Implementing educational change at the undergraduate level can be a difficult task. There are many well-documented challenges for introductory courses, including limited weekly meeting times, large class sizes, and an overwhelming amount of material to cover (Silverthorn et al., 2006). When faced with these challenges, instructors are often pressured to spend more time on content and less on developing conceptual understanding (Tanner & Allen, 2005). This “breadth over depth” approach causes students to miss out on developing conceptual frameworks that can help them understand the material (Lunsford & Diviney, 2020). As stated in Vision and Change in Undergraduate Biology Education (American Association for the Advancement of Science, 2011, p. 11),

To change the way undergraduate courses are taught, more focus should be placed on conceptual understanding. Teaching a course that emphasizes content over conceptual understanding leads to less effective learning and students’ inability to apply the material in real-life contexts (Mattheis & Jensen, 2014; Tanner & Allen, 2005). Through reform efforts, changes are possible to reshape and restructure courses that suffer from an overemphasis on content (Lunsford & Diviney, 2020; Tanner & Allen, 2005). These challenges are common in introductory courses across the science disciplines.

One introductory undergraduate course that struggles with integrating core concepts such as those laid out in Vision and Change (American Association for the Advancement of Science, 2011) is anatomy and physiology (A&P; Lunsford & Diviney, 2020; Mattheis & Jensen, 2014). A&P courses are terminology dense, spanning a vast amount of content. Therefore, students spend a large amount of time memorizing rather than focusing on higher level thinking skills such as comparing, analyzing, explaining, or predicting to build conceptual connections (Knight & Wood, 2017; Krathwohl, 2002). This can be improved through the implementation of conceptually driven learning activities that support these higher-level thinking skills. Researchers have identified appropriate conceptual frameworks and core principles to guide teaching and learning in A&P courses (Hull et al., 2017; Michael et al., 2009; McFarland et al., 2016; Modell et al., 2015), including homeostasis, cell-to-cell communication, and levels of organization.

By linking anatomical systems and processes to concepts and scientific scenarios, students can begin to make connections and understand how the material fits together (Hull et al., 2017). Incorporating real-world scenarios into classroom activities allows students to apply the material they learn in lecture to broader concepts. Several examples of A&P-related scenarios include rare diseases, genetic disorders, toxins and poisons, injuries, and athletic feats. Using engaging and data-rich scenarios allows students to better understand and scientifically explain them with the knowledge they gain in the classroom. Instructors can then adjust their curriculum to incorporate core concepts and broader scientific ideas into their teaching.

Predict-Observe-Explain

A concept-focused method that has been extensively studied for almost 30 years is known as the Predict-Observe-Explain (POE) strategy (White & Gunstone, 1992). Numerous studies examining the effectiveness of the POE strategy (Cinici & Demir, 2012; Coştu et al., 2011; Liew & Treagust, 1998; White & Gunstone, 1992) found that participating in the cognitive processes of prediction, observation, and explanation allows students to act as scientists and uncover the causes and meaning behind real-world scenarios (Haysom & Bowen, 2010). The POE strategy is also commensurate with assumptions about the characteristics of adult learners (e.g., self-concept, readiness to learn, etc.), as described by Knowles (1984). By using the POE strategy in combination with A&P core concepts and related scientific scenarios, curricular activities can be created to develop students’ conceptual understanding. Focusing on an overarching concept, such as homeostasis, throughout each POE activity will connect each course unit and activity.

The POE method scaffolds the students’ learning experience by introducing a real-world scenario related to the material from lecture. Next, questions are presented that are related to the scenario and require students to make predictions or hypotheses. Students then interact with data (gathered through experimentation or provided as secondhand data), allowing them to combine prior knowledge with their current understanding to generate observations. Finally, students are prompted to connect their observations with prior class material to develop causal scientific explanations of the scenario (Joyce, 2006).

This article outlines how POE activities, centered around the concept of homeostasis, were designed and implemented in an introductory undergraduate A&P course consisting of five units. Following each unit, a POE activity was conducted during a single 50-minute class period. The activities occurred after each unit and before each unit quiz and exam. Because curricular overhaul is a challenging process, wrapping up each unit with a short activity was more plausible. Each POE activity followed a similar format but focused on a new scenario and related data taken from the scientific literature (see POE sources and citations in the Online Appendix). As the course progressed, the final POE integrated Unit 5 material but also incorporated all four previous POEs to help students build on prior knowledge and to demonstrate the interconnectivity of the course content. All five activities were implemented in similar ways. Here, the POE activity for Unit 3 will be used as an example to describe how the activities were designed and implemented. All activities, templates, and resources described can be found in the Online Appendix.

