Spring Break - Teacher Style

I have a confession to make. I'm sitting on a cruise ship re-reading "Teach Like A Pirate" by Dave Burgess and reading "Hacking Assessment" by Starr Sackenstein for the first time. I'm thinking about my students and our anatomy and physiology classes.

I can't help it. I'm supposed to be switching-off for Spring Break; phones are powered-down and in the room safe. We have been lounging by the pool, boogie boarding on the FlowRider and tomorrow we will be zip-lining. This is supposed to be vacation.

This IS vacation. I choose to read education books. I choose to think about my classes; our failures, our successes and ideas for improvement. I can't help it.

I think about a former student's email from a few weeks back in which he told me that our class helped him develop and cultivate his love of trauma care. He is currently deployed as a Combat Infantry Medic in Afghanistan, shouldering much more responsibility than he could have ever imagined while in high school. I am grateful that his fellow soldiers are safer in part to a spark that was lit in our classroom.

I think about the student whose favorite class this is. Every night she monopolizes the conversation at the dinner table talking about all she learned in our class that day. I think about wanting to meet her high expectations every single day, provide her with an awesome and engaging experience and not disappoint her.

I thin about a freshman student a few years ago. Great kid, got to know her well. We spent plenty of lunches talking about life, school, things that were upsetting her as well as her successes and her plans for the future. She didn't say goodbye the last day of school; she just left. She later told me that saying goodbye would have been too tough.

I think about the students going through unimaginable turmoil at home. Or in school. For some students school is their only sane and safe haven. For some school is Hell. Some hate school so much that our class is the only reason they get out of bed in the morning. Some students hate home so much they cry at the thought of having to spend a break or a summer away from school.

I feel guilty if I am not in school, having to sick-out. I feel as though I am letting these students down. I feel guilty if a lesson turns-out crappy. Or even just decent. I want our 75 minutes together to be exceptional. That's a lot of pressure I put on myself. A lot of pressure.

I'm always thinkings of ways to improve our classroom experience together. I'm thinking about shaking-up our class. I'm thinking more and more about centering the class solely on case studies and dissection and putting very little emphasis on the low-level stuff (I've already flipped the low-level stuff to micro video lectures). How cool would that be to teach an anatomy and physiology class almost 100% on case studies?

We could bring the unconference EdCamp experience into our classroom. Students could brainstorm their medical interests and conditions, form groups around similar topics, research all they can about their topic and present it to their peers for critique and questions. This means that all three classes (on the block schedule) would be learning different things at different times. What a logistical nightmare. How cool would that be?

It's a lot to ponder over Spring Break as I watch the moonlit waves roll by.

Asynchronous Learning

Setting-up asynchronous flipped mastery is coming along nicely. I have organized our first unit (Introduction to A&P) activities around several core concepts. I decided to go with the 1.1, 1.2, 1.3 numbering system for each concept, with the integer portion correlating to the "reference book chapter" and the fractional portion referring to the sequential order throughout the unit.

For each given concept students have a several assignments to choose from:

• a book assignment w/ accompanied guiding questions
• a Visible Body assignment w/ accompanied guiding questions
• a video assignment
• a fourth "other" activity

Once those assignments have been completed, students will take a practice quiz on Canvas. Anatomy lends itself nicely to these automated quizzes as it is generally low-level recognition and memorization. After an 85% proficient has been earned on the practice quiz, students will then be eligible to take the corresponding paper quiz in class.

The time-consuming portion of setting-up these assignments and formative assessments has been aligning all three/four assignments with each concept in such a manner that students can easily find resources on Canvas. So, for example, concept 1.5g is blood pressure. Book reading assignment 1.5g is parallel to video assignment 1.5g, practice quiz 1.5g and real quiz 1.5g.

Now that alignment is complete, I need to import last semester's classes Canvas modules into this semester, tweak the assignment/activity titles to match concept alignment. Should be good to go then. Stay tuned...

Year-End Summary & Suggestions for Next Year

As this year comes to a close, I think it is important to think back on the past year and look at the good, the bad and the ugly. I tried-out several new "things" to help improve my students' experiences. There were mixed results.

