MULTIMODAL INTEGRATION OF

ANATOMY AND PHYSIOLOGY CLASSES: HOW INSTRUCTORS UTILIZE

MULTIMODAL TEACHING IN THEIR CLASSROOMS

by

Gerald M. McGraw, Jr.

B.S., University of Oklahoma, 1979

M.P.A.S., University of Nebraska, 1997

M.B.A., Webster University, 1999

A Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree

of Doctor of Education ____________________________________________________

Division of Educational Administration

Adult & Higher Education Program in the Graduate School

University of South Dakota December 2014

ii

© 2014

Gerald McGraw

ALL RIGHTS RESERVED

iii

ABSTRACT

Gerald McGraw, EdD, Educational Administration

The University of South Dakota, 2014

MULTIMODAL INTEGRATION OF

ANATOMY AND PHSYIOLOGY CLASSES: HOW INSTRUCTORS UTILIZE

MULTIMODAL TEACHING IN THEIR CLASSROOMS

Dissertation directed by Dr. Karen Card

Multimodality is the theory of communication as it applies to social and

educational semiotics (making meaning through the use of multiple signs and

symbols). The term multimodality describes a communication methodology that

includes multiple textual, aural, and visual applications (modes) that are woven

together to create what is referred to as an artifact. Multimodal teaching

methodology attempts to create a deeper meaning to course content by

activating the higher cognitive areas of the student’s brain, creating a more

sustained retention of the information (Murray, 2009).

The introduction of multimodality educational methodologies as a means

to more optimally engage students has been documented within educational

literature. However, studies analyzing the distribution and penetration into basic

sciences, more specifically anatomy and physiology, have not been forthcoming.

This study used a quantitative survey design to determine the degree to which

instructors integrated multimodality teaching practices into their course curricula.

The instrument used for the study was designed by the researcher based

on evidence found in the literature and sent to members of three

iv

associations/societies for anatomy and physiology instructors: the Human

Anatomy and Physiology Society; the iTeach Anatomy & Physiology Collaborate;

and the American Physiology Society. Respondents totaled 182 instructor

members of two- and four-year, private and public higher learning colleges

collected from the three organizations collectively with over 13,500 members in

over 925 higher learning institutions nationwide.

The study concluded that the expansion of multimodal methodologies into

anatomy and physiology classrooms is at the beginning of the process and that

there is ample opportunity for expansion. Instructors continue to use lecture as

their primary means of interaction with students. Email is still the major form of

out-of-class communication for full-time instructors. Instructors with greater than

16 years of teaching anatomy and physiology are less likely to use video or

animation in their classroom than instructors with fewer years.

This abstract of approximately 250 words is approved as to form and

content. I recommend its publication.

v

vi

ACKNOWLEDGEMENTS

Though it is common and even expected that doctoral students thank their

advisor in the acknowledgements area of their dissertation, there is no way that I

can express the wealth of dedication, support, encouragement, and assistance

that Dr. Karen Card has provided throughout this process. She has consistently

and constantly been behind me, beside me, and sometimes in front of me, pulling

me along through each and every facet of this journey. I can only give her my

heartfelt thanks when she deserves so much more. She has been my mentor

and advisor yes, but she has also been my friend. Thank you Dr. Card not only

for all the major things you have done but also the myriad of little things. I can

only hope that someday I can provide the same outstanding support for a future

doctoral student where I will have the opportunity to exhibit the calm, leadership,

and friendship that you have provided me. I would also like to thank the rest of

my advisory committee for their guidance and leadership. From the first class to

the very last class, Dr. Mark Baron provided his unique leadership and guidance

salted with his dry humor. What our class discovered was that every tidbit of

information, especially that laced with a quip, would be a nugget for us to hold

onto, each one a priceless and essential component of our dissertation journey.

Dr. Aderhold, thank you for your steady guidance, your ability to apply the “real

world” to our sometimes self-created artificial one when we became too

embroiled in the process without remembering that the product we were creating

would have meaning and value. Finally, thank you to Dr. Steve Waller. I am

extremely thankful that I had the forethought to include you in my advisory

vii

committee. Having been my supervisor for almost four years, I could not have

imagined the significance of your participation in this journey. Your insight has

made this study far more than it would have ever been in your absence.

I would also like to thank my fellow faculty members and department staff.

They have put up with my constant barrage of questions, requests, and verbiage

about my dissertation subject for the last two years. They have been ever

supportive and participative and I will forever be eternally grateful. This work is

also a reflection of the support provided by my fellow Division of Basic Sciences

colleagues at the University of South Dakota. Additionally, I would like to

specifically thank Dr. Barbara Goodman. She was kind enough to help me

establish another survey source late in the process that would serve to provide

access to key information for the work.

This dissertation is dedicated to the love and support of my family. To my

daughter Jordynn who accepted that daddy was “working on his paper for

school” instead of spending the time lost with her. At the age of seven, she has

essentially grown up with daddy going through this process and I am sure she is

looking forward to filling that time with other activities more particular to her liking.

Thank you to my biggest supporter and the love of my life, my wife Julia, for

always being there. Without you this truly would not have been possible. You

have filled in those countless hours with our daughter when I was either in-class,

studying, or writing. This dissertation is very much a product of the love that we

have shared for almost ten years. I cannot imagine taking on such a

monumental task without you by my side.

viii

“Every journey, even those that seem the most difficult, begins with a

single step.” – Ancient Chinese Proverb

ix

TABLE OF CONTENTS

Abstract ................................................................................................................ iii

Doctoral Committee .............................................................................................. v

Acknowledgements .............................................................................................. vi

List of Tables ....................................................................................................... xii

Chapter

1. Introduction ................................................................................................ 1

Statement of the Problem ............................................................... 4

Purpose of the Study ....................................................................... 5

Research Questions ........................................................................ 6

Significance of the Study ................................................................. 6

Definition of Terms .......................................................................... 7

Limitation and Delimitations ............................................................ 8

Organization of the Study ................................................................ 9

2. Review of the Literature ........................................................................... 11

The Parameters by Which Students Learn ................................... 15

Effective Classroom Practices....................................................... 25

The Multimodal Classroom ........................................................... 30

Technology Drives Change ..................................................... 30

Specific Elements of the Multimodal Classroom ..................... 36

Multimodality in Anatomy and Physiology ..................................... 45

Summary ....................................................................................... 51

x

3. Research Methodology ............................................................................ 52

Statement of Purpose ................................................................... 53

Research Questions ...................................................................... 54

Review of Selected Literature ....................................................... 54

Population ..................................................................................... 55

Research Design ........................................................................... 57

Instrumentation ............................................................................. 60

Data Collection .............................................................................. 61

Data Analysis ................................................................................ 61

4. Findings ................................................................................................... 63

Response Rate ............................................................................. 64

Demographic Data ........................................................................ 65

Findings ........................................................................................ 70

Summary ....................................................................................... 86

5. Summary, Conclusions, Discussion, and Recommendations .................. 87

Summary ....................................................................................... 87

Purpose of the Study .......................................................... 87

Research Questions ........................................................... 87

Review of Literature ........................................................... 88

Methodology ....................................................................... 93

Findings .............................................................................. 94

Conclusions .................................................................................. 97

Discussion ..................................................................................... 98

xi

Recommendations ................................................................................ 102

Recommendation for Practice ..................................................... 102

Further Research ........................................................................ 103

Conclusion ............................................................................................. 104

References ....................................................................................................... 105

Appendices ....................................................................................................... 120

A. Survey Instrument ............................................................................. 120

B. Survey Matrix .................................................................................... 129

C. Survey Cover Letter .......................................................................... 132

D. Additional Results.............................................................................. 135

xii

LIST OF TABLES

Table Page

1. Differences in Highest Degree Earned ............................................... 65

2. Differences in Teaching Status ............................................................... 66

3. Teaching Rank ........................................................................................ 67

4. Differences in Teaching Assignments in Anatomy and Physiology ......... 68

5. Differences in Total Years of Teaching Experience ................................ 69

6. Differences in Total Years of Teaching Experience in Anatomy and

Physiology .............................................................................................. 70

7. Differences in Time Spent in Each Mode ................................................ 72

8. Differences in Integration of Multimodal Elements Into the Class

Experience .............................................................................................. 74

9. Differences in How Students Were Instructed to Submit Multimodal

Elements ................................................................................................. 76

10. Instructor Perceptions of Training Quality and Quantity .......................... 77

11. Time that Technologies Were Available in the Classroom ...................... 78

12. Instructor Perception of the Administration Support ................................ 79

13. Significant Differences in Total Years Teaching In Anatomy and

Physiology .............................................................................................. 81

14. Analysis of Significant Differences in Total Years Teaching in Anatomy

and Physiology ....................................................................................... 82

15. Significant Differences in Highest Degree Earned .................................. 83

16. Analysis of Significant Differences in Highest Degree Earned ................ 84

xiii

17. Significant Differences in Teaching Status .............................................. 85

18. Analysis of Significant Differences in Teaching Status ........................... 85

1

CHAPTER 1

Introduction

Multimodality is the theory of communication as it applies to social and

educational semiotics (making meaning through the use of multiple signs and

symbols). The term multimodality describes a communication methodology that

includes multiple textual, aural, and visual applications (modes) that are woven

together to create what is referred to as an artifact. The multimodal artifact is a

collection of modes that prescribe how the audience will interpret the information

or concept. Multimodal teaching methodology attempts to create a deeper

meaning to course content by activating the higher cognitive areas of the

student’s brain and creating a more sustained retention of the information

(Murray, 2009)

The rapid rate of technological advancement which has spurred the

growth of the online classroom educational delivery approach has created a

secondary stimulus in the traditional face-to-face classroom, redefining the

multimodal educational environment. That drive has been based on the ready

access of information in real-time within the confines of the traditional classroom

(Tucker, 2012). Access to video, animation, reference documentation, and

scholarly studies has expanded the traditional classroom into a global access

environment where students and instructors alike can draw on information from

an infinite number of resources almost instantly. The potential for integrating any

or all of the potential media types into the classroom experience is limited only by

2

the technology that is present and the willingness of the instructor to utilize it (Ball

& Moeller, 2010).

Unfortunately, the expansion of multimodal methodology has moved faster

than instructors have been willing to assimilate it into their student experiences

(Bolter & Grusin, 2000). Additionally, universities have traditionally been

reluctant to incur the additional costs of creating online access and full

multimodal capability in-classrooms because of the increased demands it creates

in the annual budget. Incorporating internet access, high-level video, telephone

conferencing, and graphic applications is expensive. The case for incurring the

additional cost is sometimes difficult to justify to leadership. It is also difficult to

apply a true dollar value to potential increases in long-term student achievement

in higher verses lower cognitive retention and/or enhancement of critical thinking

skills (Lanham, 2004). Yet students consistently tune out the noise of the

classical “lecture and listen” style classroom environment and show ever

decreasing knowledge retention. Studies have shown that traditional monologue

styled lectures do not allow students to absorb the knowledge gained in such a

manner as to make it portable and usable in other future scenarios (Breckler,

Joun, & Ngo, 2009). In clinical career fields, faculty who teach the clinically

centered courses have complained again and again how students seem to have

not absorbed even the most obvious facets of the basic science courses and

cannot apply any knowledge gained from those courses in a higher cognitive

manner (Murray, 2009).

3

The limiting factors in instituting and integrating the multimodal classroom

fall into three main areas. The first area relates to the instructors and their

willingness to alter customary traditional student experiences by redefining the

classroom into a multimodal, multi-experience environment (Davis & Shadle,

2007). Instructors must also receive adequate training to develop a multimodal

approach (Anderson, 2006). The second area is dependent upon facility

limitations. The classroom must have access to internet, video, audio, or DSN

(Devoss, Cushman, & Grabill, 2005). Finally, the third area relates to the

institution’s administration. The administration must be willing to fund the

additional upfront costs and support the annual maintenance costs of the

multimodal classroom (Ball, 2004). Additionally the administration must be

knowledgeable about the advantages of multimodal educational methodologies

over the linear classroom model (Bolter & Grusin, 2000).

Academia traditionally does not move as quickly as technology when it

comes to its application in the classroom. Though the recent literature shows

instructors are aware of multimodal methodologies, the cost of transition and the

conceptual paradigm shift makes the change problematic (Picciano, 2011). To

compound the situation, there is a significant lack of empirically based studies

devoted to the assessment of multimodal applications in any type of classroom

curriculum. The quantity and quality of assessment of multimodal classroom

environments is minimal at best. Of the studies that do exist, none are devoted

specifically to basic science curriculums supporting clinically focused, medical

career tracts (Shipka, 2005).

4

Statement of the Problem

Scholars agree that the multimodal classroom experience creates far

greater comprehension and retention than older traditional modalities among

students. Neurological studies have shown that higher cognitive brain areas,

which are not engaged in lecture-based classroom experiences, are significantly

engaged when the curriculum is presented utilizing a multimodal approach

(Lanham, 2004). Murray (2009) traced specific connections between multiple

areas of the brain’s higher cognitive areas when engaged in a multimodal

educative process. There is an absence of empirically based studies devoted to

defining the level of transition and/or limiting factors from the traditional “pen and

paper” lecture-based classroom characteristics towards the multimodal

classroom experience. This is particularly true as it applies to the basic clinical

sciences (anatomy & physiology, microbiology, and chemistry) (Picciano, 2011).

Fink (2003) stated that “significant learning experiences” makes a

substantive change in students’ lives. Research has shown that significant

learning is associated with more than memorizing information. To be sustained

and conceptually understood, information must be learned utilizing the higher

cognitive areas of the brain. To accomplish that, the information must interact

with a student’s past knowledge, emotions, and/or beliefs. The information must

also be valuable to the student and integral to their future success professionally

and/or socially (Pratt and Malabar, 1998). To create the bridge between the

students’ past and future, the information must be learned through higher

5

cognitive brain paths. Multimodal educational methodologies create a multi-

track interaction with students’ higher cognitive brain areas (Murray, 2009).

Adult learning requires that each student identify the knowledge that they

want to learn and the methodology they want to use to learn it. This puts a

responsibility on the instructor to create multiple pathways for students to

facilitate their varied learning style choices (Tough, 1979). Students are more

successful if they understand their learning style and are taught how to apply it

when obtaining knowledge. This approach transforms the instructor into that of

the helmsman of a ship; guiding the passengers (students) to successful

destinations and understanding that each student has very different goals and

approaches to successfully obtain those goals (Fink, 2003).

Purpose of the Study

The purpose of this study was to identify the extent to which multimodal

teaching methodologies were used by instructors in anatomy and physiology

courses. The study identified how multimodal teaching elements were used by

instructors in anatomy and physiology classes, how much actual time was spent

in each modality, and how the multimodal elements were submitted by students.

The study identified instructors’ perceptions of barriers that prevented anatomy

and physiology instructors from integrating multimodal methodologies as they

related to training, facility infrastructure, and administration. The study analyzed

the variation in the integration of multimodal methodologies based on instructor’s

personal characteristics.

6

Research Questions

This study was guided by the following research questions:

1. How do instructors integrate multimodal elements into anatomy and

physiology courses?

a. How much actual course time is spent in each modality?

b. How is each multimodal element integrated into the educational

experience?

c. How is multimodal elements submitted?

2. What are instructors’ perceptions of the barriers preventing them from

optimally engaging multimodal teaching methodologies as they relate

to

a. Training

b. Facility/Infrastructure

c. Administration

3. What is the variation in the integration of multimodal methodologies

based on instructors’ personal characteristics?

Significance of the Study

Traditional educational methodologies utilized in higher learning classes

transfer knowledge only through monologue-based lecture and do not engage

students in their higher cognitive areas of their brain. Multimodal approaches

engage the brain at both the lower and higher cognitive areas (Lanham, 2004).

Though the multimodal integration has become an integral and valued element in

forward thinking online classes, its incorporation into face-to-face classes has

7

been approached with less velocity. That pace has been mirrored in clinically

focused basic science classes (Shipka, 2005).

There is a void of empirically based studies that define the level of

multimodal penetration into clinically focused basic science classes, particularly

those in anatomy and physiology. Additionally, there is an absence of formal

investigation to identify which instructor, institutional, and student characteristics

inhibit the transition (Shipka, 2005). This study evaluated the status of anatomy

and physiology curricula and correlated specific instructor characteristics that

may play an inhibitory or facilitative role in the application of multimodal

methodologies. The study also provided insight into the components that

facilitate and prohibit full integration of multimodal elements into anatomy and

physiology curricula. It subsequently identified potential follow-on studies based

on the analysis of the data collected.

Definition of Terms

The following definitions are provided to ensure uniformity, transparent

dialogue, and an understanding of the terms applied throughout this study.

Artifacts: Surrounding furniture, art, animals (pets), any other

possessions. Anything created by humans that gives information about

the culture (Cicca, Step, & Turkstra, 2003).

Chronemics: Waiting times, amount of time spent in interaction,

punctuality (Cicca, Step, & Turkstra, 2003).

Haptics: Intensity of touch, eye contact, type of touch (Cicca, Step, &

Turkstra, 2003).

8

Kinesics : Use of hand or arm gestures, body movement, posture, eye

gaze, and facial expression (Cicca, Step, & Turkstra, 2003).

Multimodal : Utilizing a new yet familiar technological communication

mechanisms and media (Fougnie & Marois, 2006). The term

multimodality describes a communication methodology that includes

multiple textual, aural, and visual applications (modes) that are woven

together to create what is referred to as an artifact (Murray, 2009). A

multifaceted, multimodal based student experience (Lanham, 2004).

Physical Appearance: Hairstyle, cosmetics, clothing, smell (Cicca, Step,

& Turkstra, 2003).

Proxemics: Interpersonal distance, territoriality, any other space based

relationships (Cicca, Step, & Turkstra, 2003).

Semiotics: the study of meaning-making and the philosophical theory of

signs and symbols (Bezemer & Kress 2008).

Significant Learning Experience: As student-centric learning

environment whereby information is presented and deducted to the

student’s best advantage (Fink, 2003).

Vocalics: Voice volume, rate, pitch, silence, or pause (Cicca, Step, &

Turkstra, 2003).

Limitations and Delimitations

There are several factors that potentially affected the results of the study

and/or how the results were interpreted, limiting validity and generalizability of the

study results:

9

1. The Human Anatomy & Physiology Society (HAPS), iTeach, and

American Physiological Society (APS) sample populations are not

purely random in that membership is self-selected and may not

accurately represent the trends and behaviors of the total population of

all anatomy and physiology instructors in higher learning. Additionally,

instructors who took the survey tool fell into a second-level self-

selected subset that voluntarily chose to belong and participate.

2. The study was conducted as a snapshot of the data (summer, 2014)

and is not usable for defining the timeframes required for transitioning

from one degree of multimodal teaching to another.

3. The tool used to measure the variables within this study (Appendix B)

was developed by the investigator based on the literature search. It

was scrutinized via a formal critique and a subsequent formal review.

Utilization of another tool may give variable results.

Organization of the Study

This study is divided into five chapters. Chapter 1 presents the

introduction, statement of the problem, purpose of the study, significance of the

study, and limitations/delimitations. Chapter 2 contains a review of related

literature and current research regarding the parameters by which students learn,

effective classroom practices, and multimodal methodologies and applications in

the face-to-face classroom. Chapter 3 contains the design, rationale, and

methodology for the study. Chapter 4 contains the analysis of the reported data

and the subsequent findings. Chapter 5 summarizes the findings, conclusions,

10

discussion, and recommendations for practice to include suggestions for follow-

up studies.

11

CHAPTER 2

Review of Selected Literature and Research

The study of effective teaching practices within higher education, and

relevant research and literature was reviewed in this chapter. General classroom

theories, applications, and methodologies as they apply to the optimal set of

effective teaching practices in higher learning classrooms have been researched

and reported on extensively. Multimodal applications and methodologies have

been categorized and defined as they apply to the educational environment.

Selection of the literature was based on timeliness of the document, the

focus of the original research, the significance of the research validated using

evidence-based practice methodologies of hierarchy, and the pertinence of the

research to this study. Initially the approach to identify and collate literature for

this research project was to review everything written about traditional classroom

theory, multimodal teaching methodologies, effective teaching practices in higher

education, and effective teaching practices specifically in medical/clinical focused

education. Boote and Beile (2005) described this approach as creating an

essential foundation in substantive research. Though this methodology provided

a wide range of focused as well as tangential reference publications, it became

evident that the plethora of information would far out-reach the scope of this

study. As Maxwell (2006) suggested, the literature presented within this study

are those that emphasize and focus on its central theme; effective teaching, adult

learning practices in higher education, and subsequently effective teaching

12

practices in educating students who are working towards medical/clinical career

tracks.

The chapter is presented as a literature review in four sections: (1) The

parameters by which students learn; (2) Effective classroom practices; (3) the

Multimodal classroom, and (4) Multimodality in the anatomy and physiology

classroom. The chronological and philosophical methodologies that have been

applied by instructors and educational systems historically have focused upon

putting the student in the optimal learning environment. Historical theories

generally focused more on the delivery of the information than on how the

student might best assimilate it; that is, taking a faculty-centric or an educational

system-centric approach rather than including the student as a significant player

in the planning. For instance, the behaviorist theory was one that recommended

putting the student in a series of repetitive experiences so that over time they

would be able to complete the given task without any consideration to the

student’s internal thought process (Grippen & Peters, 1984).

