James Clark, King’s College London, UK

https://doi.org/10.36866/pn.119.42

Towards the end of 2019 I was the recipient of the Otto Hutter Physiology Teaching Prize from The Physiological Society. It’s a great honour but would not have been possible without the support and enthusiasm of my colleagues in the department. We are very proud to have retained our physiology department at King’s College London and I have benefitted from such a focussed environment in my teaching. Let’s face it, teaching physiology is enormously engaging and Otto Hutter (University of Glasgow) was described as a ‘virtuoso’ of small group physiology teaching, famed for throwing blackboard chalk to students to encourage participation. 

I have been pondering over the past few months what pioneers of this mode of education, including Otto Hutter, will make of what is likely to come. As we start to tentatively emerge out of the COVID-19 global pandemic we can see the new education landscape unfolding in front of us. We are faced with online/remote delivery of our programmes for at least the first part of our new academic year and physiology departments all over the world are going through the same process of determining how to deliver teaching and evaluate students’ learning without sacrificing quality, accessibility and equality among home and international students. So it is not surprising that I have been reading about using alternative forms of delivery and student engagement. 

How do we teach human physiology, a practical subject, remotely? Whilst we have certainly been ‘flipping’ and ‘blending’ classes for many years; this has usually been a voluntary process and there is debate around the use of asynchronous vs. synchronous delivery in physiology education. The available literature is not wholly supportive of a blended learning approach in physiology. We know however that environments where students participate in the learning process (active learning) have proven successful for most university programmes.

In a study published in 2019 by Joseph Rathner and colleagues, delivery and assessment of two physiology modules (neuroscience, and cardiorespiratory and renal physiology) were flipped between the 2017 and 2018 academic years (1). Their method was, unsurprisingly, a combination of asynchronous, “chunked” presentations and synchronous workshops with a mix of formative and summative assessments using online tools; replacing didactic lectures with pre-recorded online delivery and synchronous small group tutorials around each topic covered. The provision of well-prepared asynchronous material (not just a re-run of last year’s recorded lectures) is invaluable for flexible student engagement. We must, however, be mindful of students’ access to quiet working environments and the technology required to access this material. Without any change in module content, Rathner’s approach resulted in fewer fails and higher scoring passes in the cohorts studied (1). I believe physiology education lends itself well to this mode and the ‘new normal’ of flexible education, with flipped classes and a blended delivery of material, is certainly going to be our approach. It is reassuring to have published evidence to support educational approaches at a time when hasty decisions could have a major impact on our students and their learning experiences. 

It is important to understand the theory behind different types of learning before redesigning a module or programme as transitioning to a flipped classroom model can be challenging for both student and instructor. A really good summary of pragmatic flipped delivery is summarised in a paper by Heather French. Whilst its context is focussed on US graduate medical education, the underpinning theory and best practice for flexible delivery in adult education is outlined in a clear and unambiguous approach (2). Heather highlights the use of virtual laboratories, the provision of real [physiological] data and worked examples of experimental approaches, data acquisition and analysis. Certainly, the use of these online tools will go some way to ensure that our students will ‘buy into’ a more hands-off approach to physiological science at least in the short term. For the past three years I have been using a commercially available online e-learning system (Lt from AD Instruments) for undergraduate physiology practical classes (data acquisition and analysis) workshop preparation and both formative and summative assessment; I’m glad I invested time in researching and using this technology before now.

I have, for more years that I have been a physiologist, experimented in music composition and have produced music primarily for my own entertainment although it has at times entered my work life (see: https://www.youtube.com/watch?v=Q1YIYx8VBkI). Did you know that songs about physiology can play a role in enhancing learning in science education (3)? In his 2020 publication, Gregory Crowther from Everett Community College, Washington elegantly demonstrated that musical ‘jingles’ that describe simple physiological principles and mechanisms can be used as a useful study aid (3). We all ask students to write descriptive prose, but have you thought about asking them to write a song lyric. Maybe you should? 

So, I end this by returning to Glasgow, the home of Prof Hutter, but not to the department of Physiology but that of Psychology and the work of Dr Emily Nordmann. Whatever approach you take, however you engage with your students this autumn I can wholeheartedly recommend reading Emily’s paper listing 10 simple rules for supporting our new endeavour (4). This paper is, at the time of writing, published as a pre-print but is a valuable read for all academics in the current climate. As research scientists we often lean on the evidence of others to justify our work. As educators we should not be afraid of doing the same.

Stay safe and I’ll see you online!

James Clark is a Reader in Human & Applied Physiology at King’s College London and the Education lead for the School of Cardiovascular Medicine and Sciences. Having graduated with a BSc in Applied Biology from Bath University he undertook a PhD in Surgical Research at UCL. He then moved to KCL where he undertook a BHF intermediate fellowship in cardiac signalling before securing a lectureship in Physiology in 2010. 

References

1. Joseph Rathner and Mark Schier. The impact of flipped classroom andragogy on student assessment performance and perception of learning experience in two advanced physiology subjects. Adv Physiol Educ 44: 80–92, 2020. 10.1152/advan.00125.2019. 
2. Heather French, Anna Marie Arias-Shah, Carly Gisondo, Megan Gray. Perspectives: The Flipped Classroom in Graduate Medical Education. NeoReviews 2020; 21; e150. 10.1542/neo.21-3-e150.
3. Gregory Crowther, Jason Wessels, Lawrence Lesser, and Jennifer Breckler. Is memorization the name of the game? Undergraduates’ perceptions of the usefulness of physiology songs. Adv Physiol Educ 44: 104–112, 2020. 10.1152/advan.00112.2019. 
4. Emily Nordmann, Chiara Horlin, Jacqui Hutchison, Jo-Anne Murray, Louise Robson, Michael Seery, Jill MacKay. 10 simple rules for supporting a temporary online pivot in higher education. Pre-print: 10.31234/osf.io/qdh25