Faculty Insights: Teaching Medical Laboratory Science in a Blended Learning Format

Thus far, we’ve talked about the structure of our blended model of curriculum delivery and the learner experience, but what about the instructor experience teaching in this format?

I surveyed a few of our faculty members about their experience teaching in our Medical Laboratory Science (MLS) Program, and their comments about our blended model of curriculum delivery fell into a few themes:

Benefits of the “flipped classroom” model

“Having students complete the lecture content as homework and then meeting with them for the hands-on ‘face-to-face’ learning adds another layer and more reinforcement of key concepts. If learners can’t understand what they’ve read or interacted with in the online component, they’ve got another chance to hear a short review of the material and actually perform a hands-on, real-world lab activity to reinforce again what they have learned. This is what makes blended learning so effective—read, learn, see, do—it hits the learning from every angle.”

“I believe the blended learning style with the online component is very effective, and I would bet that students retain more information and retain the information longer than in traditional formats. It’s all about reinforcement.”

Role of the instructor from “Sage on Stage” to a facilitator of the student’s knowledge acquisition and enhanced student learning

“As an instructor, I am no longer required to be the “Sage on the Stage,” and the questions from our students tend to be more specific, in that they come into the classroom prepared, having some base knowledge of the content.”

“I love teaching with a blended format. Having the online component allows the student to review the learning content prior to coming to lab where we meet face to face. The online blackboard format allows for several different ways to attack the learning, which is nice for the variety of students that we have (age, gender, and background), as well as a variety of learning styles.”

“Teaching with the online component allows for embedded written lessons, recorded lectures, PowerPoint handouts, images, YouTube videos, interactive activities such as a discussion board and wikis, and online worksheets—all at which the student can work through as fast or as slow as needed. Online learning allows for multiple levels of reinforcement to help make the information stick. It also helps learners be in control of their own learning. Access to information is not just a one-time shot in a live lecture. It’s there to use and review as much as needed.”

More time for instructor-led hands-on activities

“Time is another factor. We are only given so much time with the MLS students, and if we had to present all the lecture material in the classroom, we would not have time for all the laboratory activities that we have developed.”

“I like the fact that it puts the onus on the learner to engage with the material ahead of time, which allows for more hands-on learning in the classroom. The blended format makes it extremely conducive for a laboratory-based class.”

“When teaching morphology of cells, I like to use online question ‘banks’ with images of cells, crystals, casts, etc., for the students’ practice. They can review these question banks as much or as little as needed outside of the classroom. They can practice morphology identification at home, outside of class—all without the need of a microscope. Not only do they come into the classroom/lab knowing their cells, but they can work more efficiently and progress more quickly to advanced case studies.”

“I think the flipped model we implement is a great way to enhance our students’ reading skills and comprehension, while holding them accountable for completing the required assignments.”

“The blended approach allows us to address more difficult concepts. While the students may be able to grasp the concepts from their online reading, they also need talking points to confirm that they actually understand and can apply the concepts. We have found that giving the students the task of learning the online concepts can only really be successful if we follow up with them the next day, starting with a discussion about their online homework. We also give quizzes and have designed laboratory activities that apply the online concepts.”

Varied thoughts about course maintenance

“While the time to develop online content can be extensive, once it’s built in this format, it is easier to update and maintain on an annual basis.”

“It is not so easy to maintain the details in the online course. It takes a lot of time and effort to update all of the dates for assignments and other activities for each class section. Once the core components are built, one can easily add to the content. However, if one is building a new module or lesson, it can take a lot of time. It seems that the time to maintain an online course is similar to the time it takes to keep materials up-to-date in a traditional course.”

“At first, it took some getting used to grading assignments online, but I am used to it now and actually prefer it. It’s so easy for a student to do a “copy/paste” when filling out an online worksheet, so I do question typing (copy/paste) vs. writing things out on a worksheet and how well the information is sticking. With the intensity of our program, time is of the essence. I like that as soon as students submit their online assignments, I can grade it. Some students like to work ahead, and some turn things in at the last second. With the online submissions, I can grade as they come in, instead of getting hit with 24 assignments at once, which is a big time-saver for me.”

