The A&P Professor podcast (TAPP radio) episodes are made for listening, not reading. This transcript is provided for your convenience, but hey, it’s just not possible to capture the emphasis and dramatic delivery of the audio version. Or the cool theme music. Or laughs and snorts. And because it’s generated by a combo of machine and human transcription, it may not be exactly right. So I strongly recommend listening by clicking the LISTEN button provided.
Episode 7 | Transcript
Teaching for Long Term Learning
Kevin Patton: It wasn’t until I was about 10 or 15 years into teaching human anatomy and physiology that I realized that there was fundamental flaw in the way I was doing things. What was that flaw and what are some ways to fix it? Stay tuned. (Music plays)
Aileen: Welcome to the AMP professor. A few minutes to focus on teaching human anatomy and physiology with host Kevin Patton. (Music plays)
Kevin Patton: In this episode, I discuss the temperature of mitochondria. I give a Podcast recommendation and we continue a prior discussion of long-term learning.
Kevin Patton: Today’s lucky number is 10. Why 10? Well, it turns out that there’s some information just published that suggests it’s quite possible that the temperature difference between mitochondria and the rest of the cell, the rest of the body, is about 10 degrees Celsius. So 10 for 10 degrees. That’s a little bit of information that isn’t central to our understanding of human anatomy and physiology but we certainly talk about the fact that mitochondria do produce heat and a lot of it. That helps us explain thermoregulation in the body. It helps us explain how muscles when they’re mitochondria, which they have bajillions of, are really cranking, that’s going to possibly overheat the body and we’re going to have to turn on our cooling system to get it to cool down or take various behavioral strategies to cool things down.
Kevin Patton: When we’re too cold, we can start shivering our muscles and doing other muscular activity to kick those mitochondria in gear and get our body temperature warmer than it was before. So, 10, a little number we can stick in our pocket and pull out sometime when we’re telling the story of metabolism or thermoregulation or homeostasis or who knows what. (music)
Kevin Patton: As you know, I like to share different resources with you on this podcast and that’s going to include other podcasts that you might find interesting or useful. The first of those is one that just recently just came out of the University of Utah. As a matter of fact, the last episode isn’t finished yet. It is a limited series podcast, which means that they’re telling the story over a series of very short episodes and it’s called Secrets of the Campus Cadavers.
Kevin Patton: What it is, is they were expanding one of their old historic buildings and the architect was visiting the site and practically tripped over a human skill. They had to figure out where it came from. This isn’t a spoiler but it turns out that they were remains from human cadavers that were used in medical education many, many decades before this excavation took place. The story of how they were found, how they were analyzed, and what they found out about these cadavers, and sort of the history of the use of cadavers and so on is related in this very well written and very well produced podcast.
Kevin Patton: I contacted Paul Gabrielson, who is one of the main movers and the narrator of this podcast and he sent me this clip that I think you’ll find interesting that introduces this podcast.
Paul Gabrielsen: Hi, this is Paul Gabrielsen. I’m a science write at the University of Utah. Most days I’m report on the latest science and research news from the U. But sometimes, we here at the University communications office come across a story that’s bigger than a press release. For the past year, we’ve been working to tell one of these stories as a serial podcast.
Paul Gabrielsen: Our story starts in the morning hours of April 20, 2016. Charles Shepherd is a historical architect with the University of Utah and this morning he’s making a routine visit to a construction site on the university’s historic President’s Circle.
Charles Shepherd: The ground was, the excavated soil service was quite smooth. It was kind of a sandy surface, rather sandy soil. There’s was what I thought was a large cobblestone over to my left and I walked over to it thinking it was just a big rock. And, immediately could tell that it was not just a big rock. I’m not an anthropologist or a, you know, never had an anatomy class in my life or anything but I could recognize a skull when I saw it.
Paul Gabrielsen: Local media pounces on the story.
Reporter 1: The University of Utah has a mystery on its hands right now.
Reporter 2: Construction workers found what appears to be human remains just before 8 this morning. Work has been halted on the site until the state forensic anthropologist reviews everything.
Derinna Kopp: I was assuming that this was what the vast majority are, for me, which was they had accidentally hit ancient archeological human remains.
Paul Gabrielsen: That’s the state forensic anthropologist. Her name is Derinna Kopp and she’s called in whenever someone comes across human remains anywhere in the state of Utah.