How students learn can be as diverse as the number of students in a

given classroom. Successful knowledge is that in which the student makes a

chronological and philosophical connection between knowledge and experience

that they already have, the new knowledge, and the value that the new

knowledge will have in their future. Each individual comes to the educational

table with a different set of past experiences, prior knowledge, cultural beliefs,

social interactions, and levels of maturity. Each student learner enters the

classroom with a different set of aspirations of the future creating dissimilarity in

13

their assessment of the innate value of a given curriculum content (Bransford,

Brown, & Cocking, 1999).

Section one (the parameters by which students learn) presents the

variables present within the students themselves. It explores the neurological

interactions that occur to assimilating knowledge as well as the social interlays

and their importance to the adult student. Additionally, it depicts the effects of

past experiences and past knowledge, how a given student gains new

knowledge, and the importance of creating educational value for the curriculum

content. It is imperative that a student perceives that the knowledge will have

significant importance in their future endeavors. Creating a multimodal arena

whereby the student experiences the knowledge in varied and multifaceted

manners creates fertile ground for retention (Kress, Jewitt, Ogborn, &

Charalampos, 2006).

Application of a student-centric classroom requires an in-depth

understanding of the process steps that are required to turn theory into action.

In a more step-by-step fashion, identification of pertinent elements is essential for

the instructor in creating the optimal learning environment. Determining how and

when to engage the students in the planning phases of the curriculum so that

they become engaged in the learning process is essential. Identifying which

learning elements are important in developing the student experience is crucial to

ensure a multifaceted approach that maximally engages the students. The goal

is to provide the students with the most optimal chance of absorbing the content

knowledge and reapplying it in future endeavors in a multitude of potential

14

scenarios. Engaging the student utilizing both their lower and higher cognitive

skills is essential in determining the optimal learning situation (Bland, Saunders,

Kreps, & Frish, 2007).

Section two (effective classroom practices) identifies the application of

experiences that include development of critical thinking skills, integration of

curriculum knowledge into past knowledge and experiences, and development of

educational currency or curriculum value in the minds of the student. This

section will expand on which methodologies and modalities have been shown to

be effective in student learning. Technological advances have altered the

classroom environment both within and without. Student interaction is no longer

limited to the hours spent in the classroom or during office hours. Lecture-only

based classrooms cannot deliver the three dimensional experience of the

multimodal classroom (Karabulut, 2012). The internet has created a means

where education can occur in an asynchronous manner. The instructor and the

student no longer have to be at the same place doing the same thing at the same

time. The online educational world has changed how the student may access

knowledge. What is not obvious but is never the less as profound is that the

online educational experience has altered the expectations for the face-to-face

experience significantly.

Section three (the multimodal classroom) presents the approaches that

are included under the umbrella of multimodal educational methodologies and

how those approaches create an individualized experience for each student.

Integration of social interaction between students both in the classroom and out

15

of the classroom electronically is now the standard. The integration of texting,

social media platforms, and online data into the classroom has become essential.

The integration of all the potential technology is more than just a mere trend but

an opportunity to create a multifaceted, multimodal-based experience for the

student. Coined “multimodal” this technologically driven approach provides the

opportunity to engage the student in varied approaches that can be woven into

an intricate pattern of sights, sounds, media, and timing to maximize student

engagement and subsequently student learning (Newman, Couturier, & Seurey,

2004).

Section four (multimodality in anatomy and physiology) focused more

closely on how multimodal has been and could be utilized more extensively

within an anatomy and physiology classroom (Shipka, 2005). The dynamics of

developing a true multimodal classroom within the confines of the content

material that must be included in the transfer of knowledge creates a more

defined process within the basic science classroom than perhaps other

alternatives, and predictably result in better student retention of the material over

traditional methodologies. Web-based laboratory experiences potentially offer

students the opportunity to repeat experiences with almost no cost over

traditional classroom lab experiences which have proven to be cost prohibitive in

many instances (Gopal, Herron, & Mohn, (2010).

The Parameters by Which Students Learn

The over-reaching theories of adult learning require a series of interwoven

mechanisms and processes that create congruency from theory to the

16

classroom. Understanding which elements maximize the instructor-to-student

interaction most efficiently and create an optimal learning environment is

essential to achieving the best student outcomes possible. Understanding what

students require to be successful is essential when crafting the in-class

mechanisms of multimodality. There are several well-laid precepts that have to

be considered when designing the “significant classroom experience” (Fink,

2003).

Ambrose (2010) defined seven main principles that contribute to how

students obtain and integrate new knowledge which are applicable to the

multimodal educational approach.

The first principle was that students do not come into the new

classroom as empty vessels but instead arrive with all the previous

knowledge, experiences, and beliefs that they have developed

throughout their prior lives which both facilitate and limit their ability to

interpret and incorporate new knowledge into their collective

knowledge trust.

The second principle was that each student has a unique manner in

which they organize and assimilate new knowledge. Students with

more randomized approaches may have more difficulties with technical

and abstract knowledge.

The third principle was that the level of success that the student

experiences in the classroom and incorporates the new knowledge into

their collective memories is very much dependent upon their motivation

17

to do so. The more motivated they are, the more that students engage

in the flow of information and participation in the classroom.

The fourth principle was that not only must students acquire

component skills, they must also have the opportunity to practice those

skills within a safe and cooperative learning environment.

The fifth principle was that the knowledge presented must be goal-

oriented with predictable, repetitive, and consistent feedback so the

student is constantly aware of where they are in the journey and how

far they have yet to go.

The sixth principle Ambrose presented was that the knowledge being

assimilated must interact with the students at their social, emotional,

and intellectual interfaces to be successfully integrated.

The seventh and last principle was that in addition to gaining the core

knowledge presented in the course curriculum, students must learn to

become self-learners with the ability to self-monitor their strengths and

weaknesses when approaching a given scenario.

Effectively engaging students starts with an understanding of how they

learn and what motivates them to learn. The passive “banker” format of learning

where the instructor imparts his/her knowledge expecting each student to

automatically absorb it and then regurgitate it back at a later date has proven to

be insufficient (Freire, 1970). Students do not learn well in instructor-centered

learning environments where the only voice in the classroom is the instructor’s.

They learn more efficiently when they are engaged in the knowledge and are

18

participating in a dialogue with the instructor and other students (Bligh, 2000).

Successful learning is accomplished when the student is able to connect their

new knowledge with past experiences and beliefs, and perceive that this new

found information will be important to them in the future. Individuals are learners

from early childhood, learning billions of pieces of data about things, people,

language, etc., with an inherent curiosity that drives their learning in a positive

and self-satisfying course (Bransford, Brown, & Cocking, 1999).

Students must see the relevance of the knowledge being taught and there

must be a connection between that knowledge and predictable future

opportunities to utilize it (Svinicki, 2004). Students must be motivated and

inspired to approach the learning with enthusiasm and passion. This is most

often accomplished through the mentorship of the people around the student,

particularly the instructors (Feldman, 1998). The knowledge must create an

emotional attachment in students that generates the need for them to want to

learn and remember it. It must engage the frontal lobe of the brain as well as the

limbic system creating a connection between the learning process areas and the

emotional centers respectively (Lanham, 2004). The content must be relevant to

the student, and important to them emotionally and academically. Instructors

must show enthusiasm and passion for the content, creating connectivity

between themselves, the student, and the knowledge. The content must be

presented so that it is equally pertinent to all the students, taking into account

differences in ages, generational variations, racial particularities, gender

distinctions, etc. (Mangurian, 2005). Students learn effectively when the

19

educational information is delivered in a multi-modal methodology; that is the

knowledge is delivered in multiple modalities and utilizing different approaches

(Kress, Jewitt, Ogborn, & Charalampos, 2006).

Adult learners, in particular, demand that the knowledge be portable not

only to support their career aspirations but also their emotional lives. The

information must create an opportunity for reflection so that it can be quickly

integrated into their life’s “toolbox” for future utilization. Adult learners do not

learn well with rote memorization and have little interest in theoretical

applications that have no real practical use. They must be able to able share

their views with others (in-class and out of class), integrating it with past life

experiences, and testing their perceptions against other students views as well

as the instructor’s observations and experience (Aslanian, 2001).

In addition to basic cognitive learning (memorizing factual and data-based

knowledge, identifying patterns and concepts, and analyzing and synthesizing

information), higher learning courses must integrate other equally significant

relevant components to include psychomotor, affective, social, and ethical

elements. Psychomotor skills are comprised of the ability to “manipulate specific

objects correctly and efficiently” which is imperative in careers such as art,

engineering, and healthcare related fields. There is a significant connection

between higher cognitive learning and students’ ability to integrate their emotions

and past experiences with the knowledge under scrutiny (McDrury & Alterio,

2000). Affective skills include the capacity to integrate knowledge into the

students’ internal emotional dynamics, affecting how they receive information,

20

respond to knowledge from outside sources, and value knowledge. The effective

result is vital, particularly for students seeking healthcare, counseling, or ministry-

related careers. It is also extremely important in management, human resources,

and marketing professions (NMC, 2009). Social learning outcomes are focused

on group efforts and teamwork, and creating a collaborative and interactive

atmosphere. They are essential in healthcare and social settings as well as with

any interactive endeavor. Ethical outcomes have come to the forefront of

education because of the need to engage and nurture students into being

accountable for their moral choices both personally and professionally. The

ethical outcome has application in all areas of a student’s life but is particularly

important with career tracks comprising life-giving and life-sustaining services to

others (Krathwohl, Bloom, & Masia, 1999).

When asked, students consistently criticized the manner in which

instructors traditionally teach, in contrast to the high expectations put upon them

to learn. The most common negative criticism is that traditional instructors

focused on dissemination of knowledge through lectures (with or without graphics

and overheads) even when more technological methodologies were available.

Concurrently, students express a concern for the general lack of hands-on

learning in the form of interactive exercises, experiences, and opportunities.

Students articulated that generally they were not good self-directed learners, felt

that they were not learning as much as was possible, and were concerned that

college instructors felt no compulsion to interact with them. The result is that

21

students were not motivated to engage in the class with any degree of depth

(Courts & McInerney, 1993).

Within the framework of higher education, students felt that the learning

was disjointed, fragmented, and had no continuity between one course and

another. Because of the traditional lack of interaction between themselves and

the instructor as well as between themselves and other students, students

perceived themselves as isolated, depressed, and feeling no attachment to the

learning process (Gouge, 2009). Because it is expected that students spend two

hours out of class studying for each hour in-class, creating a 30 hour demand for

the average 15 credit per semester student, students perceived the task as

undoable when added to their other time demands of family and work (Fink,

2003).

To overcome the traditional limitations of the non-interactive education,

Fink (2003) suggested that higher education instructors incorporate “significant

learning experiences” into the curriculum. These are defined as experiences that

create a significant alteration or modification in the student’s life. Significant

learning experiences are far more than just feeding the student’s short-term

memory with the intention of measuring their retention through subsequent

multiple choice exams at a later date (Florida, Kaimal, Oblinger, & Blessing,

2007). They are experiences that generally show attachments at both ends of

the student’s chronological learning track; one that is founded in past learning

experiences and a second that is attached to predictable and valued experiences

in the future. Fink described this as the inserting knowledge not only into the

22

student’s “course file” but into their “life file.” It makes the knowledge more than

just another piece of trivia with no discernible substantive value to the student’s

perception of their future; it makes it a congruent piece of information that is

melded into their day-to-day deliberations (Graham & Robinson, 2007). It also

means getting students to actively engage in their own learning and expanding

their motivation and desire to understand. Fink defined the significant learning

experience as that event where the student is an active participant and the

knowledge attained creates a lasting and persistent change because it is

perceived as valuable by the student. The expectation is that students will

achieve better critical thinking skills, better interaction capabilities with their

peers, and become more engaged in the world around them (Hill, 2004).

Fink’s (2003) “significant learning” philosophy includes six major facets:

foundational knowledge, application, integration, the human dimension, caring,

and learning how to learn. Foundational knowledge is that information which is

incorporated into each student’s past experiences and knowledge. It includes

not only the knowledge pertinent to the present course curriculum but all of the

tangential and peripheral knowledge the student has accumulated through their

past education and their past experiences (Gardner, 1983). Foundation

knowledge creates a unique signature for each student dictating how they

interpret and assimilate new knowledge based on their past frames of reference.

Foundation knowledge sets the table for how the student will engage in critical

thinking exercises, creative scenarios, and practical experimentation (Massie,

2003). The art of communication is rooted in this area since the manner in which

23

a student interacts with others is strongly based on how their past experiences

(George, 2002).

Integration is the manner in which students are able to categorize,

separate, integrate, and associate ideas and knowledge. It allows learners to

make significant connections between past knowledge and the present course

content under consideration. This also is important for students to be able to

understand how different courses have congruency in successfully obtaining

global goals (Willingham, 2008). In many ways integration is connected to

foundation knowledge in that foundation knowledge represents the student’s past

experiences while integration refers to how the student blends the new

knowledge in with the old (Fink, 2003).

The human dimension incorporates how students feel about themselves

and how they interact with others. It also includes the student’s awareness of

how the knowledge applies to them both on a personal plane as well as how the

knowledge has implications on a greater social scale (Vie, 2008). The student’s

self-image plays an integral part in how the information is absorbed and

dispersed. The student also acquires insight into how the information affects

others and how others perceive both positive and negative implications

associated with the information. The human dimension enables students to see

the social significance of the knowledge that they have learned (Fink, 2003).

In the area of “significant learning,” caring plays an important role in

determining how much the students value the knowledge incrementally or in its

entirety. The new knowledge may rekindle old feelings, both good and bad, or it

24

may create a new paradigm of feelings that incorporate past experiences with the

new content. When students care about something in a personal or psychosocial

way, they are more likely to highly value the information and retain it (Fink, 2003).

Finally, learning how to learn provides the super strata within which the

other categories reside (Fink, 2003). Learning how to learn is the art of how

students better learn to acquire the significant elements of the content knowledge

and subsequently apply it in a myriad of social, professional, and individual

scenarios. It also creates the lifelong learning drive in students that take them to

far greater heights then just memorizing data to meet near future demands (Fink,

2003)

Nelson (2010) suggested that facilitating how students assimilate

knowledge requires a well-planned and comprehensively formulated toolbox. It

should include multiple course formats, a wide-range of teaching methodologies,

and “teaching moves” (the manner in which instructors present and explain

course content, the learning strategies shared with the students, and the in-class

activities integrated into curriculum). Only with a well pre-planned, yet flexible

application of these three elements can an instructor ensure the optimal learning

outcomes.

Course formats comprise the class setting and which activities are

integrated into the content. It can include lecture only, any combination of lecture

and discussion periods, laboratories, skill sessions, or seminars. The

combination of formats does not appear to be as important as the amount of

student in-class activity and interactivity. The selection of the appropriate format

25

combination based on the planned class activity is essential (Hoyte & Perera,

2000).

Effective Classroom Practices

Effective classroom practices and approaches that effectively serve

student learning have been debated ad infinitum (Burgan, 2006). The lecture

format of teaching has undergone immense scrutiny and negativity. Many

studies have shown that even lecture formats can be effective if presented by

exceptional lecturers. To be effective the lectures must include current research

in the presented field of study, and integrate information and data from a wide

based of resources. Lectures must also contain personal observations, provide

valid research, model and teach critical thinking skills, and engage students in

such a manner as to motivate them and build an intrinsic passion for the field of

study (Thompson, Bolin, & Coe, 2012).

Alternately, data suggest that lecture focused methodology can be

significantly limiting with negative results (Zoller & Tsparlis, 1997). Monologue-

based lecture provides only a one-way manner of communication and only

engages students in their lower cognitive areas. This creates a process whereby

students are spoon-fed the information with the expectation that they will

regurgitate it back during some future exam. This promotes a setting where

students retain little of the content, and fails to engage students in their higher

cognitive skill areas (Bland, Saunders, & Kreps-Frish, 2007).

A third cluster of authors suggest that the methods themselves have little

to do with the overall outcome but it is more so the quality of the modality being

26

presented (Prince, 2004). A significant subset of students may actually exhibit a

resistance to the student-centered models (Sorcinelli, 1991). In their study of

instructor-centered methods and their efficiency (Walker, Cotner, Baepler, and

Decker, 2008), compared and contrasted faculty-centered approaches with

student-centered approaches. For this study, student-centered approaches

consisted of shortened lectures (broken up throughout the class period),

ungraded group activities, announced quizzes, multiple choice exams, and some

graded homework. In contrast, faculty-centered methodologies were defined as

traditional lectures, unannounced quizzes, and multiple choice exams. Their

conclusion was that statistically there was little difference in the mean between

the two groups. Additionally, when students were surveyed and asked to

evaluate the course as a whole as well as their instructors, the faculty-centered

methodology was significantly higher. Knight and Wood (2006) suggested that

the student-centered model can be very effective when integrated into large

lecture presentations; combining both approaches into an interwoven,

comprehensive classroom environment.

The most substantive question, no matter which approach or combination

of approaches is utilized, is whether the result engages the students’ higher

cognitive learning areas and perpetuates critical thinking experiences (Crowe,

Dirks, & Wenderoth, 2008). How much of the student-centered learning modality

is integrated into the historical lecture-based approach predictably can also have

a significant influence on student retention and comprehension (Allen & Tanner,

2005). Marton (1992) described the goals of student success as they apply to

27

the higher cognitive intellect in that they should, “change the way a person

experiences, conceptualizes, or understands” (p. 46) the course content. Taylor

and Mariennau (1997) suggested that, “knowledge is neither given nor gotten,

but constructed” engaging students’ ability to, “take perspective on one’s own

beliefs and the realization that learning and development are worthy life-long

goals.” The instructor must be prepared to build upon the existing knowledge in

a student’s brain to ensure that the student not only retains the knowledge but

understands the mechanism that helped them successfully remember it (Kegan,

1994).

Keegan (2000) suggested that learning is more than just acquisition of

knowledge but more so real-life modification of behaviors and beliefs. The

neurological event of learning is the ability to make meaning of the information

more than just memorizing it. The course curriculum and its core content

become an expansion of what each adult learner already knows through past

experiences making the new material more familiar and more likely to be retained

in the student’s long-term memory. This increases the potential that the student

will shift from a passive learning mode to an active one (Taylor, Marienau, &

Fidler, 2000).

Campbell and Smith (1997) compared what they refer to as the “old and

new paradigms” as they apply to teaching in the college environment. They

suggested that in the old paradigm knowledge is something that is doled out by

the faculty to the students, while the new paradigm is one whereby the faculty

and the students construct the knowledge concurrently. The student moves from

28

the passive vessel to be filled in the old paradigm to an actively integrated

participant constructing and transforming the knowledge before them into the

new one. Singular memorization is traded for relating with the new information

and actively integrating it into both past and future experiences. Faculty

transform from individuals who simply classify and sort information to those that

actively participate in the student’s development. Students no longer simply

strive to complete the assigned requirements but instead focus on the goal of

being a lifelong learner both within and outside of their professional focus.

Relationships transform from impersonal to interactive, and the power within the

classroom moves from faculty-centric to a participative empowerment between

faculty and students. Technology moves from being the subject of a lecture to

being the driving force in delivering the information.

Fink (2003) suggested that courses that entice students to engage early

and consistently must challenge the student with knowledge that will be

significant to them in the future and yet has roots in their past experiences. In

addition, learning must highly active and interactive. Courses must include

instructors that honestly care about the subject content they are teaching, and

those instructors must interact well with the students they teach. There must be

a congruent and consistent methodology of feedback that provides both the

student and instructor with an accurate accounting of where the student is in the

journey at any given time. Students retain knowledge more comprehensively

and for extended lengths of time when the knowledge builds a bridge between

their past experiences and emotions, and predictable future scenarios. For

29

instance, a nursing student who has had a close relative with a disease the class

is studying has a past emotional bridge to the content, and understands the value

that the knowledge will provide for his/her treatment of future patients.

Pratt and Malabar (1998) identified the principles that support the need to

bridge the student’s past experiences and emotions with future scenarios. They

suggested that present learning must be built on past knowledge or emotion to

ensure retention. They also suggested that the linkage between the student’s

past and present knowledge is itself as important as the information. Bransford,

Brown, & Cocking (2000) identified three doctrines that facilitate student learning

with consideration to linking their past with their future. Instructors must

understand that each student has a unique mix of past experiences and

expectations for the application of future knowledge. To successfully achieve

deep understanding, students must be given more than objective data; they must

be given the relevancy of the information and how it will be useful at a later time.

Students must be able to develop their own metacognitive strategies so that the

knowledge can be used in future significant scenarios.

Technologically focused components of the student-centered approach

include using technology for real-time feedback (web-based, text, or clicker

response methodologies to survey students anonymously), asking abstract or

scenario-based questions, the inclusion of student team projects that are

presented to the class, problem-based or scenario-based learning, and case

studies that incorporate student led learning and modeling. The amount of

instructor control verses student control also has a significant effect on

30

successful student outcomes. The main predictor of success consistently

appears to be how much and how often students’ higher cognitive learning

centers are engaged (Thompson, Bolin, & Coe, 2012).

Learning should be high energy and create dynamic student learning

engagements. The learning must also create a lasting change that extends into

the student’s future professional and social life. The knowledge should enhance

the student’s life, enhance their social interactions with other students in and out

of their career track, and prepare them for future success. Course design should

include the nature of the knowledge, student characteristics, instructor

characteristics, and social culture (local, regional, and global). Students should

be guided through multifaceted processes that engage their higher cognitive

brain areas and help build their critical thinking skills (Fink, 2003).

The Multimodal Classroom

Advances in technology have been the driving force for the evolution of

the multimodal classroom. The primary stimulus has been through online

education which has extended into the face-to-face classroom environment

(Newman, Couturier, & Seurey, 2004). Students’ expectations are that the

technology they experience outside of the classroom should be integrated into

the curriculum to include internet interaction and social media sites (Wang, Chun-

Fu, & Wei-Cheih, 2012).

