Don't Do Cookie Cutter

I have spent all my years working on my online courses working hard NOT to fall into the ‘cookie cutter’ mode. What I mean is I work to avoid, at all costs, posting publisher-provided power point lectures, followed by publisher-provided handouts, culminating in publisher-provided assessments. Blah! Yuck! Spew! If an instructor was going to do that, then why don’t we just hire more ITS guys to post this stuff for us and then the instructor would really not have to do anything, heck maybe we don’t even need that instructor. (Note, this is not a bash on ITS guys since they are the BEST and we would be pretty much a body full of ideas and no one to help us get the ideas into reality… it is about instructors just being ‘up loaders’ and not ‘instructors’). So, what I am saying is I try to ‘teach’ and ‘create’ from scratch, every idea I want to get across. I have a textbook I recommend student use to follow along (of course they don’t need the high dollar newest version since I teach anatomy and no one has spouted new arms lately so it does not change much). But I make my videos, supplemental material and exams based on the learning outcomes and the content I put together. But has it worked out? I spent years avoiding the ‘plug-and-play’ from the publisher-provided content and web sites. Buuuuut…. this semester, I decided to play with fire. Can I play with the ‘publisher gadgets’ and still be original. Can I be authentic? 

So here is what I did. I had my students pay for access to a publisher provided online virtual cadaver program ($35.00). I was thinking, that just giving them the ‘goodie bag’ of sheep brains and eyeballs may not be enough. The online images I have are not that great and the publisher lured me in with great imagery and content…. but don’t they all? I was looking for a program or book or CD or app that my students could use that would show them cadaver images (quality images not gross ones, if there is such a thing for cadavers). This was important to me because a few years ago (when I last dabbled in this and used a program from another publisher) one of the comments on my student evaluation was about the images they had to view “looked like a coyote got to it before the photographer did”. After that I had sworn off this type of content and doubled my efforts to make ALL of my own content without ANY help from the publisher. 

However, the program I found, I have to say has the best images I have seen. I am pretty excited that it even lets you use a slider bar to look deeper into the body so you can see the relationship of one feature to the next. In addition, with just the click of a button, you can have all the instructor-designated features shown so students know what they are supposed to be looking for (the program has a list that an instructor chooses their features from so there are no items labeled that they don’t need to know). That was exactly what I was looking for. Then the bonus, it included microscope slides and radiologic images (x-ray, MRI, PET scans). 

But how do I use it and still make my class, my class? Well the answer is I don’t know, but I like the program and I am working to integrate it into the class like a lab that they can do from home. In fact the cadaver images and slides are better than what they would see if they were in the classroom. The bottom line is that I have my standards and I can evolve and incorporate or throw out things as I go along. And just because I used the ‘coyote-ate’ images years ago, I was not so scarred to not give it another try. That is a day in the life of an online instructor that just can’t leave well enough alone and just do the same thing over again. Never stagnate, keep changing and mostly keep evolving. 

Playing with Clay in College

Studying anatomy can be pretty straight forward when you have a list of things you must know and identify. Physiology starts to warp their minds when they have to figure out how things work. Anatomy can be difficult when all the things look the same and are the same shade of tan or grey. I am talking about a brain. A preserved sheep brain, specifically. It looks like a squiggly blob and then they get a list of things they have to identify and know what it does.

So we are actually talking about ‘brain surgery’ here. Where can you cut or if you cut what will you affect?

To get my students to really figure out the brain in a 3-D way I have them play with clay.

During my brain lab, I begin with asking students to build a brain. They are using clay and have to build a three dimensional brain including all the features they have to know about. My online students have to do the same thing. All my students build a brain. When they are done, they have to tell their classmates about it. In class, each student group (they sit at round-ish tables) will have one representative that ‘presents’ their brain. Then the class votes for the best one. Online students do this individually. They have to make a brain with clay and post a video to their blog pointing out each of the features Fellow students then comment on their colleague’s brain.

Students laugh when I first present this assignment, but then are excited to get to work. Some of them are fantastic and very detailed. The activity forces every student to do something and get involved in the learning as they each have to make different parts of the brain, even if there is one person putting it together. It is very much a collaborative project.

