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.

Canvas Roll-Out

It has been a few weeks since the beginning of the semester in our A&P courses. I rolled-out an introduction to Canvas LMS which included the following:

• how to access Canvas from a desktop or laptop
• how to access Canvas using the mobile app for phones and tablets
• where to find my contact info, daily summary of everything we did in class as well as the suggested homework, and modules
• how to navigate between modules
• how to progress through modules in a linear fashion

We used a laptop cart with one laptop per student. The roll-out was fairly smooth, with hitches mostly like the typical user name or password issues. Our course did not appear on the dashboards of several students either on the web version or the app. It was simply because the course was not favorited. Once starred, the course appeared. Homework that night was to get into Canvas, play around and start to get familiar with the module set-up.

Some students were already familiar with Canvas, as there are a handful of teachers in our building who started using it last year. I encouraged my students to get familiar with it, as our teacher websites (hosted by SchoolWires) were going to fall pretty much by the wayside. In addition, most colleges and universities use some sort of LMS like Canvas or Blackboard. About two weeks ago, I received this tweet from a former student:



All-in-all it was a fairly easy roll-out and students were quite receptive.

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...

Flipped Mastery Journey

Background

Last year I tried-out 20% Time with my first semester students, with mixed results (that’s a previous blog post). Although 20% Time benefited some students, it left me with less in-class instructional time than in previous semesters. At the same time, district teachers were allowed (and encouraged to) access our newly-adopted LMS, Canvas. Several of us teachers and coaches had been granted access to the sandbox version in October prior to going live in January(ish). Up until January I had not had (or made) the time to jump into Canvas. Well, now I was forced to figure-out a way to finish teach this course with limited time.

Why flip?

I did not NEED to finish the course; I WANTED to. You see, I view completion of this course as not exactly a necessity or an endpoint, but more of a jumping-off or starting point in a clinical path. I want my students to be well-prepared for a future in clinical medicine. This means getting a jump on not simply the low-level anatomy, but more so the higher-level thinking required in clinical decision-making. For example obtaining accurate H&Ps (History and Physicals), developing differential diagnoses, forming clinical impressions and treatment plans and evaluating their efficacy. It is the clinical aspect of medicine that must be taught and explored in the classroom; it is most difficult, I would argue impossible, to learn on one's’ own. Anatomy boils-down to memorization. Physiology involves the interconnected relationships of phenomena occurring in the body. Clinical decision-making is the utilization of both to chart a course for the treatment of the patient. We NEEDED to get past the low-level anatomy and REALLY spend good, high-quality classroom time on clinical stuff. That is why I started flipping lectures to videos.

How I started flipping

I started by recording the remaining of the traditional sage-on-a-stage anatomical Google Slides lectures using the free Chrome Store app Screencastify. I first heard of Screencastify in a “Chromebook for Education” class I completed in the Spring of 2016. Great class, facilitated by Tom Mcgee. It is easy to use and can record via webcam, active tab capture or entire desktop capture. In addition, there is a preview feature (box within a box) that enables preview while recording. Annotation is possible with pen tools and the use of a stylus. Lastly Screencastify integrates well with Google Drive, allowing you to instantly playback the video as it saves to your Drive in the background. Like it? Give it a title/file name from within the app (it will name it as such on your Drive). Don’t like the way it came out? Hit the trashcan icon and re-record.

I assigned the flipped lectures as homework and briefly went over the more difficult aspects at the beginning of each class. Most students liked the lectures, while some missed the interaction with me and the dialogue that always accompanies our lecture discussions. Yet others were used to multiple years of note-taking. Something else was missing.

Intro to Flipped Mastery Learning

But aren’t teachers supposed to teach? What are teachers going to do during class if students are watching lecture videos for homework? Good point. How about the higher-level thinking stuff that we struggle to get to because we get so bogged-down with the low-level stuff?

Enter Flipped Mastery. FM takes the ownership of learning low-level content and places it squarely in the lap of the students. FM does not necessarily refer to the flipping of lectures into homework, but rather the flipping of responsibility of learning low-level content to the students. I will admit I thought flipping was simply the making and viewing of videos. But after lots of reading (especially Flip Your Classroom: Reach Every Student in Every Class Every Day by Jonathan Bergmann and Aaron Sams) and asking questions of my Twitter PLN, I not only learned that FM was more than videos, but a way of helping students demonstrate mastery while learning asynchronously.

