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Why Do A&P Students Hate Histology? And How Do We Fix That? | TAPP 113

by Kevin Patton

Why Do A&P Students Hate Histology? And How Do We Fix That?

TAPP Radio Episode 113


Episode | Quick Take

Host Kevin Patton discusses the fact that many students hate histology. And perhaps even some faculty. Are there any ways to fix that? Kevin thinks he may have found a breakthrough idea.

  • 00:00 | Introduction
  • 01:20 | Sponsored by AAA
  • 02:25 | Why Do Students Hate Histology?
  • 16:27 | Sponsored by HAPI
  • 17:06 | Birding For Tissues
  • 39:15 | Sponsored by HAPS
  • 40:14 | A Breakthrough
  • 51:25 | Staying Connected


Episode | Listen Now

Episode | Show Notes

“Thirty years ago my older brother, who was ten years old at the time, was trying to get a report written on birds that he’d had three months to write, which was due the next day. We were out at our family cabin in Bolinas, and he was at the kitchen table close to tears, surrounded by binder paper and pencils and unopened books about birds, immobilized by the hugeness of the task ahead. Then my father sat down beside him put his arm around my brother’s shoulder, and said, “Bird by bird, buddy. Just take it bird by bird.” (Anne Lamott)


Sponsored by AAA

62 seconds

A searchable transcript for this episode, as well as the captioned audiogram of this episode, are sponsored by the American Association for Anatomy (AAA) at anatomy.org.

Searchable transcript

Captioned audiogram 

Don’t forget—HAPS members get a deep discount on AAA membership!

AAA logo


Why Do Students Hate Histology?

14 minutes

Students often hate histology. At least they start off that way. Why is that? Maybe because histology is not simple. It’s stratified.


Sponsored by HAPI Online Graduate Program

35 seconds

The Master of Science in Human Anatomy & Physiology Instruction—the MS-HAPI—is a graduate program for A&P teachers, especially for those who already have a graduate/professional degree. A combination of science courses (enough to qualify you to teach at the college level) and courses in contemporary instructional practice, this program helps you be your best in both on-campus and remote teaching. Kevin Patton is a faculty member in this program at Northeast College of Health Sciences. Check it out!


Logo of Northeast College of Health Sciences, Human Anatomy & Physiology Instruction


Birding For Tissues

22 minutes

One approach to making histology more interesting—and perhaps easier—is to share  and teach our expert eye. As when learning to identify animals such as birds from an expert. We look at what that expert looks at. In birding, Peterson called these field marks. In histology, Kevin calls these landmark characteristics.

  • Peterson Field Guide to Birds (shows birds with field marks and range maps) geni.us/gvAP411
  • An Expert Derived Feedforward Histology Module Improves Pattern Recognition Efficiency in Novice Students (journal article from Anat Sci Educ) AandP.info/2tf
  • Eye tracking reveals expertise-related differences in the time-course of medical image inspection and diagnosis (journa article from J of Medical Imaging) AandP.info/y6f
  • AAA Histology Education Resources (includes links to virtual microscope, collections, etc.) AandP.info/npu
  • Field Guide to the Human Body (web page for students;  has help using Kevin’s “field guide” approach to learning tissues and other body structures) AandP.info/fieldguide
  • Finding Media | Images and More for Teaching Anatomy & Physiology (sources for histology images—and even Jackson Pollock paintings)


Sponsored by HAPS

36 seconds

The Human Anatomy & Physiology Society (HAPS) is a sponsor of this podcast.  You can help appreciate their support by clicking the link below and checking out the many resources and benefits found there. Watch for virtual town hall meetings and upcoming regional meetings!

Anatomy & Physiology Society


HAPS logo


A Breakthrough

11 minutes

Using clickers in a kind of gamification strategy that leverages spaced retrieval practice, Kevin found that his students not only have fun, but also begged for more practice time!

Need help accessing resources locked behind a paywall?
Check out this advice from Episode 32 to get what you need!

Episode | Transcript

The A&P Professor podcast (TAPP radio) episodes are made for listening, not reading. This transcript is provided for your convenience, but hey, it’s just not possible to capture the emphasis and dramatic delivery of the audio version. Or the cool theme music.  Or laughs and snorts. And because it’s generated by a combo of machine and human transcription, it may not be exactly right. So I strongly recommend listening by clicking the audio player provided.

AAA logoThis searchable transcript is supported by the
American Association for Anatomy.
I'm a member—maybe you should be one, too!

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Kevin Patton (00:01):
The author Anne Lamott, famously wrote to this passage. “30 years ago, my older brother who was 10 years old at the time, was trying to get a report written on birds that he’d had three months to write, which was due the next day. We were out at our family cabin in Bolinas and he was at the kitchen table close to tears, surrounded by binder paper and pencils and unopened books about birds immobilized by the hugeness of the task ahead. Then my father sat down beside him, put his arm around my brother’s shoulder and said, bird by bird buddy. Just take it bird by bird.”