Technology drives change. High-tech advances in recent years have

created the opportunity to incorporate multiple levels of media and technology

into the classroom experience, creating the potential for a highly sophisticated

31

and interactive relationship between the students, the instructor, and the

knowledge itself (Newman, Couturier, & Seurey, 2004). The dissemination of

knowledge no longer is limited to the boundaries of the brick and mortar of the

classroom walls; it can now be delivered and experienced from literally

anywhere. The online education explosion has created a concurrent explosion in

the face-to-face classroom, resulting in the potential for information to be

delivered and experienced through multimodal applications that can be delivered

in an interwoven methodology (Domingo, 2012).

Communicating knowledge from instructor to student in the most effective

and efficient manner is generally the main thrust of most classroom environments

but represents only a piece of the total ideal education experience. Teaching

students how to learn and how to apply knowledge in an abstract, multi-scenario

manner in relevant future circumstances is the significant “other side of the coin”

that often gets missed in traditional, mono-modal, lecture-based classrooms

(Karabulut, 2012). Instructors can no longer teach only the course content but

must additionally consider critical thinking skills that facilitate students’ ability to

apply new knowledge in ever changing environments and circumstances (Siegel,

1984).

Though scholars have long identified the need to integrate critical thinking

skills opportunities into course contents, in truth the inclusion does not

consistently reach fruition. This is in part due to the extra curriculum planning,

classroom management, and more sophisticated classroom activities that are

required to introduce a critical thinking skills theme (Wright, 1995). Approaches

32

that include intra- and extra-classroom discussions, writing activities (case

studies or journaling), and open-ended questions that can have varied correct

responses depending on the context in which they are applied or the culture in

which they are interpreted create an interaction that is less instructor only defined

and more students and instructor defined (Karabulut, 2012).

Bezemer and Kress (2008, p. 166) defined the term “mode” as a “socially

and culturally shaped resource for meaning making.” Critical thinking growth can

be enabled through the use of multiple tangential interactions that observe and

examine the presented content in varying “modes” that replace the traditional

linear classroom (uni-modal) with multiple methodologies (multimodal). The

multimodal (non-linear, multi-faceted) classroom can include elements of

imagination, interpretive analysis, dynamic and interactive experiences, visual

and/or auditory participation, and mobility that utilize the ever expanding

technologies (Coiro, Knobel, Lanshear, & Leu, 2008). The multimodal classroom

encompasses all that is technologically possible in an interaction that engages

students where they learn. This creates the potential for numerous variations of

delivery and generates a learning opportunity where students must abstract

information from multiple sources and then generate their own unique result.

When students must then recall the information in future alternative scenarios,

they are more able to apply the actual knowledge appropriately (New London

Group, 2000).

The multimodal classroom approach creates a multi-literacy learning

environment that is less likely to be culturally filtered. It is much more likely to

33

create an opportunity to evaluate and critically dissect the content knowledge,

resulting in knowledge that can then be applied by the student in multiple

circumstances (Anstey & Bull, 2006). In the multimodal approach the student

becomes critically oriented to the information in such a manner that they can then

apply it in the ever evolving digital media and interactive world (Leu, 2002).

The multimodal classroom approach confronts students’ multiple

interfaces whether they are media focused and/or situation focused. In either

spectrum, the instructor attempts to engage the student utilizing a multitude of

sensory focused interactions that enable all students, despite their foundational

learning methodology, to engage in the content in an environment that best suits

them (Kress, 2004). The multimodal philosophy is based on the perception that

humans interact utilizing touch, vision, hearing, etc. in an individually specific

manner and that when and how they use each tool is based on their past

experiences and interactions. The multimodal methodology is based on not

being defined within a single medium of communication but diverse elements

creating a harmony within the class content in which all who listen take away the

important essentials (Kress & Leuween, 2001).

According to Beaudouin-Lafon (2004), the communicating individual

generates a sensory-motor complex that is perceived by the receiving individual.

That interaction can be positively or negatively interpreted by the receiving

individual such that they achieve understanding that is incrementally altered

within the variations of the interaction and remains both constant and concurrent

between past and future similar interactions. By combining the alternative

34

interactions and alternative communication media, the receiving individual will

interpret the events less as a basic communication phenomenon but more as an

interpretation of the variation in the signals given. This creates understanding at

not only the conscious level but also at the sub-conscious level (Munck & Mayer,

2000).

All interaction is by definition multimodal when conclusions and

alterations in knowledge are more so shaped then by what is heard. Humans

communicate through a multiplicity of mechanisms that include gestures,

posture, facial expressions, proximity between the communicating individuals,

volume, and appropriateness of diction and verbiage. All elements of an

interaction play some minor or major role in its ultimate retention. All

movements, local or peripheral objects, and/or primary or tangential noise have

some level of influence on the ultimate memorability of the event (Norris, 2004).

Cicca, Step, and Turkstra (2003) broke these potential variations into eight

categories, one being a verbal code (spoken language) and the other seven

being nonverbal codes:

Kinesics – use of hand or arm gestures, body movement, posture, eye

gaze, and facial expression.

Vocalics – voice volume, rate, pitch, silence or pause.

Physical appearance – hairstyle, cosmetics, clothing, smell.

Haptics – intensity of touch, eye contact, type of touch.

Proxemics – interpersonal distance, territoriality, any other space

based relationships.

35

Chronemics – waiting times, amount of time spent in interaction,

punctuality.

Artifacts – surrounding furniture, art, animals (pets), any other

possessions

Spoken language (verbal expression) is defined as a communicative

code.

To be successful the multimodal classroom experience must include

advances in technology, particularly when those advances are part of the

student’s normal daily routine. Integrating the use of cell phones into the

classroom, employing the various social media applications, and creating an

interactive classroom experience connect the student’s foundation of knowledge

with the new information in a manner that utilizes new yet familiar technologies

(Fougnie & Marois, 2006). The efficient application of the full range of

multimodal modalities must take into account eight major principles:

Retention is significantly improved utilizing a combination of words and

pictures over just words alone.

Students must see the connections between words and pictures so

they must be presented proximal to each other.

Students sustain learning better when words and graphics/pictures are

presented at the same time instead of successively.

Learning is optimized when extraneous elements (words, pictures,

audio) are eliminated.

36

Students learn better from animation and narration rather than just

animation and on-screen text.

Students retain information better when there is no redundancy

between modalities

Design effects are higher for low-knowledge learners than high-

knowledge learners, and higher for high-spatial learners than low-

spatial learners

As the content complexity increases, the impact of direct manipulation

of the animation and pacing also increase (Mayer & Moreno, 2003, p.

233).

Specific elements of the multimodal classroom. The first thing

instructors must consider is their role in the multimodal classroom. The instructor

must also assume the alternate positions of researcher, production engineer, and

director. These new job requirements are strange and foreign to many traditional

instructors (Plenderleith & Adamson, 2009). The best way to think about the

classroom is to consider it as an entertainment arena in which students are not

only educated but entertained. The thought is repugnant to most senior

instructors but is nevertheless a true interpretation of the demands of the

multimodal classroom experience. The goal is to produce sophisticated

classroom experiences that promote higher cognitive interactions as well as

critical thinking skills (Wright, 1995).

The best way to consider the “production” of a multimodal classroom is to

first identify what is possible in the classroom based on its size, logistics, media

37

availability, etc. The instructor must determine which elements are available in

the realm of video, audio, and animation? The components to consider are does

the classroom have an overhead projector with computer input (wireless or

hardwired) (Tutkun, 2011); does it have a “Smartboard” (Goodin, 2012) that

allows presentation of material by touching the white board; does it have access

to the internet that can be displayed to the class; can content be added through

audio sources (telephone call in, conference call capability, and/or internet)

(Wang, Mattick, & Dunne, 2010); and is there computer access for instructors

and students in the classroom? If the answer is yes to all of those, then the

instructor has the optimal arena to “produce” his/her next class.

The next objective is to determine which media is appropriate with which

content elements. As Wright (1995) stated, the more sophisticated and complex

information elements are, the better they are retained by students when they are

presented in an animated or video based format. Short videos (animated or

otherwise) are the best mode to utilize as the primary cognitive element with

supplementation from other modalities (Mayer & Moreno, 2003). Interactive

exercises and interactive lectures as supplements can also be considered. Many

texts now come with instructor resources that include animations, short videos,

and interactive exercises that promote student participation (Alvermann &

Wilson, 2011). Many more alternatives can be found online where there are

some excellent sources available. For instance, a totally free site that has many

very appropriate videos for almost any acumen is the Khan Academy

(https://www.khanacademy.org ). YouTube© has a multitude of very well done

38

short videos (http://www.youtube.com/ ); with the caveat that the instructor will

need to review the material for accuracy and validity. Additionally the Higher

Learning Commission has other resources (http://www.ncahlc.org/ ). Literally

every career track has at least one site and more often many sites where

animated or video based information can be obtained. Wikipedia

(http://www.wikipedia.org/ ) can be a source but the instructor must closely

review all the material for accuracy and validity (LaFrance & Calhoun, 2012). It is

also a good place to locate additional sources of information. The instructor has

to be the researcher in this case and scour the internet, institutional library, and

public library for potential elements that can be included in the course content.

Another multimodal mode is the online web-based lab experience.

Historically lab experimentation, particularly in the basic science and medical

fields, has been messy, expensive, and required dedicated space in which to

perform each experiment (Gopal, Herron, & Mohn, 2010). The cost was so

prohibitive that students were either only given a single opportunity to complete

the experiment, or for more expensive experiences, the students would

congregate around the instructor while he/she completed the exercise. The

result was often less than favorable. The web, due in part to the expansion of

online education, has generated another methodology: the web-based video lab

experiment (Lin, 2006). In this modality, students perform their experiments

utilizing an online interface. Unlike the historical methodology, if the student

makes a mistake, he/she can reenact the experiment again and again until they

get it correct and/or understand the content. Almost all up to date, multimodal

39

based textbooks incorporate this type of student interaction. The web-based lab

experience can be used as an individual experience, a group experience, and/or

an entire class experience, depending on the content and outcome goals

(Straub, 2007).

The multimodal classroom can include several other strategies that

generally fall in line with narrative learning. The goal of narrative learning is to

create a blending between the academic, sociologic and socioeconomic, and

individual emotional elements of the student’s life. This approach allows the

student to combine past knowledge, emotions, behaviors, and sensations with

the new knowledge; assimilating them into their higher cognitive learning areas

(Keen & Valley-Fox, 1989). An example of this approach is the short vignette

where the class views a video which is used as the foundation of a directed

dialogue. When the use of technology is not available, other alternatives can be

employed. For instance students can be put into preformatted role playing or a

scenario can be presented in written or verbal format. Whatever the format, the

result is that students are given an opportunity to interpret the information and

respond to it utilizing their past believes and experiences. This approach creates

not only a substantive event that can be incorporated with their past experiences,

it can create major changes in their foundational beliefs (Clark & Dirkx, 2000).

A second example of employing the narrative learning approach is the use

of case studies. Students complete case studies, accomplish critical reviews of

incidents or events, and/or complete exemplars. Case studies can be applied in

a myriad of formats. For instance, they can be accomplished within the

40

classroom as a group project (Casotti, Beneski, & Knabb, 2013). The case study

is presented to the class and then the class is broken down into groups to

answer a preset set of questions or to identify a set of solutions to the presented

problem. Case studies can also be used as an investigative tool for students to

do in-depth research on a given subject (Morton, 2000). In either case the

results can be simply turned into the instructor for evaluation or used as the

content subject for class discussion (depending on time and subject matter).

Case studies provide a “how to approach” that enables the student to critically

evaluate a given situation, event, etc., and then respond to that circumstance

utilizing past knowledge, experience, and beliefs (Ockjean, Utke, & Hupp, 2005).

This methodology also makes the information easily portable to other future

scenarios where the knowledge can be applied (Baumgartner & Merriam, 1999).

The third example of the narrative approach is the use of group projects.

Students in this format are given a group or class-wide project with a defined set

of deliverables. For instance, a group may be assigned to research a given

subject and then present it to the class utilizing one or several multimodal

strategies. The students can be allowed to work on their projects within and/or

outside of the classroom. Project deliverables can include a PowerPoint©

presentation, a classroom presentation with group work, a non-PowerPoint©

presentation with a follow-on survey or quiz, and/or a class participation exercise

that teaches the rest of the class how to accomplish a given strategy or task. An

example of this approach would be role playing (Kangas, 2012).

41

The last approach utilizing the narrative format is the use of

autobiographies, defined as “stories about one’s self.” Formats can include

journals, logs, a written or verbal presentation, or blogs (Kitchakam, 2012). This

modality can utilize technology or not. If one chooses to use technology, the blog

format is the most utilized format if the subject matter can be disseminated

publically (or at least to the instructor and other students). The blog format has

become very popular in the social media world. Sites like Facebook©,

Myspace©, and others have become very much a part of most students’ lives

(and is not so age dependent as one might suspect). Instructors can create

class-specific pages whereby students can interact on either proscribed or non-

proscribed subjects. The author utilizes the non-proscribed approach where a

Facebook page is created that is focused on a given class. Students past and

present are encouraged to “like” the page and thus interact with others. The goal

is to create bridges between students in different parts of their career pipeline.

The author also “likes” sites within the Facebook page so students can utilize

them as resources for cases studies. Similar techniques can be applied to

MySpace and many others (Wang, Chun-Fu, & Wei-Cheih, 2012).

A more controlled form of the blog is the discussion question format where

students are assigned either as a class or by groups, a question or series of

questions. Students are able to see what their peers have presented, giving

them insight into how others might see the content. Discussion questions can

also require that students respond to some of their classmates, creating

interactions and reactions to what an individual presents. The discussion

42

question offers a unique, technologically based format for students to present

their views on a given subject to their peers, observe how those peers interpret

their information, and then reflect on that interaction, sometimes with responses

to the responses. The discussion question allows students to actively explore

the precepts of the information, reflect on its short-term and long-term meaning,

and integrate the knowledge into their own past experiences (Whitehouse, 2008).

The autobiography can also be accomplished using a non-technological

approach. For instance journaling allows students to document their thoughts

regularly so that they can use it for retrospection in the future. One can think of it

as an educational diary. Students can be assigned journal homework using

pencil and paper with the outcome goal of them either retaining the information

for their own use, submitting the information to the instructor for comment and

feedback, and/or presenting the material to their fellow classmates at a later

date. The approach selected should consider the subject content of the material

when deciding whether the contents are appropriate for which outcome (Clark &

Rossiter, 2002).

The historical lecture format is one where the lecturer presents information

(with or without the use of overheads, PowerPoints, or supplementary

information) with little student interaction (Karabulut, 2012). There is little

activation of the student’s brain in areas other than the lower cognitive zones.

Though this process may utilize some level of technology, it does not engage the

students sufficiently to produce the optimal learning environment. Contrary to

how many instructors intuitively feel about the use of lecture as a class format, it

43

can be an effective form of knowledge transfer so long as it provides current

research on the subject presented; information is integrated from a wide base of

resources, personal observations, or valid research; there is an element of

modeling and teaching of critical thinking skills within the curriculum; and it

engages students in a manner that motivates them and builds an intrinsic

passion for learning (either within or outside of the given field of study)

(Thompson, Bolin, & Coe, 2012).

The lecture format can be useful as a modality in a classroom

environment as long as it is integrated with other methodologies. For instance, if

an instructor utilizes a PowerPoint© embedded with videos, graphics, and

animations, and intersperses classroom activities at regular intervals, the lecture

transforms from a single direction monologue into an interactive multimodal

presentation. Taylor and Mariennau (1997) stated that, “knowledge is neither

given nor gotten, but constructed,” and that it should engage students to, “take

perspective of their own beliefs and realize that learning and development are

worthy life-long goals.” To accomplish this, the lecture has to engage the higher

cognitive areas of the brain and produce growth in critical thinking skills

(Thompson, Bolin, & Coe, 2012).

The final element of the multimodal classroom environment to consider is

the “flipped classroom.” In part due to the readily available technology, students

can now accomplish what used to be confined to the classroom, in their own

homes via the internet (Tucker, 2012). Students’ experience within the

classroom includes evaluation of scenarios, analysis of problems, and engaging

44

in collaborative learning. The flipped classroom allows the instructor to

maximally present and develop the more theoretical elements of the content, and

establishes opportunities for dialogue between students and the instructor as well

as between students and their classmates. The lectures are moved out of the

classroom and collaborate work, discussions, experimental exercises, debate,

and lab experiences are moved into the classroom. This approach facilitates

higher cognitive interactions in the classroom as well as perpetuating critical

thinking skills (Gerstein, 2012).

For the flipped classroom to be successful several elements must be

present. First of all the students need to be personally connected with the topic.

It must have emotional, social, and future scenario implications that are validated

by the student. The interactions within the classroom should be such that the

subject is personalized for each student through classroom collaborative

participation (Gerstein, 2012). Even in a multimodal classroom, lectures still

have a part in the process, but they should not be instituted until after the student

has explored the content on their own. This transforms the historical lecture into

an interactive collaborative review of the material. The flipped classroom is

supported by the National Center on Universal Design for Learning (2012) which

calls for instructors to apply multiple means of student engagement with multiple

means of presenting information. This affirmation was made after studies in

neurosciences showed that multimodal interactions activated the recognition,

strategic, and affective networks. This created an optimal learning experience

that facilitated long term memory and critical thinking skill growth so that the

45

knowledge gained could be applied by the learner in future diverse scenarios

(Fulton, 2012).

The standard flipped classroom moves the lecture, testing, and non-direct

learning elements out of the times when the class is assembled. The classroom

is used for student interactive activities, group projects, dialogue-based

experiences, and critical thinking skills opportunities. The basic reading, listening

to lectures, and monologue presentations are moved outside of the classroom.

Students are expected to come to class prepared so that they can take full

advantage of the higher level of learning (Strayer, 2012). If they do not come

prepared, they cannot fully collaborate because the content will not be familiar to

them. On the other hand, if they arrive with little preparation, the classroom

experience has the propensity to motivate them not to arrive ill prepared again,

and even then may help them better understand the material by observing and

interacting with the instructor and their peers (Tucker, 2012).

Multimodality in Anatomy and Physiology

Traditionally clinically focused anatomy and physiology curricula have

fallen into three models: the traditional regional format, the problem-based

format, and the systems-based format. The traditional format relies on a passive

learning, monologue-based paradigm where information is transferred from

instructor to student via a lecture-based and faculty-centered process. The

problem-based learning concept requires active learning on the part of the

student but has historically fallen short when students have attempted to apply

the knowledge presented in alternating and diverse clinical scenarios. Systems-

46

based curriculum is based on a 10 system breakdown whereby the anatomical

and physiological features are presented at the gross anatomical level, the

microscopic anatomical level, and the chemical or molecular level. Generally the

systems are broken down into cardiovascular, endocrine, digestive, urinary,

reproductive, respiratory, immune, skeletal, muscular, and nervous areas

(Heyling, 2002).

All of the traditional models have one consistent commonality: they

generally do not engage the student in the higher cognitive brain areas. The

result is that the information is poorly retained and not portable into other

subsequent clinical courses (McKeown et al., 2003). Students who successfully

pass the basic anatomy and physiology courses are often not able to apply the

principles and applications in subsequent clinically focused classes. Barrows

and Peters (1984) criticized the passive, lower cognitive approach taken by most

instructors when teaching basic sciences generally and anatomy and physiology

specifically. Since the 1990s medical education, to include anatomy and

physiology, has undergone massive transformation with penetration into

horizontal and vertical integration, student-centered approaches, and problem-

based learning concepts (Dornan & Bundy, 2004).

With the dynamic of increasing class sizes, advances in multimodal

presentation, and advances in technology, mono-modal approaches have

become less and less feasible. The use of computer-assisted learning has

become one of predictability but with serendipitous application and integration

(Trelease, 2002). In the anatomy and physiology classroom, the use of

47

anatomical informatics, three-dimensional modeling, and modeling using virtual

reality resources have become more readily available. However, though the

technology has increased exponentially, transitioning of the actual classroom

environment has occurred at a less substantial rate (Trelease & Rossett, 2008).

Presenting anatomy and physiology content requires a complicated

interwoven approach that includes text, graphics, anatomical models, histological

images and/or models, videos, and animations. To understand the human body

and its systems, students must be able to visualize and comprehend not only the

anatomical element being discussed, but how that element acts and reacts at the

basic chemical level, the microscopic level, and the gross anatomical level. To

accomplish that understanding, students must see the process in a multitude of

media and applications (Weir & Abrahams, 1997). For instance to understand

how the heart functions the student must not only know the anatomy of the heart

but in additional must understand how cardiac muscle functions at the chemical

and microscopic level, how the heart moves blood throughout its chambers, how

the pressures manage the movement of blood, how the electrical activation of the

heart causes specific components to contract in a systematic and comprehensive

sequence, and what the heart’s relationship is with other organ systems within

the body (Durosaro, Lachman & Pawlina, 2008).

For clinical career track students, anatomy and physiology is the

obligatory basic science that generates the scaffolding onto which all ensuing

clinically focused courses are connected. It is generally a required class that

must be accomplished in the preclinical years (Collins, 2008). A thorough

48

understanding of the normal anatomical and physiological functioning of the

human body is imperative when applying it to such subsequent courses as

pharmacology, pathophysiology, microbiology, and all clinically based laboratory

courses. It is crucial that students are not only able to retain the basic precepts

of anatomy and physiology but that they are also able to apply the knowledge in

a multitude of clinical scenarios (Sugand, Abrahams, & Khurana, 2010). To

maximize the student’s retention of the material, it is imperative that it be

integrated into the higher cognitive areas of the brain so that the basic precepts

and applications can be applied in a multitude of variations within specific

disease spectrums (Pabst, 2002). Even after graduation, the corollaries,

cognitive applications, and theoretical foundation learned in anatomy and

physiology courses are integral to the majority of clinical applications. Graduates

are expected to retain and rely on the knowledge gained from basic anatomy

throughout their careers (Moxham & Plaisant, 2007).