Repurposing

“One of the greatest positives with [the software] Blackboard Learn is that we can use the system with multiple learners. The learner has easy access to the course once he/she is added to system. One cannot always say that with traditional classroom teaching/learning. Unless the content/didactic is recorded, there is not easy access to the materials.”

In summary, I would stress the following key points as benefits of adopting a blended approach to curriculum delivery:

  • Increased classroom time for hands-on activities that are more closely aligned with what the students will actually be doing once they graduate, get jobs, and go to work.
  • Increased instructor satisfaction.
  • Students are more prepared for the classroom activities.
  • Increased ability to engage students with higher-learning concepts.
  • Course maintenance is more efficient, and learning tools are enhanced.
  • Time and cost savings are realized, related to repurposing of curriculum across different learners.

 

Lehman_small

-Susan M. Lehman, MA, MT(ASCP)SM graduated from the University of Wisconsin-Madison in 1983 with a BS in medical technology. She is program director for the Medical Laboratory Science Program and course director for Clinical Microbiology I and II; her areas of interest include distance education and education methodology.

Components of an Online CLS Course

When interviewing prospective candidates for Mayo Clinic’s program in medical laboratory science (MLS), I provide an overview of one of our blended courses and compare and contrast it to one of our more traditionally taught (lecture-based) courses. This gives me the opportunity to emphasize expectations and recommended study habits based on some of the “best practices” we’ve learned from our students.

Our online MLS courses include the following components:

  • Syllabus
  • Weekly calendar
  • Online lessons
  • Homework assignments
  • Discussion boards
  • Study guides
  • Self-assessments
  • Practice exams
  • Resources (links to related online resources)

Our students are expected to review each online lesson before coming to class as preparation for their laboratory session. Since we teach “immersion style” courses, two at a time (where a typical four-credit course is condensed into six weeks), we recommended that our students plan to study a minimum of 4 to 6 hours per day.

Each lesson is presented in a written format, following instructional-design recommendations for online learning that includes “chunking” of the content—using bullets to convey information instead of complete sentences (where appropriate) along with concisely written text that emphasizes “key concepts,” graphics, and images. The lessons are straightforward and present basic knowledge, and the higher learning concepts are integrated into the discussion-board assignments.

Each online course is easy to navigate and is presented in such a way that it’s intuitive and requires little “outside” instruction. All the courses in our program follow the same format, so once the students become familiar with navigation of their first course, they do not have to re-learn the lesson format each time they start a new course.

We provide a study guide of objectives for every written examination. Our students are encouraged to create a learning document from the study guide that they can use for review over the duration of the program and to prepare for their national certification examination in medical laboratory science offered through the American Society for Clinical Pathology.

To give you an idea of how our online courses are designed in Blackboard Learn, I have taken a series of screen shots demonstrating the layout of a course and lesson plan (shown below).

When our students log into Blackboard Learn and open a course, they land on the home page, which includes a navigation menu and links to the syllabus and introductory discussion boards. The home page discussion boards include “student introductions,” “faculty expectations,” “updates and handouts,” “ask your instructor or classmates,” and an “MLS Café” (for social interactions).

1_Welcome

From the menu, our students can open the course content. The first page opens to the weekly course calendars. At a glance, our students can examine the week’s activities.

2_Weekly Calendar

Clicking the “Course Week” link opens the week’s lesson plans.

3_Lesson Plan_Week 2 List of Lessons

Each lesson is formatted the same way and begins with a brief description, overview (goals or learning objectives), author, and references.

4_Lesson Plan_Overview

The second page is a table of “steps to completion” so that our students know exactly what is required of them.

5_Lesson Plan_ Steps to Completion

The lesson is presented in a written format. A table of contents allows the students to navigate the pages of the lesson.

 

 

6_Lesson Plan Introduction

The lesson concludes with a self-assessment. The self-assessment is embedded in the lesson, includes feedback loops, and is also linked to the home page menu. The students are able to take the self-assessments as often as they’d like, and the course grade book is set to record their highest score.

7_Example of Self Assessment

In this course, there is a weekly discussion board. The students are directed to work as a team in assigned groups to answer the questions in the discussion. Credit for this discussion is based on participation in the thread and “substantive” contributions to the dialogue. Students are encouraged to build upon one another’s commentary, generating comprehensive answers to the questions. Each group member must contribute at least two to three substantive answers to receive credit for the assignment. One group member is designated to post a summary of the discussion on behalf of the group.

