During the emergency shift to online instruction during the Spring 2020 semester, many science courses grappled with the question: how do we teach science labs without hands-on activities? Further, during that same spring, our nation awakened to long-resident social justice issues and the need seek equitable and inclusive practices. While there were multiple educational innovations that were utilized to address this former need, such as simulated laboratory experiences, remote activities using students’ resources, or data interpretation exercises, one anatomy and physiology course at the University of Northern Colorado leveraged Problem-Based Learning (PBL) as the basis for a collaborative curriculum to teach physiological concepts. Additionally, our PBL was aligned with Universal Design for Learning (UDL) Principles to promote access for all students.
What is PBL in Human Anatomy and Physiology Education?
PBL refers to learning activities that prompt students to solve a real-world problem. This problem is “ill-structured,” meaning there is no correct path of inquiry and there are multiple valid conclusions. In higher education, PBL has been championed by medical schools as a way to engage students in diagnostic thinking. While students in undergraduate anatomy and physiology courses do not need to be clinical decision-makers at the end of the course, PBL had potential to help students learn the interdependence of anatomical and physiological concepts through the lens of pathologies.
The PBL modules were composed by two graduate teaching assistants (myself and Alex Vita) prior to the Spring 2020 semester as a part of a broader research project. The curriculum included three PBL modules completed as group projects over four to six weeks each. The PBL modules present a fictional patient, including multiple details typically found in a clinical chart (vital signs, laboratory test results, and patient history). Each week, students are engaged with new questions to connect health and pathological pathways, and discuss how these may connect with the patient’s symptoms and laboratory test results. Students are encouraged to identify what else they need to understand to make a diagnosis, research those topics outside of class, and present their findings to the rest of the group each week. The final product at the end of the PBL module is a written case report.
How did we refine PBL instruction?
After the initial implementation of PBL during the Spring 2020 and Fall 2020 semesters, we further refined the PBL modules in accordance with Universal Design for Learning (UDL) Principles:
- Increasing authenticity. We expanded on the prompts containing details about the symptoms of the fictional patient to more closely mirror a clinical history chart. This meant adding more details about the demographic characteristics, lifestyles, and challenges facing the patient beyond their symptoms and lab test results. We also changed the names of our fictional patients (i.e. initial versions were traditional white men or women names) to increase representation.
- Offering both synchronous and asynchronous engagement. The objectives of the PBL module were designed to be completed primarily during class. Activities primarily involved discussion and research using a computer, which meant synchronous engagement could be in-person, online, or in a hybrid format. However, parts of the investigation could be completed outside of class and discussed during synchronous sessions, allowing for flexibility.
- Assessing both process and product. The final product at the end of the PBL module is a group submission of a case report. The case report includes the notes students wrote during their investigation, their comparison of the patient’s test results with normal reference ranges, and patient communication. This assessment provides multiple points of evaluation and allows students to demonstrate their process and product.
Each fall, a new set of graduate students rotate in to teach this high-enrollment Anatomy & Physiology class. In the Fall 2021 semester, the new cohort of graduate teaching assistants needed to be trained about PBL in order for the UDL principles to translate into their practices:
- Training instructors. In PBL, the role of the instructor is one of a tutor and guide. We created a training module to support graduate teaching assistants with examples of how address student questions and give feedback on the case reports.
What benefits did we notice?
Research about the efficacy of this curriculum is ongoing, but as an instructor, I noticed the following about the impact of PBL curriculum on student engagement:
- Adapting to multiple course delivery formats. These activities were successfully implemented in in-person and online course delivery formats. Thus, the PBL modules are agile and robust laboratory activities for teaching anatomy and physiology.
- Activating students’ interest. I enjoy “pedagogical wandering” around the classroom when students work on the PBL activities because it gives me the chance to overhear their debates, questions, and discoveries. The authenticity and ill-structured nature of the PBL prompt means they are free to explore multiple lines of inquiry, and so they are empowered to follow their curiosity before making a diagnosis.
- Leveraging students’ experiences. One of the most powerful observations about teaching the PBL has been its accessibility. The problem cannot be solved by a simple read through of the prompt. Students can bring their own experiences in receiving or working within healthcare to bear in the discussions as a jumping-off point.
If you would like to be updated about future publications stemming from this project, or to get in touch about implementing PBL in your anatomy and physiology course, please contact Emily Royse: roys1092@bears.unco.edu
Resources
Vita AA, Royse EA, Pullen NA. 2021. Problem-based learning for physiology: Synthesizing the cardiovascular system, respiration, macronutrient metabolism, and renal function. CourseSource. https://doi.org/10.24918/cs.2021.28