The anatomy and physiology classroom has undergone a significant

transformation, in part due to both the increasing costs of materials (cadavers,

reagents, and histological specimens) and the exponential growth and

sophistication of multimodal expansion (Sugand, Abrahams, & Khurana, 2010).

Human cadaver laboratories which are expensive and require the utilization of

toxigenic, teratogenic, and carcinogenic chemicals (formaldehyde, formalin, etc.)

are being substantially replaced with multimodal based experiences. Though the

cadaver experience is highly regarded by students, its use in contrast to other

49

modalities has not shown any significant or substantive improvement in the

quality or quantity of knowledge retained (Pawlina & Lachman, 2004).

The multimodal methodology has brought video, animation, web-based

laboratory experiences, email, and internet search-ability into the confines of the

traditional face-to-face anatomy and physiology classroom. The utilization of

computerized learning packages (anatomical informatics) has reduced the

dependency on cadaver experiences and actual laboratory requirements

(McNulty, Sonntag, & Sinacore, 2009). Web-based laboratory experiments have

begun to replace the traditional hands on experiences. Even the use of cadaver

labs have been replaced or significantly reduced by more dynamic modalities like

A.D.A.M.©, where the body can be dissected at every angle and any depth to

examine a given anatomical element in a multimodal computerized environment

(Putz & Pabst, 2002). Rudimentary lab experiences have been replaced by web-

based lab exercises that can be repeated without limitation until the student

understands the goals and objectives without the additional cost of traditional lab

exercises (Turney, 2007).

The application and benefits of integrating multimodal methodologies into

basic courses have been well documented (Airey & Linder, 2009; Jewitt & Kress,

2003; Kress, Ogborn, & Tsatsarelis , 2001). The development of multimodal

textbooks and instructor resources has become the norm for all curriculums to

include basic sciences (anatomy & physiology, microbiology, biology, chemistry).

A few studies, as they apply more specifically to basic science classroom

environments, have focused on multimodal-based lectures and classroom

50

activities (Prain & Waldrip, 2006). These studies have looked at the dynamic

multimodal curricula and what is included in their multi-dimensional layering.

Even elements as basic as monologue lectures and chalkboards can represent

modes within the multiple alternatives. These varying modalities carry potentially

different meanings and different emphasis with subsequent different experiences

for the students (Jewitt & Kress, 2003).

It is the integration of diverse modalities as well as the multiplicity in how

they are applied that can determine how students absorb the information and

then integrate it into their higher cognitive learning areas (Roth & Lawless, 2002).

The ultimate output of the basic science classroom experience is a dynamically

layered event that includes the primary presentation mode (monologue or

dynamic dialogue lectures, video, animation, audio, chalkboard, whiteboard,

and/or Smartboard©), intra-layered by one or all of the following: textbook,

manner of speech, and classroom ideology (andragogy verses pedagogy) (Roth

& Lawless, 2002). Specifically, in the basic science classroom there are a variety

of signs, graphs, abbreviations, algorithms, pneumonics, etc. that are integral to

the curriculum content. These very specific elements often dictate the optimal

media by which the knowledge may be presented. Combinations of media,

sounds, visual images or videos, and collaboration create ideal knowledge

transfer (Finn & McLachlan, 2009).

51

Summary

The substantial advancement of technology in the professional and social

landscape, both internal and external to education, has driven student

expectations as to how curricula should be presented in both online and face-to-

face environments. Students have come to expect that the technology they

enjoy and utilize outside of the classroom will be integrated into the methodology

inside of the classroom. Unfortunately the integration of that technology into the

face-to-face classroom has occurred at a rate substantially slower than its rate of

development. The important question is, “what are the limiting factors that inhibit

multimodal applications?”

52

CHAPTER 3

Research Methodology

Chapter 3 presents the design, research methodology, and procedures

utilized to complete the study to determine the distribution and penetration of the

multimodal teaching methodology in anatomy and physiology curricula. It

includes a brief overview of the methods utilized to conduct a literature review,

the study’s purpose, the research questions that are inherent to the study, a

discussion of the research methodology, and the process that was employed to

collect and subsequently analyze the data to determine the study’s conclusions.

The researcher explored applicable foundational theoretical education

methodologies as well as the conceptual and operational aspects of multimodal

based learning. The writing guide for this dissertation was the Publication

Manual of the American Psychological Association, sixth edition (2009).

The literature for this review was collected from multiple sources:

professional journals, books, dissertations, electronic databases, and

governmental publications. References for this study were collected primarily

from the research databases available through the University of South Dakota’s

website and included: ERIC, Dissertation Abstracts International (DAI), Social

Science Abstracts, ProQuest, and bibliographies presented in other publications

found within those databases. Internet searches were accomplished utilizing

Google.com®, Bing.com®, and Ask.com®. Search terms included multimodal

methodologies, multimodal applications, multimodal integration, and multimodal

applications.

53

The framework for the study was based on the significant learning

concepts presented by Fink (2003) depicting the optimal learning environment

through precognitive layering and integration of multimodal interactions. Fink has

been a long standing proponent of creating the student-centric, higher cognitive,

and student-valued educational interaction. Fink suggested that to be dynamic

learning must engage students within their higher cognitive brain tracks and that

those tracks are best stimulated through multimodal approaches that provide

mechanisms for learning that allow students to identify their own learning style,

and then engage the knowledge using that style. Fink defined the significant

learning experience as that event where the student is an active participant and

the knowledge attained creates a lasting and persistent change because it is

perceived as valuable by the student. The expectation is that students will

achieve better critical thinking skills, better interaction with their peers, and

become more engaged in the world around them (Hill, 2004).

Statement of Purpose

The purpose of this study was to identify the extent to which multimodal

teaching methodologies were used by instructors in anatomy and physiology

courses. The study identified how multimodal teaching elements were used by

instructors in anatomy and physiology classes, how much actual time was spent

in each modality, and how the multimodal elements were submitted by students.

The study identified instructors’ perceptions of barriers that prevented anatomy

and physiology instructors from integrating multimodal methodologies as they

related to training, facility infrastructure, and administration. The study analyzed

54

the variation in the integration of multimodal methodologies based on instructors’

personal characteristics.

Research Questions

This study was guided by the following research questions:

1. How do instructors integrate multimodal elements into anatomy and

physiology courses?

a. How much actual course time is spent in each modality?

b. How is each multimodal element integrated into the educational

experience?

c. How are multimodal elements submitted?

2. What are instructors’ perceptions of the barriers preventing them from

optimally engaging multimodal teaching methodologies as they relate

to:

a. Training

b. Facility/Infrastructure

c. Administration

3. What is the variation in the integration of multimodal methodologies

based on instructors’ personal characteristics?

Review of Selected Literature

A comprehensive review of related literature was conducted for the

purposes of this study. Multiple mechanisms were utilized creating a broad base

of information as it related to educational theory, multimodal methodology, and

multimodal application in basic science classrooms, specifically those involving

55

anatomy and physiology curricula. Literature sources included (a) electronic

indexes and databases, (b) professional journals, (c) books, (d) dissertations, (e)

governmental publications, and (f) conference proceedings. The references

utilized in this study were provided by the University of South Dakota’s website

(www.usd.edu/library) and included EBSCOhost, ERIC, Educational Abstracts,

Dissertation Abstracts International (DAI), ProQuest, Psychological Abstracts,

Social Science Abstracts, and bibliographies of the other publications found

through those specific databases. Additional internet searches were

accomplished utilizing Google.com©, Bing.com©, and Ask.com©. The primary

library facility employed was the I.D. Weeks Library at the University of South

Dakota in Vermillion.

The Publication Manual of The American Psychological Association (6th

edition) (2009) was used as a guide for clarity and consistency in the

development and writing of this proposal. Dr. Baron’s Dissertation Guide,

provided during his EDAD 885 Dissertation Seminar, and has been adopted as a

model for this proposal.

Population

The population studied included instructors from three anatomy and

physiology associations/societies. Though instructors from K-12 are members,

they were filtered from the study. The three population sources were

1. Human Anatomy and Physiology Society (HAPS) representing instructors

who teach in high schools, post-secondary education, or at two-year and

four-year year colleges and universities. The organization includes over

56

1,700 members, in over 300 institutions who teach anatomy and

physiology from educational institutions throughout the United States. It

should be noted that this study only included the instructors in higher

education and that high school instructors were excluded from the sample

studied, focusing only on members from higher education who taught in

two- and four-year colleges. The reason that the HAPS membership was

considered for the study sample was that the goals of the organization are

fundamentally supportive of advancements in anatomy and physiology

education. HAPS goals are to enhance the quality of anatomy and

physiology instruction at colleges and universities, promote

communication and collaboration among instructors of human anatomy

and physiology and encourage innovation, research, and publication by

human anatomy and physiology instructors.

2. iTeach Anatomy & Physiology Collaborate. This collaborate has a

membership of approximately 1,300 anatomy and physiology instructors

and is made up of a private community that provides college instructors

with discussion forums, teaching resources, current event feeds, shared

calendars, and a member community. iTeach has the following goals: (1)

bring together A&P instructors from multiple teaching institutions so that

they may exchange and discuss ideas related to A&P instruction, and (2)

create quality and innovation solutions to improve student learning

outcomes. iTeach was selected as a participating source for this study

57

because it represents instructors who are engaged in the advancement of

teaching methodologies in anatomy and physiology classrooms.

3. The American Physiology Society (APS) is a nonprofit organization

devoted to fostering education, scientific research, and dissemination of

information. The society was founded in 1887 with 28 members and has

grown to over 10,500 members, with most members having doctoral

degrees in physiology and/or medicine (for health professions). APS is a

member of the Federation of American Societies for Experimental Biology

(FASEB), a coalition of 26 independent societies that play an active role in

lobbying for the interests of biological scientists. APS was selected as a

source for this study because of its longevity in supporting all aspects of

anatomy and physiology education and research.

Research Design

The choice to utilize a positivist/quantitative approach, a methodology

introduced in the modern world by Auguste Comte Giddens (1974), was because

it allowed the researcher to collect and then analyze the data based on numerical

representation of observations with the consequential intent to quantify the

phenomenon. Quantitative research, being both deductive and particularistic, is

based on the process of applying a research hypothesis, then verifying the

validity of that hypothesis through empirical manipulation of the acquired data

(Frankfort-Nachmias & Nachmias, 1992). The importance of the quantitative

methodology is recognized as one of the most viable research approaches to

explain a given phenomenon (Pawson & Tilley, 1997).

58

Survey research is designed for quantitative descriptive studies and

allows researchers to define and describe patterns within the data from

respondents (Bridwell-Bowls, 1991). A survey by definition is cataloging a large

group (a population) of people to obtain a representative sample of the specificity

of the group as it applies to the subject being surveyed. The survey tool allows

the researcher to engage in an extensive analysis of a relatively large population

subset with a minimum of cost.

The survey tool included multiple choice questions, single answer, 0-100%

interpretations, and Likert scaled questions as well as demographic information

about the participant and the institution where he/she taught. The tool was

divided into five sections:

- Section A: Multimodal Elements Utilized by anatomy and

physiology instructors

o Questions one through six identified the level of multimodal

engagement in the instructor’s course for each multimodal

element.

Questions one and four were percentage-based.

Questions two, three, five, and six were multiple-choice

based.

- Section B: Institutional Demographics

o Questions seven and eight identified the type of higher learning

institution as well as the degree track of the students. They

were multiple-choice based.

59

- Section C: Infrastructure

o Question nine identified the availability of instructor computer

access, audio/visual support, and internet access for the

instructor and/or wireless access for the students. This question

was percentage-based.

- Section D: Administrative Support

o Questions 10 through 14 identified the instructor’s perception of

how their administration supported multimodal teaching. These

questions were Likert-based.

- Section E: Faculty Information

o Questions 15 through 21 established the teaching status, total

years of teaching overall, years of teaching anatomy and

physiology specifically, degrees earned, and curricula levels

taught (undergraduate, masters, or doctorate).

Questions 15 and 16 were percentage-based.

Questions 17 through 21 were demographic-based.

o Questions 22 and 23 establish the participant’s perception of the

quantity and quality of his/her training. These questions were

Likert-based.

The researcher submitted the survey cover letter (Appendix C) to the

HAPS, iTeach, and APS list serves. Though the membership included both

instructors of higher learning and high school instructors, all high school

instructors were filtered from the data received to specifically focus the study on

60

instructors in higher learning teaching. The subset studied therefore only

included instructors from two-year and four-year university institutions.

Instrumentation

The instrument (Appendix A) used for this study was created by the

researcher based on evidence found in the literature (Appendix B). Research

design was guided by John Creswell’s (2003), Research Design, Qualitative,

Quantitative, and Mixed Methods Approaches. Instructors were directed to

complete the questions on a web-based survey tool (Survey Monkey©).

Because the survey tool had not been employed in this format prior to this study,

it was distributed among the University of South Dakota anatomy and physiology

instructors first (six individuals) for a formal critique. Upon completion of the

formal critique, appropriate corrections were made and the tool was then sent out

a second time to 10 members of the Sanford School of Medicine and the original

six individuals who performed the original critique (total of 16 individuals) who

took the survey and offered specific feedback. Their suggestions were integrated

into the final survey tool.

Once the tool was validated through the critique and survey evaluation

process, it was submitted to the members of HAPS, iTeach, and APS. The items

in the survey tool were mapped in a matrix that provided content validity by

connecting the survey items to the corresponding literature research and the

stated research questions (Appendix B). The survey tool included multiple

choice questions and Likert scaled items. The validity and statistical relevance of

61

the Likert scale methodology was well-established (Allen & Seaman, 2007). All

variables were analyzed for reliability. The Cronbach’s Alpha result was 0.76.

Data Collection

Approval to conduct this study was requested and approved from the

Institutional Review Board (IRB) at the University of South Dakota prior to

implementation. Data were collected over a 30-day period via an online, web-

based survey mechanism (Survey Monkey©). An online email through the

HAPS, iTeach, and APS list serves was submitted to the potential participants

explaining the reason for the survey and its value to improving the overall quality

of anatomy and physiology curricula. The email also included the study’s title,

purpose, description, risks, benefits, alternatives, confidentiality, a statement of

implied consent, and the researcher’s name and contact information with a link to

the actual survey.

Data Analysis

The researcher used the IBM Statistical Package for the Social Sciences

(SPSS) 20 to complete the statistical analyses. A significance level of p<.05 was

used for these analyses. Inferential and descriptive statistics were conducted on

the quantitative data. Results were analyzed as they applied to the total study

subset as well as each type of participant group represented within the study.

The goal was to evaluate any and all trends within those variables.

Research Question 1 regarding the integration of multimodal teaching

elements (total time spent on each, how they were integrated, and how they were

62

submitted) used in anatomy and physiology classes was determined by

calculating the means and standard deviations for survey items 1 through 6.

Research Question 2 regarding instructors’ perceptions of barriers that

prevented them from integrating multimodal methodologies as they related to

training, facility infrastructure, and administration was determined by calculating

the means and standard deviations for survey items 9, 10 - 14, 22, and 23.

Research Questions 3 regarding the integration of multimodal

methodologies based on variations as they apply to the instructor was

determined by calculating the means, standard deviation, and ANOVA for survey

items 15 – 21. All significant ANOVA were followed up with a post hoc Tukey’s

Test. The independent variables included number of years of teaching

experience, numbers of years of teaching specifically anatomy and physiology,

the instructors’ highest degree earned, teaching status, and teaching rank. The

independent variable were the 12 modes of multimodality.

63

CHAPTER 4

Findings

Chapter 4 presents the findings of analysis of the data gathered for the

study. The purpose of the study is revisited, followed by the survey response

rate and demographics data. The study results are then presented in tabular

format with accompanying narratives to explain the statistical processes used.

The IBM SPSS 9 (Version 20.0) software package was used for all statistical

analysis.

The problem addressed in this study was to identify the extent to which

multimodal teaching methodologies were used by instructors in anatomy and

physiology courses. The study identified how multimodal teaching elements

were used by instructors in anatomy and physiology classes, how much actual

time was spent in each modality, and how the multimodal elements were

submitted by students. The study identified instructors’ perceptions of barriers

that prevented anatomy and physiology instructors from integrating multimodal

methodologies as they related to training, facility infrastructure, and

administration. The study analyzed the variation in the integration of multimodal

methodologies based on instructors’ personal characteristics.

The following questions guided the study:

1. How do instructors integrate multimodal elements into anatomy and

physiology courses?

a. How much actual course time is spent in each modality?

64

b. How is each multimodal element integrated into the educational

experience?

c. How are multimodal elements submitted?

2. What are instructors’ perceptions of the barriers preventing them from

optimally engaging multimodal teaching methodologies as they relate

to:

a. Training

b. Facility/Infrastructure

c. Administration

3. What is the variation in the integration of multimodal methodologies

based on instructors’ personal characteristics?

Response Rate

The target population studied included anatomy and physiology instructors

from three associations/societies. Though K-12 teachers were members, they

were filtered out from the study. The three groups studied were Human Anatomy

and Physiology Society (HAPS), iTeach Anatomy & Physiology Collaborate, and

The American Physiology Society (APS).

The three associations/societies totaled memberships of over 13,500

anatomy and physiology instructors. Only members who participated in their

respective organization’s list serves were surveyed. This resulted in an

estimated study population of approximately 3,675. A total of 181 instructors

responded to the survey for a return rate of 4.93%. Not all instructors answered

every question.

65

Demographic Data

Instructor demographics included the following specifics: highest degree

earned, teaching status, teaching rank, the percent that each individual taught

anatomy and physiology, total years teaching, and total years teaching anatomy

and physiology, specifically. Of those instructors who answered the question

asking their highest degree earned, two (1.1%) had bachelors, 34 (19.3%) had

master’s, and 140 (79.6%) had doctorates (see Table 1).

Table 1

Differences in Highest Degree Earned

Degree f Valid Percent

Bachelors 2 1.1

Masters 34 19.3

Doctorate 140 79.6

Total 176 100.0

Instructors were queried concerning their teaching status as it applied to

tenured, contracted, or adjunct. Of those instructors who answered teaching

status, 95 (55.9%) were full-time tenured, five (2.94%) were part-time tenured, 57

(33.5%) were full-time contracted, four (2.3%) were part-time contracted, and

nine (5.3%) were adjunct (see Table 2).

66

Table 2

Differences in Teaching Status

Status f Valid Percent

Full-time Tenured 95 55.9

Full-time Contracted 57 33.5

Adjunct 9 5.3

Part-time Tenured 5 2.9

Part-time Contracted 4 2.4

Total 170 100.0

Instructors were queried as to their teaching rank. Choices were instructor,

assistant professor, associate professor, or full professor. Of those instructors

that answered teaching rank, 32 (19.1%) were instructors, 40 (23.8%) were

assistant professors, 34 (20.2%) were associate professors, and 62 (36.9%)

were full professors (see Table 3).

67

Table 3

Differences in Teaching Rank

Rank f Valid Percent

Instructor 32 19.1

Assistant Professor 40 23.8

Associate Professor 34 20.2

Professor 62 36.9

Total 168 100.0

Instructors were queried as to what percentage of their teaching assignments

was directly related to anatomy and physiology. Of those instructors that

answered the percent of their teaching assignments that were anatomy and

physiology classes, three (1.7%) were less than 10%, six (3.4%) were 20%, 12

(6.8%) were 30%, eight (4.5%) were 40%, 20 (11.3%) were at 50%, 14 (7.9%)

were at 60%, 24 (14.0%) were at 70%, 23 (13.9%) were at 80%, 13 (7.3%) were

at 90%, and 54 (30.5%) were at 100% (See Table 4).

68

Table 4

Differences in Teaching Assignments in Anatomy and Physiology

Percent of Assignments f Valid Percent

10 3 1.7

20 6 3.4

30 12 6.8

40 8 4.2

50 20 11.3

60 14 7.9

70 24 14.0

80 23 13.0

90 13 7.3

100 54 30.1

Total 177 100.0

Instructors were queried as to their total years of teaching experience. Of the

instructors that answered total years of teaching, two (1.1%) answered less than

one year, 18 (10.1%) answered one to five years, 34 (19.1%) answered six to 10

years, 27 (15.2%) answered 10 to15 years, 29 (16.3%) answered 15 to 20 years,

and 68 (38.2%) answered greater than 20 years (see Table 5).

69

Table 5

Differences in Total Years of Teaching Experience

Years f Valid Percent

<1 2 1.1

1-5 28 10.1

6-10 34 19.1

10-15 27 15.2

15-20 29 16.3

>20 68 38.2

Total 178 100.0

Of the instructors that answered total years of teaching in anatomy and

physiology specifically, three (1.7%) answered less than one year, 34 (19.1%)

answered one to five years, 30 (16.9%) answered six to 10 years, 22 (12.4%)

answered 10 to15 years, 28 (15.8%) answered 15 to 20 years, and 61 (34.3%)

answered greater than 20 years (see Table 6).

