Missouri Course Redesign Initiative
University of Central Missouri
Course Title: Human Anatomy
At the University of Central Missouri (UCM), Human Anatomy and Physiology I and II (A&P I and I) are primarily service courses for programs of study in the departments of kinesiology and nutrition, nursing, and safety science, with approximately 60-65% of the enrollment from nursing majors alone. Over the last three academic years, A&P I has experienced a 40% increase in enrollment (248, 291, and 347 students), while A&P II has experienced a 35% increase in enrollment (181, 190, 244 students), and the university expects this growth to continue. These growth rates, coupled with the current course design, present significant logistical problems to the quality of the courses themselves, as well as to the department’s ability to maintain the quality of its degree programs.
The A&P I and II courses are offered as three-credit, large enrollment lecture sections with multiple one-credit, 24-student lab sections. The current approach aligns the teaching of the physiological systems with the relevant anatomical structures, splitting the body’s systems between the two consecutive courses. While this format is conducive to combining the study of form and function, it also presents a significant academic challenge to first- or second-year students, which make up 60% of the students. They are confronted with a large volume of anatomical structures and complex physiology at the same time, with limited exposure to the time demands, study strategies and complexity of content inherent in this subject. Some respond quickly, while others do not. Over the last two academic years, the average DFW rate has been slightly over 30% in both courses. The goal is to reduce this rate while maintaining or enhancing the academic rigor of the course series.
The current course structure also places resource and growth restrictions on the course series. Most current lab sessions begin with a physiology exercise or anatomical lecture and end with an anatomy focus session, which means that both facilities must be dedicated to each scheduled lab. This structure also limits the number of days that sections of either course can be offered. Growth is further impeded by staffing issues since both an instructor and a graduate teaching assistant (GTA) are required to be assigned to each lab section due to complex protocols and safety requirements in the physiology lab exercises. The result is that 54% of total departmental GTAs are dedicated to these two courses (increased from 25% two years ago.) The redesign will allow the assignment of instructors and GTAs to avoid unnecessary overlap as well as utilize undergraduate learning assistants (ULAs) where possible.
The overall redesign plan will restructure the two courses into a first-semester Human Anatomy course and a second-semester Human Physiology course. The current redesign will focus on Anatomy using the Replacement Model; the Physiology course will subsequently be redesigned as well. In Human Anatomy, students will be supported in mastering a large volume of human anatomical structures by incorporating electronic learning modules, group active-learning strategies, and recitation sessions for the students in danger of failing. One large weekly lecture will increase the consistency of course expectations and information provided, leading to greater coordination of the total course. Supervised laboratory sessions will supplement the knowledge introduced in lectures by engaging students in a team-learning approach at custom-designed learning stations with core model sets, microscopes and electronic learning resources. The teams will utilize customized online modules, coupled with studying histological slides and anatomical models. The sessions will conclude with required online group assessments for instant feedback and will be auto-graded using McGraw Hill’s LearnSmart system. Students will then be expected to complete the same assessment on their own that night. A composite score will either mandate they attend a two-hour recitation section for additional work if the score is below 65% or spend at least one hour in an unsupervised open lab block if the score is over 65% to work on deficiencies identified in the previous lab session or lecture. Students will then enter Human Physiology, which covers a large volume of highly complex material, with their study habits and level of expectation in line with the demands of the course.
The redesign of Human Anatomy will increase the course enrollment from 336 to 480, increase the lab section size from 25 to 40 and reduce the number of lab sections from 14 to 12 annually. In addition, non-tenure track faculty will replace tenure-track faculty. Since there are no longer safety concerns in the redesigned labs as all physiology systems will be taught in the second course, GTAs assisted by ULAs will manage the labs. These changes will reduce the cost-per-student by 68%, from $345 in the traditional format to $111 in the redesigned course. UCM plans to reinvest that cost savings into additional upper-level/graduate course offerings or reassigned time for faculty to be more involved in the graduate research program, a long-standing desire of the UCM administration.
In the redesign, did students learn more, less or the same compared to the traditional format?
The assessment of UCM’s Human Anatomy course redesign involved a performance comparison between two traditional courses that combined the teaching of human anatomy and physiology (i.e., A&P I and A&P II) in the same semesters to the redesigned Human Anatomy course that solely focused on human anatomy content. To resolve these issues the team implemented a pre/post test comparison among all sections.
All sections reported student improvement between the pre-test and post-test, with the traditional course averaging an increase of 4.82%, while the redesign course averaged an increase of 1.91%. This difference was not statistically different.
The results from the pre-test comparisons suggest that the students entering into UCM’s redesigned course were less prepared for the material as the average pre-test score was 37.55 ± 14.92%, while the average pre-test scores from the combined traditional courses was 46.77 ± 15.3%. While this difference was not statistically significant, the nearly 20% decrease in performance would suggest the populations were not perfect comparisons. In addition, the average ACT score for the redesigned course was 20.9 versus 22.4 for the traditional courses combined, which represents a nearly 9.5% decrease in ACT performance in the students enrolled in the redesign.
