Redesigning first year anatomy and physiology subjects for allied health students: Introducing active learning experiences for physiology in a first semester subject

In this paper we describe the initial development of flipped classroom learning activities for the physiology component of a first year anatomy and physiology class for allied health students, and the subsequent transformation to focus on active learning strategies over a period of three years. The learning activities incorporated included the use of audience response systems for in-class quizzing, mini case studies, role plays, and simulations. Results of on-course assessment items, consisting of on-line quizzes, was compared in order to determine whether active learning approaches improved academic performance. We found that academic performance increased across the cohorts when first implemented as flipped classroom, and the increase was maintained in the subsequent years focussing on the active learning strategies alone. We conclude that the introduction of active learning experiences to this class enhanced engagement and academic performance across the student cohorts

Redesigning first year anatomy and physiology subjects for allied health students: Impact of active learning strategies

To combat high failure rates in an Anatomy and Physiology for first year Occupational Therapy, Physiotherapy and Sport Science students, a flipped classroom was introduced in 2015. It became apparent that students did not engage with materials prior to classes, but they did engage with in-class active learning strategies. In subsequent years of this study, our focus changed to delivery with student active learning in mind. The active learning approaches introduced resulted in improvements in academic performance for all three student cohorts. Occupational Therapy students’ marks improved by 12.9% when comparing pre-intervention (2014) results to the end of the post-intervention period (2017), Physiotherapy students’ marks increased by 6.9%, while the greatest gains of 14.8% were seen in Sport Science students. When investigating the relationship between student performance and university entrance scores, students with high entrance scores demonstrated modest gains in performance, while those students with lower entrance scores benefited the most. Our results suggest that the introduction of active learning may result in the transition of the learning style of students under-prepared for university studies, to be more like those of more successful students; that is, to a deeper level of learning

Instructor creativity in producing learning activities for a diverse cohort of first year anatomy and physiology students

We co-teach first year anatomy and physiology to 320 allied health students studying 4 different programs (Occupational Therapy, Physiotherapy, Speech Pathology, and Sport and Exercise Science). The cohort is comprised of just over half first-in-family students, with diverse academic backgrounds, as evidenced by a broad range of university entrance scores (Australian Tertiary Admission Rank (ATAR) 99.95-35, with just under half of ATAR 87 or lower). Historically the subject has been characterised by student disengagement, and a high failure rate. As an initial strategy to address this issue, in 2015 we introduced activity-intensive workshops as part of flipped-classroom learning experiences. The activities were designed to increase visualization of concepts. The instructor needs both a solid understanding of the concept and a high degree creativity when designing these activities. For example, orange safety mesh was used to model the cell membrane for a role play on cellular transport processes and simple garden irrigation equipment used to simulate a nephron. Students also used a high degree of creativity in producing posters for case studies, which were utilised as another strategy to enhance student learning and engagement. Students were surveyed regarding their experiences in both 2015 and 2016. They were ambivalent about how useful the different activities were in helping understanding of concepts in 2015. In 2016 we increased the instruction around how the exercises should be utilised and this resulted in the students gaining much more satisfaction from the activities

Student creativity in assessment of an anatomy and physiology subject: the digi-explanation

We co-teach first year anatomy and physiology to 320 allied health students studying 4 different programs (Occupational Therapy, Physiotherapy, Speech Pathology, and Sport and Exercise Science). The cohort is comprised of just over half first-in-family students, with diverse academic backgrounds, as evidenced by a broad range of university entrance scores (Australian Tertiary Admission Rank (ATAR) 99.95-35, with just under half of ATAR 87 or lower). Historically the subject has been characterised by student disengagement, and a high failure rate. As part of a continuing strategy to address these issues, we included a group based digi-explanation (which involves the students making a video) in the assessment regime. Digi-explanations harness the skills and creativity students already possess in terms of being able to manipulate digital resources for social purposes. Groups of 4-6 students were tasked with producing a 3 minute video which explained a specific topic covered in the subject. The topics were tailored for the different cohorts to increase relevance of the exercise for the students. Instructional documentation was produced to assist the students in this process. Students could assemble a composite video from public domain materials, or film and produce an entirely original video. Most groups used a mix of public domain materials and original footage for their videos. Students were surveyed regarding their digi-explanation experiences and 75% of students found the exercise was useful for exploring their understanding of the material, and that it increased the relevance of the material to their degree