Derinna Kopp: When I looked down there and started picking through the soil and finding the bone fragments, I saw a part of a cranium that had been purposefully sectioned off with a saw. And, that’s when I was like, “Oh, where these are not archeological Native Americans. They are actually anatomical specimens.”
Paul Gabrielsen: They’re cadavers. A hundred years old from the early days of the university’s medical school. But whose bones are these and how did they end up underneath the building?
Paul Gabrielson: Find out the rest of the story in our 7 part podcast series, Secrets of the Campus Cadavers, available now on Tunes, Stitcher, and on the web at unews.utah.edu/cadavers.
Kevin Patton: Well, there you have it. I’ve been finding this podcast series Secrets of the Campus Cadavers, very interesting. I hope you will too. (music plays)
Kevin Patton: In the episode before this podcast, I discussed cumulative testing and how I used that in my anatomy and physiology courses to try and promote long-term learning. Well, right after episode aired, my friend Margaret Thompson Reese posted this comment, which I think is spot on and will help us take that conversation to the next level.
Kevin Patton: Here’s what she said: “It also gets past them memorizing a section and then doing a brain dump to make room for the next set of material. Once in lab class, I told my students as we began learning muscles to refer back to their notes on bones because it would help them with their muscle names. They told me that they had thrown away those notes because they were done with bones and they did not like clutter.”
Kevin Patton: Whew. Well I think all of us have experienced that sort of thing one time or another in our teaching and I think Margaret’s comment really emphasizes the fact that there is a fundamental flaw in the way we were taught as undergraduates. When Margaret asked her students to take what they had learned about muscles and bring it forward into their learning about bones, her students were surprised. In previous courses, they’d never been asked to do something like that.
Kevin Patton: I know, it was 10 or 15 years into my own teaching that I started to realized that there was something I could do about this phenomenon of them not remembering anything from the prerequisite courses or at least it didn’t seem like they remembered much from their prerequisite courses. Then, I would occasionally hear from clinical instructors something like why didn’t you teach that topic to these students in A and P because they need to have that in my course. I would look at them and think, “Oh my gosh, we spend a week on that topic. I didn’t skip that topic.” My students did well on it on the test so how did that disconnect happen and what can I do to fix that because I know I’m covering it. It’s not that I’m not covering it. I know I tested on it and they tested well so it’s not that there wasn’t any level of understanding. So, what is it?
Kevin Patton: Well, I think it gets back to what we were talking about in episode 4 about cumulative testing. That is that we don’t do that often enough. Yes, we will often have a comprehensive or cumulative final exam, but by then it’s kind of too late. There’s a lot of things that have been forgotten and that’s why those final exams are so horrendously scary and they’re so tough and the performance on final exams isn’t really what it should be if students have been mastering the material all along.
Kevin Patton: So, in episode 4, I talked about how every single test and quiz that they get is cumulative. There are always questions about not only the preceding topics or set of topics, but there’s questions about all of the topics of the course that preceded that test. Then, we go on to the next module, and the test on that module is going to be cumulative and include everything before that. So, go back to episode 4 and see how I did that.
Kevin Patton: I think that that is a very good strategy for getting things into long term memory so that when students move from bones to muscles, they already know how the course is set up. They already know that they can’t throw that away not just in terms of throwing away their notes, which I’m going to talk about that a little bit in a minute, but dumping it out of their brains. That is, getting the mindset that they’ll never need to use that again because even though I think they know somewhere in the back of their minds that they’re going to be bringing this into a nursing program or OT, or PT, or med school, or wherever it is they are going after they take A and P. They kind of know that in the background but I think they view our course as just a hoop to get through to get there not really as the foundation that they need to understand what it is they are going to be learning in those later courses and eventually in their health sciences career.
Kevin Patton: Using the cumulative testing as I’ve described it I think is a good start. Another thing that we can do is leverage our own cumulative tests and quizzes with any of those prepackaged adaptive learning tools that are offered by publishers and third parties that have done a lot of the hard work of assembling test banks and assembling a platform with various kinds of algorithms that give student feedback and so on and let them keep practicing things over and over and over. Most of those platforms have some options as to what is included in any one test or quiz or module or whatever that they’re organized in. The options allow us to pick and choose subtopics often and those that allow us to go back and bring in some material or some activities from prior topics I think could be leveraged along with your own tests and quizzes into this cumulative approach. They’re getting tested on older topics again and again from this angle and from that angle. The more we do that, the harder it is, but the harder it is, the better, the more deeply they are going to learn.
