"School of Athens." Fresco by Raphael (1509-1511). For more information, visit: https://mymodernmet.com/school-of-athens-raphael/ and https://artincontext.org/the-school-of-athens-raphael/

Course set-up:

• PSIO 202 (Human Anatomy and Physiology II) is Fall/Spring/Summer Semester lecture + laboratory course format- this projects is based on the laboratory portion.

• Required for Physiological Sciences majors, but there are students from other STEM and health professions majors. 

• It is expected that students come with a basic knowledge in biological sciences (and have passed PSIO 201 (Human Anatomy and Physiology I) with a grade B or higher). 

• In-person.

• Each lab section has 24 students maximum, and each teaching assistant (TA) usually has two sections. Final grade is determined by the total number of points collected throughout the semester. All assessments are summative (lecture exams, lab quizzes and lab practicals), and each modality of summative assessment carries a different number of points.

• Laboratory sessions are primarily lecture- based and are 2 hours and 50 minutes long.

Lab #7: The Anatomy of Digestive System

• This is seventh (7th) laboratory session of the semester in the third block (Block #3) of the course (excluding days of the practical).

• In the Spring Semester, it usually falls in the middle of the semester and mid-March.

• It is followed by the lecture material on the physiology of the digestive system.

Following learning objectives only include what was explored in this TAR project, and do not include the entire scope of the lecture material covered in the 2 min 50 hour laboratory session. They will be assessed through pre- and post-lab assessments, as described in the "Methods" section.

Learning Objectives (LOs):

LO#1: Name and locate the layers and sphincters of the four major organs of the gastrointestinal (GI) tract on the anatomical models. 

LO#1a. Draw the four major organs of the gastrointestinal (GI) tract and list their layers and sphincters.

LO#2: Describe the function of the layers and sphincters in the four major organs of the gastrointestinal (GI) tract using the framework of movement and mechanical digestion and the GI tract-specific terminology.

LO#3: Recognize and name the organs of the gastrointestinal (GI) tract and accessory organs on a histology slide.

LO#3a. Identify characteristics of each organ on the histology slides that will help distinguish them in the future, independent of the histological slide itself. 

Learning objectives (LOs) were prioritized based on the level of prior knowledge needed to achieve each outcome. In physiological sciences, structure usually equals function, so for example, in order to describe how layers and sphincters in the four major organs of the gastrointestinal (GI) tract aid in the basic function of this system, students first need to name, locate, and label these layers and sphincters. 

"Jigsaw" Method

The "jigsaw" method refers to a classroom group work modality which requires students to interact with and understand the key concepts of their assigned material on a topic, so that they can teach it to another group of students. This active learning strategy highlights the importance of teamwork, develops empathy, and increases quality of oral and written communication. (1) It has been found to be useful to students in the physiological sciences while learning complex concepts. (2, 3, 4) The following example shows how this method was implemented in this TAR project.

References:

1 Luis Manuel Tobaja Márquez, Julia Gil Llinás, Francisco Solano Macías. Collaborative learning: Use of the JIGSAW technique in mapping concepts of physics. Problems of Education in the 21st Century 75(1):92-101. February 2017. (PDF) Collaborative learning: Use of the jigsaw technique in mapping concepts of physics

2 Bhandari B, Mehta B, Mavai M, Singh YR, Singhal A. Jigsaw Method: An

innovative way of cooperative learning in physiology. Indian J Physiol Pharmacol.

2017;61(3):315-21.

3Veena Bhaskar Sampangi Rame Gowda et al., Co-operative Learning by Jigsaw in Biochemistry. 

4 Suman Sharma, Sangita Chauhan, Manjinder Kaur. (2019). Introduction and Assessment of Jigsaw Method of Teaching on Challenging Topics in Physiology for First Year Medical Students. International Journal of Physiology, 7(4), 238–245. https://doi.org/10.37506/ijop.v7i4.99

TAR Question:

PROJECT GOAL

To introduce an alternative in-class learning method and compare change in pre- to post-lab assessment scores to student rating of the method. This comparison will give us a better understanding how to bridge the gap (if such exists) between students' perceived knowledge and their actual intrinsic understanding of the content. 

METHODS

The following assessments were given to two laboratory sections, each led by a different Teaching Assistant (TA). One laboratory section was labeled as a "Control Group (Lecture-based Teaching Approach, LTA)" and the other one as "Jigsaw Group (Experimental-based Teaching Approach, ETA)". I led the former laboratory session, with the assistance of their teaching assistant (TA) and their undergraduate preceptor. 

Change in pre- to post-lab assessment scores was assessed by short pre- (Assessment 1) and post-lab (Assessment 2) summative assessments in a form of a five (5) minute quizzes. Both groups completed both assessments, with the caveat that ETA group was allowed to use their notes to complete Assessment 2. The format of Assessments (1) and (2) followed the quiz guidelines established by the course director (e.g. a mix of question modalities: multiple choice, fill in the blank, etc.) and included wording from the learning objectives (LOs). The questions resembled questions to be expected on all laboratory graded assessments (e.g. quiz following the lecture and the practical at the end of each block). There was a total number of nine (9) questions, and each was worth one (1) point, for a total of nine (9) points.