Aileen (00:49):
[music] Welcome to The A&P Professor, a few minutes to focus on teaching human anatomy and physiology with a veteran educator and teaching mentor, your host, Kevin Patton.

Kevin Patton (01:03):
[music] In this episode, I discuss why students hate histology and they do and what to do about it. [music]

Sponsored by AAA

Kevin Patton (01:20):
Before we dive into the topic of teaching histology, I want to take a moment to mention the AAA, the American Association for Anatomy has a huge collection of histology slides that you can use for teaching. Launched in 2017, the virtual microscopy database or VMD, is a centralized repository where a community of anatomy and histology scholars and researchers share a large selection of virtual tissue slides for enhancing education, research and scholarship. Learn more about the VMD by going to anatomy.org and clicking on the resources menu and then selecting teaching resources. And if I ever mentioned that a searchable transcript and a caption audiogram of all episodes of this podcast are funded by the American Association for Anatomy. That’s anatomy.org. [music]

Why Do Students Hate Histology?

Kevin Patton (02:25):
Why do A&P students hate histology? And I don’t say this isn’t a thing. You know it is. Even if you love histology and I love histology and my buddy who teaches A&P loves histology, not a whole lot of A&P students get to that point. And they certain don’t start at that point. I recently ran a poll in The A&P Professor Community. Our online hangout at theAPprofessor.org/community. It was a hot cold pole where respondents could be anywhere on the graph between positive to negative ends. And guess what? …

Read the rest of this transcript

When asked how their students feel about histology, nobody dropped their pin in the positive half of the graph. Nobody. And quite a few pins were dropped at the most negative point on the spectrum. Quite a few. So why is that? I don’t know. Really, I don’t know for sure. But after thinking about this for years and years and years and talking to both students and faculty about it, I do have some hypotheses.

Kevin Patton (03:45):
One idea I have is that, well, it’s just not easy when you first start to learn histology. It’s very unfamiliar to any of us the first time we see tissues under microscope. I mean, really, it looks like a mess in there. Doesn’t it? I mean really a complete mess and totally unfamiliar to almost every one of us. It’s like looking at mud or a Jackson Pollock painting that’s just a huge canvas with thousands of little paint drops all over it. What we don’t think about when we have those thoughts is that there are a whole bunch of people who can look at a handful of mud and tell you all kinds of things about it. Farmers can do that, ecologists can do that, potters, they can do that. They can tell you about that mud. And so mud wrestlers for that matter.

Kevin Patton (04:44):
A whole bunch of people are mud experts in different ways, but they know a lot about that mud, but those people weren’t born with that knowledge of course, nor did any of them just intuitively figure it out within a few minutes of being asked what they know about different kinds of mud. It took time and effort and practice and some guidance usually. Same with the Jackson Pollock painting. I used to think those were ridiculous. I mean, come on paint drips, what’s artistic about the same pattern I must have seen a million time on uncle Roberts white overalls. My uncle Robert was a house painter when I was growing up. But then I took an art appreciation class and learned about Jackson Pollock and about his paintings. And you know what? Today, I love many of those paint drip pieces. Not all of them, but a lot of the ones I’ve seen because I know what to look for. I know what some of the different artistic aspects of such a painting are. And so, that makes me able to either appreciate them or not appreciate it, but that took practice and expert guidance.

Kevin Patton (06:02):
I needed an expert artist to kind of walk me through what to look for in a piece of art and what makes one piece of art different from another piece of art and what even makes it art. And by doing that, you know what? I also appreciate uncle Roberts white overalls more too, or at least the paint drips on him, because I learned about something called found art, where we can learn to recognize the art in ordinary things that we find as we live our lives every day. Another idea I have about why students hate histology, is that even if a student is convinced that if a person can learn about Jackson Pollack’s painter paintings and even start to love them and even if that student understands that many, many, many people have learned the basics of histology and have learned to appreciate them, that individual student is not necessarily convinced that they themselves can learn histology.

Kevin Patton (07:02):
Like, “Okay, good for you. You understand Jackson Pollock paintings, good for you you know what to look for in a chunk of mud, but I can’t do that and I am not going to be able to do that with this histology stuff.” And we need to think about this fact that many of the community college students that I deal with in histology or with the histology part of the A&P course, they’ve struggled with learning or struggled with keeping focused on learning. Some of them may be returning learners who have all kinds of confidence issues, even though they are among our best learners, they’re still, oh man, they have some struggles with confidence. Don’t they? And many of the students I taught at a competitive university had some variation of imposter syndrome that often made them think that they weren’t truly capable of what appears to them as a massive feat of learning.