After students complete their clay brain and have presented it to the class (or video) then they "get to dissect" a preserved sheep brain. Students then show me the same features from their list that they had to know and make for their clay brain. I have found that students do so much better on learning the brain features and functions when they do the clay brain activity first. I noticed a significant improvement in brain identification and regional understanding when the clay brain project was incorporated compared to previous semesters when I was not using the clay activity. The purchase of clay is included in my syllabus class requirements now and I have expanded it to also make a clay model of any eye before dissecting a cow eye.

Anatomy Goodie Bag

We are close to Halloween so I think it would be appropriate to tell you about the “goodie bags” I have my online anatomy students pick up for class.

Putting together an online course takes quite a while to just think out what you are going to do. Like most things, it is so much easier the more you plan and follow the plan. In a traditional classroom format, it is much easier to ‘wing-it’ when a lab doesn’t work or you want to make changes based on student feedback or learning level. In the online environment, students need to plan too, so you have to have everything laid out from the start. I already knew my online anatomy class was not going to miss out on the smells and textures of an in-person class. Dealing with the smell and feel of dissection specimens is sort of a rite of passage. Far be it for me to allow my online students miss out.

About two weeks before the semester I open up my Blackboard site with all the class videos, notes, study guides, web links, lab resources, syllabus, and calendar. I post an announcement welcoming them but warning them about what they will be asked to do (to allow any squeamish students to back out and a chance for another to be able to get in or ask for an alternative activity, if necessary). To make sure that all my students are aware of the class requirement and to mimic the in-class requirement of ‘attending the first day of class to remain enrolled in the class’ policy, I have my online students complete a syllabus quiz and their lab safety quiz. To answer the questions they have to be aware of the policies of the course including grading, withdrawal dates, exam formats, and locations (some exams are at a testing center, some are online), and email policies. In addition, they have to read ‘lab safety’ information so they are aware of what they will be getting in their ‘goodie bags’. After I know they know the rules and risks of the class, they then have to complete a ‘class introduction video’ by the middle of the first week. I create a blog assignment in Blackboard that each student will have access to but other students will be able to view (if a student prefers not to have their information or face disclosed to the other students in the class, I allow them to post their video to a journal page, which only I can see or they can just email it to me directly). This video accomplishes three things. First, I get to see and hear my student and get to know a little more about them than a name on the roster. Second, they get to figure out how to make a video and upload it; a skill they need to know for their upcoming labs. Lastly, they get to view other student’s videos introductions and feel like they are in a class with others and not just on their own island. Great! Now they know what to expect in the class, they get to know each other, I get to know them, and they know how to use basic technology.

Once I know they have completed the lab safety quiz, students are allowed to come to my office to pick up their ‘Lab Kits’ (a.k.a. goodie bags). I set them outside of my office door on my cart so they can pick them up at their convenience. I let them know when I will be there to encourage them to stop in so we can meet in person. I really miss that part when I teach online so it is nice to be around when they come by. I also noticed that students that make the effort to meet me in person at the start of class is much more likely to contact me or come by for help when they need it (not just when I contact them after they did poorly on an exam). In their lab kits I provide the basic specimens lab activity resources. They get the lab guides and more information on Blackboard. My BIO 201 class gets a sheep brain and eyeball (they are required to purchase on their own clay and a mini skeleton). My BIO 202 class gets a sheep heart, blood typing kit, urinalysis dip stick, and a sheep kidney. Most of my students are really excited, in a geeky way about getting these kits. (I even have provisions for pregnant students that do not want to experience the wonderful smells of anatomy).

"Hands On" or Applicable Labs

I have visions of ‘more effective’ learning in terms of practical application when I update my anatomy classes each year. Bridging the gap from pointing to a heart on a table or even better in a cadaver to reading an MRI or ultrasound. Here is the basic image of a heart that all anatomy students must learn.