Asynchronous learning

Instead of assigning nightly homework and assessing all students at the same time, it actually makes more sense to allow students to learn the material at their own pace and be assessed once they have mastered the material. Some students have after-school sports activities or part time jobs. Or simply want to relax after school. We differentiate learning. Why not differentiate the way students utilize their time? While some students may learn the material quickly on their own and are assessed in class, other students may need more personalized 1:1 help or alternative assignments until they master the material. It really is dumb to expect students to learn material at exactly the same pace. Why not have set checkpoints to keep them on track?

Thoughts on implementation

I think that asynchronous learning will work-out pretty well for my students, especially during dissection labs. I usually have seven lab groups with 4-5 students per group. Typically one dissects, a second assists and third takes pictures and/or videos as needed. Roles rotate every day we dissect (which is almost every day or every other day). There is significant down-time for the third and fourth lab group members. Why not have them productively use their time by completing asynchronous assignments, complete remedial learning opportunities or be assessed if they have mastered content and are proficient? I am excited to try this out with them.

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!

Ditch That Textbook

I finished Ditch That Textbook by Matt Miller a few days ago and am only now making the time to summarize what I believe to be the most important and useful take home points for me.

I took notes as I was reading but invariably got sidetracked (you know how it goes).  As a result, there may be some points here that were not specifically mentioned in the book but, frankly, I don't see the need to parse them all out.  After all, this is not a NYT book review. Also, I have typed them up in the order I read them or in the order that I made connections from them.

• Backchannels:
• examples:

• Socrative
• Padlet
• TodaysMeet:

• goals/ideas:
• give quieter students a voice
• put up a question or prompt as students enter the room (like a Do Now; students must use their names to receive credit (?)
• use for a digital brainstorming session
• after school office hours for a moderated review session before a test - I really like this one; can use as college virtual office hours
• Flubaroo for quick grading in Google Sheets:

• free clipart:
• search.creativecommons.org:

• Openclipart:

• Paper (app) by FiftyThree for drawing and note-taking on iPads:

• WeVideo for creating and editing videos:

• ShowMe interactive whiteboard iPad app:

Miscellaneous ideas:

• Brainstorm with students first day of class and make a list of what THEY want to learn. Incorporate these ideas into our curriculum
• Post a class hashtag in classroom for students to use anytime during class on Twitter (see this post about students using their own phones to tweet using classroom Twitter account).
• Do GHOs (Google Hangout) with a high school class first, then other schools within the district, then out of district, out of state, across the globe. Why? To see what other classrooms are doing and to show what is going on in our classroom.
• Same with Periscope
• I really like this quote by Jeff Charbonneau mentioned in Ditch That Textbook. I find it to be so true:

• Here is another quote by Matt Miller that I also like: "I have become pretty good at gathering new ideas in my head without turning them into reality." Sounds a lot like me. Time to change that.
• Can't find the perfect resource? Make it!
• Another great Matt Miller quote from Ditch That Textbook: "Teachers who pay attention to students' lives and interests and incorporate them into their class give students the opportunity to see themselves in the curriculum. When they see themselves, they see the relevance." True that.

Chapters 34 (Establish Your Philosophy), 35 (Create a Mission Statement) and 36 (Identify Major Themes) cut right to the core of the matter: What do you want your students to be able to do/know/create when they walk out your door in 90 (or 180) days? What does your course boil-down to? I think that while the previous chapters contained great insight and shared fantastic tech tools, these chapters really caused me to look at what I ask my students to accomplish.

For my Anatomy and Physiology courses, I want students to get a taste of what to expect in college A&P, nursing and medical school.  I want my students to discover the connections between seemingly disconnected physiological phenomena.  I want students to start to look at patients as puzzles or mysteries, and hunt for objective and subjective clues that will lead to a differential diagnosis. I want students to begin to develop differential diagnoses, clinical impressions and treatment plans. I want students to be able to evaluate their course of action, critique it, and make adjustments. I want students to think.

I don't want this course to be merely about the memorization of anatomy (although necessary).  I want to look into other A&P classrooms K-16 and see what good things other students and teachers are doing. I also want to share what we do.

I think I need to make some adjustments before starting in seven days...

Teach Like a Pirate #tlap Notes/Ideas:

I had been hearing a lot about the book Teach Like a Pirate by Dave Burgess.  The #tlap hashtag is everywhere in EduTweets and and there seems to be a lot of excitement surrounding it.  Curious, I bought a copy from Amazon last week and it arrived the very next morning (I wish I could grade essays that quickly).  I spent the day in the hammock reading and taking cursory notes (as suggested by the author).
















