COVID struggles: undergraduate teaching assistants balance teaching and learning during a pandemic.

Undergraduate teaching assistants (UTAs) have become valuable collaborators with faculty in large undergraduate first-year classes. Their participation requires them to manage their teaching duties and their own learning. The pandemic posed unusual problems for them. Here, two students, along with their instructor, provide an inside look. Throughout the pandemic, UTAs were found to increase their efforts during tutorials in attempts to help ensure that students were more prepared and engaged through the online learning formats. New strategies were implemented to maintain student attendance and participation in class, which greatly increased the workload for UTAs. Students not turning on their cameras and speaking up in online classes made teaching more tiring and stressful, which was compounded by the already present "Zoom fatigue" during online education. UTAs found real challenges in balancing senior year classes and extracurriculars with preparation for tutorials, especially closer to assignment or exam deadlines when the engagement and questions from students would sharply increase. Despite numerous efforts and adaptations made by UTAs to adjust to the impacts of the pandemic, online learning was an immense challenge to both students and teachers in comparison to the in-person formats.NEW & NOTEWORTHY Undergraduate teaching assistants balance teaching others with their own learning during the recent pandemic. Their struggles provide an inside look into a student's plight.

Answering Huxley: "now" students take a "then" exam.

Twenty-eight undergraduate students in a health sciences program volunteered for an exercise in the history of examinations. They had completed a second-year course in anatomy and physiology in which they studied modern texts and took standard contemporary exams. For this historical "experiment," students studied selected chapters from two 19th century physiology texts (by Foster M. A Textbook of Physiology, 1895; and Broussais FJV. A Treatise on Physiology Applied to Pathology, 1828). They then took a 1-h-long exam in which they answered two essay-type questions set by Thomas Henry Huxley for second-year medical students at the University of London in 1853 and 1857. These were selected from a question bank provided by Dr. P. Mazumdar (University of Toronto). A questionnaire probed their contrasting experiences. Many wrote thoughtful, reflective comments on the exercise, which not only gave them an insight into the difficulties faced by students in the past, but also proved to be a valuable learning experience (average score: 8.6 ± 1.6 SD).

Network analysis of the structure of inter-professional knowledge exchange related to Electronic Health Record Medication Reconciliation within a Social Knowledge Networking system.

BACKGROUND: In fall 2016, a 2-year grant was secured to pilot a Social Knowledge Networking (SKN) system pertaining to Electronic Health Record (EHR) Medication Reconciliation (MedRec), to enable Augusta University Health System to progress from "limited use" of EHR MedRec technology, to "meaningful use" (MU). A total of 50 "SKN users" (practitioners), participated in discussing practice issues related to EHR MedRec, over a 1-year period. These discussions were moderated by five "SKN moderators" (senior administrators). The pilot study, completed in fall 2018, found that inter-professional knowledge exchanges on the SKN, enabled several collective learning ("aha") moments to emerge. These learning dynamics in turn, were associated with distinct improvement trends in two measures of MU of EHR MedRec technology, identified for the study. A key takeaway was that an SKN could be a valuable tool in enabling MU of EHR MedRec technology. PURPOSE: The study's key findings related to the content and dynamics of inter-professional knowledge exchange on the SKN system, and their association with trends in measures of MU of EHR MedRec technology, have been described in a separate publication. This paper seeks to describe the structure of inter-professional knowledge exchange (or the pattern of connections) related to EHR MedRec, over the 1-year SKN period. METHODS: Social network analysis (SNA) techniques were used to describe the structure of inter-professional knowledge exchange on the SKN system. RESULTS: Results revealed that three of the five SKN moderators played a strong "collective brokerage" role in facilitating inter-professional knowledge exchange related to EHR MedRec, to enable learning and practice change. Together, they played complementary roles in reinforcing best-practice assertions, providing IT system education, and synthesizing collective learning moments, to enable "champions for change" to emerge from among SKN users. CONCLUSION: Results provide insight into the structure of effective knowledge-sharing networks for enabling inter-professional learning and practice change in health care organizations.

Effort and trust: the underpinnings of active learning.

Three undergraduate students and their teacher discuss two crucial issues that form the implicit basis of active learning: effort and trust. They use a single course in a Health Sciences Program to anchor their comments.

Beyond the single answer: a process-oriented exam for science students.

This commentary describes an assessment exercise known as the TRIPSE (Tri-Partite Problem Solving Exercise) that mimics science in operation. Students frame hypotheses based on limited data, design experiments to test them, which they later revise with new information. It is emphasised that there are no single correct answers, only sets with varying degrees of plausibility. The approach is flexible and can be adapted to any of the basic biomedical sciences and for students at multiple levels, undergraduate to graduate. In comparison to other testing methods, this process-oriented exercise provides a better learning experience. It captures the excitement and fascination of science and gives students a more realistic view of how scientists function.

Matters of taste: bridging molecular physiology and the humanities.