However, in the clinical setting very few (or none) will ever see this in a person. What they will see are electrical tracings or images like these:

These look nothing like what they learned in anatomy class. Being educated clinically, means re-learning anatomy in the context that will be viewed with the evaluation tools available. So I must ask myself, as their anatomy instructor, how do I prepare them for the applications of what they actually need to know.

Here at YC, we have a great cadaver program. Thanks to Dr. Bronander many years ago, we were one of the first community colleges in the state to have a cadaver program. I am very proud of what we can offer our students with these resources. We provide students with an opportunity to dissect these cadavers as first and second year undergrads; a privilege that is reserved for graduate students at any university. Oh, I digress…

The cadavers are great, but they are dead! There are lots of things in a cadaver that look nothing like they would in a live person. The spleen for example in a healthy person is a rather disgusting organ (I guess it is gross in a dead person too) in that it is a roundish, fibrous tissue blood-filled balloon. Think of a zip lock bag filled with cotton with blood flowing through it (for filtering of course). In a cadaver it is a hard, dense ‘lump-of-clay-like’ organ that has no resemblance to the squishy, delicate ‘live’ organ. Sorry, enough of the gross talk, I hope you are not eating anything right now. But trying to appreciate the spleen in real life from a cadaver is literally like studying a grape by looking at a raisin. Students can’t imagine how delicate the spleen is and how easily it can rupture (or pop) when a driver hits the steering wheel in a car accident. How can I relay to students how nearly impossible it is to stitch it back together without risk of blood continuing to ooze out of it. That is why the spleen is frequently removed after a traumatic injury. OK, enough of the anatomy lesson but you get the point that a student can’t always appreciate the anatomy they are learning for future clinical use, even in the best cadaver labs.

My dilemma and ultimate goal is to teach the clinical anatomy applications when they are first introduced to the anatomy topic in my class. The online environment is the perfect medium for this to occur. It is more conducive to images than a holding a real, stinky heart. These clinical images are really what they are going to need to know. Thus, the next frontier of my course is to establish basic anatomy along with MRI and ultrasound images so that when they move on to their clinical education they are truly prepared.

The Evolving Online Lab Report

How do I get students to get a ‘hands on’ type of lab experience at home, taking an online class? I first went through my list of topics and thought about what they needed to know and what they should be getting out of the ‘hands on’ lab experience (in the lab or at home). I also had to give up some things I feel is important, like actually working with a microscope. My first lab online was a lab about types of tissues in the body (BIO 201 Human Anatomy & Physiology I) and the hormone secreting glands (BIO 202 Human Anatomy & Physiology II). These both involved students looking at tissue slides through a microscope. OK, not a realistic thing to expect online students to have access to a microscope. There are three things I really need students to know when they are done with these labs (in the lab or online) when they are presented with a specific slide image. 1) be able to recognize where that image came from in the body. 2) know specific features from that image (e.g. collagen fibers or name of a cell). 3) describe what that tissue does or what that gland secretes.

If I let go of the importance of actually using a microscope and focus on what they need to know regarding the subject matter, then the vast array of quality photographic images available online become the primary resource for these labs. I created a lab report guide for students to follow. In that guide, I listed the tissues or glands they needed to find images for, then a list of features they needed to point out on those images, and finally a series of questions about each tissue relating to its function in the body. I left the report pretty open to allow students to be creative in how they made the report. They could have used Glogster or Prezi or Power Point or a word processor or any format that allowed them to show what I asked for in a way that made sense to them. I looked forward to seeing what the students would create.

The first semester I launched this online lab reporting I had them submit the report as a document or web link. They just had to attach it or post it to the assignment page in Blackboard where I could view it, write comments about their report and post their grade. This was great until I started grading the lab reports. The reports were mostly cut and paste jobs put into a word processor taken almost verbatim from Wikipedia with the image also provided on Wikipedia. That first round of grading did not go well as my comments included their plagiarized portions of the lab along with a warning note. Now I had to rethink this to get my students to actually ‘learn’ something from the lab (i.e. the actual purpose of doing the labs in the first place) rather than just making a ‘hoop they have to jump through’ where they only do what is listed with no attempt at gaining any knowledge from it. I had to then tighten up the report guidelines, which I hated to do because the good students did a remarkable job in finding great images and were very creative in their own way of presenting the material. The rest of the semester was a balancing act of making the report process rigid enough to force the less inclined students to gain the necessary experience and open enough to allow the creative students to generate a report that shows the depth that I had hoped for. Whew, now that semester was over, I had to rethink things. I was so impressed with many of the great reports that I thought that the other students should be able to see it and then they can also be inspired and motivated to improve or at least learn something from their fellow students.