8_Example of Discussion Board

There are 15 didactic courses in our MLS curriculum. All of our courses have an online component with approximately one-third of the courses applying the “reverse-lecture-homework” paradigm, one-third are lecture based (traditional), and one-third are a combination of both.

This variation in presentation of content provides our students a mixed learning experience, and the online format allows for us to map everything out for them. Additionally, the curricular model itself lends to the formation of study groups, which in turn helps our students build upon their teamwork and communication skills.

Since our program was instituted 10 years ago, we have seen excellent outcomes, with 100% graduation rates, 100% employment of our graduates, and 96% first-time pass rates on the national certification examination (based on a three-year average). Notably, the breakdown of the certification results by category demonstrates that overall student performance in content areas of the curricula that apply the reverse-lecture-homework paradigm are, on average, higher than those categories following a traditional course format (i.e, lecture-based).

 

Lehman_small

-Susan M. Lehman, MA, MT(ASCP)SM graduated from the University of Wisconsin-Madison in 1983 with a BS in medical technology. She is program director for the Medical Laboratory Science Program and course director for Clinical Microbiology I and II; her areas of interest include distance education and education methodology.

 

Applying the Flipped Classroom to Medical Laboratory Science

Our Medical Laboratory Science (MLS) program curricular model applies the “reverse-lecture-homework-paradigm” (more commonly known as “flipping the classroom”) to the majority of our didactic courses. For our MLS program, this model works best for those MLS courses that we are able to provide strong hands-on laboratory lessons in our classroom setting. For those courses that are not amenable to this (like clinical chemistry where the laboratory procedures are highly automated), we provide the learning content in a traditional lecture-based format with supplemental laboratory lessons. This combination of approaches to instruction and learning—whereby we provide both traditionally designed courses (live, synchronous, “face-to-face” learning) and online courses (virtual, asynchronous, distance learning)—ends up supporting all of our students’ varied learning styles.

As an example, in our course in bacteriology, we can teach hands-on laboratory lessons using manual procedures for identifying bacteria that can be readily instituted in our program classroom/teaching laboratory. Because we can easily reproduce these techniques for our students, we use the flipped-classroom approach in this course and provide all of the lecture material as online learning lessons that our students complete as homework before the next day’s laboratory session. By having our students complete the lecture material as homework, we can dedicate more classroom time to learning laboratory techniques that are more closely anchored in what our students are going to do for a living.

From the standpoint of education theory and Bloom’s cognitive domain of learning, lesson content that requires basic recall of information (knowledge and comprehension) is presented as homework in the online lesson. In the hands-on laboratories, more of the higher level cognitive domains of interpretation and problem solving are applied, and the lab techniques are performed in the presence of the instructor, allowing for greater instructor-student interaction, questions, and joint problem solving.

The instructor role radically changes in this model, and he/she is no longer put in the position of “expert at the lecture podium,” allowing for greater opportunity to partner with the students in the classroom as a facilitator or guide in their learning. The literature commonly refers to the redefining of the instructor’s role in educating the student as moving away from being the “sage on stage” to that of facilitator or “guide on the side.” Our instructors have more time to help the students hone their laboratory techniques and apply the learning material in context and also answer questions.

Our instructors have found the experience rewarding, and they have been very successful using this format. They are able to partner with our students more collaboratively, and they can assume more of a mentorship role. It should be noted that there is a substantial amount of front-end time required to build the courses. Each lesson plan includes learning objectives, an online lesson, a hands-on lab, and a self-assessment. Our courses also include online discussion boards, homework assignments, and study guides for exam preparation (both written tests and laboratory practicals). Once an online course is built, however, we have found that it is easier to update and maintain versus a lecture-based course that may need redevelopment when instructors change.

The students’ role in the classroom also changes. When they are presented with the lecture material as online homework, they gain a newfound control over the material that doesn’t exist in a face-to-face traditional lecture format. They have control over when they study the learning content and the length of time they study. They can go in and out of the online lecture content as often as they want. The lesson material can include links to additional resources that they can delve further into if they desire. This format places each student in the “driver’s seat,” and the student moves from being a passive learner to active.