POE activity design

Each activity was designed around a unique, summarized real-world scenario related to A&P concepts. A blank POE template was used to structure all five activities (see Online Appendix). The first page introduces the topic based on the prior unit material covered in class. For example, the POE activity for Unit 3 focused on nervous tissue (e.g., neurotransmitter dysfunction, membrane potentials, synapses, and action potentials). The scenario and driving questions found on the first page are structured around the Unit 3 material from class. Each real-world scenario is meant to be engaging, is based on data from the scientific literature, and requires students to use a combination of the material learned in class, their own knowledge, and data presented in the POE. The scenarios used for each POE activity were simplified for an introductory-level A&P course, and they were designed to be inclusive. Creating scenarios that include everyday activities such as running and eating candy maintains simplicity and maximizes students’ ability to connect with the scenario. The driving questions are created to help students focus on important concepts within the activity. Following the driving questions is space for students to record their initial predictions, hypotheses, thoughts, and ideas.

The following pages of the template include relevant data and analysis questions. For example, the Unit 3 activity includes data about neuromuscular junction activity and has an accompanying analysis question asking students to assess which step would be affected by the botulinum toxin discussed in the scenario. Because the POE activities are implemented in a lecture-based A&P course, the data are provided to students so they can analyze and observe important evidence to support their explanations of the scenarios. The analysis questions are designed to guide students through the data section and lead them to more complex tasks. The data are presented in a variety of forms, including tables, charts, graphs, and schematics. The analysis questions provide a scaffold for students as they navigate the data.

The last two components of the POE are the observation and explanation sections. Following the data and analysis questions is a space for students to record their observations of the data, where they organize evidence to support the claims they will make in their final explanations. The last task in the POE is the explanation, where students generate an evidence-based explanation for the scenario, answering the driving questions. Students are expected to use their observations of the data, the overarching theme of homeostasis, and concepts from lecture to support their claims. Explanations are expected to be scientific and supported with evidence.

Implementing the POE activities

Five POE activities were created and implemented in two first-semester, introductory-level undergraduate A&P lecture courses (see Online Appendix). As this is the first semester of a 2-semester course, the curriculum contains half of all the A&P material covered throughout the entire year. Each A&P section served approximately 150 students who were taught virtually via Zoom due to the coronavirus (COVID-19) pandemic. We describe how the activities would be implemented under in-person conditions. Each activity aligned with one of the five A&P lecture units while using homeostasis as the central theme. Table 1 describes the five unit topics for this first-semester A&P course, as well as the real-world scenarios used in the activities.

Before class: Student hypotheses

The week before the in-class POE activity took place, students were provided with the POE activity, instructions, and PowerPoint slides (see Online Appendix). Students were instructed to complete the first page of the activity, which involved reading the scenario and driving questions and recording their initial hypotheses and responses in the box. These POE activities were implemented in a lecture course and not a lab, so some modifications were made to the normal POE procedure. For example, it was logical for students to make hypotheses (i.e., initial explanations) instead of predictions because they were observing secondhand data rather than conducting and collecting their own data in lab.

Upon completion of this first section, students were expected to read the instructions and come prepared for in-class discussions and activities the following week. The instructions outlined class expectations and the PowerPoint slides contained additional details about the activity.

During class: Data analysis and observations

At the beginning of each 50-minute class, students were briefly reintroduced to the scenario and given key points (see example in Table 2) to focus on for the unit. Students were then reminded about the class structure and expectations (outlined in Table 3). The majority of the class period was spent in small groups, with students evaluating secondhand data and discussing analysis questions. During this time, students recorded observations based on the data and completed an online Google poll (see Figure 1) containing questions related to the Unit 3 scenario. The data analysis section helped students organize their observations and collect evidence that would be used in their final explanations.

End of class: Discussion and explanations

After the small-group work session, the class reconvened to discuss the Google poll, any remaining student questions, and confusions about the activity. The Google poll responses and student questions provided information about the challenges encountered during the activity. For example, in the activity for Unit 3, students were confused about how botulinum toxin affected neuromuscular junctions, how action potentials are affected by a lack of neurotransmitters, and how botulinum toxin leads to flaccid muscle paralysis.

