Laura Ginesi, University of East Anglia, UK

https://doi.org/10.36866/pn.119.40

‘Go home, stay there, and put your teaching online from Monday’. 

Here is 6 weeks of my diary following this email from line managers. 

WEEK 1

Entry 1. My ‘Pathophysiology of Hypertension’ workshop scheduled for Monday 0900 is out, but what should I replace it with…?

Feedback indicates my face-to-face sessions are enjoyable and engaging. Tricky when faced with 320+ nursing students, but my teaching philosophy is to facilitate active learning through questioning. I want to stay somewhat true to this, so problem solving starts now.

Entry 2. Online PowerPoints and Discussion Board activity may not suffice and I’ve no idea how to use Echo 360 [lecture capture software] from home. The School purchased licences for Lt suite [AD Instruments], but the plan was not to roll it out until the second year of the revised nursing curriculum. Colleagues have not had as much as a demonstration. Next week is probably too soon for students.

I have more questions than answers. Will my students will still “get” threshold concepts and be able to apply them in patient care settings? How do I transition from face-to-face to remote teaching and still capture the essence of interactive workshops and lectures? How do I encourage students who may also be feeling a bit wobbly with remote learning? What on earth will I do about practical sessions?

Entry 3. Despite misgivings, I spent a long weekend of repurposing and re-recording. I even felt triumphant and ready by Sunday. That was until I discovered some files are too large for Blackboard [online student portal] to handle! In the end, I uploaded a tried-and-tested folder of self-directed learning about cardiac output and regulation of blood pressure.

WEEK 2

Entry 1. My online interaction with “digital native” students is not always enhancing learning. I’m starting to become familiar with Blackboard Collaborate Ultra, which has magically appeared amongst course tools. I spend my weekend preparing several classes – all designed to deliver virtual content about different aspects of physiology – but audio and video are problematic.

Entry 2. Pop-ups on my screen keep telling me to re-join my own classrooms. Half of the students are struggling to get online. Muting microphones and switching off videos is new – how do you do that? How do I find a register? Some students could not find the chat box. Others are reluctant to take the microphone. My favourite pathophysiology module students seem more intent on discussing home-schooling, preparations in ICU and A & E, and the various toddlers and pets making intermittent screen appearances. I sometimes forgot to record sessions. Another attempt to capture a live session resulted in precisely 7 seconds being saved. Disaster!

Entry 3. Escaping from lockdown to post a letter, I had a ‘physically distanced’ conversation with a neighbour. As a lecturer in London, he doesn’t miss commutes (silver linings?). We shared ideas about how to get the best from snail-paced, unstable, rural internet connections.

Also, I sourced new headphones, started researching USB microphones, and signed up for a MOOC about the current teaching situation. Good decisions!

WEEK 3

Entry 1. Isn’t technology wonderful? My 10-year old iMac decides to call it a day. The video card is not compatible with Catalina [operating system] meaning I can’t see anyone in Microsoft Teams meetings. 

Entry 2. My new iMac is delivered by a man in a mask who stands at an appropriate distance and takes a photograph instead of coming close enough for me to sign. Thank goodness for iCloud. I can now swap files over to continue flipping the learning, download to One drive, upload to Blackboard, and take part in the exponentially increasing number of meetings about placements (paid or otherwise) and assessments.

Entry 3. The trickiest task this week was to make an exam board happen. Years of experience of paper-based ones helped me while admin teams figured out how to make SITS and Tableau work from home. Lecturers not familiar with the “old fashioned” way struggled with all the spreadsheets.

No matter how severe the pressures at work seem this week (I was often close to tears), the News brings me quickly back to earth: people are worrying about the rising incidence of COVID-19 cases and fatalities, protection, and even buying food.

My parents (aged 90) refuse to see themselves as vulnerable and I realised it may be some time before I can hug our children or granddaughter again. I organised the first of a series of quizzes with my tribe through Zoom and it was chaos.

WEEK 4

Entry 1. A month into lockdown. It’s hard work taking part in live online sessions for hours at a time. Students seem grateful to have the webinars and activities and are responding positively but I need to find a more sustainable strategy (see Fig. 1). 