Taste perception was the focus of an undergraduate course in the health sciences that bridged the sciences and humanities. A problem-based learning approach was used to study the biological issues, whereas the cultural transmutations of these molecular mechanisms were explored using a variety of resources (novels, cookbooks, and films). Multiple evaluation procedures were used: problem summaries and problem-solving exercises (tripartite problem-solving exercise) for the problem-based learning component and group tasks and individual exercises for the cultural issues. Self-selected groups chose specific tasks from a prescribed list of options (setting up a journal in molecular gastronomy, developing an electronic tongue, designing a restaurant for synesthetes, organizing a farmers' market, marketing a culinary tour, framing hedonic scales, exploring changing tastes through works of art or recipe books, and crafting beers for space travel). Individual tasks were selected from a menu of options (book reviews, film reviews, conversations, creative writing, and oral exams). A few guest lecturers (wine making, cultural anthropology, film analysis, and nutritional epidemiology) added more flavor. The course was rated highly for its learning value (8.5 ± 1.2, n = 62) and helped students relate biological mechanisms to cultural issues (9.0 ± 0.9, n = 62).

On being examined: do students and faculty agree?

Students measure out their lives, not with coffee spoons, but with grades on examinations. But what exams mean and whether or not they are a bane or a boon is moot. Senior undergraduates (A. Perrella, J. Koenig, and H. Kwon) designed and administered a 15-item survey that explored the contrasting perceptions of both students (n = 526) and faculty members (n = 33) in a 4-yr undergraduate health sciences program. A series of statements gauged the level of agreement on a 10-point scale. Students and faculty members agreed on the value of assessing student learning with a variety of methods, finding new information to solve problems, assessing conceptual understanding and logical reasoning, having assessments with no single correct answer, and having comments on exams. Clear differences emerged between students and faculty members on specific matters: rubrics, student choice of exam format, assessing creativity, and transfer of learning to novel situations. A followup questionnaire allowed participants to clarify their interpretation of select statements, with responses from 71 students and 17 faculty members. All parties strongly agreed that exams should provide a good learning experience that would help them prepare for the future (students: 8.64 ± 1.71 and faculty members: 8.03 ± 2.34).

The TRIPSE: a process-oriented exam for large undergraduate classes.

The TRIPSE (tri-partite problem solving exercise), a process-oriented exam that mimics the scientific process, was used previously in small classes (15-25). Provided limited data, students frame explanations and design experimental tests that they later revise with additional information. Our 6-year experience using it with larger numbers (155-204) in a freshman biology course, suggests that it could provide a means of assessing individual student performance. Students rated the learning value of this experience to be significantly higher than a standard MCQ on a 10-point scale (TRIPSEs 8.2, CI 8.1/8.4 vs. MCQs 4.9, CI 4.8/5.1, n = 712). Additionally, we tested one cohort (n = 146) with a group TRIPSE (groups of 6), and found that this variant also provided a valuable learning experience (8.0, CI 7.7/8.3).

The UNSIN project: exploring the molecular physiology of sins.

Although active learning works, promoting it in large undergraduate science classes is difficult. Here, three students (F. Naji, L. Salci, and G. Hoit) join their teacher (P. K. Rangachari) in describing one such attempt. Two cohorts in a first-year undergraduate biology course explored the molecular underpinnings of human misbehavior. Students were divided into 18 groups and randomly allotted to deal with one of the four deadly sins: sloth, gluttony, lust, and wrath. Students were expected to read primary sources to devise molecular ways to counter these sins. Group progress was monitored over the 12-wk period by the preceptor (P. K. Rangachari) at scheduled intervals. A single randomly selected student was questioned about the work done, and future directions were provided by the preceptor. At the end of the term, randomly selected students defended their group's approaches to the entire class. A final written report was graded. The following multiple target molecules were considered for each sin: gluttony (cholecystokinin, ghrelin, GABA, leptin, peptide YY, neuropeptide Y, and the melanocortin 4 receptor); sloth (dopamine, glutamate, GABA, and orexin); wrath (serotonin, GABA, glutamate, and corticotropin-releasing hormone receptor 2); and lust (prolactin, testosterone, oxytocin, dopamine, and estrogen). Students noted that the project provided a valuable learning experience, and the random selection approach gave students a greater sense of responsibility to their group. The project helped students hone their skills at searching, synthesizing, sharing, and presenting information, fostered group interactions, and provided a solid knowledge base for subsequent courses.

Steps to pluripotent learning: provocative teaching.

Education involves interactions between students and teachers in a societal framework. Teachers can best serve their students and society by making students flexible enough to thrive under uncertain conditions. They should, in a sense, nourish, nurture, provoke, and stimulate pluripotent "educatoblasts."

Teaching undergraduates the process of peer review: learning by doing.

An active approach allowed undergraduates in Health Sciences to learn the dynamics of peer review at first hand. A four-stage process was used. In stage 1, students formed self-selected groups to explore specific issues. In stage 2, each group posted their interim reports online on a specific date. Each student read all the other reports and prepared detailed critiques. In stage 3, each report was discussed at sessions where the lead discussant was selected at random. All students participated in the peer review process. The written critiques were collated and returned to each group, who were asked to resubmit their revised reports within 2 wk. In stage 4, final submissions accompanied by rebuttals were graded. Student responses to a questionnaire were highly positive. They recognized the individual steps in the standard peer review, appreciated the complexities involved, and got a first-hand experience of some of the inherent variabilities involved. The absence of formal presentations and the opportunity to read each other's reports permitted them to study issues in greater depth.