Because the course content changed from a combination of anatomy and physiology to only anatomy, it is difficult to make a valid course completion comparison.
The percentage of students earning a D or F across all traditional sections was 27.7%, whereas the percentage in the redesigned sections was 20.4%.
Were costs reduced as planned?
In the traditional format, Anatomy and Physiology I and II were offered as a two-semester, combined sequence. In the redesign, Anatomy and Physiology were offered as two separate courses. UCM’s cost reduction plan was to increase the course enrollment from 336 to 480, combine recitations and labs, increase the lab section size from 25 to 40 and reduce the number of lab sections from 14 to 12 annually. In addition, non-tenure track faculty were to replace tenure-track faculty. Graduate teaching students (GTAs) assisted by undergraduate learning assistants (ULAs) were to manage the labs. The plan showed a decline in the cost-per-student from $355 in the traditional format to $108 in the redesign, a 70% savings.
The implementation of the redesign followed the plan with some modifications. The increased enrollment of 480 was accommodated in sections of 40. The team decided, however, that a tenure-track faculty member should serve as course coordinator to insure that the redesign policies were clear and that consistency was maintained. The coordinator received a one-course (3 credits) release time each term. During one of the weekly labs, which included some recitation time, the non-tenure track faculty member was present and assisted by a GTA. The second weekly lab was managed by a GTA with the assistance of a ULA. These changes increased the cost-per-student in the full implementation from the planned $108 to $161, which represents a 55% percent decline in cost.
Pedagogical Improvement Techniques
What techniques contributed most to improving the quality of student learning?
Electronic resources. The team heavily incorporated the use of electronic resources in the redesign. The electronic assessment strategy in class and at home kept students on task and also provided a record of student participation and effort. These numbers were easy to harvest and showed students how their effort and participation compared to their cohort’s in order to provide justification and motivation. One common comment was that the students felt they knew how prepared they were before the exams and understood why they earned the grade they received on the in-class practicum series
Increased flexibility. A portion of students advanced past the required content in the online study modules, suggesting they were learning material the team did not have the capacity to include in the course. Another portion of students spent more time on the assigned material. This flexible learning approach was what the team intended to achieve.
Team-based learning. The team heavily incorporated the use of team-based learning in the redesign and generally felt the technique was a positive learning approach.
Cost Reduction Techniques
What techniques contributed most to reducing costs?
Combining lab and recitation and increasing section size. UCM’s cost reduction strategy was to increase the course enrollment from 336 to 480, combine recitations and labs, increase the lab section size from 25 to 40 and reduce the number of lab sections from 14 to 12 annually.
Changes in personnel. Non-tenure track faculty replace tenure-track faculty in teaching the course. Graduate teaching students (GTAs) assisted by undergraduate learning assistants (ULAs) instead of faculty managed the labs.
What implementation issues were most important?
Not conducting a pilot. UCM decided the service nature of the course would not allow them to conduct a pilot since students competing for the same spots in follow-on programs would be compared with a different metric depending on whether they were in the pilot section or not. The project experienced a significant level of student frustration and confusion with the registration and use of the learning software packages in the initial few weeks. The team believes that the project would have benefited greatly from a small pilot section to identify the issues and formulate solutions. A smaller test run of the electronic resource with enrolled students would have drastically improved the initial few weeks of the implementation. Student frustration and confusion may have been the cause of the increase in withdrawals experienced in the redesign.
Student attitudes. Student comments have varied drastically. Reports of appreciation for the increased assessment, access to material and time-on-task were equal to the complaints on issues with technology in classroom/homework assignments, increased graded workload and team-based organization. Overall, the team’s opinion is that the students generally accepted the scores they earned more readily in the redesigned course, whereas they typically complained of not knowing why they were performing poorly in the traditional format. This was most likely do to the drastic increase in assessment.
Faculty use of technology. Some members of the instructional team were not proficient in using the new electronic resources, but they worked through those issues pretty quickly.
Personnel changes. UCM’s initial plan was to turn over the coordination of the course, including management of the electronic resources, to a single non-tenure track faculty member. The need for a tenure-track coordinator, at least initially, became very apparent. A large service course that is reliant on team-based approaches seems to have two main components: organization and facilitation. The team felt that these roles were best separated with one person (a tenure-track faculty member acting as coordinator) focusing on the electronic resources and course policy communication and another (serving as a dedicated primary instructor in the laboratory) focusing on implementing the team approach and content in the lab.
Will the redesign be sustained now that the grant period is over?
The University of Central Missouri is fully dedicated to this redesign. The initial results are promising, and the full implementation of the follow-on course, Human Physiology, is currently under way during the spring 2013 semester. The spring 2013 semester of Human Anatomy is going well. A simple comparison of the cost savings versus the change in student performance suggests that UCM is on the right track, and these results are providing data for any individuals that are somewhat suspicious of the approach. In addition, the entire instructional staff associated with Human Anatomy at UCM is in full support of the format and continues to work toward perfecting the course format.