Kevin Patton: I’m not talking just about rote memorization. That’s going to be a topic for another day. I believe that in human anatomy and physiology there is a lot of rote memorization. There’s also a lot of application and deep thinking and connection of concepts and so on that has to be done as well. Learning scientists, though, are still arguing about is it better to start with the application and that will lead us to the memorization or is it better to start with memorization and that will lead us to the application. Or do we mix it all up and do them side by side? What do we do and we’ll talk about that another time. But the point is that there’s got to be both in our A and P. And this cumulative testing is going to help with both the rote memorization as well as the application of that.
Kevin Patton: When I say that I have test items or that we can pick test items in our depth of learning tool from prior topics, I don’t just mean knowledge based questions, the facts, although we want to include those to practice calling those facts. But also practice applying those concepts from prior units or modules in our course.
Kevin Patton: There’s something else we can do I think that will help us go from course to course. I teach a 2 semester human anatomy and physiology. I think that is a widely taught kind of course where you have anatomy and physiology 1 and you have anatomy and physiology 2. When my students move from A and P 1 to A and P 2, I was always very surprised that all of that stuff I hammered in to them in A and P 1 wasn’t being reflected when came back from the break and came in to A and P 2. It was like, what happened? You performed well on my tests and so on. This was before I tried the cumulative testing.
Kevin Patton: After I did cumulative testing, I found out that wow, they really are retaining a lot more than they did before. Not perfectly, though, and not as well as I’d like in an ideal world, but it improved things so that’s good. It kind of shows that my recommendation for cumulative testing has some merit to it.
Kevin Patton: But, I also found that there’s another opportunity to do cumulative testing right at the beginning of A and P 2. At the beginning of A and P 2, I start with an exam, a cumulative exam before I’ve taught them anything. Before I’ve assigned any learning activities. Before we’ve had any discussions in class, other than the discussion of the syllabus and other first day type materials. They get an exam. It’s an online exam where they need to go back and answer questions about all of the different things that they learned in anatomy and physiology 1. I call that test zero. Test zero is called that because it’s before the first test on the material of A and P 2. You’ve got to assign a number to it, so I assigned 0. I learned that in algebra class. You know, 0 comes before 1.
Kevin Patton: What do I do in that exam 0? Well, it’s an online test and it’s open book so they can take as long as they want with it. They can do 3 attempts and it’ll record their highest grade. My point in that is not just to assess where they are. The main goal is to do a formative kind of assessment that is testing as a learning process. I’m giving them another opportunity for retrieval practice. I’m giving them another opportunity to go back and refresh everything, or at least all the main things, that they learned in A and P 1. This is applying some of the principles that I’ve been talking about in prior episodes such as spaced retrieval practice, such as cumulative testing, such as using a test as a method for reviewing and learning material, and doing that spaced retrieval practice. So by doing an exam at the beginning of A and P 2, then I can really get them up to speed.
Kevin Patton: Then, I found that I would run into those issues of them not remembering things from A and P 1 that they need to remember like what is homeostasis, what’s a negative feedback loop, and even some very basic fundamental concepts like that. I didn’t have that anymore. What I had was students that as a group were remembering more and more as they came so that means we could really progress in a much more efficient way in A and P 2 than we ever could before.
Kevin Patton: Once I started doing that, I realized that I could do that at the beginning of A and P 1 too. Now our prerequisite for anatomy and physiology 1 during most of the time I was teaching it was high school biology or its equivalent within the last 5 years. The equivalent would be, if they came in without that prerequisite, would be to take one of our general biology classes at the college level or a similar fundamental level class such as human biology. I found that a lot of students weren’t remembering the stuff that this prerequisite was supposed to ensure that they already knew. Since it had worked to do an exam 0 in A and P 2, I decided to do a test 0 in A and P 1. What that contained was all of those fundamental concepts of cell biology and things like that, that we had hoped our students were bringing in with them by having them satisfy a prerequisite requirement.
Kevin Patton: Of course, that’s really scary to students at first, but when you tell them that’s okay. You can take it at a slow pace. You can use books. You can get help from me and so on as you do this. It was really presenting them with an opportunity to practice that. Practice retrieving the information that hopefully was already buried in there somewhere and if they ran into something that they had never learned or had been absent that week or whatever during that prerequisite class, then they had the opportunity to come to me or to our learning center tutors or get with each other and so on and brush up on that missing material.