Low birth weight due to intrauterine growth restriction and/or preterm birth: effects on nephron number and long-term renal health

Epidemiological studies have clearly demonstrated a strong association between low birth weight and long-term renal disease. A potential mediator of this long-term risk is a reduction in nephron endowment in the low birth weight infant at the beginning of life. Importantly, nephrons are only formed early in life; during normal gestation, nephrogenesis is complete by about 32–36 weeks, with no new nephrons formed after this time during the lifetime of the individual. Hence, given that a loss of a critical number of nephrons is the hallmark of renal disease, an increased severity and acceleration of renal disease is likely when the number of nephrons is already reduced prior to disease onset. Low birth weight can result from intrauterine growth restriction (IUGR) or preterm birth; a high proportion of babies born prematurely also exhibit IUGR. In this paper, we describe how IUGR and preterm birth adversely impact on nephrogenesis and how a subsequent reduced nephron endowment at the beginning of life may lead to long-term risk of renal disease, but not necessarily hypertension

Incompressibility of strange matter

Strange stars calculated from a realistic equation of state (EOS), that incorporate chiral symmetry restoration as well as deconfinement at high density show compact objects in the mass radius curve. We compare our calculations of incompressibility for this EOS with that of nuclear matter. One of the nuclear matter EOS has a continuous transition to ud-matter at about five times normal density. Another nuclear matter EOS incorporates density dependent coupling constants. From a look at the consequent velocity of sound, it is found that the transition to ud-matter seems necessary.Comment: Accepted for publication in Phys Lett

Catering for the masses

Background: According to Fleming (2012) there are four different learning styles: Visual, Aural, Read/write and Kinaesthetic. We co-teach first year foundation sciences (anatomy and physiology) to approximately 320 allied health students studying four different professional programs (Occupational Therapy, Physiotherapy, Speech Pathology, and Sport and Exercise Science). This group has a diverse background with just over half first-in-family, and one third regional based students. The entry scores of the group are also very broad, ranging from Overall Position (OP) 1 to 22 (equivalent to ATAR 99.95-35). Thus, we have a large number of students with diverse backgrounds, and the potential for great diversity in learning styles. Catering for this diversity in learning styles is one of our challenges. In the past, the subject materials have been delivered as three didactic lectures per week followed by a two hour practical session. The result has been a high level of student under-performance and attrition. In order to address these issues we decided to deliver the physiology component of the subject using a 'flipped classroom' technique. The learning plans were structured using the 5Es framework with the Elaborate phase structured as workshops comprising active teaching strategies such as role plays, simulations and case studies. The intention was to present materials in various formats to engage different learning styles, cater for the student diversity, and enhance student performance and retention.\ud \ud Aims: We were interested to know whether the students in different programs would show specific learning preferences. For example, could we predict that students enrolled in Sport Science would prefer kinaesthetic styles as they are the students who enjoy 'doing' things; or that the Physiotherapy students are more likely to prefer read/write styles as they are in general higher academic performers?\ud \ud Description of intervantion: As part of the 5Es model the traditional practical classes were changed to workshops and active teaching strategies associated with the Elaborate phase were employed.\ud \ud Design and methods: Students were asked to complete an anonymous questionnaire two weeks after the conclusion of the delivery of the final physiology component. Students were asked about their attitude to both the traditional and flipped delivery, their perceptions of preparedness for assessment and their engagement with both traditional and flipped materials on the learning management system. Students registered their responses to questions using a four point Likert scale. Data from the questionnaires was analysed for differences in the frequency responses of the different cohorts taking the subject.\ud \ud Results: Students studying in the Sport and Exercise Science program were most likely to agree that the role plays helped with developing concepts, while students studying Physiotherapy did not agree that the role plays were helpful. Students studying in the Sport and Exercise Science, and Occupational Therapy programs were equally most likely to agree that both the simulations and case studies helped with developing concepts, while students studying Physiotherapy and Speech Pathology were less likely to agree that the simulations were helpful

They may not like it but it is good for them!