After the large-group discussion and clarifications about the content, students were directed to individually complete and submit final explanations of the scenario by 11:59 p.m. that day. To answer the driving questions, students’ explanations were expected to be one or two paragraphs long and include information from lecture, data presented in the activity, and homeostasis. (See Figure 2 for an example student explanation of the Unit 3 activity.)

Assessing student explanations

Although students completed the entire activity packet during class, they were only assessed on their final explanations. Due to the high enrollment of this course, students were informed that their final explanations would be graded based on participation and completion of the assignment, but that did not seem to detract from students providing thoughtful explanations. To grade the activities for correctness, we provided a rubric (see Figure 3) and answer guides (see Online Appendix) to assist in this process. When grading, it is important to focus on the final explanations and compare them to students’ initial hypotheses. If students are able to use the data provided and either support or refute their initial hypotheses to the driving questions, the instructor should be able to discern whether the student truly understands the material. Students should be able to include data and major concepts from class as evidence to support their explanations.

Feedback on POE activities

Following the first four POE activities, a survey was conducted to gather opinions about the effectiveness of the activities. This survey included 10 Likert-scale (strongly disagree to strongly agree) questions and one short answer question (see Table 4). The Likert-scale questions showed that students appreciated the activities. For example, in response to a question as to whether or not the activities provided a useful example for applying the material learned in class to a real-world scenario, 87% of students (n = 291) either agreed or strongly agreed with this statement. One student noted, “I liked that the POEs related to what we were studying in class so we can see how it can be used in daily life. I also liked doing them in groups because it gave me a chance to engage with my classmates.” There were several common themes among the short-answer results, and the majority of students liked how the activities aligned with class material, incorporated real-life scenarios, were engaging, and improved their understanding of the unit material. Critiques of the activities included not having enough class time, wanting more time for large-group discussions, a lack of participation in group work, and wanting more in-depth explanations of the scenarios to improve understanding.

Discussion

By engaging students in multiple POE activities throughout their A&P course, students had numerous opportunities to strengthen their conceptual understanding while linking lecture material through the concept of homeostasis. The final Unit 5 activity was summative and incorporated all prior scenarios into a comprehensive activity. The connection between both course material and prior activities required students to understand that each topic works together through the lens of homeostasis and that they are not stand-alone topics.

The activities can be modified to fit the needs of any course and can be effective in both laboratory and lecture-based courses. We have included a blank POE activity template for use by other instructors (see Online Appendix). The consistent structure of the activities helps students become more familiar with conceptual learning as they progress through the course. After each unit in the A&P courses described above, it was evident that students were more comfortable with the activity structure in the later units. Once students began to understand how to connect material and think conceptually about course content, they began to understand the bigger picture within the course.

Possible adaptations

In the hopes of encouraging other instructors to use the POE method, all of the documents used for this project can be found in the Online Appendix in Microsoft Word format. These can easily be adapted for any discipline, thematic concept, or class structure. For example, the activities could be run over multiple class periods, which could encourage having in-depth conversations, developing rapport with classmates, or allowing time to process the material.

Another possible adaptation is incorporating different overarching themes, such as cell-to-cell communication, transcription and translation, evolution, or levels of organization. Instructors could generate new scenarios that introduce A&P concepts specific to their interests or even provide multiple scenarios for the same concept. Providing different scenarios to different groups in the same class could increase connection-making between homeostasis and other course concepts. This would also enrich large-group discussions as students compare and contrast the different scenarios while reinforcing the interconnectivity across the scenarios.

Conclusion

Ultimately, the POE activities were an effective way to engage students in thinking about core concepts as well as making connections between course material, the concept of homeostasis, and prior activities. The goal of this project was to help students step back from the narrow focus of memorizing content and instead gain a broader and more complete perspective from a real-world context of the A&P course content. From our observations of student performance and qualitative student feedback, it appears that we have met this goal. These POE activities scaffold learning not only throughout each unit but also throughout the entire semester. The activities also gave students the opportunity to work individually, as well as in small and large groups, and to write, analyze, and synthesize complex information. The scenarios are adaptable and common enough to support an inclusive large-enrollment course such as anatomy and physiology. Over time, incorporating these small curricular changes could lead to improvements in both effective teaching and learning.

Online Connections

Figure 3

Tables 1–4

Appendixes (.zip archive)

Sammi Moore is a graduate student in the Department of STEM Education, Ron Gray (ron.gray@nau.edu) is an associate professor in the Department of STEM Education, and Jeff Meilander is a doctoral student in the Department of Biological Sciences, all at Northern Arizona University in Flagstaff, Arizona.