phenomenon. The students are then asked to design and execute a controlled experiment that manipulates some aspect of the system they are studying. At the University of Texas, our laboratories are run in two-week blocks. In the first week the students learn the procedure. Before the second laboratory session, they conduct a literature search and write the protocol for the second week’s experiment. After three or four blocks, each student group selects one of their short experiments to expand into a mini-research project that they carry out over a 2–3 week period. At the end of the course they write a full scientific paper on their project and present the results in a 10-minute oral presentation to their classmates. This class has been well received by students, who feel that it gives them the opportunity to do "real science." For a few students each year, this laboratory format has diverted them from the health professions to careers in research.
H. I. Modell, J. A. Michael, T. Adamson, J. Goldberg, B. A. Horwitz, D. S. Bruce, M. L. Hudson, S. A. Whitescarver, and S. Williams (2000) Helping undergraduates repair faulty mental models in the student laboratory. Adv Physiol Educ 23: 82–90.
Variations Of physiology education around the world
G. G. Somjen
Department of Cell Biology, Duke University Medical Center, Durham, North Carolina 27710
On behalf of the Teaching Commission of the International Union of Physiological Sciences a survey has been conducted in the form of a questionnaire. Responses have been received from 50 countries. At the Workshop, tabulated results will be shown of the range of variation in course structure, fraction of time spent on various subjects, teacher/student ratios, reported fractional time spent by staff on various activities, methods of assessment, and teaching tools used, including textbooks. The presentation should launch discussions on: (1) the merits of "old" methods such as lectures versus "new" approaches, such as PBL and computer-aided instruction; and (2) on the best compromises possible between ideals and the realities of available resources.
Computers in the physiology classroom: using technology to foster learning with understanding
J. A. Michael
Department of Molecular Biophysics and Physiology, Rush Medical College, Chicago, Illinois 60612
To say that a student understands physiology means that the student has accumulated (memorized) some number of facts and concepts about physiology (including the language of the discipline) AND that the student can apply those facts to solve certain kinds of problems. Understanding, then, involves the ability to integrate information, predict the behavior of physiological systems, and explain physiological responses. Students acquire facts from lectures and textbooks. Achieving understanding, however, requires a more active engagement with the subject matter than is commonly achieved in the lecture hall. The computer can provide a learning resource with which the student can practice the skills that contribute to understanding. In the lecture hall the computer can be used to engage students in active learning (providing opportunities for testing their own mental model of a physiological system) and to help students visualize complex phenomena. In the laboratory the computer can facilitate the acquisition and analysis of data and can actively challenge students’ understanding of the physiological phenomena under investigation. The computer laboratory, where two or three students work together on a computer, can provide a setting in which the teaching program, student-student interactions, and student-instructor interactions can all facilitate learning with understanding. We have developed three teaching programs dealing with the baroreceptor reflex (CIRCSIM), the chemical control of ventilation (GASP), and acid/base balance (ABASE). Each of these programs helps the student integrate facts into a robust mental model of the system and requires the student to use this model to predict the responses of the system to specified perturbations. Experiments have demonstrated that such programs do improve student understanding, and that peer interactions, and interaction with the instructor also make significant con-tributions to learning. Thus, while the computer can deliver information to students (whether via CD-ROM or the World Wide Web), its most important use may well be in providing a tool to assist students in building their own mental models and learning to use those models to solve problems.
Evaluating and reporting teaching innovations
P. Hansen
Memorial University of Newfoundland, Canada
Master teachers apply the same level of scholarship to teaching physiology as they do to bench research. Evaluation of teaching innovations is an essential component of this process. Reporting our innovations at conferences, on line, and in print allows more than just our own students to benefit, and contributes to our understanding of best practices in education.
On-campus collaborative computer aided learning
R. E. Kemm
Department of Physiology, University of Melbourne, Victoria, 3010 Australia
We have developed a collaborative learning environment (CLE) as a student-centred approach to lecture replacement, with a special focus on assisting students’ learning of difficult concepts. The majority of the program is structured around cost-efficient web-delivered tutorials incorporating re-usable interactive components. These are supported by several stand-alone computer-based learning tutorials including ones that we developed to allow students to construct their own models of physiological mechanisms, together with computer-facilitated semester-long investigative projects to enhance their communication and critical reasoning skills. Each week for two hours during two semesters, 300 students work in groups of three with 15 iMac computers. The computer-facilitated tasks are designed to support and extend their three weekly lectures by encouraging peer-learning and peer-teaching. In this presentation, the successful attributes of this on-campus collaborative learning environment will be described and evaluated.