Background: We co-teach first year foundation sciences (anatomy and physiology) to approximately 320 allied health students studying four different professional programs (Occupational Therapy, Physiotherapy, Speech Pathology, and Sport and Exercise Science). The student group is comprised of just over half first-in-family, and one third regionally based students. The academic background of the students is very diverse, with Overall Position (OP) entry scores ranging from 1 to 22 (equivalent to ATAR 99.95-35), with just under half of OP15 (ATAR 87) or lower. In the past, the subject materials have been delivered as three didactic lectures per week followed by a two hour practical session (i.e. 'traditional delivery'). The result has been a high level of student under-performance, attrition and disengagement. In order to address these issues in Semester One, 2015 we delivered the physiology component of the subject using a 'flipped classroom' method. The physiology learning plan was structured using the 5Es framework with the Engage and Explore phases constituting the 'flipped' component of content delivery. The delivery of the anatomy component of the subject was maintained in the 'traditional' mode. The intention of changing delivery style was to increase student engagement with the content and hence increase student performance and retention.\ud \ud Aims: To determine whether students preferred the flipped classroom teaching as compared with traditional didactic delivery and whether there was any impact on academic achievement.\ud \ud Description of intervention: The four weeks of the physiology component of this subject were delivered in a flipped classroom mode. Four weeks of anatomy were delivered in traditional didactic mode, with three lectures and a two hour practical per week. The delivery styles were inter-mixed over this eight-week period. The remaining five weeks of semester were delivered in traditional didactic mode.\ud \ud Design and methods: Students were asked to complete an anonymous questionnaire two weeks after the conclusion of the delivery of the final physiology component. Students were asked about their attitude to both the traditional and flipped delivery, their perceptions of preparedness for assessment and their engagement with both traditional and flipped materials on the learning management system. Students registered their responses to questions using a four-point Likert scale. Data from the questionnaires was analysed for differences in the frequency responses of the different cohorts taking the subject. \ud \ud Results: Overall, the students preferred the traditional delivery method. Physiotherapy students most strongly preferred the traditional method, while Speech Pathology and Sport and Exercise Science students were less strongly in favour of the traditional method. Students also felt better prepared for quizzes when content was presented using the traditional teaching method, and the Occupational Therapy and Speech Pathology students felt unprepared for quizzes when content was delivered using the flipped teaching method. Despite student perceptions of their preparedness, on average, students performed 20 percentage marks (20%) better on the quizzes that assessed content delivered using the flipped method when compared with those that assess content delivered using the traditional method. This increase in performance was consistent across the four student cohorts.\ud \ud Conclusions: Our students had a strong preference for, and were more confident of, their preparation for assessment using the traditional teaching method. However, their academic performance was much stronger when the content was delivered using the flipped classroom model. As the students were first year, first semester students, pre-conceived ideas on how they might be taught at university should have been minimal. As such, the finding that they preferred the traditional model is surprising, as the flipped classroom involves them much more actively in their learning than the traditional model. It is possible that students felt that the material delivered traditionally focused only on what would be assessed when in reality what is delivered is broader. This misperception could engender a false sense of confidence in preparedness for assessment. The flipped model of content delivery relies on students preparing for the face-to-face sessions. It is likely that the students were uncomfortable with this as it relies on them taking responsibility for their own learning. It is also possible this is the first time students have experienced this approach. As a significant proportion of the students scored low in the OP ranking, it is also likely that they may not have the academic skills to enable them to learn independently and increased scaffolding of tasks may be required to engender confidence in their performance.\ud \u

Redesigning first year anatomy and physiology subjects for allied health students:impact of active learning strategies

To combat high failure rates in an Anatomy and Physiology for first year Occupational Therapy, Physiotherapy and Sport Science students, a flipped classroom was introduced in 2015. It became apparent that students did not engage with materials prior to classes, but they did engage with in-class active learning strategies. In subsequent years of this study, our focus changed to delivery with student active learning in mind. The active learning approaches introduced resulted in improvements in academic performance for all three student cohorts. Occupational Therapy students' marks improved by 12.9% when comparing pre-intervention (2014) results to the end of the post-intervention period (2017), Physiotherapy students' marks increased by 6.9%, while the greatest gains of 14.8% were seen in Sport Science students. When investigating the relationship between student performance and university entrance scores, students with high entrance scores demonstrated modest gains in performance, while those students with lower entrance scores benefited the most. Our results suggest that the introduction of active learning may result in the transition of the learning style of students under-prepared for university studies, to be more like those of more successful students; that is, to a deeper level of learning