Integrative and active teaching-learning

approach in basic disciplines:

the experience of FOP - UNICAMP.

Fernanda Klein Marcondes, Ph.D. Physiological Sciences Department

Piracicaba Dental School (FOP) University of Campinas (UNICAMP)

•Historic

•The proposal

•Advances

BIOSCIENCE I

BIOSCIENCE II

Dentistry – FOP Areas: basic, pre-clinics, clinics and social

1st year 2ndyear 3rd year 4th year

Anatomy 1 Histology 1 Biochemistry Microbiology Genetics

Pre-clinics 1

Bioestatística

Patology

Pre-clinics 3

Pre-clinics 4

Pre-clinics 7

Pre-clinics 8

Integrated Clínics 1

Pre-clinics 10

Social Dentistry 1

Integrated Clínics 3

Anatomy 2 Histology 2 Physiology Pharmacology Imunology

Pre-clinics 2

Pre-clinics 5

Pre-clinics 6

Pre-clinics 9

Preventive Dentistry

Integrated Clínics 2

Social Dentistry 2

Integrated Clínics 4

Historic

? Learning Evaluation of professors

1st year 2ndyear 3rd year 4th year

Anatomy 1 Histology 1 Biochemistry Microbiology Genetics

Pre-clinics 1

Bioestatística

Patology

Pre-clinics 3

Pre-clinics 4

Pre-clinics 7

Pre-clinics 8

Integrated Clínics 1

Pre-clinics 10

Social Dentistry 1

Integrated Clínics 3

Anatomy 2 Histology 2 Phisiology Pharmacology Imunology

Pre-clinics 2

Pre-clinics 5

Pre-clinics 6

Pre-clinics 9

Preventive Dentistry

Integrated Clínics 2

Social Dentistry 2

Integrated Clínics 4

Dificulty in learning

Lack of interest among students

Evaluation of students

Basic disciplines were unnecessary

Some topics seem not to make sense

Assessments: criteria were unclear and unfair

Repetitions of topics

Basic disciplines were not related to Preclinics and Clinics

Integration of basic disciplines

•2000 to 2003: discussions Anatomy Biochemistry Histology Physiology Pharmacology

•Revision of :

sequence of topics

subjects / topic

•Bioscience I 250 horas 1. Atoms, ions, molecules

2. Cells and tissues

3. Cellular metabolism

4. Dinamic of membrane and homeostasis

5. Muscular system

6. Nervous system

1st semester

Monday 08:00 a.m. – 12:00 p.m. 13:30 – 17:30 p.m.

Tuesday 13:30 – 17:30 p.m.

Wednesday 08:00 a.m. - 12:00 p.m.

•Bioscience II 270 horas 1. Cardiovascular system

2. Respiratory system

3. Digestory system

4. Urinary system

5. Metabolism and endocrine system

6. Pharmacodynamics, Pharmacocinetics

7. Pharmacological agents with action in the nervous system

8. Pharmacological agents used in Dentistry

9. Reproductive system

10. Pharmacotoxicology

11. Basic support of life

2nd semester

Monday 08:00 a.m. – 12:00 p.m. 13:30 – 17:30 p.m.

Tuesday 08:00 a.m. – 12:00 p.m. 13:30 – 17:30 p.m.

Friday 08:00 a.m. - 10:00 p.m.

The proposal

Area Subject Group

31/07/2015 Friday 10h Anatomy heart T A/B

03/08/2015 Monday 08h Histology heart T A/B

03/08/2015 Monday 10h Anatomy heart P A

03/08/2015 Monday 10h Histology heart P B

03/08/2015 Monday 13h30 Histology heart P A

03/08/2015 Monday 13h30 Anatomy heart P B

03/08/2015 Monday 15h30 Physiology basics of cardiac function T A/B

04/08/2015 Tuesday 08h Physiology cardiac cycle P A

04/08/2015 Tuesday 10h Physiology cardiac cycle P B

04/08/2015 Tuesday 13h30 Anatomy blood vessels T A/B

04/08/2015 Tuesday 13h30 Histology arteries T A/B

07/08/2015 Friday 08h Physiology cardiac cycle T A/B

07/08/2015 Friday 10h Histology veins T A/B

10/08/2015 Monday 08h Anatomy blood vessels P A

10/08/2015 Monday 08h Physiology veins P B

10/08/2015 Monday 10h Physiology veins P A

10/08/2015 Monday 10h Anatomy blood vessels P B

How could we engage our students?

• Intrinsic motivation

• Environment to learn: professor

http://www.planetaeducacao.com.br

(adapted from Dale, 1946)

Cone of learning

https://rongtu.wordpress.com

(Miltre et al., 2008; Berbel, 2011; Pinto et al,. 2012; Rocha & Lemos, 2014; Trindade et al., 2014)

http://cbm.msoe.edu/teacherworkshops

Teacher role?

FACILITATOR of learning

http://educador.brasilescola.com/

TRANSMITTER of information

Integrative activities (areas working together):

•questions for discussion

•dramatization

Bioscience I and II: teaching-learning methodologies

In each area:

•lectures

•practical classes

•team activities (as part of assessment of learning): educational games, questions, portfolio

•Educational games

Example: Cardiac cycle puzzle

Educational game - simulation.