Kevin Patton: In A and P 1, it helps set them all on an even playing ground to begin things. And then by doing a cumulative test at the beginning of A and P 2, then that refreshed all of that from A and P 1 and prior and made them that much more ready for A and P 2.
Kevin Patton: There’s another thing that we could do, and I haven’t done this, but I have some friends that have done this with great results. And that is at the end of A and P 2, use the HAPS exam. The Human Anatomy and Physiology Society, or HAPS, has an exam that you can use in your school. It’s a standardized exam that is given across North America and they really do a lot of work not only on how it’s been constructed. It’s been around for years so there’s been a lot of massaging over the years and tweaking, and it’s really from what I understand, a very useful tool. Compare your students performance in the HAPS exam with students across the country.
Kevin Patton: The way that my friends recommend that it be used is to just give it to them to see how they do. To tell you where the trouble spots are, compare those trouble spots to trouble spots in other parts of the country. From what I’m hearing, everybody has trouble with certain aspects of neuroscience, for example, and other topics within A and P. So that kind of makes you feel better that it’s not just me, it’s everybody and how can we make this better? But it also gives the students yet another opportunity to do their retrieval practice and to see how they’re doing in terms of everything there is to know in A and P. So that would be another opportunity to enhance their long term learning.
Kevin Patton: So by the time they’ve had all of these tests, over and over and over. Our regular tests, our, which hopefully are cumulative, these test 0’s, and now we’re going to have another test on top of all these tests at the end from HAPS. That could really build a system that could ensure that when students go into their clinical courses, that they’re really ready. They’re as prepared as they possibly can be in terms of their knowledge of human anatomy and physiology. I would recommend that maybe we start talking to some of our colleagues [crosstalk 00:21:38] and ask them to have their courses begin with a test 0 which might be our cumulative final exam for A and P 2 or something like it so that they can go in there and give those students an opportunity to refresh everything they learned.
Kevin Patton: And that’s a concern of theirs because they really want students to be well founded in human anatomy and physiology. So that they can jump right into the clinical applications and go forward. They get frustrated, as you can imagine, when they have to go back and teach the A and P because students have forgotten it.
Kevin Patton: If we’re doing all of this cumulative testing all along and then they do cumulative tests at the beginning to allow students a change to refresh themselves then maybe we can improve this process of learning all the way up the line, all the way to the very end.
Kevin Patton: One other thing that I want to mention very quickly about trying to promote this is something that goes back to Margaret’s comment about throwing away their notes. I suggest that we really spend some time, not a lot of time, but a mention every once and while, but consistently throughout A and P 1 and A and P 2, that is encouraging students to not only keep their notes, but to keep them organized so that they know where the subtopics are. Maybe put them into binders and so on by topics so they’re building their own professional library of materials where they’ve kept their notes, their outlines, their concept maps. Maybe tests that have been returned to them and they’ve done the test analysis on so they can go back and maybe practice those tests again and retake those test questions if they need to refresh something later on.
Kevin Patton: Not only that, but to keep their textbooks. A lot of students, we know how expensive textbooks are, so they either rent a textbook or they’ll get one online that expires in a little while. Some of them do, some of them don’t. Or they’ll sell back their textbook at the end of A and P. I always tell my students don’t sell back your textbook because you’re absolutely going to need them in your nursing program and then I’ll run into them on campus a year later, and I’ll say how’s it going in nursing. Oh, it’s going pretty good, it’s very interesting but hey do you have any extra A and P textbooks laying around that you don’t want because I sold mine back, and I really need it. I just laugh and think, “Yeah, I have a pile of A and P textbooks that I’m trying to give away.” No, that’s not the case, and you know, number 2, if I did they would have all been given away by now. And number 3, I told you not to sell back your textbook. That needs to become part of your professional library that you’re taking on into these professional programs maybe even many years later that you can pull off the shelf. You can pull your notes off the shelf and refresh yourself because you are absolutely going to need to do that.
Kevin Patton: So there’s a few ideas for helping promote long term learning in our course and beyond.
Kevin Patton: (music playing)
Aileen: The A and P Professor is hosted by Kevin Patton, professor, blogger, and textbook author in human anatomy and physiology.
Aileen: Before implementing any of the recommendations given in this podcast, please seek the advice of your physician.
Aileen: (music playing)
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