As for our students, they consistently come to class prepared for each hands-on activity, ask questions, and perform well on their written and practical examinations. Our students tend to form study groups outside of the classroom, and they review and process the online content with their peers, which results in a classroom environment that is collegial, team-oriented, and mutually supportive.

Reference

Bloom, Benjamin S., (Ed.), Taxonomy of Education Objectives: Handbook I: Cognitive Domain, N.Y., David McKay Company, Inc. 1956.

 

Lehman_small

-Susan M. Lehman, MA, MT(ASCP)SM graduated from the University of Wisconsin-Madison in 1983 with a BS in medical technology. She is program director for the Medical Laboratory Science Program and course director for Clinical Microbiology I and II; her areas of interest include distance education and education methodology.

The Learner Experience in a Blended Model of Curriculum Delivery

Key to successful delivery of an online course (or as in our case, a blended model of online and traditional), along with achievement of the learning objectives, is the learner experience. I’ll never forget the feelings of trepidation I had on our first day with our inaugural class, piloting this new model of curriculum delivery with our bacteriology course.

Our lesson plan requires that the students prepare for class by studying the online lecture material as homework, prior to the next day’s laboratory section. Our students were excited about starting our program and eager to learn, yet some were hesitant. I remember one student stating that they “might not be so sure about this new format.” After all, we hadn’t tried it before, and to be frank, it was scary. I remember thinking to myself, “What are we going to do if they do not study the online content? What if they do not prepare for class? What if they dislike this format? What will we do if they flunk their first exam?
Fortunately that was not the case, and our student’s performance in our program has been and continues to be highly successful.

Alex, a student in our current class put it this way:

“It is worth noting that this is not your typical college course. The program here really emphasizes the “reverse classroom” technique. For those unfamiliar, this term means that one will read about the lesson the night before and come to class the next day and perform a laboratory assignment based on that reading.

I came into the program experiencing nothing like this before, so I wasn’t sure how this learning strategy would work for me. After completing our didactic schedule, many of my peers would agree with me that this learning technique is fantastic and is very beneficial to the overall learning experience.

However, to maximize this benefit, time management is vital. Simply reading the lesson at the last minute does not cut it. Whether it helps you to take notes as you go, doing a re-read, or fill out a study guide, this style of learning is a classic example of getting out what you put into it.”

I loved hearing our student reflect that “you get out of it what you put into it.” To me, that is the ultimate goal of education, to prepare our students to be able to think critically and self-direct their learning. In this regard, our inaugural class was a success.

 

Lehman_small

-Susan M. Lehman, MA, MT(ASCP)SM graduated from the University of Wisconsin-Madison in 1983 with a BS in medical technology. She is program director for the Medical Laboratory Science Program and course director for Clinical Microbiology I and II; her areas of interest include distance education and education methodology.

Laying a Foundation for a Blended Curriculum Model

In the late 1990s—early 2000s—we were faced with a critical shortage of graduates in clinical/medical laboratory science, and we started evaluating the benefits of having our own program. Once we made the decision to seriously consider implementing our own program, I pitched a proposal for a blended model of curriculum delivery. My proposal was accepted by the Mayo Clinic School of Health Sciences as a pilot program to be supported by our newly created education technology center. Since our program and the education technology center were both new, we certainly experienced some growing pains. Also, had I known we’d have to reconstruct major elements of our online content every time we upgraded our content management system, I might have thought twice about it!

In the end, it was all worth it because today, we have an outstanding program built upon a solid foundation of both traditional and online content delivery that leverages our staff infrastructure and can be effectively managed and maintained over time.

In the curricular model developed for our academic program in Medical Laboratory Science (MLS), the didactic component is provided in an e-learning platform (Blackboard Learn) and is underscored by Transactional Distance Theory (Moore, 1991), in which the three modalities of learner interaction with content, instructor, and fellow students are integrated into the online module. Each lesson plan includes a laboratory module taught by traditional methods of interaction between the instructor and student in a classroom setting. A constructivist learning environment is facilitated, and each lesson plan is closely anchored in the context of the work the student will perform upon employment.