Kevin Patton (08:00):
What I’m saying is, is that probably part of the block in many students is a confidence issue. Histology just seems so, so big that it’s just too much to ask of them. Now yet another idea I have is that, if our students already have trouble believing us when we tell them that it’s important for their future careers in health professions or athletics or whatever it is they’re going into to learn cell biology, they’re really not going to believe that going through all that trouble of trying to figure out and then remember all that impossibly, messy and murky histology has anything useful to do with their future career. They might see it simply as a ridiculous hoop that we’re making them jump through. Another thought that occurs to me, is that we often fail to provide practical guidance on how to begin learning to identify tissues.

Kevin Patton (09:08):
What I think we often do, and I know I’ve done it before, is simply walk them through the basic tools and information without really starting from ground zero with them. And without connecting that information to how one goes about beginning to use it. We forget that understanding histology happens in layers. Oh man, that wasn’t even meant as a pun. But yeah, layers. We have simple and stratified learning going on here, right? And learning histology is stratified, right? Because it happens in layers. And it requires both basic information and it requires both basic information, some facts, but it also requires some recognition skills that they need to develop and we need to help them develop, which leads to another thought. I think our students need a lot more guided practice than we give them. A lot, lot, lot more. That’s three lots, which is my highest rating.

Kevin Patton (10:21):
Sometimes the only guidance we give them is a book and or a lab manual, which is kind of like saying, “You need to learn the different fishes found in Missouri. Go north and there’s a lake, go south and you’ll find a creek and here’s a book, the fishes of Missouri. Come and find me if you have a question.” Huh, yeah. And your students are standing around asking each other, “Which way is north?” And they can’t even get that far sometimes. Not on their own without some guidance, it’s just not a good way to start. More guidance is needed at first, I think. If I only give my students one weekend to learn the fishes of Missouri, yeah that’s not going to work well. Likewise, maybe our students need more time for more guided practice in learning histology. Maybe we can give them a little bit longer to learn and then come back a little bit later on and do some assessment rather than just go from point A to point Z all within a week or two or three. Maybe there needs to be some time for practice in there.

Kevin Patton (11:36):
Maybe it doesn’t need to be finished shortly after it’s started the way we do a lot of our topics. Something else I think is a play here, is that histology usually comes very early in A&P one. And I know everybody does things a little bit differently. So maybe it doesn’t happen that way in your course, but that’s the classic way of doing it. The traditional way of doing it. And up to that point, that early point in the course, everything we’ve talked about is either already somewhat familiar to our students like chemistry basics and cells, which… I mean, they start that early in grade school and it repeated several times before they hit us. And all those things therefore just don’t seem as complicated to the students. Even the new things like homeostasis, which they may not have encountered before, when it’s first presented, it’s actually pretty intuitive, pretty logical. It’s not complex in the same way that histology is complex.

Kevin Patton (12:38):
So this is the first time they’re getting something that is like a chunk of mud or a bunch of paint spatters, something that’s messy and complex and unfamiliar. When they hit that wall of histology, it shakes them up a bit. It’s a negative feeling that needs to be turned around right away or histology will always leave that bad taste in the mouth. My last thought for now is that our students may not like histology because we don’t seem to like histology. I think some of us in the world of A&P teaching really don’t like histology. Maybe we had a bad experience as students or don’t feel very confident in our own competence in histology, or maybe we’re not confident in our ability to teach histology or to help students develop the skills that they need. Maybe we’ve developed those skills, but we weren’t really doing a whole lot of metacognition and really didn’t really pay attention to how we did that.

Kevin Patton (13:49):
We just know that one day we woke up and we kind of got it, or maybe we either kind of like histology or really like histology and we simply fail to project that while we’re teaching histology. I think this is true of any aspect of A&P we’re teaching, but especially histology. As I’ve been saying since the early days of this podcast, we need to use our storytelling skills in our dramatic classroom or Zoom persona, even to the point where it kind of feels like we’re over dramatizing and overacting and being overtly, maybe overly enthusiastic about histology because you know what, if we don’t do that, our students will think we don’t like histology either. And you know that kind of thing rubs off on them and you know what else? It’ll feel over the top to us. It’ll feel that way. Yeah. But it won’t be perceived that way by students. This happens a lot in acting, in on the air journalism, in public speaking, where it can feel to that person.