The result?  Wow.  What a book.  I can't really put into words how the book made me feel and how it made me think (I guess that's what I teach A&P and not journalism).  I would not be able to do it justice.  I was torn between re-reading it and taking really good notes or running with what I had learned, brainstorming more and starting to implement ideas.  I really wish we had several more weeks of summer; not to put-off the first day of school, but to give me time to wrap my head around the myriad of ideas bouncing like a ping pong ball between my eight cranial bones.

So here are some ideas that originated from the book (tailored for my A&P classes).  And that's really what this book is about: thinking about teaching and developing our classroom mindsets.  Make our classrooms into places that students want to come to and not have to come to.  It's a pretty cool feeling when students opt to stay in your room in lieu of attending an optional assembly, isn't it?  I want to experience that more often.

I took my brainstormed list of ideas, developed them and categorized them into 5 sections:

• Beginning of semester
• Beginning of unit/day
• Middle of unit
• End of unit (review)
• Miscellaneous

Beginning of semester:

- at the beginning of the semester, line-up students.  step forward/back if they have been impacted in some way by a family member or friend who has a history of diabetes, sickle cell, heart disease, cancer, Alzheimer's, seizures, cardiac arrest, hypertension, congestive heart failure, cerebrovascular accident, muscle cramps, dehydration (this visually and kinesthetically demonstrates the connection that Ss will have with our areas of study and promotes buy-in and authenticity)

- 1st day sort students into areas of expertise (such as Google Docs/Sheets/Forms/Slides/Mail/Draw/Drive/Hangout, video/pict media, artistry, etc...) for work groups.  Goal is to have one "expert" in each work-group. 

Beginning of unit/day:

- create a board message hook to create buzz before bell even rings (or project just a QR code on board)

- Before starting a new chapter present and discuss a case study (like pediatric fractures before skeletal system: growth plate involvement, bone anatomy, bone development, fracture repair)



- Ss use Coggle.it to diagram and explore the various pathologies behind findings on physical exam (skin linked to pale, flushed or cyanotic) then each finding (e.g. cyanotic) is explored more deeply (physiological causes). Used as intro, Ss discover the "backstory" behind why we are earning xyz:

Middle of unit:

- Ss use Coggle.it to create mind maps of a disease of their choice (etiology, signs, symptoms, risk factors, diagnosis, treatment, prognosis):

- Ss create and teach a dance to class (show Richard Simmons video, use for directional terms, body regions, abdominal quadrants and bone identification)

End of unit (review):

- end of unit review assignment for all of Gardner's multiple intelligences (outline chapter, poem, rap, sketch, 3D art project, song, video summary like a dance, etc...)

- create a review dance video at end of unit

- play Pictionary, charades for review, Jeopardy (use Flippity.net and Google Sheets in lieu of PPT; have Ss work groups make their own Qs and As then put all together):

Miscellaneous:

- later in the semester, Ss have labels (hpi, pmhx, meds, aller, ros, pe, vs, differential diagnoses, clinical impression) and sequence themselves in order of logical progression 

-  Ss change lyrics of a song to learn course content (isn't it ionic, don't you think?)



- best dissection group gets to be guest Pandora DJ for the following day (revisit dissection rubric --> daily dissection grade)



- create something real for world to view and comment on (Google Sites dissection log):



- periscope.tv between classes in different buildings, districts, states or countries (show elementary kids what we do in the high school? compare dissections in different A&P classes through the world!)

- daily GHO w/ other A&P classes to compare notes/summarize the day?

- post articles of potential interest on wall with QR codes for Ss to scan

- black bin with 2 hand/arm holes (or use a tri-fold) hiding content from Ss; use tactile sense to distinguish between radius, ulna, humerus, scapula, clavicle, atlas, axis, lumbar vertebra, coxa, femur, tibia, fibula

- Ss problem work through/solve a mini case study in groups every day without much T help

- competitively perform a task or solve a problem using Survivor theme (tribes) or Amazing Race theme (partners)

- random student name picker (wheel of fortune type thing? digital/IWB?) - use Flippity.net (can place Ss randomly into pairs, groups, pick one, etc):

- anatomical digital scavenger hunt using Ts and Admins and Ss throughout the school (e.g. T's right femur, AP's distal antebrachial, lunch cashier's medial malleolus); post picts with label and explanation to Twitter using common hashtag (use Alice Keeler's Twitter Sheet)

So, that's about it.  For now.  PLEASE feel free to comment and offer-up suggestions.  Interested in Periscoping or GHOing with my classes this year? Contact me!