Here is a simple diagram of our curricular model:

mls-curricular-model_simple-diagram_1

The following learning theories define our program curricular model:

  1. Transactional Distance Theory (e-learning theory): The online lesson plan includes learner-content interaction, learner-learner interaction, and learner-instructor interaction.
  2. Constructivism: The roles of both the teacher and student are redefined in this educational model. The teacher moves away from the traditional role of “sage on stage” to that of a “facilitator” of the student’s acquisition of knowledge. The student becomes a more active learner in this model, moving away from the traditional role of passive learner.
  3. Anchored Learning:
  • Information is taught in the context of how the learner will apply it once he or she is working.
  • The online homework lesson correlates with a hands-on laboratory lesson designed to reinforce the e-learning content.
  1. Reversing the Lecture-Homework Paradigm (Moses, 2002): The traditionally taught lecture is provided as an online homework assignment.

Embracing technology has provided a means by which we can improve our teaching methods and promote change in our education infrastructure. More than half of our didactic courses in our MLS Program apply the new education strategy I learned about as “reversing the lecture-homework paradigm” (more commonly known as “flipping the classroom”). Instead of going to lecture, our students complete web-supported didactic modules asynchronously as “homework” assignments, allowing more classroom time for laboratory instruction.

By providing more hands-on laboratory lessons, we are giving our students the opportunity to practice laboratory procedures and apply new learning material in a way that corresponds more closely with what they will do for a living after they graduate. Instead of giving the typical “one-directional lecture” with limited opportunity for dialogue, our instructors are able to spend more time with our students, teaching practical applications of the content, answering questions, and helping problem-solve.

References

  1. Moore, M. G. (1991). Editorial: Distance education theory. American Journal of Distance Education, 5(3), 1-6.
  2. Moses, G. A. (2002). e-Technology must enable big education goals. Proceedings of the 2002 e-Technologies in Engineering Education (eTEE) Conference, Switzerland, Vol. P01, Article 20, 142-145.

Lehman_small

-Susan M. Lehman, MA, MT(ASCP)SM graduated from the University of Wisconsin-Madison in 1983 with a BS in medical technology. She is program director for the Medical Laboratory Science Program and course director for Clinical Microbiology I and II; her areas of interest include distance education and education methodology.

Online Learning for Clinical Laboratory Science Programs

What does “Reversing the Lecture Homework Paradigm,” “Transactional Distance Theory,” and constructivism have to do with teaching? Everything! These are all education theories that can provide a road map for creating a solid learning strategy in the online world of distance and blended education.

In 2008, when our first class of medical laboratory science students came to class, there was no lecture, nor furious note taking. Instead, when these 24 students met face-to-face, they came to our new teaching laboratory at Mayo with their first lesson already under their belts and finished assignments in hand. My intent for this blog post (and those to follow) is to talk about the strategies we implemented to bring up our 43-credit medical laboratory science curriculum as a blended learning model, incorporating both online and traditional methods, and I will also share our experiences.

We can all relate to the desire to have the latest and greatest online lessons that entertain like movie trailers and infomercials, but medical laboratory science faculty often work within the constraints of a budget that translates into a “DIY” model. Knowledge of related education theories is important because it helps us prioritize and understand what really makes for effective online learning experiences. It turns out that it’s not necessarily the “bells and whistles” within a lesson plan but the quality of the actual written content, how it’s formatted, and how readily the learner can navigate the online software platform.

If you are at all like me, you probably took on educational responsibilities because you have a passion for teaching and learning and a desire to utilize your creative side. I began this journey back in 1998 when my employer partnered with another academic center to offer a degree in medical laboratory science for our employees through distance learning. I quickly realized that I knew very little about online learning theory and enrolled in a distance education certificate program at the University of Wisconsin – Madison, my alma mater.  The experience and success of our partnership delivering a distance education program for our employees gave us the confidence to bring up our own accredited program utilizing a blended model of curriculum delivery. In the upcoming months, I will outline our specific online learning strategies, discuss our experiences and highlight our successes and challenges.

 

Lehman_small

-Susan M. Lehman, M.A., MT(ASCP)SM graduated from the University of Wisconsin-Madison in 1983 with a BS in medical technology. She is program director for the Medical Laboratory Science Program and course director for Clinical Microbiology I and II; her areas of interest include distance education and education methodology.