Kevin Patton (15:15):
And it might even feel to an observer if they’re close by, that, “Wow, they’re just really overacting.” But you step back from that even just a few feet and don’t think about analyzing the way they’re saying everything. It’s going to come across as enthusiasm and not as overacting. Okay. Sometimes it will be seen by students as being over the top, but maybe that’s even better. We need a big stick to defeat a big enemy. Right? And histology hate is a big, big enemy of learning. So yeah, let’s do some big over the top, overacting, or over enthusiasm. So, there are some ideas about why students might hate histology. I’m sure I’ve missed some, but that’s enough to spark some ideas. And speaking of ideas, I have some ideas about how to counteract some or all of these concerns and some idea is for teaching histology that may help you tweak your methods to improve student learning as we reduce histology hating. Hang on, I’ll be right back. [music]

Sponsored by HAPI

Kevin Patton (16:27):
Marketing support for this podcast is provided by HAPS, the Human Anatomy and Physiology Society. Promoting excellence in the teaching of human anatomy and physiology for gosh, over 30 years. If you’re looking for all kinds of opportunities for expanding your mind and expanding your heart and doing it all alongside other like minded anatomy and physiology faculty, just go to the APprofessor.org/haps. That’s H-A-P-S. [music]

Birding For Tissues

Kevin Patton (17:06):
How can we fix histology hating by our students? I got to tell you I’m not sure I have a lot of good answers, but I’ve had some success with it. And maybe what I’ve tried that seems to work okay will give you some ideas to adapt them to your situation and your style, and maybe crank them up a notch. But first, I guess we should ask if hating histology needs to be fixed. I mean, isn’t it like the Krebs cycle?

Unknown speakers (17:44):
Oh, not the Krebs cycle.

Kevin Patton (17:45):
Maybe we don’t have to love it. Well, that’s possible, but I think I’d rather love something as I put in the time, effort and potential insomnia from nightmares involving pink and purple blobs than to hate it. Yeah. Love’s better than hate I think even in learning. I think reducing histology hate does have the potential to improve student learning besides. And at the very least, I can feel good about doing my part and to reduce hate in the world if I’m working against hate of histology. When I first introduce histology, I go through most or all of the tissue types that students eventually will need to be able to identify in a lab practical. And they’re justifiably shaken for a moment, but I quickly come to the rescue and tell them it’s far easier than it looks. And I mean that sincerely and I tell them a story. Of course, I always have a story or two. I tell them about how excited I was to have my first professional animal training job as an assistant sea lion trainer.

Kevin Patton (19:04):
I was to take charge of the daily care of four California sea lions, all female in general appearance. Interestingly, we found out that one of them was intersex and had just… They just had the general form of a female sea lion which are way, way smaller than male. Anyway, they were all almost exactly the same size, same color, same bark, and same swimming form in the pool and the same waddle-y, skippy walk on the ground. They were basically identical quadruples, not genetically, but you know what I mean. In appearance. Well, not even that, just in at first glance, when you first look at them you think I’ll never be able to tell them apart, but you know what? That’s the first impression, just like the first impression that students have of all these tissues, how will I be able to tell them apart? They’re all just blobs to me. Continuing my story of sea lions, the head trainer, he gave me a bucket of fish and says, “Go get Yvonne out of the pool and go feed her over there so the older ones don’t bully her. She’s new to the group.”

Kevin Patton (20:26):
“Okay. Yvonne?” He says, “Yeah, Yvonne that one.” And he points to a small pool with revved up hungry sea lions making fast circles in the pool and splashing around. “See, that one.” Not helping. So, to make the long story short, it took me a long time to figure out who was who. But you know what? I did it. And before long, I could tell them apart at a glance, either in or out of their pools or the moats. And later I had to do much the same thing with tigers, all of whom looked pretty much like any other tiger you first meet. And I tell my students, okay, that’s pretty unique, but there are things just like that you have learned. It may be a group of puppies or it could be identifying different makes and models of cars at a glance or distinguishing which of 12 kinds of red at the store are cosmic crisps. Well, okay. That one’s easy. They’re the incredibly expensive ones, but I should say the even more expensive ones than the rest of the red apples. But you get what I’m talking about.

Kevin Patton (21:41):
You can do this. That’s what I tell my students. You can do this, you do it all the time in everyday life with those things that interest you, those things you’ve been exposed to. Sometimes without really even thinking much about it, you just do it. That’s what histology is like. It looks impressive that I can do it easily, but I wasn’t born with this knowledge and it’s not a sign of genius this or anything. It’s a sign that I put myself to the task and practiced. That’s it. Practice, practice, practice. And I had some good guidance and I’m here to give you that kind of guidance. So, here we go. We’re going to learn now how to do that and impress all our friends and family with our amazing histology skills.

Kevin Patton (22:34):
So, that and my usual confidence building and my usual dramatic over the top enthusiastic oohing and aahing over how amazing microscopy is and how amazing the variety and functions of tissues are. Hopefully, that’ll all get them started with a somewhat positive can-do attitude. Sort of a dramatization of establishing a growth mindset. Well, then it’s onto another story. Of course, I tell them about my days as an undergrad biology major taking a lot of vertebrate zoology courses. Yep, I had to learn to identify the fishes of Missouri. Yes, using a book by that name and the birds and the reptiles and amphibians and well, all kinds of animals. Out in the field, I had to be able to spot them and on a moment’s notice, identify what species or sometimes even subspecies they were. But I zero in on the birds when I’m telling this story in my course, because it was especially hard for me to learn all the birds. The others you could usually grab or net and grab pretty easily and look them up in the book while you held them in your other hand.