How this year went:

20% Time

I tried it with my 1st semester students every Friday. Some really liked the freedom to explore an A&P subject at their leisure and (more importantly) at their pleasure. Some didn't participate at all and some students were right in the middle of the pack.

I feel as though I failed my students for three main reasons:

1. I did not give then enough guidance with regards to their blogs; I am new to blogging myself.
2. I did not set aside enough time to give them good quality and timely feedback on their blogs
3. We ran out of time at the end of the semester and did not get to finish our dissections or finish learning all the A&P I wanted them to experience before walking-out our doors for the last time. 

I ultimately did not try 20% Time with my 2nd semester students. I want to revamp how 20% Time looks in our classroom first.

Introduction of Canvas LMS

I rolled-out @CanvasLMS to my two anatomy classes, placing all possible "Googleable" content on the platform at the end of 1st semester. I jumped feet-first into flipping content for two reasons:

1. We ran out of classroom time due to 20% Time
2. Now that content was able to be placed on Canvas behind a user name and password, I was able to post GSlides and videos that contained imagery from our book publisher. Previously, I was unable to share that content with my students due to copyright issues.

We started-off 2nd semester totally on Canvas. Anecdotally, students report liking the ability to access content (including daily summary of activities, handouts, videos, Google Slides and practice quizzes) 24/7 on any device. While there were some students who barely accessed Canvas, the majority did frequently (I don't have the analytics offhand to back up this claim.

Flipping

I managed to flip about 80% of the "Googleable" content from in-class GSlides to out-of-class GSlide video lectures 2nd semester. This freed-up a HUGE amount of classroom time that enabled us to do a lot more case studies and have really good and rich discussions about patient assessment. All I did was flip low-level content; it was not true flipped mastery.

Dissection journals

This year I asked my students to document the progress of their dissections in a GSlide presentation (one presentation for each lab group). As with 20% Time, I did a pretty pathetic job of providing feedback and guidance. Despite this, most of the groups did a great job of posting pictures and videos of their dissections. They can be viewed here.

Ideas for next year:

Here are some ideas I would like to implement in time for next year:

Change the name of the course

I want to change the name of the course (rebrand) from "Kinesiology" to "Medical Anatomy and Physiology". Over the years since I started teaching the course, I have changed the focus of my students to more of patient assessment, developing differential diagnoses, clinical impressions and treatment plans. We really do not learn kinesiology; the name of the course should reflect that.

Refocus the goals of the class

Thanks to Karl Lindgren-Streicher's section in Jason Bretzmann's book "Flipping 2.0: Practical strategies for flipping your class", I have once again decided to toss-out my class curriculum and start from scratch, building it from the ground up. I want students to be able to:

• assess a patient (via obtaining H&Ps)
• develop differential diagnoses
• develop clinical impression
• develop treatment plan
• reevaluate treatment plan and revise as needed

All the rest of the supportive low-level and Googleable content will be flipped.

Flip 100%

I want to flip 100% of the Googleable content to outside the classroom. I envision content to take the following three forms:

1. Read the textbook, summarize and answer questions in a study guide (written by me, focusing on key content). Scientific literacy is important. Before students can interpret scientific papers, they should be able to interpret and understand a college A&P textbook.
2. Use Visible Body software to complete a visual study guide. Visible body contains a staggering amount of animations, videos, pictures and manipulable 3D structures. Currently loaded onto our seven lab table desktops, hopefully next year I would like the software loaded onto our science department laptops (and later, when we go 1:1, hopefully on student devices).
3. Watch and take notes from instructor-generated videos. These are mostly comprised of the GSlides I used to "lecture" from in class. Additional videos are of me demonstrating various concepts such as body planes, body regions, spacial orientation and joint movements using a webcam and Screencastify. How cool would that be if STUDENTS made the videos and not me? More on that below...