70

Table 6

Differences in Total Years of Teaching Experience in Anatomy and Physiology

Years f Valid Percent

<1 3 1.7

1-5 34 19.1

6-10 30 16.9

10-15 22 12.4

15-20 28 16.7

>20 61 34.3

Total 178 100.0

Findings

Responses to each research question are presented separately. Coupled

reliability is calculated via Cronbach’s Alpha (0.76). As these reliability data

suggested that items could be combined to form scales, an analysis between

groups was done. The means were compared using one-way analyses of

variance (ANOVA). Results are presented in the narrative and table form for the

significant findings. More results can be found in table format in Appendix D.

How instructor integrated multimodal elements into anatomy and

physiology courses. This area was broken down into three sub-categories:

how much time instructors spent in each modality, how instructors integrated

71

each modality into the educational experience, and how multimodal elements

were submitted for grading. The first sub-category queried instructors about how

much time was spent with each multimodal element. Instructors were asked to

estimate what part of their overall student interaction time was spent in each

mode. Instructors could select 0-20% (1), 21-40% (2), 41-60% (3), 61-80% (4),

or 81-100% (5) for each mode (See Table 7). Lecture had the highest frequency

at 61- 80% (n = 178, M = 3.40, SD = 1.11). In-class lab had the second highest

frequency at 41–60% (n = 164, M = 2.12, SD = 1.12). The remaining 12 modes

were used only 21–40% of the time.

72

Table 7

Differences in Time Spent In Each Mode

Mode n M SD

Lecture 178 3.40 1.11

In-Class Labs 164 2.12 1.12

Video/Animations 161 1.76 0.97

Discussion Questions 158 1.69 0.88

Email 146 1.55 1.03

Case Studies 163 1.52 0.76

Cadaver Experiences 146 1.40 1.00

Computer Simulations 148 1.34 0.68

Student Presentations 144 1.32 0.69

In-Class Polling 146 1.30 0.59

Web-Based Lab Experiences 146 1.20 0.57

In-class Texting 137 1.04 0.31

Social Media Experiences 138 1.04 0.22

Public Blogging 138 1.04 0.28

The second subcategory queried instructors about how they integrated

multimodal elements into the educational experience. Instructors were asked to

identify if each mode was not used, completed in-class as an individual

73

experience, completed in-class as a group experience, completed out of class as

an individual experience, or completed out of class as a group experience (See

Table 8). The most common out-of-class individual modality selected was email

(40.23%, f=35). However 35.63% (f=31) of the instructors responded not used.

The most common out-of-class group modality selected was also email (14.94%,

f=13). The most common in-class group modality selected was lecture (75.26%,

f=73), which was also the second highest in-class individual modality (18.56%,

f=18). The most common in-class individual modality selected was class polling

mechanisms (25.58%, f= 22). Modalities that were identified as not used greater

than seventy-five percent of the time included: social media (88.24%, f=75),

public blog (96.43%, f=81), and in-class texting (95.40%, f=83).

74

Table 8

Differences in Integration of Multimodal Elements into the Class Experience

Mode Not Used In-Class Individual

In-Class Group

Out-of- class Individual

Out-of- class Group

N

Lecture 2.06%

f=2 18.56%

f=18 75.26%

f=73 4.12%

f=4 0.00%

f=0

97

Video/ animations

14.74% f=14

10.53% f=10

45.26% f=43

28.42% f=27

1.05% f=1

95

Discussion question

19.15% f=18

5.32% f=5

63.83% f=60

8.51% f=8

3.19% f=3

94

In-Class lab experiences

21.28% f=20

9.57% f=9

69.15% f=65

0.00% f=0

0.00% f=0

94

Case Study

30.53% f=29

2.11% f=2

50.53% f=48

13.68% f=13

3.16% f=3

95

Email

35.63% f=31

9.20% f=8

0.00% f=0

40.23% f=35

14.94% f=13

87

Simulation (computer or mannequin)

50.55% f=46

3.30% f=3

26.37% f=24

17.58% f=16

2.20% f=2

91

Web-based Lab experiences

57.95% f=51

1.14% f=1

12.50% f=11

27.27% f=24

1.14% f=1

88

Class Polling Mechanisms

59.30% f=51

25.58% f=22

10.47% f=9

4.65% f=4

0.00% f=0

86

Student Presentations

62.79% f=54

3.49% f=3

32.56% f=28

1.16% f=1

0.00% f=0

86

Cadaver

73.03% f=65

3.37% f=3

22.47% f=20

1.12% f=1

0.00% f=0

89

Social Media

88.24% f=75

0.00% f=0

2.35% f=2

8.24% f=7

1.18% f=1

85

75

Mode Not Used In-Class Individual

In-Class Group

Out-of- class Individual

Out-of- class Group

N

Public Blog

96.43% f=81

0.00% f=0

0.00% f=0

2.38% f=2

1.19% f=1

84

In Class Texting

95.40% f=83

2.30% f=2

1.15% f=1

1.15% f=1

0.00% f=0

87

The third sub-category queried instructors about how instructors had

students submit their multimedia experiences. Instructors were asked to identify

if each mode was not used, presented to the entire class, presented to a sub-

group of the class, or turned into the instructor only without any other action (See

Table 9). The highest mode presented in-class was the discussion question

(55.32%, f=52), with case studies second (31.25%, f=30). Modes not used a

majority of the time included social media interaction (89.66%, f=78) and public

blog (96.55%, f=84).

76

Table 9

Differences in How Students Were Instructed to Submit Multimodal Elements

Mode Not

Used Presented

in class Presented to a group

Turned into the

instructor N

Discussion question 21.28% f=20

55.32% f=52

12.77% f=12

10.64% f=10

94

Case Study 32.29% f=31

31.25% f=30

10.42% f=10

26.04% f=25

96

Web-based Lab experiences

59.09% f=52

6.82% f=6

6.82% f=6

27.27% f=24

88

Social Media Interaction 89.66% f=78

3.45% f=3

3.45% f=3

3.45% f=3

87

Public Blog 96.55% f=84

3.45% f=3

0.00% f=0

0.00% f=0

87

Instructors’ perceptions of the causes preventing them from

optimally engaging in multimodal teaching methodologies. This area was

broken down into three sub-categories: the quality and quantity of training,

limitations in the teaching facility, and support provided by the institution’s

administration. The first sub-category queried instructors whether the quality and

quantity of training was sufficient. Instructors could respond that they strongly

disagreed, agreed, were neutral, agreed, or strongly agreed (See Table 10). The

instructors’ results indicated that they were generally neutral as to whether the

amount of training was sufficient (n = 175, M = 2.85, SD = 1.03). Responses by

77

percentage were: strongly agree (6.25%), disagree (34.38%), neutral (23.96%),

agree (30.21%), and strongly agree (5.21%). The instructors’ results indicated

that they were generally neutral as to whether the quality of the training was

sufficient (n = 176, M = 2.97, SD = 0.99). Responses by percentage were

strongly agree (5.21%), disagree (31.25%), neutral (29.17%), agree (31.25%),

and strongly agree (3.13%).

Table 10

Instructor Perceptions of Training Quality and Quantity

Training N M SD

Training Quality 176 2.97 0.99

Training Quantity 175 2.85 1.03

The second sub-category queried instructors to estimate the amount of

time that selected technologies were available to them in the classroom.

Selected technologies included: instructor internet access, computer access,

multimedia projector availability, student wireless internet access, audiovisual

access. Instructors could select 0% (1), 25% (2), 50% (3), 75% (4), and 100%

(5) (See Table 11). If the answer was “never” instructors were instructed to

answer 0% and if the answer was “always” instructors were instructed to answer

78

100%. Instructors reported that all technologies were available in the classroom

most of the time with all means above 4.76 (75–100%).

Table 11

Time that Technologies Were Available In the Classroom

Technologies N M SD

Instructor Internet Access 176 4.86 0.61

Computer Access 177 4.84 0.63

Multimedia Projector Availability 176 4.80 0.68

Student Wireless Internet Access 176 4.78 0.70

Audiovisual Access 175 4.76 0.69

The third sub-category queried instructors to identify their perception of

how their institution’s administration supported them in integrating multimodal

methodologies into their curriculum. Instructors could select strongly disagree

(1), disagree (2), neutral (3), agree (4), or strongly agree (5) (See Table 12).

Instructors reported that they generally strongly agreed that their administration

understood the benefits of multimodal methodologies (n = 175, M = 4.84, SD =

0.94) and supported new technologies (n = 177, M = 4.25, SD = 0.80).

79

Table 12

Instructor’s Perception of the Administration Support

Administration n M SD

Benefits of Multimodal Methodologies 175 4.84 0.94

Supports New Technology 177 4.25 0.80

Budget Limitations 177 4.02 0.84

Facility Limitations 177 3.44 1.12

Supports Faculty 173 2.99 1.19

Variations in the integration of multimodal methodologies based on

instructor’s characteristics. The integration of multimodal methodologies was

based on specific instructor characteristics. The characteristics analyzed were

percent of teaching assignment in anatomy and physiology, years of teaching,

years of teaching anatomy and physiology, instructor’s highest degree, teaching

status, and instructor’s rank. The first instructor characteristic analyzed was the

difference in the instructor’s percent of teaching assignment specifically in

anatomy and physiology and the multimodal elements. Instructors were given

the choices of 0% (1), 10% (2), 20% (3), 30% (4), 40% (5), 50% (6), 60% (7),

70% (8), 80% (9), 90% (10), and 100% (11). Instructors percentages were

assembled into quartiles for the one way ANOVA; 0–40% (1), 50–70% (2), 80-

90% (3), and greater than 90% (4). There was no significant difference in the

80

modes that instructors used based on the percentage of their teaching

assignments in anatomy and physiology. The ANOVA did find a significance

difference in the use of in-class texting but the post hoc analysis did not support

it. The individual results are located in the Appendix D.

The second instructor characteristic analyzed was the differences in the

total years the instructor had been teaching and the multimodal elements.

Instructors were given the choices of less than one year (1), one to five years (2),

six to 10 years (3), 11 to 15 years (4), 16 to 20 years (5), and greater than 20

years (6). Instructor’s responses were assembled into quartiles for the one way

ANOVA. Groups were established as follows: one through 9 years (Group 1), 10

through 20 years (Group 2), and greater than 20 (Group 3). There was no

significant difference in the modes that instructors used based on the number of

years instructors had been teaching. The individual results are located in the

Appendix D.

The third instructor characteristic analyzed the differences between the

total years the instructor had been teaching anatomy and physiology and the

multimodal elements. Instructors were given the choices of less than one year

(1), one to five years (2), six to 10 years (3), 11 to 15 years (4), 16 to 20 years

(5), and greater than 20 years (6). Instructor’s responses were assembled into

quartiles for the one way ANOVA. Groups were established as follows: one

through 10 years (Group 1) (n = 66), 11 through 20 years (Group 2) (n = 50), and

greater than 20 (Group 3) (n = 61). There were two significant differences based

on the total years of teaching anatomy and physiology. The first significant

81

difference (df = (2, 155), F= 3.246, p = 0.042) based on years of teaching

anatomy and physiology was that instructors with 21 years or longer teaching

anatomy and physiology were less likely to use video or animations (M = 1.48) in

their classroom when compared to instructors who taught one to 10 years (M = 1.

93) and instructors who taught 11 to 20 years (M = 1.79). The second significant

difference (df = (2, 140), F = 4.784, p = 0.010) based on years of teaching

anatomy and physiology was that instructors with 11 to 20 years of teaching

anatomy and physiology were more likely to include the cadaver experience in

their classroom (M = 1.79) when compared to instructors who had taught one to

10 years (M = 1.19) and instructors who taught greater 21 years or greater (M =

1.30). The individual results are located in the Appendix D.

Table 13

Significant Differences in Total Years Teaching In Anatomy and Physiology

Mode Quartile N M SD

Cadaver Experience

1.00 54 1.192,3 0.68

2.00 42 1.791 1.37

3.00 47 1.301 0.86

Video animation

1.00 61 1.933 1.06

2.00 47 1.793 1.04

3.00 50 1.481,2 0.65

Note. 1one to 10 years; 211 to 20 years; 321 years or greater.

82

Table 14 Analysis of Significant Differences in Total Years Teaching In Anatomy and Physiology

Mode df F p

Cadaver

Experience

Between Groups 2 4.784 .010

Within Groups 140

Video

Animation

Between Groups 2 3.246 .042

Within Groups 155

Note: significant at p<0.5

The fourth instructor characteristic analyzed was based on instructors’

highest degree earned and the multimodal elements. Instructors were given the

choice of: associates degree (1), bachelor’s degree (2), master’s degree (3), and

doctoral degree (4). No instructor chose associates degree as an option in the

study so it was removed from the analysis. There were two significant

differences based on the instructor’s highest degree earned. The first significant

difference (df = (2, 155), F = 3.395, p = 0.036) based on the instructor’s highest

earned degree and multimodal elements was that instructors with doctoral

degrees (M = 1.65) were less likely to use video or animations in their

classrooms when compared to instructors with bachelor’s (M = 2.50) or master’s

(M = 2.10) degrees. The second significant difference (df = (2, 170), F = 3.522, p

= 0.032) based on the instructor’s highest earned degree and multimodal

83

elements was that instructors with bachelor’s degrees (M = 1.50) were less likely

to use lecture in their classrooms when compared to instructors with master’s (M

= 3.25) or doctorate (M = 3.45) degrees. The individual results in tables 19 and

20 are located in the Appendix D.

Table 15

Significant Differences in Highest Degree Earned

Mode Degree N M SD

Video animation

Bachelors 2 2.50d 2.12 Masters 30 2.10d 1.06 Doctorate 126 1.65b,m 0.90

Lecture Bachelors 2 1.50m,d 0.71 Masters 32 3.25b 1.08 Doctorate 139 3.45b 1.09

Note. bBachelors; mMasters; dDoctorate.

84

Table 16 Analysis of Significant Differences in Highest Degree Earned

Mode df F Sig. = p

Video

Animation

Between Groups 2 3.395 .036

Within Groups 155

Lecture Between Groups 2 3.522 .032

Within Groups 170

Note: significant at p<0.5

The fifth instructor characteristic analyzed was the relationship between

the teaching status and the multimodal elements. Instructors were given the

choice of full-time tenured (1), part-time tenured (2), full-time contract (3), part-

time contract (4), and adjunct (5). There were no responses to the part-time

tenured choice so it was eliminated from the analysis. The only significant

difference (df = (3, 132), F = 2.913, p = 0.037) based on the instructor’s teaching

status and multimodal elements was that instructors who are full-time contract (M

= 1.87) or full-time tenured (M = 1.40) were more likely to use email when

compared to instructors who are part-time contract (M = 1.25) or adjunct (1.00).

The individual results are located in the Appendix D.

85

Table 17

Significant Differences in Teaching Status

Mode Status N M SD

Email

Full Tim Tenured 80 1.403,4 0.82 Full-time Contract 47 1.873,4 1.28 Part-time Contract 4 1.251,2 0.50 Adjunct 5 1.001,2 0.00

Note. 1Full-time Tenured; 2Full-time Contract; 3Part-time Contract; 4Adjunct. Table 18 Analysis of Significant Differences in Teaching Status

Mode df F Sig. = p

Email Between Groups 3 2.913 0.037

Within Groups 132

Note: significant at p<0.5

The sixth instructor characteristic analyzed was the relationship between

the instructor’s rank and the multimodal elements. Instructors were given the

choice of instructor (1), assistant professor (2), associate professor (3), and

professor (4). There was no significant difference in the modes that instructors

86

used based on the instructor’s rank and the multimodal elements. The individual

results are located in the Appendix D.

Summary

Chapter 4 presented the findings of the study. All instructor variables

were analyzed against their relationship with each multimodal element. Chapter

5 presents a summary of the study as well as the conclusion and

recommendations.

87

CHAPTER 5

Summary, Conclusions, Discussion, and Recommendations

Chapter 5 includes a summary of the study, conclusions, discussion, and

recommendations based on the study. The first section is a summary that

includes the purpose of the study, research questions, brief review of literature,

methodology, and the significant findings. Conclusions, discussion, and

implications for practice as well as future research comprise the remainder of this

chapter.

Summary

Purpose of the study. The purpose of this study was to identify the

extent that multimodal teaching methodologies were used by instructors in

anatomy and physiology courses. The study identified how multimodal teaching

elements were used by instructors in anatomy and physiology classes, how

much actual time was spent in each modality, and how the multimodal elements

were submitted by students. The study identified instructors’ perceptions of the

barriers preventing them from optimally engaging multimodal teaching

methodologies as they related to training, facility infrastructure, and

administration. The study analyzed the variation in the integration of multimodal

methodologies based on the instructor’s personal characteristics.

Research questions. This study was guided by the following research

questions:

1. How do instructors integrate multimodal elements into anatomy and

physiology courses?

88

a. How much actual course time is spent in each modality?

b. How is each multimodal element integrated into the educational

experience?

c. How are multimodal elements submitted?

2. What are instructors’ perceptions of the barriers preventing them from

optimally engaging multimodal teaching methodologies as they relate

to:

a. Training

b. Facility/Infrastructure

c. Administration

d. Administration

3. What is the variation in the integration of multimodal methodologies

based on instructors’ personal characteristics?

Review of literature. Multimodality is the theory of communication as it

applies to social and educational semiotics (making meaning through the use of

multiple signs and symbols). The term multimodality describes a communication

methodology that includes multiple textual, aural, and visual applications (modes)

that are woven together to create what is referred to as an artifact. The

multimodal artifact is a collection of modes that prescribe how the audience will

interpret the information or concept. Multimodal teaching methodology attempts

to create a deeper meaning to course content by activating the higher cognitive

areas of the student’s brain, creating a more sustained retention of the

information (Murray, 2009).

89

Fink (2003) established that learning must include dynamic interactions

between students and instructors, between the students themselves, and

between students and the knowledge. The information must create a bridge

between the student’s past experiences, emotions, and beliefs, and their future

where they will need to apply the knowledge. Pratt and Malabar (1998) identified

seven major principles that support that learning must be built on past knowledge

or emotion to ensure retention. They also suggested that the linkage between

the student’s past and present knowledge is in itself as important as the

information. Bransford, Brown, and Cocking (2000) identified three doctrines that

facilitate student learning with consideration to linking their past with their future.

Instructors must understand that each student has a unique mix of past

experiences and expectations for the application of future knowledge. To

successfully achieve deep understanding, students must be given more than

objective data. They must be given the relevancy of the information and how it

will be useful at a later time. Finally, students must be able to develop their own

metacognitive strategies so that the knowledge can be used in future significant

scenarios.

Scholars agree that the multimodal classroom experience results in

higher student comprehension over older, less technologically advanced

methods. Neurological studies have consistently shown activity in higher

cognitive brain areas with multimodal approaches that is not present in

monologue lecture-based approaches (Lanham, 2004). Neurologists have

traced specific connections being activated between multiple areas of the brain’s

90

higher cognitive areas with multimodal approaches (Murray, 2009).

Comparisons of student outcomes between traditional modalities and new

technological multimodalities have been explored but the actual distribution and

penetration of multimodal concepts into course curricula is not present in

available literature, specifically in basic science courses supporting clinical career

tracts (Shipka, 2005).

Advances in technology have primarily driven the rapid growth rate of

online classroom delivery, and created a secondary student expectation for

similar experiences in the face-to-face and hybrid environments. The integration

of multimodal delivery is less and less limited by the available technology and

more and more by the willingness of the instructor to utilize it (Ball & Moeller,

2010). The result is that expansion of multimodal penetration into the traditional

classroom has not met student expectations (Bolter & Grusin, 2000).

Students have come to expect that classroom curricula and the actual

delivery of knowledge will integrate the level and types of technologies that they

experience in their normal daily out of classroom lives. Students want to

incorporate smart phones, social media, and web-based experiences into the

learning process (Wang, Chun-Fu, & Wei-Cheih, 2012). Students have come to

expect the course content be more suited to their needs and delivered in a

manner that best engages their learning styles. Students perceive that learning

is disjointed, fragmented, and without continuity between one course and other.

This creates an environment where students perceive themselves as isolated,

depressed, and without attachment to the learning process (Gouge, 2009).

91

Creation and application of multimodal educational experiences creates a

multifaceted learning approach that engages the higher cognitive areas of the

brain and is applicable to almost all learning styles, resulting in greater retention

of the information. Unique student characteristics do not limit knowledge transfer

(Kress, Jewitt, Ogborn, & Charalampos, 2006). Engaging students at their higher

as well as their lower cognitive brain function is essential in creating optimal

learning and retention that is portable to other life and professional scenarios

(Bland, Saunders, Kreps-Frish, 2007).

The factors that limit the integration of multimodal delivery categorically fall

into three main areas. The first deals with faculty development. Academia has

not customarily moved as quickly as technology when it comes to its application

in the classroom. Recent research on multimodal methodologies has only begun

to create an alternative paradigm with instructors who teach higher learning

courses (Picciano, 2011). Traditionally instructors as a whole have been less

than willing to become early adaptors when new methodologies are available,

especially when the new elements are strikingly dissimilar to the approaches that

have been practiced in the past (Davis & Shadle, 2007). This is problematic in

clinical career tracts where instructors who teach subsequent courses and are

expecting students to be well versed in the basic sciences have complained

repeatedly that students are not able to apply the knowledge learned in their

basic courses in subsequent clinically focused scenarios (Murray, 2009).

Tangentially instructors’ training in the new multimodal, technological demanding

92

methodologies has generally been perceived as poor quality, poor quantity, or

non-existent in the majority of cases (Anderson, 2006).