Kevin Patton (24:00):
But okay, sometimes the fish squirm around and even the snakes squirm around a little bit and you have to be really careful if the snake you’re holding could be a venomous snake and you got to look it up in the book and make sure first, but birds, not so much, you can’t really grab them very easily as they fly by and hold on to them as you’re looking them up in a book. A buddy of mine, he tried to do that and he actually succeeded a few times. But the problem is even if you could grab them easily, holding them in your hand for even a few minutes, could cause some serious harm for some, especially those smaller wild birds. With birds, you may have only a few seconds to get a good look when they’re sitting on a tree and then they fly away or sitting on that log over there and then boo, they’re gone. Usually they’re gone at even the first sighting is at some distance.

Kevin Patton (24:51):
So you’re not really getting a great look at them and it’s going to take some time to get your field classes aimed at them, but then they’re flown away. So birds, they’re kind of hard to even see much less to practice identifying. So just like in a lab, practical, the identifications when you’re doing that, they have to be quick. You can’t just ham and haw and think about it and go through things in your mind and so on, because that timer’s going to go off, that bird is going to fly away. So you need to get to a point where you can do it quickly with some reasonable accuracy. And at that point in the story, I pass around a couple different Peterson’s field guides, like the different field guides to birds. And I point out that Peterson and other bird guide designers have developed systems of how to sort out the birds by their appearance. That is to help you be able to do it quickly, not just by providing a picture, but providing other kinds of information.

Kevin Patton (25:51):
For example, some systems they have, you kind of think about what group the bird is in. Like a very large group and then maybe subgroups or smaller groups within that larger group. And then of course it gets trickier. Let’s say you’ve narrowed it down to little brown songbirds. Okay. Well, I mean that gets you so far, but only so far. And so now what are you going to do? Well, Peterson for example, has these little arrows that tell you where the distinguishing characteristics are on that bird. What I usually call the landmark characteristics when I’m looking at tissues in histology. And there might be a little range map there to show you that it can’t be that bird, they’re only found in Alaska and here I am in Missouri. So forget that one, move on to another one. And because this one’s not… Well, I shouldn’t say not possible because anything’s possible, but not likely. And I tell my students we’re going to learn histology like I learned birding sort of. We’re going to use that same general approach.

Kevin Patton (26:58):
In my ornithology class, we did spend some time in the classroom talking about birds and looking at pictures of birds and we spent some time in the lab with study skins of birds. And we walked over to the library where there were always birds hitting the huge windows and leaving a ring of bird bodies around the library’s foundation. So there’s always birds to see and to identify over there. But then, every Saturday morning we went out in the field to identify birds. So yeah, I start with an overview of what we’re looking for with the tissues. I start with how to group our birds. I mean, tissues into smaller and smaller groupings based on their physical characteristics, where in the body they’re likely to be found. Those kinds of things. And well, because structure always fits function, those groupings, those physical anatomical groupings are related to what each tissue is doing for us and our bodies.

Kevin Patton (28:02):
Next, I take them on their first field trip by showing slides of oh, so perfect tissue specimens, because that’s what we usually have slides of. Right? The really good ones. Those are the ones that are in our textbook in our lab manual. And those are the ones that if we purchase some images of tissues, they’re… Well, nobody’s going to pay for sloppy, messy, hard to figure out ones, right? They’re going to be perfect ones. Just like the pictures of birds in my ornithology book, they were beautiful. Well, they still are. I still have my ornithology book. They’re really clear pictures of birds and they’re characteristics. And that’s the way we kind of do it in histology. And you know what? That’s not a bad place to start with the ideal specimen. That’s where we start. That’s not what we’re going to end up, but that’s where we start. So I do that and I point out their landmark characteristics. The things I look for when I’m identifying tissues. Just like my ornithology professor and other guides did with me.

Kevin Patton (29:12):
They’re going to tell me how they tell what kind of bird that one is, how they know that one is that kind of Sparrow and not this other kind of Sparrow. This approach to teaching and learning identification is sometimes called using the “expert eye.” What that refers to is the idea that if you follow an expert’s eye, you’ll learn what they’re looking at first and then looking at second and then third, in order to make their determination. If you can figure that out, you’ll also know where to look. You may have your own way of teaching the histology expert eye to your students. This just happens to be my way of doing it. And then the next field trip I take my students on is under the microscope. I’ve often used a video microscope to do this. A friend of mine uses a virtual microscope tool to do this.