Putting students in charge: a symposium on student-centered learning.

BACKGROUND: Many symposia and workshops are held to discuss issues of student-centered learning, but few put students in charge. DESCRIPTION: An international meeting was held at McMaster University, Hamilton, Ontario, Canada, to discuss Student-Centered Learning in the Life and Health Sciences where there were no plenary, oral, or poster presentations. Sessions were run in a problem-based, small-group format. Educational problems written specifically for the symposium served as springboards for learning. Undergraduate and graduate science students took center stage by taking an active role in the planning and organization of the event and serving as chairs and facilitators for the sessions. In addition, they summarized the sessions in written reports, which thus enabled their opinions to be documented. Eminent educators from several countries (Australia, Denmark, Spain, Portugal, Finland, the UK, and the United States) participated in these sessions as both learners and content experts. EVALUATION: A questionnaire as well as comments suggested that the participants enjoyed the learning experience, which gave faculty, staff, and students opportunity to discuss in-depth educational issues related to process, content, and delivery of curricula.

Of tacit knowledge, texts and thing-based learning (TBL).

Practical knowledge has two dimensions- a visible, codified component that resembles the tip of an iceberg. The larger but crucial tacit component which lies submerged consists of values, procedures and tricks of the trade and cannot be easily documented or codified. Undergraduate science students were given an opportunity to explore this component through an inquiry-based course.

Back to the future? Active learning of medical physiology in the 1900s.

In the early 1900s, teachers of medical physiology faced a problem familiar to those teaching the subject in a contemporary setting: too much information, too little time, too many students in crowded rooms, and exams that discouraged real learning. They wanted students to question authority and demand evidence and thus be better prepared for medicine. Their solution was to bring students into laboratories and minimize didactic learning as they felt strongly that useful information could not be obtained merely from books. Thus, they were strong proponents of what we now call active learning.

Texts in context: Horace Davenport, carbonic anhydrase, and gastric acid secretion.

Many standard textbooks of physiology have a diagram that shows the transporting elements that lead to the secretion of HCl by the parietal cell. The transporters are neatly aligned, and students see an elegant mechanism that neatly balances the ions to maintain electroneutrality. They little realize the time and effort required to tease out each of those steps bit by bit. This essay uses three papers by Horace Davenport to highlight the experimental evidence for a crucial step in that process: the generation of H(+) and HCO(3)(-) through the agency of carbonic anhydrase. All three papers form part of the classic papers available through the American Physiological Society Legacy Project.

Information literacy in an inquiry course for first-year science undergraduates: a simplified 3C approach.

In this article, we describe a simplified approach to teach students to assess information obtained from diverse sources. Three broad categories (credibility, content, and currency; 3C) were used to evaluate information from textbooks, monographs, popular magazines, scholarly journals, and the World Wide Web. This 3C approach used in an inquiry course for freshmen in an undergraduate science program can be readily transferred to other settings.

Low doses of ionizing radiation can prevent radiation-induced colonic epithelial hyporesponsiveness to muscarinic agonists.

PURPOSE: Colonic epithelium hyporesponsiveness to different secretagogues occurs after exposure to ionizing radiation, increasing susceptibility to bacterial translocation and intraluminal toxins. Growing evidence suggests that the biological effects of radiation might be hormetic in nature. We investigated if exposure to low doses of ionizing radiation (LDR) can prevent colon hyposecretion due to subsequent larger doses. METHODS: Rats were exposed to LDR (0.05 Gy) 24 h prior to 6 Gy, high dose radiation (HDR). The cyclic adenosine monophosphate (cAMP)-mediated pathway was explored using forskolin (FSK) and the intracellular Ca2+-mediated pathway through cholinergic stimulation. Changes in the colonic epithelium at the ultrastructural level were also explored. RESULTS: Maximal short circuit current (Isc) response to carbachol was significantly reduced in the group exposed to 6 Gy HDR and this was completely prevented by prior exposure to LDR. Responses to both FSK and electrical field stimulation (EFS) were significantly reduced after HDR but they were not prevented by prior adaption of LDR. Hyposecretion was not prevented by the inducible nitric oxide synthase (iNOS) inhibitor L-N6-(l-iminoethyl)lysine (L-NIL) ruling out a role for iNOS-derived nitric oxide (NO) in the colonic hyposecretion associated with whole body radiation. Prior exposure to LDR diminished the deleterious effect of full HDR on the ultrastructure of colonic epithelium as colonocytes vacuolization, microvilli lost and separation between neighboring cells were less evident. CONCLUSIONS: Previous exposure to LDR can prevent intracellular Ca2+-mediated colonic hyposecretion associated with exposure to HDR but fails to modify cAMP-mediated hyposecretion. Morphological damage at the ultrastructural level is less evident after prior LDR.