Groups: 4-6 students; monitors (graduate students)

Cardiac Cycle

Phase Atrial state

Ventricular

state

State of

Atrioventricular

valves

State of Aortic

and pulmonary

valves

(Marcondes et al., Advan. in Physiol. Edu., 39: 27-31, 2015) closed

closed

closed

open

open

open

Relaxed filling

Atrial contraction Ejection

relaxed

relaxed

relaxed

relaxed Ventricular isovolumetric

relaxation

Ventricular isovolumetric contraction

1st heart sound

2nd heart sound

relaxed

relaxed

closed

closed

open

•Team works

Example of questions:

1) What muscles are activated during mastication? What is the function of each of these muscles? Which muscles may be visually identified and which ones require palpation?

2) How does the digestion of food induce satiety? How are mastication (fast or slow), volume of food ingested and satiety related? How might they be related to overweight and obesity?

Groups: 3 - 6 students

Writing activity

•Portfolio Physiology of Endocrine System (2013 – 2014)

• Groups : 2 - 3 student

• Search textbooks and Internet:

Sheets 1 – GH

2 - Prolactin e oxytocin

3 - Calcitonin, PTH and vitamine D

4 – Insulin and glucagon

5 - CRH, ACTH, cortisol e aldosterone

6 – ADH

7 - TRH, TSH, T3 e T4

1. Hormone (s)

2. Classification

3. Site of production

4. Secretion control

5. Mechanism of action

6. Effects and specific subjects (ex: difference between Diabetes I and II; importance of breastfeeding to the stomatognathic system)

7. Relation to Dentistry

8. Wrong or incomplete information found on Internet

• During classes: guidelines for the preparation of portfolio

• Portfolio = reference material for the assessment

Examples of questions for learning assessment: • Compare and discuss the levels of prolactin and oxytocin of women in exclusive

breastfeeding and combined breastfeeding + milk bottle. What is the importance of exclusive breastfeeding?

• Felipressin activates ADH receptors and may be used with local anesthetics in Dentistry. Where does felipressin act? What are its effects on local anesthesia.

Integrative Activities (Anatomy, Biochemistry, Pharmacology,

Physiology, Histology)

• Discussion of questions

• Dramatization

Integrative Activities

• aplication of concepts in practical situations

• integration of topics among the areas

• identification of doubts

• cooperation among students

•8 questions / groups: 10 students

•7 – 10 days before discussion, the groups receive all the questions

•before assessment

•Discussion in class: a question is drawn for each group; additional questions are made during the presentation

•Discussion

Example:

Student has to amputate the leg after being hit by drunk driver. Americana - SP, 29/04/2013 http://noticias.uol.com.br/cotidiano/ultimas-noticias/2013/04/29/

An 18 year old business student had his leg amputated after being run over in front of a bakery on Sunday morning on Avenida Paulista in Americana (127 km from Sao Paulo). The driver Ricardo Guimarães, 32, showed signs of alcohol use.

1) In this case, amputation occurred just below the knee. What muscles were "lost"?

How are they classified? Describe in detail the anatomy, histology and ultrastructure of these muscles.

2) In such situations, it´s frequent the victim report that still feel the presence or

pain of the member which was amputated. This phenomenon is called phantom limb. Explain how does it occur.

Active learning strategies

Freeman et al. 2014. Active learning increases student performance in science, engineering, and mathematics. PNAS 111: 8410 - 8415, 2014.

Better scores / Decrease in flunk rates

www.globalgiving.org/projects/

•Dramatization Groups: 20 students 4 themes

After assessment

Theme / group: drawing

• 10 – 15 days – preparation of dramatization with feedback of professors

Example:

Show which, and how, the muscles of mastication participate in the

digestive process. Illustrate the relation between chewing and

satiety, addressing the role of stomach distention, absorption of

food and gastric and intestinal secretions in satiety and weight

control.

• Groups present the dramatization in class

• Professors evaluate the dramatization and make corrections

Assessment of learning

www.pinterest.com

Assessement - A Privileged Time to Study, Not an Account Adjustment. Moretto VP, 2010. Publisher Lamparina.

• Discussing the assessment

- before students know their scores

- in class (students and professors)

• Reassessment

- students’ view of the assessment with template - review request written

Assessment of learning

• Activities – part of assessment

• Theorethical assessment

Advances

Evaluation of disciplines by students

T h is d isc ip line is re lated to Prec lin ics and C lin ic s?

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Answer: Yes

T h e asse ssm e nt p ro ce ss is a cco rd ing w ith th e to p ics taugh t ,

a n d th e cr ite r ia w e re c le a r?

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Answer: Yes

Was the assessment in accord with the topics taught and were the criteria clear?

2014 : 10 years Bioscience I and II - FOP

Prof. Darcy Tosello

2014 : 10 years Bioscience I and II - FOP

“Professors know not more than you, but

their ignorance is better organized.”

Edgar Dale