Kevin Patton (30:14):
So they’re not looking at actual specimens under a microscope and just using a video camera to do it, they’re actually using an image from a computer database and using software that mimics the use of a microscope, and they look around for a tissue spot in a tissue specimen and then zoom in on it and do it that way. So there’s a variety of different ways to do this stage, where you’re the guide and you’re taking them under the microscope and walking them through what you look for, sharing with them your expert approach, your expert eye. Now on this kind of field trip, we have to figure out what habitat we’re in. Right? Are we somewhere where we can find a muscle or find epithelial tissue or whatever it is that we’re looking for? Because if not, then we’re wasting our time. We have to kind of get the lay of the land. We have to see well, what kinds of things are around here in this particular area of this particular specimen?

Kevin Patton (31:17):
Now here’s where I have to pause and let you know that this is when I demonstrate what structures might like in the kinds of cross sections we’ll be visiting. That is I demonstrate in some very simplistic ways, often just on the whiteboard, but sometimes using objects or clay like modeling clay or Plato or something like that. How a folded membrane looks, well, on a side view, a cross section looks kind of like a rounded zigzag going back and forth. And how a tube on a cross section looks like a circle. And if you have a bunch of tubes, usually with this one, I just take a bunch of drinking straws and say, “Look, they’re a bunch of tubes.” Right? But then you look at them on the end and what do they look like? A whole bunch of little circles cramed together. And how when we cut out part of a tube on a longitudinal section or a bend in the tube, it looks more oval or hourglass in shape.

Kevin Patton (32:14):
So, I do that sort of thing so that students can sort of figure out what they’re looking at when they’re looking at these cross sections under the microscope as I begin walking them through it. Often we use prepared slides that are labeled with a tissue type, such as smooth muscle. And students think, well, that’s all they’re going to see on the slide. Whatever it is they’re seeing, that must be smooth muscle because that’s what the label says. But of course, that’s not right. It’s like we’re saying, we’re going to the river to see bald eagles. And the first big soaring bird we’ll see might be an eagle, but it could be a vulture, that one over there that’s lazily flapping along, that might be a heron and well, there’s a bunch of other kinds of birds too that it could be. So saying that we’re going to a spot that’s good to sight eagles… I mean, some of them even have signage that say this is the eagle observation area. Well, that doesn’t mean you’re only going to see eagles there.

Kevin Patton (33:12):
And doesn’t even guarantee that you’re going to see any eagles there. It’s just that the habitat we’ve picked is likely to contain bald eagles. So you know that smooth muscle slide, yeah, it should have some smooth muscle in it somewhere, but it’s also going to have a bunch of other stuff too. We’re now learning things about the environment inside our body. There are different habitats and each has its own collection of light residents. And that kind of knowledge helps us learn to find and identify different kinds of tissues. Because we’re learning how different tissues relate to one another. And that in turn helps us to begin, I don’t know, to build a conceptual framework work of where to find them and what their function is. Okay. Then I let the students guide me. I put up a new slide and start asking them, what am I supposed to be looking at here? Where do I go if I’m trying to find, oh, I don’t know an epithelial tissue? Well, they might tell me I look for the white spaces.

Kevin Patton (34:25):
I hope they tell me that because that’s what I just told them. Because if I look for the white spaces, I’m going to find epithelia facing white spaces. I’m not always going to find epithelia there, but if I’m going to find epithelia, they’re probably facing a white space. They’re on an edge, they’re along the edges of those spaces. If it’s skin, it’ll be along one whole side probably of this big slice that I’m looking at, which side has what looks like a layer or two of cells all stuck together. Well, if we find that sign that has that layer or two of cells stuck together, that’s probably the epithelium we’re looking for. So maybe we can zoom in on that and see if we were right. And then maybe identify what kind of epithelium that is. Is it the kind we were looking for?

Kevin Patton (35:17):
Because it could be a different kind just because the label on our slides that we can find one kind that doesn’t mean every kind of epithelium in that whole tissue, that whole specimen of tissue is going to contain only that particular kind of epithelium. Or maybe there’s a whole bunch of little white dots instead of a free edge. Well, looking at the perimeter of those little white dots, do we see a layer or two of cells all stuck together? Well, these might be tubes with epithelial walls. I’m giving them that kind of expert guidance. We’re having those kinds of scenarios play out right in front of us. And at first I walk them through and then I let them try to walk me through. And I nudge them this way and when they need to be nudged, of course, that’s part of what we do as teachers. Right?

Kevin Patton (36:06):
And then of course, comes the issue of once we zoom in on what we think is the epithelium we’re looking for, then is there one layer? Is there more than one layer of cells? The cells that we see there on the edge, are they tall and skinny? Are they about as tall as they are wide? Or are they smooshed down into a pancake shape? And we can use that to help us narrow down what type of epithelium we’re looking at. And so, all of these characteristics are what I call the landmark characteristics. How many layers of cells do they have? If they’re an epithelium, are they along the edge first? And then if they are, are they one or more layers of cells? Okay. Another landmark characteristic is how many layers? Is it one layer or is it more than one layer? Another landmark characteristic is, what is the shape of the cells in that outermost layer? And then they get to go on their own field trips. I encourage them to work in pairs each with their own microscope, looking at the same tissue type in their own microscope.