The four (4) criteria for student rating of the method are:

1) student confidence to teach others;

2) student ability to define key ideas from the lab session;

3) how useful this learning strategy is for learning the concepts of this lab session and

4) student preference for this learning strategy over a traditional lecture.

These criteria were assessed in a form of post-lab survey with a Likert scale and free response. 

All assessments used in this project are posted below.

ANALYSIS METHODS

1. Calculating percentage (%) of participants per Likert scale subgroup: (total number of responses for a Likert scale category/total number of students who took the survey)* 100%

   • Percentages were rounded to a whole number.

   • When making conclusions on overall agreement/disagreement in each Figure, "agreement/preference" was calculated as a sum of "agree" and "strongly agree" percentages, while "disagreement/lack of preference" was calculated as a sum of "disagree" and "strongly disagree" percentages. Otherwise, separate values are reported. 

2. Calculating percent (%) correct answers: (total number of correct answers/total number of points)*100

3. Calculating fold change: (Assessment 2 percent correct answers/Assessment 1 percent correct answers)-1

RESULTS

DISCUSSION 

The key results which will help us decide if TAR question is answered are:

1. There is no statistically significant difference in performance (as measured by the fold change between Assessments 1 and 2) between the student group who was taught the concepts of anatomy of the digestive system through a lecture-based teaching approach versus the one being taught through an experimental-based teaching approach ("jigsaw" method). (Figure 5B.) Interestingly, students in the jigsaw group (ETA) overall stayed consistent with the performance on the post-lab assessment, which could be contributed to their ability to use their notes if so desired. (Figure 5A.) Since there is no record of how many students actually did use their notes in this group, or a comparison of performance of ETA group students who used their notes versus the ones who have not, this is a potential confounding factor. It would be interesting to see how the ability to use notes in a post-assessment correlates to perceived knowledge.

2. In somewhat contrast to the result above, students in the control group (LTA) have more self-perceived knowledge compared to the jigsaw group (ETA), as demonstrated in Figures 2A-4B and 2B-4C by increased percentage of "agree" and "strongly agree" statements sum. This can easily be explained by be the fact that jigsaw student group (ETA) uses to them an unfamiliar learning method, which can lower self-esteem and perceived knowledge on the topic. This is especially true as this student group is put "on the spot" do not only learn their assigned key concepts in ~twenty (20) minutes, but also demonstrate it to their peers right after. Because of a confounding factor mentioned above, it is not clear whether their actual performance is better than their perceived knowledge. 

3. In addition, jigsaw group (ETA) expressed somewhat more "dislike" towards the introduced active method of learning (Figure 4D.), while the control group was somewhat split on their decision towards the lecture-based teaching approach (Figure 2C.). These are valuable results as they point out that it takes more than a sudden introduction to a new teaching method to get students out of their "lecture style comfort zone".  

So, do these key findings answer the TAR question: "How do student feelings towards learning the anatomy of the digestive tract in PSIO 202 lab in a “jigsaw" method setting compare to their performance on short pre- and post-lab summative assessments on this lab content?"  They do (Key Results 1 and 2), albeit not to an extent wanted, due to some of the factors mentioned above. Do we have a better understanding how to bridge the gap (if such exists) between students' perceived knowledge and their actual intrinsic understanding of the content? Yes, to an extent. Clearly, Key Result 3 suggests a need for an introduction of an alternative teaching/learning method to lecture-based teaching approach in if not only in the laboratory session dedicated to anatomy of the digestive system, possibly in PSIO 202 laboratory as a whole. However, there is a caveat- the same results suggest that introduction of such approach should be done gradually, and with the teaching assistant (TA) students are assigned to at the beginning of the semester. 

LESSONS LEARNED

Creating, executing, and completing this TAR project was a very valuable experience and lesson in project management and navigation when it does not all go according to plan. I feel more confident to continue not only learning, but actively creating learner-centered spaces, because this opportunity gave me a framework to refer to when planning such efforts. I also appreciate more the value of pre-assessments, as they really do drive the comparative nature of this and similar projects. Something I would like to continue learning is how to improve the relationship between qualitative data collection process and that data being informative for the question(s) being asked, and qualitative data analysis.

If I were to complete this same project again, I would improve several key aspects of it:

• I would have ensured that the method rating criteria is supported by the same number of questions that  describe whether that criteria has been fulfilled or not. Currently, some criteria has only one survey question associated with it, while same has many (e.g. Criteria 4 is described by Likert scale for Q6, while Criteria 3 has many Qs describing it).

• I would have asked students to write a code name on both of their summative assessments and completed surveys to more accurately link the rating spectrum with the summative assessment scores (for example, to compare how well students who highly or negatively rated the learning method performed on both summative assessments).

• I would have included more free response questions to understand why students prefer one teaching method over the other, to explain why they felt or did not feel confident in their perceived knowledge, as well as to actually demonstrate they do know what the key concepts by writing them out, and not just complete the assessments.

• Teach the TAs how to implement some aspects of this active learning technique throughout the semester before implementing the whole technique to avoid a sudden change of teaching/learning modality. 

• Teach the TAs how to implement this active learning technique to avoid a "stranger danger" effect by being an unfamiliar face to students.

RESOURCES

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