The second area affecting the speed of integration of multimodal

methodologies into course curricula is that of infrastructure limitations in the

teaching facility so they can utilize the new technology. Often upgrades have

large dollar costs that must compete with other demands within the institution as

well as multi-year maintenance contracts that require expensive upkeep of

software and hardware (Devoss, Cushman, & Grabill, 2005). Universities have

traditionally been reluctant to incur the additional costs of creating online access

and full multimodal capability in-classrooms. Incorporating internet access, high-

level video and telephone conferencing, and graphic applications is extremely

expensive (Lanham, 2004).

The third and final area, inhibiting expansion of multimodal applications

from being incorporated into course curricula, is the difference between what the

instructors perceive is necessary and what the administration perceives is

reasonable. The upfront costs of upgrading facilities so that new technologies

can be utilized is significant and often does not compete well with other

budgetary demands because administration may not comprehend how the

improvements can result in improved student outcomes (Bolter & Grusin, 2000).

It is also difficult to apply a true dollar value to long-term, far-reaching student

achievements in higher cognitive retention and improved critical thinking skills

(Lahham, 2004).

93

Methodology. A descriptive survey research design was used for the

study. After IRB approval was obtained, an electronic survey mechanism was

created that allowed the researcher to distribute a survey link to potential

participants. A copy of survey was sent out to members of the University of

South Dakota (USD) Basic Biomedical Sciences Division who taught anatomy

and physiology for critique. Once suggestions/criticisms were received from the

critique, a revamped survey was sent out to faculty members of the Sanford

School of Medicine and instructors in the USD Basic Biomedical Sciences

Department utilizing an electronic link. The survey was again revamped in

response to suggestions from the participants. The link was then sent to

members of three societies/associations made up of faculty members who taught

anatomy and physiology through each organization’s list serve. Though there

were members in the sample population who taught only at the high school level,

only members who taught in two or four year colleges were included the study.

The instrument (Appendix A) used for the study was created by the

researcher based on evidence found in the literature. Survey elements were

mapped to a matrix that provided content validity by connecting the survey

questions to the corresponding literature and research (See Appendix B). The

survey tool included multiple choice, single answer, 0-100% selections, Likert

scaled questions, and demographic information. The tool was divided into five

sections: (A) Multimodal Elements Utilized by Anatomy and Physiology

Instructors, (B) Institutional Demographics, (C) Infrastructure, (D) Administrative

Support, and (E) Faculty Information.

94

Descriptive statistics were used on the quantitative data. The penetration

and dispersion of multimodality teaching elements used in anatomy and

physiology courses were analyzed by calculating frequencies, percentages,

means, and standard deviations. Analysis of variables that potentially facilitated

or inhibited the distribution of those multimodal elements was performed by

calculating frequencies, percentages, means, standard deviations, and ANOVAs.

Findings. The following are the significant findings compiled from the survey

distributed via Survey Monkey (Appendix A) to three groups: Human Anatomy

and Physiology Society (HAPS), iTeach Anatomy & Physiology Collaborate, and

The American Physiology Society (APS).

1. Instructors were asked to estimate what part of their overall student

interaction time was spent in each mode. Lecture had the highest

frequency at 61-80% (n = 178, M = 3.40, SD = 1.11). In-class lab had the

second highest frequency at 41–60% (n = 164, M = 2.12, SD = 1.12). The

remaining 12 modes were used only 21–40% of the time.

2. Instructors were asked to identify if each mode was not used, completed

in-class as an individual experience, completed in-class as a group

experience, completed out of class as an individual experience, or

completed out of class as a group experience. The most common out-of-

class individual modality selected was email (40.23%, f=35). However

35.63% (f=31) of the instructors responded not used. The most common

out-of-class group modality selected was also email (14.94%, f=13). The

most common in-class group modality selected was lecture (75.26%,

95

f=73), which was also the second highest in-class individual modality

(18.56%, f=18). The most common in-class individual modality selected

was class polling mechanisms (25.58%, f= 22). Modalities that were

identified as not used greater than 75% of the time included social media

(88.24%, f=75), public blog (96.43%, f=81), and in-class texting (95.40%,

f=83).

3. Instructors were asked how they had students submit their multimedia

experiences. The highest mode presented in-class was the discussion

question (55.32%, f=52), with case studies second (31.25%, f=30).

Modes not used a majority of the time included social media interaction

(89.66%, f=78) and public blog (96.55%, f=84).

4. The instructors were generally neutral as to whether the amount of training

was sufficient (n = 175, M = 2.85, SD = 1.03). The results by percentage

were: strongly agree (6.25%), disagree (34.38%), neutral (23.96%), agree

(30.21%), and strongly agree (5.21%).

5. The instructors were generally neutral as to the whether the quality of the

training (n = 176, M = 2.97, SD = 0.99) was sufficient. The results by

percentage were strongly agree (5.21%), disagree (31.25%), neutral

(29.17%), agree (31.25%), and strongly agree (3.13%).

6. Instructors reported that all technologies were available in the classroom

most of the time with all (75 – 100%) (M = 4.76).

7. Instructors reported that they generally strongly agreed that their

administration understood the benefits of multimodal methodologies (n =

96

175, M = 4.84, SD = 0.94) and supported new technologies (n = 177, M =

4.25, SD = 0.80).

8. There was no significant difference in the modes that instructors used

based on the percentage of their teaching assignments in anatomy and

physiology.

9. There were two significant differences based on the total years of teaching

anatomy and physiology. The first significant difference (df = (2, 155), F =

3.246, p = 0.042) based on years of teaching anatomy and physiology was

that instructors with 21 years or greater teaching anatomy and physiology

were less likely to use video or animations (M = 1.48) in their classroom

when compared to instructors who taught anatomy and physiology one to

10 years (M = 1. 93) and instructors who taught anatomy and physiology

11 to 20 years (M = 1.79). The second significant difference (df = (2,

140), F = 4.784, p = 0.010) based on years of teaching anatomy and

physiology was that instructors with 11 to 20 years of teaching anatomy

and physiology were more likely to include the cadaver experience in their

classroom (M = 1.79) when compared to instructors who had taught

anatomy and physiology one to 10 years (M = 1.19) and instructors who

had taught anatomy and physiology 21 years or greater (M = 1.30).

10. There were two significant differences based on the instructor’s highest

degree earned. The first significant difference (df = (2, 155), F = 3.395, p

= 0.036) based on the instructor’s highest earned degree and multimodal

elements was that instructors with doctoral degrees (M = 1.65) were less

97

likely to use video or animations in their classrooms when compared to

instructors with bachelor’s (M = 2.50) or master’s (M = 2.10) degrees. The

second significant difference (df = (2, 170), F = 3.522, p = 0.032) based on

the instructor’s highest earned degree and multimodal elements was that

instructors with bachelor’s degrees (M = 1.50) were less likely to use

lecture in their classrooms when compared to instructors with master’s (M

= 3.25) or doctorate (M = 3.45) degrees.

11. The only significant difference (df = (3, 132), F = 2.913, p = 0.037) based

on the instructor’s teaching status and multimodal elements was that

instructors who are full-time contract (M = 1.87) or full-time tenured (M =

1.40) were more likely to use email when compared to instructors who

were part-time contract (M = 1.25) or adjunct (1.00).

12. There was no significant difference in the modes that instructors used

based on the instructor’s rank and the multimodal elements.

Conclusions

The following conclusions were made based on the study and statistical

analysis of these data gathered via Survey Monkey.

1. Instructors continue to use lecture as their primary means of interaction

with students and do not take advantage of multimodal methodologies. .

2. Public blogs, social media, and in-class texting are not generally a part of

the classroom experience.

3. Email is still the major modality of out of class communication.

98

4. Most instructors are neutral regarding the quality and quantity of the

multimodal training they received.

5. Instructors generally feel that they are receiving support from their

administration and that the administration understands the benefits of

integrating multimodal experiences into the classroom.

6. Instructors with 21 years or greater teaching anatomy and physiology are

less likely to use video or animation in their classroom than instructors

with fewer years.

7. Instructors with 11 to 20 years of teaching anatomy and physiology are

more likely to include cadaver experiences in their classroom than other

instructors.

8. Instructors with doctoral degrees are less likely to include video and

animations in their classroom experience than those with bachelor’s or

master’s degrees.

Discussion

The first research question in this study focused on the how much time

instructors integrated each mode into their classrooms and in what manner they

utilized. Scholars agree that integration of multimodal educational methodologies

results in higher student comprehension. The multimodal methodology

consistently shows activation of higher cognitive brain areas that are not present

with monologue lecture-based approaches (Lanham, 2004). Though multimodal

teaching methodologies have been documented in the literature and proven to

show significant improvements, instructors have not generally incorporated them

99

into their classrooms (Ball & Moeller, 2010). Instructors continue to rely on

lecture as their primary mode within the classroom. New technologies that

created educational opportunities with public blogs, social media, and the use of

cell phones with in-class texting have generally not been integrated into most

classrooms. Instructors with bachelor’s degrees are more likely to minimize the

use of lecture and maximize the use of the other modalities. However, those with

masters and doctoral degrees still rely heavily on lecture as a means of

presenting content to students.

This dissimilarity presents itself again with the use of video or animation.

As the content complexity increases, the impact of animation also increases

(Mayer & Moreno, 2003, p. 233). Many texts now come with instructor resources

that include animations and short videos (Alvermann & Wilson, 2011).

Instructors with greater than 20 years of teaching anatomy and physiology are

less likely to integrate video or animation into their course content when

compared to instructors with 20 years or less. This indicates again that the more

senior instructors are less likely to integrate modes that require new technology

into their classroom experiences.

Instructors also showed variation in their use of email. Some use it as

their primary out of class communication (43%) while a second subset does not

use it at all (35.6%). Upon further examination, the subset that tends to use the

email is made up of full-time instructors (full-time tenured and full-time contract)

while the part-time or adjunct instructors make up the majority of the group that

do not use email at all to communicate with their students. This suggests that

100

full-time instructors generally communicate more with their students out of the

classroom than part-time or adjunct instructors. George (2002) suggested that

the central thread of all education is based on the adequacy of the

communication and that communication in higher learning courses must extend

outside of the confines of the classroom.

The second research question in this study focused on the barriers that

instructors perceive they have that prevent them from integrating multimodal

methodologies into their classrooms. Instructors generally perceive that their

administration understands the benefits of integrating multimodal methodologies

into the classroom and supports new technology as a teaching tool in the

curriculum when appropriate but are often limited by budget and facility

restrictions. Administration must be knowledgeable about the advantages of

multimodal education over the linear classroom model (Bolter & Grusin, 2000).

Instructors must receive high quality and sufficient quantity of training to

ensure that they can successfully integrate multimodal methodologies into their

classrooms (Anderson, 2006). Most instructors were neutral as to whether they

perceive the quality and quantity of their multimodality training. This suggests

that instructors may not strongly feel that they are actually being supported

overall.

Instructors should alter their traditional teaching methodologies by

redefining their class through the integration of multimodal educational practices

(Davis & Shadle, 2007). The study indicates that there was no variation in the

instructor’s use of multimodal teaching in anatomy and physiology classes based

101

on the number of years the instructor had been teaching, the percentage of the

instructor’s teaching assignments in anatomy and physiology, or the instructors

rank.

The third and final research question in this study focused on the

variations in the integration of multimodal methodologies based on instructors’

personal characteristics. The study showed that based on instructors’ total years

of teaching in anatomy and physiology, even though the means for each

category was low, there was variation between how much instructors used video

and animation modes. Instructors with 21 years or greater teaching anatomy and

physiology (M = 1.48) were less likely to use video or animations in their

classroom when compared to instructors who had taught anatomy and

physiology one to 10 years (M = 1. 93) and instructors who had taught anatomy

and physiology 11 to 20 years (M = 1.79). This was further supported by the

variation between instructors based on their highest degree earned and the use

of video and animation. Instructors with doctoral degrees (M = 1.65) were less

likely to use video or animations in their classrooms when compared to

instructors with bachelor’s (M = 2.50) or master’s (M = 2.10) degrees. This would

suggest that as new instructors enter education, they tend to become assimilated

into the methodologies practiced by their senior mentors. Their senior mentors in

turn tend to practice as they were guided in their careers. This suggests that as

instructors are integrated into the system they are more likely to repeat past

methodologies and less likely to integrate new ones in order to be consistent with

their more senior peers.

102

Recommendations

The following recommendations for practice and further study transpired

from the findings and conclusions of the study.

Recommendations for practice.

1. Colleges and universities should review how they integrate new

instructors into their systems. New instructors should have the

opportunity to be mentored by individuals who are trained in

multimodal educational methodologies. Mentors should be selected

not only on their longevity but also on how they integrate multimodal

methodologies into their classroom.

2. Instructors should be encouraged to develop common modules that

can be exchanged so that new multimodal applications can be passed

along easily.

3. Instructor focus groups should be initiated to determine what resources

instructors perceive they require to better integrate multimodal

technologies into their classrooms.

4. A multimodality mentor or group of mentors should be assigned to all

instructors to help them develop and expand multimodality

methodologies in their classes. A formalized set of goals and

expectations should be established by leadership to be accomplished

so each instructor and mentor is clear on the expectations.

5. All textbooks should be evaluated based on the opportunity to apply

multimodality methodologies. Focus on optimally integrating all

103

appropriate multimodalities should be considered and evaluated for

each new textbook.

6. Adjunct and part-time instructors should be interviewed to determine

how they might better communicate with students. Contracts with

adjunct and part-time instructors should contain specific goals and

expectations for communication with students.

7. It is recommended that multimodal methodologies be integrated into all

department and division meetings, literature, and faculty evaluations.

Additionally, formal review should be established by department

leaders to ensure that the process is sustained.

8. All faculty preparatory programs should include coursework on how to

apply multimodal educational methodologies.

9. Ongoing faculty development should include multimodal teaching

methodologies.

Further research.

1. It is recommended that an evidence based practice study be

established to compare student outcomes in-classes that have

integrated multimodal methodologies and those that have not. The

study should not only include how students do in the initial class, but

also how they do in follow-on classes that require the original class for

baseline information.

2. It is recommended that other institutions and states follow through with

similar studies to better understand and ultimately expand the

104

integration of multimedia methodologies into higher learning

classrooms.

3. It is recommended that a qualitative research study be done to

discover more specifically what prevents instructors from integrating

multimodal methodologies into their classes.

4. It is recommended that a study be done focusing on how to better

integrate adjuncts and part-time instructors into faculty development.

Conclusion

The data show that multimodal educational methodologies improve

student retention of class content and that when implemented they not only

increase sustainment, but create retained knowledge that can be recalled into

future scenarios. There is an excellent opportunity for growth of anatomy and

physiology instructors in multimodal methodologies through a formalized process

where goals and expectations are established for instructors and integrated into

annual evaluations. A strong faculty development plan, instituted and sustained,

can move the paradigm from the present status quo to a multimodal approach

that better serves students.

105

REFERENCES

Aiery, J. & Linder, C. (2009). A disciplinary perspective on university science

learning: Archiving fluency in a critical constellation of modes. Journal of

Research in Science Teaching, 46(1), pp. 27-49

Allen, D., & Tanner, K. (2006). Rubrics: tools for making learning goals and

evaluation criteria explicit for both instructors and learners. CBE Life

Science Education 5, pp. 197-203

Allen, E. & Seaman, C. (2007). Likert Scales and Data Analysis. Quality

Progress, pp. 64-65

Alvermann, D., & Wilson, A. (2011). Comprehensive Strategy Instruction for

Multimodal Texts in Science. College of Education and Human Ecology,

50, pp. 226-124

Ambrose, S. (2010). How Learning Works: Seven Research-Based Principles,

San Franciso: Jossey-Bass, pp. 3-5

Anderson, Daniel (2006). Integrating Multimodality into Composition Curricula:

Survey Methodology and Results from A CCCC Research Grant.

Composition Studies, 34

Anstey, M. & Bull, G. (2006). Teaching and learning multiliteracies: Changing

times, changing literacies. Newark, DE: International Reading Association

Aslanian, C. (2001). Adult students today. New York: College Board

Ball, Cheryl (2004). Show Not Tell: The Value of New Media Scholarship.

Computers and Composition, pp. 402-425

106

Ball, C. & Moeller, R. (2008). Converging the Assumptions between U and ME:

or How new media can bridge a scholarly/creative split in English studies.

Computers and Composition Online, Web 12 Mar

Barrows, H. & Peters, M. (1984). How to Begin Reforming the Medical

Curriculum. 1st. Ed. Springfield, IL: Southern Illinois University School of

Medicine, p. 204

Baumgartner, L. & Merriam, S. (1999). Adult development and learning:

Multicultural stories. Malabar, Fl: Krieger

Beaudouin-Lafon, M. (2004). Design interaction, not interfaces, AVI’04. Gallipoli,

LE, Italy, May 25-28

Bezemer, J. & Kress, G. (2008). Writing in multimodal texts: A social semiotic

account of designs for learning. Written Communication, 25(2), pp. 166-

195

Bolter, J. & Grusin, R. (2000). Remediation: Understanding New Media.

Cambridge: MIT Press

Bransford, J., Brown, A., & Cocking, R. (2000). How people learn: Brain, mind,

experience, and school. Washington, DC: National Academy Press. p. 33

Bland, J., Saunders, G., and Kreps-Frish, J. (2007). In defense of the lecture.

Journal of College Science Teaching. 37(2), pp.10-13

Bligh, D. (2000). Taxonomy of educational objectives: The classification of

educational goals. Cognitive Domain, Vol. 1. New York: McKay

Bolter, J. & Grusin, R. (2000). Remediation: Understanding New Media.

Cambridge: MIT Press

107

Boote, D. N., & Beile, P. (2005). Scholars before researchers: On the

centrality of the dissertation literature review in research

preparation. Educational Researcher 34(6), pp. 3-15.

Bransford, J., Brown, A., & Cocking, R. (1999). How people learn: Brain,

mind, experience, and school. Washington, DC: National Academy Press

Bridwell-Bowles, L. (1991). Research in Composition: Issues and Methods. An

Introduction to Composition Studies. New York: Oxford University Press,

pp. 94-117

Breckler, J., Joun, D., & Ngo, H. (2009). Learning Styles of Physiology Students

Interested in the Health Profession. Academy of Physiologic Education,

33, pp. 30-36

Burgan, M. (2006). In defense of lecturing. Change, 38: pp. 30-35

Campbell, W. & Smith, K. (1997). New Paradigms for College Teaching. Edina,

MN: Interaction Book Company

Casotti, G., Beneski, J., & Knabb, M. (2013). Teaching Physiology Online:

Successful Use of Cases Studies in a Graduate Course. Advanced

Physiologic Education, 37: pp. 65-69

Chickering, A. & Gamson, Z. (1991). Applying the seven principles for good

practice in undergraduate education. Sand Franciso, CA: Jossey-Bass

Cicca, A., Step, M., & Turkstra, L. (2003). Show me what you mean: Nonverbal

communication theory and application. The ASHA Leader, 4-5, 34

108

Clark, M. & Dirkx J. (2000). Moving beyond a unitary self: A reflective dialogue. In

A. I. Wilson & E. R. Hays (Eds.), Handbook of adult and continuing

education, (pp. 101-116). San Francisco: Jossey-Bass

Clark, M. & Rossiter, M. (2008). Narrative Learning in Adulthood. New Directions

for Adult and Continuing Education, No. 119

Coiro, J., Knobel, M., Lankshear, C., & Leu, D. (2008). Handbook of research on

new literacies. New York: Erlbaum

Collins, J. (2008). Modern approaches to teaching and learning. BMJ, 337a, p.

1310

Courts P. & McInerney, K. (1993). Assessment in Higher Education: Politics,

Pedagogy, and Portfolios. Westport, Conn.: Praeger. pp. 33-38

Crowe, A., Dirks, C., & Wenderoth, M. (2008). Biology in Bloom: Implementing

Bloom’s taxonomy to enhance student learning in biology. CBE Life

Science Education 7, pp. 368-381

Davis, R. & Shadle, M. (2007). Teaching Multiwriting: Research and Composing

with Multiple Genres, Media, Disciplines and Cultures. Cargondale:

Southern Illinois UP

DeVoss, D., Cushman, E., & Grabill, J. (2005). Infrastructure and Composing.

The When of New-Media Writing, CCC 57, pp. 14-44

Dornan, T. & Bundy, C. (2004). Learning in practice: What can experience add to

early medical education? Consensus survey. BMJ, 329, pp. 834-837

109

Domingo, M. (2012). Linguistics Layering: Social Language Development in the

Content of Multimodal Design and Digital Technologies. Learning, Media

and Technology, volume 37, n2, pp. 177-197

Durosaro, O., Lachman, N., & Pawlina, W. (2008). Use of knowledge-sharing

web-based portal in gross and microscopic anatomy. Ann Acad Med,

Singapore 37, pp. 998-1001

Feldman, K. (1998). Effective college teaching from the students’ and faculty’s

view: Matched or mismatched priorities? In K. A. Feldman & M. B.

Paulson (Eds.) Teaching and learning in the college classroom, 2nd

edition. Neeham Heights, MA: Allyn & Bacon, pp. 215 - 240

Finn, G. & McLachlan, J. (2009). A qualitative study of student responses to body

painting. Anatomy Science Education, 3, pp. 33-38

Fink, L. (2003). Creating significant learning experiences: An integrated

approach to designing college courses. San Francisco: Jossey-Bass. pp.