Kevin Patton (37:15):
And then they can kind of help each other because they’re trying to find the thing. So they work on the same thing at the same time in pairs. And then they might give their slides over to a different pair and swap with them, and now they’re looking at a new tissue type. So, this way they can help each other and collaborate and do some learning because of that collaboration. And these days we don’t even have to use is classic microscopes. That’s what I’ve always used. And I prefer that. At least right now I do ask me. In a couple of years, maybe I’ll say no, no I hate using real microscopes. So I mean, everybody has their own preference and teachers have their own preference, students have their own preference. But I prefer the classic microscope. But we have access to virtual microscopes these days and virtual tissue databases like the one from AAA I mentioned earlier in this episode, that we can use for teaching and learning.

Kevin Patton (38:09):
All of this can be done on devices in the lab or even remotely, at least now we can do it. And that’s a recent development. Good thing these days, right? That we’re able to do this remotely. At least theoretically we’re able to do it remotely. And then my students they start going out in the field on their own every day. And they’ll be learning their tissues bird by bird. And that’s the end of my story. [needle scratching vinyl record] Wait, wait, wait, wait, wait. That’s not the end. About a decade or so, I stumbled on what was a breakthrough in how I teach histology. Something that, oh, it’s super easy and wait for it. Students love, love, love this technique. That’s three loves for histology. Really? So, hold on for just a moment and I’ll be back soon with that amazing breakthrough. [music]

Sponsored by HAPS

Kevin Patton (39:16):
The free distribution of this podcast is sponsored by the master of science and human anatomy and physiology instruction. The HAPI degree. I’m on the faculty of this program at Northeast College of Health Sciences and I’m excited about the upcoming graduation of our latest cohort. If you know someone interested in all the evidence-based teaching strategies and how to apply them to all the major topics in the anatomy and physiology course, well, now is the time to get information and enroll in time for the new fall cohort, which is forming now. Check out this online graduate program at northeastcollege.edu/hapi. That’s H-A-P-I. Or click the link in the show notes or episode page. [music]

A Breakthrough

Kevin Patton (40:15):
I’ve been talking about teaching introductory baby histology, typical of the undergraduate two semester A&P course. Of course there are as many approaches to this teaching and learning task as there are different A&P courses and A&P faculty. One size does not fit all. That in itself is an interesting topic for another episode down the road. But one thing that does seem to be common among all the different flavors of histology modules within undergrad A&P courses is this, many, possibly most students hate histology. And since that ubiquitous survey of tissue types usually comes early in the course, it’s often an ugly way for students to start out. They fail possibly. And almost certainly don’t have a fun time of it. They may be so discouraged that they quit the course. If not literally, they may withdraw from A&P in their heads and in their hearts.

Kevin Patton (41:31):
I’ve discussed some reasons that might be. And I also talked about some things that we can think about as we flail around trying to make that histology survey a better experience for our students and for us. For example, finding a way to part to them your expert eye in identifying tissues. I said that I had a breakthrough in my own teaching. I’d already been using that field guide to the tissues approach as if we were learning the fishes or the birds of Missouri and well, that by itself worked way better than anything I’d tried before, because I think, it was something that I could bring a personal story to. And more importantly use as a way to bring them along as I applied my expert eye. And it’s pretty easy because I was able to channel those zoology professors and other guides I’ve had in learning how to identify animals in the field or stream.

Kevin Patton (42:48):
But I don’t know about a decade or so ago. I stumbled onto a way to push that into hyperdrive or hyper, micro, histo, gamification drive. I know what you’re thinking. Get on with it if you have a breakthrough, tell us what it is. Okay. I had designed an elective A&P one supplement course that I taught alongside A&P one to help students with whatever they needed help with. But I did it as a group. And unsurprisingly histology was the first major topic that they all begged me to help them with. I had already been using clickers in this supplement course since they already had clickers they were using for their lecture course. The thing about clickers, if you really dive into the literature and talk to the clicker use experts, there’s this general rule, almost a commandment written in stone, that clickers should be used sparingly, just a few clicker questions per hour. If even that many and spaced far apart from each other.

Kevin Patton (44:12):
And in my experience, that really seems to be the best way to use clickers. Another general rule about clicker use, is to give students a bit of time to think of an answer. I usually encourage my students to chat with their neighbors about it before committing to an answer to a clicker question. And so, yeah, I give them a little bit of time. And that has worked very well for me. But like any useful rules, there may be exceptions. And I found such an exception in my supplement class. Each supplement class was run very loosey goosey. Like I like to run most of my lab sessions. We go where we need to go with that group to meet our learning goals. Well, one time I was daydreaming I guess, or maybe I was napping and having a sleep dream. And I pictured a scenario where I had not only run a large number of clicker questions, but I do them back to back and I do it at high speed.