Entry 2. Although the SAMR (substitution, augmentation, modification, and redefinition) model provides a framework, lesson plans are not as organised as I would like. I am, at least, fully online and communicating something about physiology in various formats. Students have opportunities to draw on the whiteboards, participate using polling systems, answer true/false using icons like ‘thumb up/down’. Despite my unreliable internet, our learning technologists are helping and I am taking part in more remote teaching support sessions.

Could I do better? Definitely. Is it stressful? Totally exhausting! I’ve worked every day (despite being a part-timer heading for retirement). I wish the golf course was open.

Figure 1: My mind map for transitioning to full online delivery

WEEK 5

Entry 1. Students seem more confident working with technology but I still hate teaching a screen. 

Entry 2. With a clinical colleague, I include some breakout groups in a session about the autonomic nervous system, stress and resilience. Feedback from paramedics was positive and we overran because the discussion was going so well. 

With new confidence, I tried a workshop about neurotransmitters with occupational therapists and they also asked for more! This feels like progress.

WEEK 6 

After countless discussions about my connectivity, I eventually spoke to a kindly technician from our internet provider and things improved significantly. 

Part of a hastily put together team planning a new Health & Life Sciences module due to start in September; we are now launching in June. A few weeks to grasp the nettle and plan – I love curriculum development! The first three weeks are timetabled and new online content will see us through until the summer break. Yay! 

REFLECTION

I’m supposed to retire soon and I have often felt too old to learn new tricks. Transitioning to online delivery in entirety – albeit in this emergency situation – has been one of the most challenging but strangely rewarding periods in my teaching career. Six weeks ago, I had rarely narrated a PowerPoint; now I can screencast, podcast, manage webinars and even make movies. Phew!

I miss the face-to-face contact with students terribly. What works for me is to imagine how they might feel; I try to feed off that to sustain my energy, enthusiasm, and some kind of presence that helps students to engage with the physiology topic in hand.

I owe enormous thanks to two other lecturers: my brother for helping me find the right buttons to click and an old pal for sharing the nuttiness.

Laura is a physiologist and lecturer in Health Sciences at the University of East Anglia, UK.  She gained more than 20 years experience as Senior Lecturer at City College Norwich and Birmingham City University. She is co-author of Anatomy & Physiology: An Introduction for Nursing and Healthcare (Lantern; in press) and Dementia Care at a Glance (Wiley). Laura has experience of teaching a range of topics and has been a stress management coach for decades. 

Recommended Reading

1. Berman AC. (2015) Good teaching is good teaching: A narrative review for effective medical educators. Anat Sci Educ 8:386–394 
2. Cleveland-Innes, M. (2019) ‘The Community of Inquiry Theoretical Framework: Designing Collaborative Online and Blended Learning’. In Rethinking Pedagogy for a Digital Age: 
3. Principles and Practices of Design, edited by H. Beetham and R. Sharpe, 3rd ed., 85–102. Abingdon: Routledge. 
4. Collins, HL; Rodenbaugh, DW, Murphy,TP, Kulics,JM, Bailey,CM; DiCarlo,SE (1999) An inquiry-based teaching tool for understanding arterial blood pressure regulation and cardiovascular function. Available online from Advances in Physiology Education [https://journals.physiology.org/doi/abs/10.1152/; accessed 15th May 2020] 
5. Horrigan, L (2018) Tackling the threshold concepts in physiology: what is the role of the laboratory class? Available online: https://doi.org/10.1152/advan.00123.2017 
6. Hattie J. (2009) Visible Learning: A Synthesis of Over 800 Meta-Analyses relating to Achievement. 1st Ed. Abingdon, Oxon: Routledge. p392 
7. Lujan, HL; DiCarlo, SE (2006) Too much teaching, not enough learning: what is the solution? Advances in physiology education: 30(1); 17-22 
8. Mason,MJ; Gayton, AM )2019) Flipping physiology: can we teach physiology in a different way? Physiology news: Issue 116; 31-33 
9. Modell HI, DeMiero FG, Rose L. 2009. In pursuit of a holistic learning environment: The impact of music in the medical physiology classroom. Adv Physiol Educ 33:37–45 
10. Puentedura, R. R. (2006, November 28). Transformation, technology, and education in the state of Maine [Web log post]. Retrieved from http://www.hippasus.com/rrpweblog/archives/2006_11.html 
11. Puentedura, R. R. (2013, May 29). SAMR: Moving from enhancement to transformation [Web log post]. Retrieved from http://www.hippasus.com/rrpweblog/archives/000095.html