The elements of problem based learning in medical education
W. R. Galey
University of New Mexico, School of Medicine, Albuquerque, NM
Problem Based Learning (PBL) has become a popular approach to learning in medical curricula worldwide. It is an "active" learning process which uses medical cases as the basis for learning. PBL has been most successful in small groups of 5 to 9 students who repeatedly engage in this learning process. The group is usually led by a tutor (often a faculty member) who insures participating and facilitates the group process but generally does not "teach" the students. Learning begins when students encounter a medical problem, discuss the case and identify "learning issues" which they need to know in order to fully understand the case. Students then seek the information they need through individual, self-directed study. Subsequently they return to the small group setting and integrate their new acquired knowledge into the case. In this presentation I will discuss:
Problem based learning and curriculum design in medicine, dentistry and science
A. Sefton
Faculties of Medicine and Dentistry, University of Sydney, NSW 2006 Australia
Problem-based learning is increasingly being used in the teaching of clinical disciplines, especially medicine. "Problem-based learning" is used to mean different things in different environments; there are many definitions and adaptations of the method that will be discussed. I urge a common use of the terminology. Specifically, the new integrated four-year medical curriculum at the University of Sydney will be outlined, showing how problem-based learning is used to encourage the learning of physiology and the other basic and clinical sciences. That learning is supported by web-based resources and examples will be shown. Key educational values include: encouraging the students’ active and self-directed learning; emphasising clinical reasoning and evidence-based decision-making; integration and application of knowledge; early clinical contact for communication and examination skills; information literacy; aligning assessment with the overall goals; ongoing evaluation by students and staff. More recently, the dental curriculum at the University of Sydney has also moved to an integrated, problem-based model and the issues in modifying the medical curriculum for dental use will be reviewed. The issues include: matching the common goals and objectives of the programs; adopting similar educational philosophies; agreeing on common teaching methods and assessment strategies; developing the necessary dentally-specific skills. A variant of the approach focused on research questions has been used successfully to teach students in the final year of a three-year science degree. Some of the issues in design will be discussed, and student evaluations will be presented.
Flexible web based learning
A. Sefton
Faculties of Medicine and Dentistry, University of Sydney, NSW 2006, Australia
There is an accelerating trend towards the use of new technologies in teaching; the greatest challenge is to demonstrate its effectiveness. In approaching the decision to use new methods, what were the aims of the initiators? While their over-riding expectation or hope is usually to enhance learning in a specific area, other possible outcomes may include reaching more students, providing experiences otherwise impossible, offering flexible access to a wider range of information, encouraging rehearsal and practice in virtual environments, the development of more generic skills - including the use of computers themselves. Unless these expectations are made explicit, the impact or effectiveness of the technological solution cannot be measured against its own goals. On-going evaluation in use can subsequently feed into quality improvement cycles. The technology can represent everything from a complete program that is web-supported (e.g. the University of Sydney Medical Program), through specific information (learning packages, explanations, simulations) and formative self-quizzes for testing understanding to small learning units (individual images, graphs) including short notes. The technology can also be used to provide asynchronous communication between students, whether separated in time, or scattered into different placements or locations. Such communications can be enriched with some teacher input, moderating the discussion and offering help when appropriate. Access can also be provided to distant web sites and to library resources, often with links to make it easy to navigate. Is this strategy better than other more familiar approaches? Comparative judgment is difficult. There is by no means agreement on the best methods of decision-making in incorporating the innovation, even for the most basic of questions: Is the technology more effective in enhancing students’ learning than are the alternatives it replaces? Is it cost-effective? Is it received better by the students? Does it open opportunities (e.g. for flexibility of study)? Is it interactive? Conventional teaching methods have by no means always been evaluated rigorously, so the baselines for comparison are lacking or flawed. Complex variables (characteristics of the program in which the technology is embedded, students, teachers) inevitably confound any differences found, so absolute judgments are rarely possible.
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  D. B. Rivers USING A COURSE-LONG THEME FOR INQUIRY-BASED LABORATORIES IN A COMPARATIVE PHYSIOLOGY COURSE Advan Physiol Educ, December 1, 2002; 26(4): 317 - 326. [Abstract] [Full Text] [PDF]
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