Kevin Patton (45:21):
I’d only give students a few seconds to respond before I cut off the receiver. So I made a game of it. I called it the need for speed. Each clicker question would have an image on a PowerPoint slide of an unidentified tissue and they’d get five choices of what that tissue type is. And they’d get about 10 seconds. I had it set on timer and there’d be a buzzer go off when the time was up. Then I’d ask them to tell me their answers if they felt like it. And then I’d reveal the graph showing the results. Now of course at the beginning, the results would be all over the place. I might walk them through the process of figuring out what that tissue is and well, we’ll try another one. Eventually, they’d get better and I could start giving them trickier images. And then we walk through those together if they mess it up. And from item to item and week to week, they would get really good at it surprisingly fast.

Kevin Patton (46:41):
For each batch and the students getting better and better at identification, I would reduce the time on the timer until we’re, I don’t know, we’re approximating Jeopardy! speed. That’s fast. Really, this is all just an application of that magical strategy of spaced retrieval practice or what I often call testing as teaching. And of course, one can do a similar thing using a strategy other than clickers, for example, online tests or quizzes, Anki or Quizlet decks can be used. Well, there are all kinds of creative adaptations that can be made to that. It doesn’t have to be clickers, but clickers happens to be the way I’ve done it. But that’s not even the breakthrough part. Well, not all of it. The other part is that the students love it. I mean, love, love, love it. That’s three loves. Their first reaction, especially from the higher-performing students, is something like, “Wow, I’m nowhere near ready for a practical I can see now I haven’t been studying the right way, I need to get on the stick.”

Kevin Patton (48:15):
And the lower-performing students, they express something sort of along the lines of, “Oh, I guess studying can help me do better on the practical.” But that quickly progresses into real fun. And puzzling out each mystery slide and doing it together, I kid you not in every single section of that course over many semesters, it was a party atmosphere. When we played that game at the end of the day session, nobody tried to leave early anymore. Instead, they kept asking when that part of the session would start. “Hey, can we start doing that? Come on, we’re ready. Let’s go.” My Dean did his obligatory visit one time and remarked afterward that it seemed like the class was about to get out of control. I’m not sure what kind of riot he was anticipating, but I thought to myself, yes. And isn’t it wonderful how out of control they were jumping all over each other trying to get the right answer in histology? How many times does an A&P course turn into a loud riotous festival?

Kevin Patton (49:38):
I mean really, with students shouting answers when one group gets it wrong or laughing and celebrating when they all finally get a tough one right. Or talking over one another, trying to explain why that can’t possibly be smooth muscle on that slide. Those were some of the best times I’ve ever had in the lab. We did it in a lab. And can you believe it, we were doing histology. The icing on that party cake came when they started asking if they could stay past the end of class time and do more practice. And that didn’t always work. Because there often was a lab class coming in or some other kind of class coming into the room. But I did eventually manage to get 10 minutes added to our schedule after that. But you know what? Even that wasn’t enough, it was never enough time. They just loved doing it. They couldn’t wait to do it. Another cool thing is that they found ways to play this game themselves in small study groups.

Kevin Patton (50:45):
And even cooler is, that we and they started applying this gamification to studying their bones and bone markings and their muscles. And well, everything that they needed to be able to identify quickly. But it was histology where the fun began for them, which is a sentence that early in my teaching career, I never thought I’d hear myself saying that it was histology where the fun began for them. [music]

Staying Connected

New Speaker (51:25):
Know another A&P teacher who deals with histology hatred among students? Of course, you do. Why not share this episode with them? It’s easy. Just go to theAPprofessor.org/refer to get a personalized share link that will get your friend all set up. As always, I have lots of links to related content. If you don’t see links in your podcast player, go to the show notes at the episode page at theAPprofessor.org/113, that’s 1-1-3. And while you’re there, you can claim your digital credential for listening to this episode.

Kevin Patton (52:05):
And you’re always encouraged to call in with your questions, comments, and ideas to share at the podcast hotline. That’s 1-833-LION-DEN or 1-833-546-6336, or send a recording, a written message to podcast@theAPprofessor.org. And you’re invited to join my private A&P teaching community way off the social platforms at theAPprofessor.org/community. I’ll see you down the road. [music]

Aileen (52:45):
The A&P Professor is hosted by Dr. Kevin Patton, an award-winning professor and textbook author in human anatomy and physiology. [music]

Kevin Patton (52:59):
Action figures are sold separately. [music]

Kevin Patton (53:14):
We’re living in strange times. Aren’t we? There’s a lot of health misinformation and disinformation coming at us from all directions. As science faculty, we have an obligation to promote only evidence-based information and critical analysis. Let’s all help each other keep everyone safe and healthy.

Episode | Captioned Audiogram

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