3-10, 22-32, 55-57, 98-106

Florida, R., Kaimal,G., Oblinger, D., & Blessing, L. (2003). How Generations X

and Y (Millenials) Will Reshape Higher Education. Society for College and

University Planning Virtual Seminar, June 30

Fougnie, D. & Marois, R. (2006). Evidence From Attentive Tracking and Visual

Working Memory Paradigms. Psychological Science, 17(6), pp. 526-534

Frankfurt-Nachmias, C. & Nachmias, D. (1992). Research methods in the social

sciences. (4th Ed.). New York: St. Martins’ Press, pp. 186-198

110

Freire, Palo (1970). Pedagogy of the Oppressed. London: Continuum

International Publishing Company

Fulton, K. (2012). Upside Down and Inside Out: Flip Your Classroom to Improve

Student Learning. Learning & Leading with Technology, v39, n8, pp. 12-17

Gardner, H. (1983). Frames of Mind: The Theory of Multiple Intelligences. New

York: Basic Books. pp. 39-88

George, D. (2002). From Analysis to Design. Visual Communication in the

Teaching of Writing. CCC 54. Pp. 11-39

Gerstein, J. (2012). The Flipped Classroom: The Full Picture. Creative

Commons Attribution-NonCommercial (Kindle Books)

Giddens, A. (1974). Research Methods in Business Studies. (3rd ed). London,

England: Heinemann Education Books, Ltd., pp. 224-321

Goodin, L. (2012). Incorporating Technology Into the Instruction of Social

Studies. Dissertation, APR2013

Gouge, C. (2009). Hybrid Courses and the Future of Writing Programs. College

English 71, pp. 338-362

Gopal, T., Herron, S., & Mohn, R. (2010). Effect of an Interactive Web-Based

Instruction in the Performance of Undergraduate Anatomy and Physiology

Lab Students. Computers & Education, v55, n2, pp. 500-515

Graham, C. & Robinson, R. (2007). Realizing the Transformational Potential of

Blended Learning: Comparing Cases of Transforming Blends and

enhancing Blends in Higher Education. Blended Learning Research

Perspectives. Needham, MA: The Sloan Consortium

111

Grippin, P. & Peters S. (1984). Learning theory and learning outcomes. Lanham,

MD: University Press of America.

Groves, R., Fowler, F., Floyd, J., Coupter, M., Lepkowski, J., Singer, E. &

Tourangeau, R. (2004). Survey Methodology. Hoboken, NJ: John Wiley &

Sons. pp. 88-83

Heyling, D. (2002). Anatomy 199-2000: The curriculum, who teaches it, and

how? Medical Education, 36, pp. 702-710

Hill, C. (2004). Reading the Visual in College Writing Courses. Visual Rhetoric in

a Digital World. New York: Bedford/St. Martin’s. pp. 107-130

Hill, R. (2004). Activism as practice: Some queer considerations. In R. St. Clair &

J. A. Sandlin (Eds.), Promoting critical practice in adult education (pp. 85-

94). New Directions for Adult and Continuing Education, No. 102. San

Francisco: Jossey-Bass

Hoyt, D. & Perera, S. (2000). Teaching approach, instructional objectives, and

learning. IDEA Research Report No. 1. Manhattan, KS: IDEA Center

Jewitt, C., & Kress, G. (2003). Multimodal Literacy. New York: Peter Lang

Kangas, B. (2012). Not Waving but Drowning: A Review of Tufte’s “The Cognitive

Style of Powerpoint©”. International Journal of Teaching and Learning in

Higher Education, v24, n3, pp. 421-423

Karabulut, U. (2012). How to Tech Critical-thinking in social studies education:

An Examination of Three NCSS Journals. Eurasian Journal of Educational

Research, Issue 49, Fall 2012, pp. 197-212

112

Kegan, R. (1994). In Over Our Heads: The Mental Demands of Modern Life.

Cambridge, Mass.: Harvard University Press

Keegan, R. (2000). What form Transforms? A Constructive-Development

Approach to Transformation Learning. IN J. Mezirow and Associates

(eds.), Learning as Transformation. San Franciso: Jossey-Bass

Keen S. & Valley-Fox, A. (1989). Your mythic journey: Finding meaning in your

life through writing and storytelling. New York: Tarcher/Putnam

Kitchakam, O. (2012). Using Blogs to Improve Student’s Summary Writing

Abilities. Turkish Online Journal of Distance Education, v13, n4, pp. 209-

219

Knight, J. K., and Wood, W. B. (2005). Teaching more by lecturing less. Cell

Biology Education, 4, pp. 298–310

Krathwohl, D., Bloom, B., & Masia, B. (1999). Taxonomy of educational

objectives: Book 2: Affective Domain. Reading, MA: Addison-Wesley

Kress, G. (2004). Reading Images: Multimodality, Representation and new Media

at IIID Conference, Expert for Knowledge Presentation. Preparing for the

Future of Knowledge Representation.

http://www.knowledgepesentation.Org/BuildingTheFuture/Kress2.html

Kress, G. & Leuween (2001). Multimodal Discourse: The modes and media of

contemporary communication. London: Oxford University Press

Kress, G., Jewitt, C., Ogborn, J., & Tsataarelis, C. (2001). Multimodal teaching

and learning. The rhetorics of the science classroom. London: Continuum

113

Kress, G., Jewitt, C., Ogborn, J., & Charalampos, T. (2006). Multimodal teaching

and learning: The rhetorics of the science classroom. London: Continuum

LaFrance, J. & Calhoun, D. (2012). Student Perceptions of Wikipedia as a

Learning Tool for Education Leaders. International Journal of Educational

Leadership Preparation, v7, n2

Lanham, R. (2004). Implications of Electronic Information for the Sociology of

Knowledge. Visual Rhetoric in a Digital World. New York: Bradford/St.

Martin’s, pp. 455-473

Lefrancois, G. (1999). The Lifespan (6th ed.). Belmont, CA: Wadsworth

Leu, D. (2002). The new literacies: Research on reading instruction with the

Internet. In A. Farstrup & S. Samuals (Eds.), What Research has to say

about reading instruction (3rd ed). Newark, DE: International Reading

Association, pp. 310-336

Lin, S. (2006). Student Characteristics, Sense of Community, and Cognitive

Achievement in Web-based and Lab-based Learning Environments.

Journal of Research and Technology in Education, 39(2), pp. 205-223

Lutkewitte, C. (2010). Multimodality is….: A survey investigating how graduate

teaching assistants and instructors teach multimodal assignments in first-

year composition courses. Dissertation submitted to Ball State University

Mangurian, L. (2005). Learning and teaching practice: The power of the affective.

Paper presented to the annual Lilly Conference on College Teaching

South. Greensboro, NC

Marton, F. (1992). Phenomenography and the Art of Teaching All Things to All

114

Men. Qualitative Studies in Education, 5(3), pp. 253-257

Massie, E. (2003). E-Learning, the Near Future. The AMA Handbook of E-

Learning, pp. 411- 418

Maxwell, J. A. (2006). Literature reviews of, and for, educational research: A

commentary on Boote and Beile's "Scholars Before Researchers".

Educational Researcher 35(9), pp. 28-31

Mayer, R. & Moreno, R. (2003). Nine ways to reduce cognitive load in multimodal

learning. In Web-Based Learning: What Do We Know? Where Do We Go?

Geenwich, CT: Information Age Publishing. pp. 23-44

McDrury, J. & Alterio, M. (2000). Achieving reflective learning using storytelling

pathways. Innovations in Education and Teaching International. 38 (1). pp.

63-73

McKeown, P, Heylings, D., Stevenson, M., McKelvey, K., Nixon, J., & McClusky,

D. 2003). The impact of curricular change on medical students’ knowledge

of anatomy. Medical Education 37. pp. 954-961

McNuylty, J., Sonntag, B., & Sinacore, J. (2009). Evaluations of computer-aided

instruction in a gross anatomy course: A six year study. Anatomy Science

Education, 2, pp. 2-8

Morton, G. (2000). Combining a Case Study and Original Research in an

Extended Writing Assignment. Business Communication Quarterly,

Volume 63, Number 2, June 2000.

Moxham, B. & Plasiant, O. (2007). Perception of medical students towards

clinical relevance of anatomy. Clinical Anatomy, 20, pp. 560-564

115

Munck, A. & Mayer, P. (2000). Designing Human Protocols: A model of human

collaboration in the light of technology.

http://www.lmunch.Com/articles/HumanComputerProtocls.pdf

Murray, J. (2009). Non-discursive rhetoric. Image and Affect in Multimodal

Composition. New York: SUNY

National Center On Universal Design for Learning (2012). Universal Design for

Learning (UDL): Initiatives on the Move. National Center on UDL

Nelson, L. (2010). Teaching At Its Best. San Franciso: Wiley & Sons, Inc.

Newman, F., Couturier, L. & Seurey, J. (2004). The Future of Higher Education.

San Franciso: Jossey-Bass

New London Group (2000). A pedagogy of multiliteracies designing social

futures. IN B. Cope & M. Kalantzis (Eds.), Multiliteracies: Literacy learning

and the design of social futures. London: Routledge, pp. 9-37

New Media Consortium (NMC) (2009). 2009 Horizon Report.

www.nmc.org/publications/2009-horizon-report . Apr

Norris, S. (2004). Multimodal discourse analysis: A conceptual framework. In

Levine, P. & R. Scollon, editors. Discourse and technology: Multimodal

discourse analysis. Washington, DC: Georgetown University Press

Ockjean, K., Utke, B. & Hupp, S. (2005). Comparing the Use of Case Studies

and Application Questions in Preparing Special Education Professionals.

Teacher Education and Special Education, Volume 28, No. 2, 104-113

Pabst, R. (2002). Modern macroscopic anatomy: more than just cadaver

dissection. Anatomy Record, 269, p. 209

116

Pawlina, W. & Lachman, N. (2004). Dissection in learning and teaching gross

anatomy: Rebuttal to McLachlan. Anatomy Record, 281B, pp. 9-11

Pawson, R. & Tilly, N. (1997). Realistic Evaluation. London, England: Sage

Publications. pp. 18-76

Picciano, A. (2011). Blending with Purpose: The Multimodal Model. Journal of

Asynchronous Learning Networks, Volume 13, Issue 1

Prain, V., & Waldrip, B. (2006). An exploratory study of instructors’ and students’

use of multi-modal representations of concepts in primary science.

International Journal of Science Education, 28(16), pp. 1843-1866

Plenderleith, J. & Adamson, V. (2009). The Policy Landscape of Transformation.

Transforming Higher Education Through Technology-Enhanced Learning,

pp. 6-18

Pratt D. & Malabar F. (1998). Five Perspectives on Teaching in Adult Higher

Education. Malabar, FL: Kreiger Publishing

Prince, M. (2004). Does active learning work? A review of the research. Journal

of Engineering Education, 93(3): pp. 223-231

Putz, R. & Pabst, R. (2002). Sobotta Interaktiv, Multimodalles Lernprogramm:

Organe (CD ROM). Version 1.0, Munich, Germany: Urban & Fischer

Roth, W., & Lawless, D. (2002). Scientific investigations, metaphorical gestures,

and emergence of abstract scientific concepts. Learning and Instruction,

12(3), pp. 285-304

117

Shipka, Jody (2009). Negotiating Rhetorical, Material, Methodological, and

Technological Difference: Evaluating Multimodal Designs. CCC 61:1. pp.

343-366

Siegel, I. (1984). A constructivist perspective for teaching thinking. Educational

Leadership, 42(3), pp. 18-21

Smith, M,, Wood, W., Krauter, K., & Knight, J. (2011). Combining Peer

Discussion with Instructor Explanation Increases Student Learning from

In-Class Concept Questions. Life Sciences Education, Vol. 10, Spring

2011, pp. 55-63

Sorcinelli, M. (1991). Research findings on the seven principles. New Directions

for Teaching and Learning, 47, pp.13–25

Straub, K. (2007). Digital Application of Web-based Laboratory Experiences at

Idaho State University. Geological Society of America

Strayer, J. (2012). How Learning in an Inverted Classroom Influences

Cooperation, Innovation and Task Orientation. Learning Environments

Research, v15, n2, pp. 171-193

Sugand, K., Abrahams, P., & Khurana, A. (2010). The Anatomy of Anatomy: A

Review for Its Modernization

Svinicki, M. (2004). Learning and motivating in the postsecondary classroom.

Bolton, MA: Anker

Taylor, K., & Marienau, C. (1997). Constructive-Development Theory as a

Framework for Assessment in Higher Education. Assessment and

Evaluation in Higher Education, 22(2), pp. 233-243

118

Taylor, K., Marienau, C., and Fidler, M. (2000). Developing Adult Learners:

Strategies for Teaching and Trainers. San Franciso: Jossey-Bass

Thompson, Bolin, G., and Coe, A. (2012). Assessing the Degree of Integrated

Learner-Centered Instructions on Student Outcomes in a Large Non-Major

Environment Science Course. International Journal for the Scholarship of

Teaching and Learning, Vol. 6, No. 1, January 2012

Tough, A. (1979). The Adult’s Learning Projects: A Fresh Approach to Theory

and Practice in Adult Learning. 2nd Edition, Research in Education Series

1. Ontario Institute for Studies in Education. Austin TX

Trelease, R. (2002). Anatomical informatics: Millennial perspectives on a newer

frontier. Anatomical Record 269, pp. 224-235

Trelease, R. & Rosset, A. 2008). Transforming clinical imaging data for virtual

reality learning objects. Anatomy Science Education 1, pp. 50-55

Tucker, C. (2012). Blended Learning in Grades 4-12: Leveraging the Power of

Technology to Create Student-Centered Classrooms. Thousand Oaks,

CA: Sage Publications. pp. 44-69

Turney, B. (2007). Anatomy in a modern medical Curriculum. Ann R.

Coll,Surgical English 89, pp. 194-107

Tutkun, O. (2011). Internet Access: Use and Sharing Levels Among Studnets

During the Teaching-Learning Process. Turkish Online Journal of

Education Technology, July, Vol 10, Issue 3. pp. 152-160

119

Vie, Stephanie (2008). Digital Divide 2.0: Generation M’ and Online Social

Networking Sties int eh Composition Classroom. Computers and

Composition 25, pp. 9-23

Walker, J., Cotner, H., Baepler, P., and Decker, M. (2008). A delicate balance:

Integrating active learning into a large lecture course. Journal of Life

Sciences Education 7(4), pp. 361-367

Wang, J., Chun-Fu, C., & Wei-Chieh, W. (2013). Meaningful Engagement in

Facebook Learning Environments: Merging Social and Academic Lives.

Turkish Online Journal of Distance Education, v14, n1, pp. 302-322

Wang, R., Mattick, K., & Dunne, E. (2010) Medical Students’ Perceptions of

Video-Linked Lectures and Video-Streaming, Research in Learning

Technology, v18, pp. 19-27

Weir, J. & Abrahams, P. (1997). Imaging Atlas of Human Anatomy CD-ROM,

Version 2.0. 1st Edition, London, UK: Mosby

Whitehouse, J. (2008). Discussion with a Difference: questions and co-operative

learning. Ethos, Term 1.

Willingham, D. (2008). What is Developmentally Appropriate? American

Instructor, 32(2): pp. 34-39

Wright, I. (1995). Critical-thinking in social studies: Beliefs, commitments, and

implementation. Canadian Social Studies, 29(2), pp. 66-68

Zoller, U., & Tsparlis, G. (1997). Higher and lower-order cognitive skills: The case

of chemistry. Research in Science Education, 27(1), pp. 117-130

120

Appendix A

Survey Instrument

121

122

123

124

125

126

127

128

129

Appendix B

Survey Matrix

130

Survey Matrix

Survey Question

Research Questions

Cited Literature Reference

1 - 6 1 Lecture: (Murray, 2009), (Courts & McInerney, 1993), (Walker, Cotner, Baepler, & Decker, 2008), (Knight & Wood, 2006), (Alvermann & Wilson, 2011), (Gerstein, 2012), (National Center on Universal Design for Learning, 2012), (Strayer, 2012), (Prain & Waldrip, 2006), (Roth & Lawless, 2002). Web Based Labs: (Hoyte & Perera, 2000), (Gopal, Herron, & Mohn, 2010), (Lin, 2006), (Straub, 2007), (Gerstein, 2012), (Sugand, Abrahams, & Khurana, 2010), (McNulty, Sonntag, & Sinacore, 2009), (Putz & Pabst, 2002), (Turney, 2007). Case Studies: (Thompson, Bolin, & Coe, 2012), (Karabulut, 2012), (Morton, 2000), (Ockjean, Utke, & Hupp, 2005), (Casotti, Beneski, & Knabb, 2013), (Baumgartner & Merriam, 1999). Discussion Questions: (Karabulut, 2012), (Ockjean, Utke, & Hupp, 2005), (Whitehouse, 2008), (Gerstein, 2012). Public Blog: (Kitchakam, 2012), (Wang, Chun-Fu, & Wei-Cheih, 2012), (Whitehouse, 2008). Simmulation: (Hoyte & Perera, 2000), (Gopal, Herron, & Mohn, 2010), (Lin, 2006), (Straub, 2007), (Gerstein, 2012), (Sugand, Abrahams, & Khurana, 2010), (McNulty, Sonntag, & Sinacore, 2009), (Putz & Pabst, 2002), (Turney, 2007). Cadaver: (Pawlina & Lachman, 2004), (McNulty, Sonntag, & Sinacore, 2009), ( Putz & Pabst, 2002). In-class Labs: (Gopal, Herron, & Mohn, 2010), (Pawlina & Lachman, 2004), (Turney, 2007). Student Presentations: (Ambrose, 2010) Social Media: (Newman, Couturier, & Seurey, 2004), (Wang, Chun-Fu, & Wei-Cheih, 2012),

131

(Fougnie & Marois, 2006). Class Polling Mechanisms: (Thompson, Bolin, & Coe, 2012). Video/Animations: (Ball & Moeller, 2010), (Lanham, 2004), (Devoss, Cushman, & Grabill, 2005), (Tutkun, 2011), (Alvermann & Wilson, 2011), (Lin, 2006), (Clark & Dirkx, 2000), ((mayer & Moreno, 2003), (Alvermann & Wilson, 2011), (LaFrance & Calhoun, 2012), (Weir & Abrahams, 1997), (McNulty, Sonntag, & Sinacore, 2009), (Roth & Lawless, 2002), (Finn & McLachlan, 2009). Email: (McNulty, Sonntag, & Sinacore, 2009). In-class Texting: (Newman, Couturier, & Seurey, 2004).

7 & 8 4 (Lutkewitte, 2010), (Moxham & Plaisant, 2007).

9 2b (Ball & Moeller, 2010), (Lanham, 2004), (Devoss, Cushman, & Grabill, 2005), (Bransford, Brown, & Cocking, 2000), (Wang, Mattick, & Dunne, 2010).

10 - 14 2c (Bolter & Grusin, 2000)

15 - 21 4 (Davis & Shadle, 2007), (P:icciano, 2011),(Grippen & Peters, 1984), (Walker, Cotner, Baepler, & Decker, 2008), (Knight & Wood, 2006), (Campbell & Smith, 1997), (Pratt & Malabar, 1998), (Thompson, Bolin, & Coe, 2012), (Heyling, 2002).

22 & 23 2a (Shipka, 2005), (Walker, Cotner, Baepler, & Decker, 2008).

132

Appendix C

Survey Cover Letter

133

Date:

Dear Colleague:

If you teach in a two or four year college or university, you are invited to participate in a

research study to help determine the penetration of multimodal teaching in the anatomy

and physiology classroom as well as the perceived barriers that may limit or prevent it

from being used. The results of this study will be published and made available to the

membership upon completion of the researcher’s successful dissertation defense.

For the purposes of this study, the term “multimodal” will be defined as, “teaching

students using multiple media in an approach that incorporates several kinds of media.

For instance a classroom set up in a multimodal methodology would include internet

access, overhead projectors, web-based experiences, interactive blogs or discussion

questions, or group activities.

We very much hope you will participate in this study because it will be specifically

focused on anatomy and physiology classrooms. It will represent an opportunity to

evaluate a subject near and dear to those of us who teach this curriculum. The entire

survey will require less than ten minutes to complete but will offer an extensive

opportunity to exhibit how much technology is integrated into teaching of anatomy and

physiology.

To participate in the survey, just click on the following link: [Survey Link]

There are no known risks from being in this study, and you will not benefit personally.

However, we hope that others may benefit in the future from what we learn as a result of

this study.

All survey responses that we receive will be treated confidentially and stored on a secure

server. However, given that the surveys can be completed from any computer (e.g.,

personal, work, school), we are unable to guarantee the security of the computer on

which you choose to enter your responses. As a participant in our study, we want you to

be aware that certain "key logging" software programs exist that can be used to track or

capture data that you enter and/or websites that you visit.

Your participation in this research study is completely voluntary. If you decide not to be

in this study, or if you stop participating at any time, you will not be penalized or lose any

benefits for which you are otherwise entitled.

If you have any questions, concerns or complaints now or later, you may contact us at the

number below. If you have any questions about your rights as a human subject,

complaints, concerns or wish to talk to someone who is independent of the research,

134

contact the Office for Human Subjects Protections at 605/677-6184. Thank you for your

time.