The following semester, instead of having students submit their reports to the assignment page where I was the only one to see it, I had them post it to the designated blog for that topic in Blackboard. Then I made it a requirement that each student had to view and comment (including one constructive criticism and one complementary comment) on three fellow students lab reports. I thought that by forcing students to view other students works they would be inspired and also knowing that their reports were going to be viewed, they would be more motivated to present a better report (as if submitting a report to their instructor for a grade was not enough, which it wasn’t for some students). This improved things a great deal but for me when I did my portion of the grading, I still could not tell if the students ‘got it’ or if they just were better at paraphrasing.

My next change was to make the students ‘teach’ their fellow students. Instead of having students write reports, I wanted to hear them tell me about what they know. I took that part for granted when I would teach students on campus. I had a verbal interaction that allowed me more insight into where a student was on their learning process and I could better read what they needed from me. Online, I never even knew if they could pronounce the words. So, I decided their lab report should be a video. Same report outline but now they had to make a video that was ‘showing’ or ‘teaching’ the class about that topic. They still had to include all the tissues or glands on the list and the features and the actions. However now instead of bullet lists with attached images, they show an image on the screen and recorded their audio while pointing out what they are talking about. This helped a lot for me to get a better feel of where students were in their understanding. As anyone on our side of the desk knows, you learn more about the subject each time you teach it. Why not give students that opportunity? They posted their video as a link and their fellow students still had to view it and comment. This not only sparked better content demonstrations and many mini tutorials for other students to learn from but it broke down some of the online barriers and made students communicate in a more meaningful way.

Science Online: How do you do "do"?

One of the most difficult things I have faced as an online instructor is the implementation of meaningful lab activities into my course. The question that always comes up is: “How can you do anatomy labs online?” That is a great question, and the main one that I struggled with for years before taking the online plunge. To wrap my head around how I was going to do this, I started at square one; the student. What do I want the student knowing or being able to do when they leave my class? This question applies to all of my classes (traditional, hybrid, and online). This statement seems obvious as we all follow the learning outcomes for our courses. To me, this question means more. My question is not what I need to check off on a list of topics we must cover, but instead what they should know. I can only speak for science here, but in science it is important to not only know but to be able to do. Again this applies to whether I see them in person (traditional or hybrid) or not at all (online)? So, how do you do “do” in the online environment?

With that perspective in mind, it became easier to approach building activities for the online student. Instead of trying to adapt in-class activities to online students, I looked at the outcomes and tried to think of ways to get the student to that point. Once I shifted my mind to that style of thinking, the learning possibilities broke wide open .I was able to generate visions of the online class labs being more effective in practical learning and application than the traditional format.

If a student needed to achieve mastery in understanding the anatomy of the heart, two questions come to mind. How are they going to learn about the heart? What are they going to use that information for? This then brings up the subject of my student population and where they are going, academically. Anatomy & physiology (basically form and function) is the backbone of any educational path in the health care field; doctors, physician’s assistants (PA), nurses, pharmacists, physical therapist, athletic trainers, radiologists, dentists, dental hygienists, etc… They need to learn about the heart so that when they get to their clinical training (medical, PA, or nursing school) they can have a basis from which to read the diagnostic tests. Even then it is not enough to read the results. They must be able to interpret the data. That is the critical leap. All of my students need to walk away from our anatomy classes with the understanding of how something works so they can figure out what has gone wrong in a patient. Then, when their medical training teaches them the treatment protocols, it makes sense and becomes more than a ‘if this happens to this” learning rubric. Basically, the information they need to be given forms the foundation to develop their skill set for interpretation of the information they will get and the application of that information to the patient.