Implement Flip Mastery

Lastly, I would like to learn and about and implement flipped mastery. A&P tweeps Cara Johnson and Gerry Marchand have successfully implemented flipped mastery into their A&P classes. This enables students to work at their own pace inside and outside the classroom to master content through a series of activities and tasks that satisfy learning objectives. Once the students feel confident that they have mastered the content, they can then be assessed through a variety of ways: paper quiz, online Canvas quiz or creating a blog or a mini project. Or MAKING A FLIP VIDEO FOR FUTURE CLASSES TO LEARN FROM!!! How cool would that be???

I really like the idea of flipped mastery because all students learn at different paces. Flipped mastery allows them to learn at their own pace and be assessed once THEY feel confident, not the instructor. Because different students will be completing different tasks at different times and will require assessments at different times, this could make for an organizational debacle. I have been assured by Cara and Gerry that the payout for this front-loaded effort is well worth it, both in student learning and grades.

So while I will have a busy summer on the personal side (family, paramedic job, rebuilding a fence, shed and countless other home improvement projects that have fallen by the wayside), I am really looking forward to providing my 2016-2017 students with the best Medical Anatomy and Physiology experience yet.

Anatomy Scavenger Hunt

Although we do lots of Simon Says to practice learning anatomical regions, anatomy can still be a little dry. Necessary but dry.

So, after trading thoughts over the summer with Texas A&P instructor Cara Johnson (@AHSAnatomy) and tweaking @alicekeeler's classroom Twitter account idea, I came-up with the Anatomical Scavenger Hunt. Cara's students tweet Syndaver selfies (#syndaverselfie15), tagging them with the appropriate anatomical region, as well as a brief description of that region. Alice's students fill-out a Google Form with their tweet request, filling a Google Sheet. She approves the tweet and one click later it is sent-out via the classroom Twitter account.

Here is what the checklist and tweet directions look like:

Feel free to follow our escapades!

Introduction to my course(s)

Originally created as a high school kinesiology course by retired teacher, track coach and good friend Craig Nishiyama, our two courses here at Hatboro-Horsham High School have morphed into medical anatomy and physiology courses.  The overarching goals of these courses are to:

1. give students a taste of the A&P necessary for the following fields:
1. nursing school
2. medical school
3. physician assistant
4. athletic training
5. physical therapy
6. occupational therapy
7. medical illustration
2. prepare students for college-level A&P

Both courses are electives (not required for graduation) and have been traditionally quite popular.  Our basic (College Prep, or CP) course starts with an introduction to human anatomy and physiology, then skeletal A&P, joint A&P then muscle A&P.  The advanced course (Honors, or H) additionally examines various tissues and the integumentary system in particular.

In addition, the Honors course also examines a "case study", a fictional multi-systems trauma patient that permeates throughout the semester.  Through discussions and small group work, students learn how to:

1. evaluate mechanism of injury
2. develop index of suspicion
3. assess level of consciousness
4. evaluate and treat CAB's (basic and advanced)
5. determine chief complaint
6. obtain vital signs
7. obtain history and physical
8. correlate VS with anatomical and physiological findings
9. use MOI, IOS, CC, VS & H&Ps to develop differential diagnoses
10. develop clinical impression
11. develop treatment plan
12. treat various traumatic injuries

Both courses also dissect the white rat and fetal pig.  Rats are for practice (to hone their dissection skills) and serve as an introduction to anatomical spacial relationships.  The pigs are for more independent dissections with less assistance from me; students rely on each others experience.  For both dissections, students are placed into heterogeneous lab groups according to their interests, experiences and results of a personality/leadership propensity survey.  Students learn about the roles, responsibilities and expectations of Attending, Chief Resident, Intern and Medical Student.  On the first day of dissection in the semester, one student is picked as Attending and in then task with assigning staff roles.  Those roles are:

1. Attending - oversees dissection group and helps prn
2. Chief resident - sets-up, functions as lead dissector, cleans-up
3. Intern - responsible for recording dissection through pictures and videos and posting on our classroom Google Site (under reconstruction as of 6/5/15)
4. Medical Student - researches assigned related topic using either textbook or Visible Body anatomical software (at lab bench on desktop)

Students rotate roles every day.