Sincerely,

Dr. Karen Card, EdD Gerald McGraw, PA, MPAS, MBA

Educational Administration Doctoral Candidate

(605) 677-5815 (605) 545-0656

135

Appendix D

Additional Results

136

Differences in Instructor’s Teaching Assignments in Anatomy and Physiology

Mode Quartile N M SD

Lecture

2.00 83 3.49 1.19

3.00 32 3.00 0.98

4.00 57 3.47 1.00

Total 172 3.40 1.11

Web-based Labs

2.00 70 1.17 0.56

3.00 24 1.04 0.20

4.00 48 1.29 0.65

Total 142 1.19 0.56

Case Studies

2.00 80 1.54 0.78

3.00 25 1.36 0.57

4.00 54 1.56 0.82

Total 159 1.52 0.76

Discussion Question

2.00 76 1.68 0.87

3.00 27 1.37 0.63

4.00 51 1.82 0.95

Total 154 1.68 0.87

Public Blog

2.00 69 1.03 0.17

3.00 23 1.00 0.00

4.00 43 1.07 0.46

Total 135 1.04 0.28

Computer Simulation

2.00 73 1.30 0.68

3.00 25 1.24 0.44

4.00 46 1.41 0.78

Total 144 1.33 0.68

Cadaver Experience

2.00 70 1.47 1.09

3.00 25 1.16 0.47

4.00 47 1.43 1.10

Total 142 1.40 1.01

In-class Lab

2.00 78 1.96 1.17

3.00 32 2.19 0.93

4.00 50 2.36 1.17

Total 160 2.13 1.13

Student Presentation

2.00 70 1.31 0.67

3.00 25 1.32 0.69

4.00 45 1.33 0.74

137

Total 140 1.32 0.69

Social Media Experience

2.00 68 1.00 0.00

3.00 23 1.04 0.21

4.00 43 1.09 0.37

Total 134 1.04 0.23

In-class Polling

2.00 73 1.26 0.50

3.00 25 1.16 0.37

4.00 44 1.41 0.79

Total 142 1.29 0.59

Video animation

2.00 79 1.73 0.96

3.00 27 1.56 0.85

4.00 51 1.88 1.01

Total 157 1.75 0.96

Email

2.00 74 1.54 1.06

3.00 23 1.39 0.78

4.00 45 1.71 1.12

Total 142 1.57 1.04

In-class Texting

2.00 67 1.00 0.00

3.00 23 1.22 0.74

4.00 43 1.00 0.00

Total 133 1.07 0.31

138

ANOVA of Differences in Instructor’s Teaching Assignments in Anatomy and Physiology

Mode df F Sig. = P

Lecture

Between Groups

2 2.564 0.08

Within Groups

169

Web-based Labs

Between Groups

2 1.702 0.186

Within Groups

139

Case Studies

Between Groups

2 0.626 0.536

Within Groups

156

Discussion Questions

Between Groups

2 2.449 0.09

Within Groups

151

Public Blog

Between Groups

2 0.505 0.605

Within Groups

132

Computer Simulation

Between Groups

2 0.626 0.536

Within Groups

141

Cadaver Experience

Between Groups

2 0.893 0.412

Within Groups

139

In-class Lab

Between Groups

2 1.955 0.145

Within Groups

157

Student Presentation

Between Groups

2 0.01 0.99

Within Groups

137

Social Media

Between Groups

2 2.278 0.107

Within 131

139

Groups

Between Groups

2 1.607 0.204

Polling Within Groups

139

Video Animation

Between Groups

2 1.053 0.351

Within Groups

154

Email

Between Groups

2 0.779 0.461

Within Groups

139

In-class Texting

Between Groups

2 4.905 0.009

Within Groups

130

140

Differences in Total Years Teaching

Mode Quartile N M SD

Lecture

1.00 54 3.28 1.11

2.00 53 3.36 1.11

3.00 65 3.49 1.09

Total 172 3.38 1.10

Web-based Labs

1.00 46 1.13 0.34

2.00 47 1.28 0.68

3.00 50 1.16 0.58

Total 143 1.19 0.56

Case Studies

1.00 51 1.53 0.73

2.00 47 1.61 0.90

3.00 61 1.44 0.67

Total 159 1.52 0.76

Discussion Question

1.00 48 1.71 0.85

2.00 50 1.82 1.00

3.00 57 1.53 0.73

Total 155 1.68 0.87

Public Blog

1.00 42 1.02 0.15

2.00 43 1.07 0.46

3.00 51 1.02 0.14

Total 136 1.04 0.28

Computer Simulation

1.00 46 1.28 0.50

2.00 46 1.50 0.96

3.00 53 1.23 0.47

Total 145 1.33 0.68

Cadaver Experience

1.00 43 1.23 0.75

2.00 46 1.65 1.32

3.00 54 1.31 0.84

Total 143 1.40 1.01

In-class Lab

1.00 50 2.36 1.05

2.00 53 2.13 1.21

3.00 58 1.91 1.11

Total 161 2.12 1.13

Student Presentation

1.00 45 1.29 0.51

2.00 46 1.39 0.83

3.00 50 1.28 0.70

141

Total 141 1.32 0.69

Social Media Experience

1.00 42 1.07 0.26

2.00 43 1.05 0.31

3.00 50 1.00 0.00

Total 135 1.04 0.23

In-class Polling

1.00 45 1.42 0.78

2.00 46 1.24 0.48

3.00 52 1.23 0.47

Total 143 1.29 0.59

Video animation

1.00 50 1.84 0.98

2.00 52 1.92 1.15

3.00 56 1.50 0.66

Total 158 1.75 0.96

Email

1.00 45 1.73 1.23

2.00 46 1.67 1.07

3.00 52 1.33 0.76

Total 143 1.57 1.04

In-class Texting

1.00 42 1.07 0.46

2.00 41 1.05 0.31

3.00 51 1.00 0.00

Total 134 1.04 0.31

142

ANOVA of Differences in Total Years Teaching

Mode df F Sig. = P

Lecture

Between Groups 2 .579 .562

Within Groups 169

Total 171

Web-based

Labs

Between Groups 2 .905 .407

Within Groups 140

Total 142

Case Studies

Between Groups 2 .697 .500

Within Groups 156

Total 158

Discussion

Questions

Between Groups 2 1.583 .209

Within Groups 152

Total 154

Public Blog

Between Groups 2 .426 .654

Within Groups 133

Total 135

Computer

Simulation

Between Groups 2 2.216 .113

Within Groups 142

Total 144

Cadaver

Experience

Between Groups 2 2.265 .108

Within Groups 140

Total 142

In-class Lab

Between Groups 2 2.112 .124

Within Groups 158

Total 160

Student

Presentation

Between Groups 2 .372 .690

Within Groups 138

Total 140

Social Media

Between Groups 2 1.204 .303

Within Groups 132

Total 134

Polling

Between Groups 2 1.565 .213

Within Groups 140

Total 142

Video Animation Between Groups 2 3.058 .050

Within Groups 155

143

Total 157

Email

Between Groups 2 2.250 .109

Within Groups 140

Total 142

In-class Texting

Between Groups 2 .647 .525

Within Groups 131

Total 133

144

Differences in Total Years Teaching In Anatomy and Physiology

Mode Quartile N M SD

Lecture

1.00 65 3.29 1.07

2.00 50 3.40 1.12

3.00 58 3.50 1.13

Total 173 3.39 1.10

Web-based Labs

1.00 56 1.14 0.35

2.00 43 1.26 0.69

3.00 44 1.18 0.62

Total 143 1.19 0.56

Case Studies

1.00 62 1.56 0.82

2.00 43 1.58 0.85

3.00 55 1.42 0.60

Total 160 1.52 0.76

Discussion Question

1.00 58 1.76 0.96

2.00 46 1.76 0.92

3.00 51 1.51 0.67

Total 155 1.68 0.87

Public Blog

1.00 53 1.02 0.14

2.00 38 1.08 0.49

3.00 45 1.02 0.15

Total 136 1.04 0.28

Computer Simulation

1.00 56 1.30 0.54

2.00 42 1.45 0.97

3.00 47 1.26 0.49

Total 145 1.33 0.68

Cadaver Experience

1.00 54 1.19 0.68

2.00 42 1.79 1.37

3.00 47 1.30 0.86

Total 143 1.40 1.01

In-class Lab

1.00 62 2.21 1.06

2.00 47 2.26 1.21

3.00 52 1.90 1.14

Total 161 2.12 1.13

Student Presentation

1.00 58 1.31 0.54

2.00 39 1.38 0.88

3.00 44 1.27 0.69

145

Total 141 1.32 0.69

Social Media Experience

1.00 53 1.06 0.23

2.00 38 1.05 0.32

3.00 44 1.00 0.00

Total 135 1.04 0.23

In-class Polling

1.00 56 1.38 0.73

2.00 41 1.27 0.50

3.00 46 1.22 0.47

Total 143 1.29 0.59

Video animation

1.00 61 1.93 1.06

2.00 47 1.79 1.04

3.00 50 1.48 0.65

Total 158 1.75 0.96

Email

1.00 55 1.82 1.32

2.00 42 1.48 0.77

3.00 46 1.35 0.79

Total 143 1.57 1.04

In-class Texting

1.00 53 1.06 0.41

2.00 36 1.06 0.33

3.00 45 1.00 0.00

Total 134 1.04 0.31

146

ANOVA of the Differences in Total Years Teaching In Anatomy and Physiology

Mode df F Sig. = P

Lecture

Between Groups 2 .542 .583

Within Groups 170

Total 172

Web-based

Labs

Between Groups 2 .503 .606

Within Groups 140

Total 142

Case Studies

Between Groups 2 .737 .480

Within Groups 157

Total 159

Discussion

Questions

Between Groups 2 1.427 .243

Within Groups 152

Total 154

Public Blog

Between Groups 2 .584 .559

Within Groups 133

Total 135

Computer

Simulation

Between Groups 2 1.013 .366

Within Groups 142

Total 144

Cadaver

Experience

Between Groups 2 4.784 .010

Within Groups 140

Total 142

In-class Lab

Between Groups 2 1.483 .230

Within Groups 158

Total 160

Student

Presentation

Between Groups 2 .277 .758

Within Groups 138

Total 140

Social Media

Between Groups 2 .882 .416

Within Groups 132

Total 134

Polling

Between Groups 2 .949 .390

Within Groups 140

Total 142

Video Animation Between Groups 2 3.246 .042

Within Groups 155

147

Total 157

Email

Between Groups 2 2.868 .060

Within Groups 140

Total 142

In-class Texting

Between Groups 2 .486 .616

Within Groups 131

Total 133

148

Differences in the Highest Degree Earned

Mode Degree N M SD

Lecture

Bachelors 2 1.50 0.71 Masters 32 3.25 1.08 Doctorate 139 3.45 1.09 Total 173 3.39 1.10

Web-based Labs

Bachelors 2 1.00 0.00 Masters 25 1.28 0.46 Doctorate 116 1.17 0.58 Total 143 1.19 0.56

Case Studies

Bachelors 2 1.50 0.71 Masters 28 1.39 0.83 Doctorate 130 1.55 0.75 Total 160 1.52 0.76

Discussion Question

Bachelors 2 1.00 0.00 Masters 27 1.74 0.90 Doctorate 126 1.67 0.87 Total 155 1.68 0.87

Public Blog

Bachelors 2 1.00 0.00 Masters 23 1.00 0.00 Doctorate 111 1.05 0.31 Total 136 1.04 0.28

Computer Simulation

Bachelors 2 1.00 0.00 Masters 26 1.35 0.63 Doctorate 117 1.33 0.69 Total 145 1.33 0.68

Cadaver Experience

Bachelors 2 1.00 0.00 Masters 25 1.44 0.96 Doctorate 116 1.40 1.03 Total 143 1.40 1.01

In-class Lab

Bachelors 2 3.50 0.71 Masters 30 2.07 1.05 Doctorate 129 2.12 1.15 Total 161 2.12 1.13

Student Presentation

Bachelors 2 1.50 0.71 Masters 24 1.17 0.48 Doctorate 115 1.35 0.73 Total 141 1.32 0.69

Social Media Experience

Bachelors 2 1.00 0.00 Masters 23 1.00 0.00 Doctorate 110 1.05 0.25 Total 135 1.04 0.23

149

In-class Polling

Bachelors 2 1.00 0.00 Masters 24 1.38 0.71 Doctorate 117 1.28 0.57 Total 143 1.29 0.59

Video animation

Bachelors 2 2.50 2.12 Masters 30 2.10 1.06 Doctorate 126 1.65 0.90 Total 158 1.75 0.96

Email

Bachelors 2 1.00 0.00 Masters 25 1.64 1.15 Doctorate 116 1.56 1.02 Total 143 1.57 1.04

In-class Texting

Bachelors 2 1.00 0.00 Masters 22 1.00 0.00 Doctorate 110 1.05 0.34 Total 134 1.04 0.31

150

ANOVA of the Differences in the Highest Degree Earned

Mode df F Sig. = P

Lecture

Between Groups 2 3.522 .032

Within Groups 170

Total 172

Web-based

Labs

Between Groups 2 .498 .609

Within Groups 140

Total 142

Case Studies

Between Groups 2 .466 .629

Within Groups 157

Total 159

Discussion

Questions

Between Groups 2 .680 .508

Within Groups 152

Total 154

Public Blog

Between Groups 2 .256 .775

Within Groups 133

Total 135

Computer

Simulation

Between Groups 2 .243 .784

Within Groups 142

Total 144

Cadaver

Experience

Between Groups 2 .176 .839

Within Groups 140

Total 142

In-class Lab

Between Groups 2 1.525 .221

Within Groups 158

Total 160

Student

Presentation

Between Groups 2 .752 .474

Within Groups 138

Total 140

Social Media

Between Groups 2 .410 .664

Within Groups 132

Total 134

Polling

Between Groups 2 .493 .612

Within Groups 140

Total 142

Video Animation Between Groups 2 3.395 .036

Within Groups 155

151

Total 157

Email

Between Groups 2 .359 .699

Within Groups 140

Total 142

In-class Texting

Between Groups 2 .209 .812

Within Groups 131

Total 133

152

Differences in Instructors’ Teaching Status

Mode Status N M SD

Lecture

Full Tim Tenured 97 3.37 1.03 Full-time contract 55 3.42 1.18 Part-time contract 4 2.75 0.50 Adjunct 9 3.44 1.59

Web-based Labs

Total 165 3.38 1.11 Full Tim Tenured 81 1.15 0.50 Full-time contract 48 1.27 0.68 Part-time contract 4 1.00 0.00

Case Studies

Adjunct 6 1.17 0.41 Total 139 1.19 0.56 Full Tim Tenured 90 1.54 0.80 Full-time contract 51 1.59 0.78

Discussion Question

Part-time contract 4 1.25 0.50 Adjunct 8 1.25 0.46 Total 153 1.54 0.77 Full Tim Tenured 87 1.72 0.92

Public Blog

Full-time contract 50 1.74 0.83 Part-time contract 4 1.50 0.58 Adjunct 6 1.33 0.82 Total 147 1.71 0.88

Computer Simulation

Full Tim Tenured 77 1.04 0.34 Full-time contract 44 1.02 0.15 Part-time contract 4 1.00 0.00 Adjunct 6 1.17 0.41

Cadaver Experience

Total 131 1.04 0.29 Full Tim Tenured 82 1.24 0.60 Full-time contract 48 1.48 0.77 Part-time contract 4 1.25 0.50

In-class Lab

Adjunct 6 1.33 0.82 Total 140 1.33 0.67 Full Tim Tenured 81 1.35 0.94 Full-time contract 47 1.57 1.21

Student Presentation

Part-time contract 4 1.50 1.00 Adjunct 5 1.00 0.00 Total 137 1.42 1.03 Full Tim Tenured 88 2.08 1.12

Social Media Experience

Full-time contract 54 2.26 1.22 Part-time contract 4 3.00 0.82 Adjunct 8 1.38 0.74 Total 154 2.13 1.15

153

In-class Polling

Full Tim Tenured 80 1.36 0.73 Full-time contract 46 1.28 0.69 Part-time contract 4 1.25 0.50 Adjunct 5 1.20 0.45

Video animation

Total 135 1.33 0.70 Full Tim Tenured 77 1.04 0.25 Full-time contract 44 1.02 0.15 Part-time contract 4 1.25 0.50

Email

Adjunct 5 1.00 0.00 Total 130 1.04 0.23 Full Tim Tenured 79 1.28 0.48 Full-time contract 48 1.40 0.79

In-class Texting

Part-time contract 4 1.00 0.00 Adjunct 7 1.00 0.00 Total 138 1.30 0.60 Full Tim Tenured 85 1.58 0.75

Full-time contract 44 1.28 0.54 Part-time Contract 4 1.00 0.00 Adjunct 5 1.00 0.00

154

ANOVA of the Differences in Instructors’ Teaching Status

Mode df F Sig. = P

Lecture

Between Groups 3 .461 .710

Within Groups 161

Total 164

Web-based

Labs

Between Groups 3 .637 .593

Within Groups 135

Total 138

Case Studies

Between Groups 3 .630 .597

Within Groups 149

Total 152

Discussion

Questions

Between Groups 3 .466 .706

Within Groups 143

Total 146

Public Blog

Between Groups 3 .457 .713

Within Groups 127

Total 130

Computer

Simulation

Between Groups 3 1.261 .291

Within Groups 136

Total 139

Cadaver

Experience

Between Groups 3 .779 .508

Within Groups 133

Total 136

In-class Lab

Between Groups 3 2.261 .084

Within Groups 150

Total 153

Student

Presentation

Between Groups 3 .198 .898

Within Groups 131

Total 134

Social Media

Between Groups 3 1.254 .293

Within Groups 126

Total 129

Polling

Between Groups 3 1.383 .251

Within Groups 134

Total 137

Video Animation Between Groups 3 2.275 .082

Within Groups 148

155

Total 151

Email

Between Groups 3 2.913 .037

Within Groups 132

Total 135

In-class Texting

Between Groups 3 1.255 .293

Within Groups 125

Total 128

156

Differences in the Instructors’ Rank

Mode Rank N M SD

Lecture

Instructor 31 3.39 1.26

Assistant Professor 39 3.49 1.12

Associate Professor 34 3.41 0.99

Professor 60 3.33 1.10 Total 164 3.40 1.11

Web-based Labs

Instructor 27 1.37 0.97

Assistant Professor 29 1.17 0.38

Associate Professor 25 1.08 0.40

Professor 57 1.21 0.49 Total 138 1.21 0.59

Case Studies

Instructor 28 1.57 0.96

Assistant Professor 36 1.53 0.65

Associate Professor 26 1.46 0.58

Professor 61 1.54 0.79 Total 151 1.53 0.76

Discussion Question

Instructor 28 1.54 0.84

Assistant Professor 33 1.55 0.67

Associate Professor 28 1.75 0.84

Professor 58 1.78 0.88 Total 147 1.67 0.82

Public Blog

Instructor 25 1.00 0.00

Assistant Professor 28 1.04 0.19

Associate Professor 22 1.00 0.00

Professor 55 1.07 0.42 Total 130 1.04 0.29

Computer Simulation

Instructor 27 1.44 0.93

Assistant Professor 30 1.27 0.52

Associate Professor 24 1.33 0.48

Professor 58 1.34 0.71 Total 139 1.35 0.69

Cadaver Experience

Instructor 27 1.56 1.19

Assistant Professor 30 1.13 0.43

157

Associate Professor 24 1.21 0.66

Professor 56 1.59 1.25 Total 137 1.42 1.03

In-class Lab

Instructor 31 2.00 1.10

Assistant Professor 33 1.79 0.89

Associate Professor 30 2.00 0.98

Professor 59 2.39 1.26 Total 153 2.10 1.12

Student Presentation

Instructor 25 1.20 0.50

Assistant Professor 29 1.31 0.66

Associate Professor 24 1.42 0.78

Professor 56 1.34 0.77 Total 134 1.32 0.70

Social Media Experience

Instructor 25 1.00 0.00

Assistant Professor 27 1.00 0.00

Associate Professor 22 1.05 0.21

Professor 55 1.05 0.30 Total 129 1.03 0.21

In-class Polling

Instructor 26 1.27 0.53

Assistant Professor 30 1.33 0.84

Associate Professor 25 1.32 0.48

Professor 56 1.30 0.54 Total 137 1.31 0.60

Video animation

Instructor 30 1.60 0.81

Assistant Professor 33 1.70 0.95

Associate Professor 31 1.74 1.00

Professor 57 1.86 1.06 Total 151 1.75 0.97

Email

Instructor 26 1.54 1.03

Assistant Professor 30 1.47 1.01

Associate Professor 24 1.58 0.83

Professor 56 1.48 0.95 Total 136 1.51 0.95

In-class Texting

Instructor 25 1.00 0.00

Assistant Professor 27 1.00 0.00

Associate Professor 21 1.10 0.44

Professor 55 1.05 0.40

158

Total 128 1.04 0.32

159

ANOVA of the Differences in the Instructors’ Rank

Mode df F Sig. = P

Lecture

Between Groups 3 .153 .927

Within Groups 160

Total 163

Web-based

Labs

Between Groups 3 1.131 .339

Within Groups 134

Total 137

Case Studies

Between Groups 3 .102 .959

Within Groups 147

Total 150

Discussion

Questions

Between Groups 3 .911 .437

Within Groups 143

Total 146

Public Blog

Between Groups 3 .529 .663

Within Groups 126

Total 129

Computer

Simulation

Between Groups 3 .315 .815

Within Groups 135

Total 138

Cadaver

Experience

Between Groups 3 1.816 .147

Within Groups 133

Total 136

In-class Lab

Between Groups 3 2.401 .070

Within Groups 149

Total 152

Student

Presentation

Between Groups 3 .408 .748

Within Groups 130

Total 133

Social Media

Between Groups 3 .612 .608

Within Groups 125

Total 128

Polling

Between Groups 3 .057 .982

Within Groups 133

Total 136

Video Animation Between Groups 3 .506 .679

Within Groups 147

160

Total 150

Email

Between Groups 3 .090 .965

Within Groups 132

Total 135

In-class Texting

Between Groups 3 .519 .670

Within Groups 124

Total 127