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Episode 58 | SCRIPT

by Kevin Patton

Flashcards: Hidden Powers


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.

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Episode 58

Episode 58 Transcript

Flashcards: Hidden Powers




Kevin Patton: Author Stefanie Weisman once wrote, “Memorization has gotten a bad rap recently. Lots of students and even some educators say that being able to reason is more important than knowing facts. And besides, why bother committing things to memory when you’ve got Google. My response to this, after I finished inwardly groaning, is that of course reasoning is important, but that doesn’t mean you shouldn’t know facts as well. It’s not like you have to choose between one or the other. Besides, facts give you a foundation on which to reason about things.”

Aileen: 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: In this episode, I talk about smelling without olfactory bulbs, using gene therapy to make new neurons in the brain, and the first of a series on the hidden powers of flashcards.

Gene Therapy for Brain Cells

Kevin Patton: The generation of new neurons in adult brains has been a recurring topic over the last couple of years in this podcast and, well, in human biology in general. In fact, I’ve become so accustomed to these conversations that I think I need to get another fix right now. Over the last few years, there’s been some really exciting work being done in applying gene therapy techniques to brain tissue to promote growth of new neurons. Obviously, this could be very helpful in cases of brain injury or degeneration, for example, in stroke patients, in people with head injuries, people with Alzheimer’s disease and other neurodegenerative disorders.

Kevin Patton: In a blog post a few months ago, well known scientist Francis Collins laid out the basic idea of what’s going on in this area. I suggest you read that. And yes, it’s linked in the show notes and episode page at theAPprofessor.org/58. But, here’s the idea in a nutshell. Researchers have been able to use the retroviruses that they use in genetic engineering to insert a gene for the transcription factor called NeuroD1 into glial cells. They’ve been able to do this with astrocytes and with NG2 cells, which are sometimes called polydendrocytes. Specifically, they used the reactive, that is proliferating forms, of these glia. Reactive glia appear when there’s damage to tissue and they’re reacting to that damage, so we call them reactive glia. By inserting the neuro NeuroD1 genes into the reactive glial cells, these glia started producing functional neurons at the site of brain damage. Wow!

Kevin Patton: Like many of the science updates I share in this podcast, I don’t think that this is something we necessarily need to discuss in our A&P course. In fact, I advise against it. But, it does fill in the backstory that we faculty need to make our telling of the simplified story more confident and more informed. And you never know, there might come a student question or some tangent to your story that you think might better engage students and where this line of scientific discovery might be a nice little bit of added information, like letting our students in on the behind-the-scenes world of neuroscience.

Sponsored by HAPS

Kevin Patton: Marketing support for this podcast is provided by HAPS, the Human Anatomy & Physiology Society, promoting excellence in the teaching of human anatomy and physiology for over 30 years. I’m going to say it again, that deadline for HAPS awards that will help you be able to participate in the next annual conference is coming up soon. And I’ll let you in on a secret. Early submissions have been coming in very slowly. Nobody likes to leave travel money on the table, right? So go visit HAPS’s at theAPprofessor.org/HAPS. That’s H-A-P-S.

Something Smells Odd

Kevin Patton: I have some weird news for you from the world of science. One may be able to smell things, that is have normal olfactory reception, even if you’re missing both olfactory bulbs. Yeah, really. I know. It’s weird, right? This comes from a report in the journal Neuron. It’s an article called Human Olfaction Without Apparent Olfactory Bulbs. So, bad title kind of tells you what they discovered, right? As you and I know, the last best story is that odorants, those are molecules that trigger our sense of smell, the last best story is that odorants stimulate receptors on the membranes of olfactory sensory neurons located mostly in the olfactory epithelium at the top of the nasal cavity in the mucosa. Neural signaling then continues on to one or the other olfactory bulb lying on top of the cribriform plate of the ethmoid bone. From there, most of the olfactory pathways lead to the cortex and, well, we smell things.

Kevin Patton: Now, this study started when some researchers noticed that some women showed a lack of distinct olfactory bulbs in an MRI study but they were still able to smell normally. Ordinarily, a person without functional olfactory bulbs would have anosmia, the inability to smell anything. So, seeing the opportunity for discovery, they looked at over a thousand people’s MRIs and did smell tests. And they found out that, hey, there are some folks out there that do not have visible olfactory bulbs, and they smell okay. They’re perfectly normal smellers.

Kevin Patton: Looking at the numbers, they found that about 0.6%, that’s, you know, a little over half a percent, of the women in this study have this situation. And here’s where it gets even weirder. Among left-handed women, the incidence is about 4.25%. Whoa! And then when they looked at men, they found that this was happening in exactly zero of the men. So, only women have this, at least as far as we’ve seen so far, and left-handed women are about seven times more likely to have no olfactory bulbs but normal smell than women in general.

Kevin Patton: So, how can we explain it? That is, how can we explain these folks without olfactory bulbs can smell? Well, the researchers that were involved in this study have essentially a one-word answer, plasticity. Apparently, there are neural pathways that are not in the anatomical form of a distinct olfactory bulb but are nonetheless able to transmit olfactory signals along the pathway to the smell centers of the cortex. Now, if you want to know more, that is, sniff out the details, then check out the links and the show notes or the episode page at theAPprofessor.org.

Sponsored by AAA

Kevin Patton: A searchable transcript and a caption audiogram of this episode are funded by AAA, the American Association for Anatomy at anatomy.org. Go check out the shiny new website they’ve just unveiled at anatomy.org. Yep, a lot of exciting things are happening in AAA, and you don’t want to miss them.

Introduction to Flashcards

Kevin Patton: A recent has got me thinking about flashcards. It’s actually a blog post called Make Flashcards More Powerful with These Three Tips. Comes from Pooja Agarwal’s website retrievalpractice.org.

Kevin Patton: Now, I mentioned Pooja and her book Powerful Teaching as a recommendation from the A&P Professor Book Club in the preview episode for episode 57. I’ll circle back to that article in a minute. But first, flashcards, really? Why bring them up here? Aren’t they really just a simple strategy that everybody knows how to use? Maybe even a bit too simple for college level work? And really, aren’t we supposed to be teaching higher level thinking and scientific reasoning and not focusing on memorizing facts? Yeah, well, it’s my podcast, and I can talk about whatever I want. Besides, you and I both know that none of that is true. Flashcards are simple. Yes, of course. But they can also be used in some very advanced ways. Yeah, we should be teaching higher level thinking, but our A&P students need at least some facts to work with before they can do that. Facts, even long lists of anatomical and physiological facts, are not our enemy. And besides that, there’s this new language they have to learn with all kinds of new terminology. So, let’s start there, with this idea of language learning.

Kevin Patton: I’ve said this before, for example, in episode 16 when I was talking about pronunciation, and it bears repeating. I think it’s useful to think of A&P terminology as a new language to be learned by our students, just like a native English speaker learning Spanish for the first time, or Chinese, or Arabic. This isn’t really just a metaphor. It’s literally true. Think about it. There are almost 4,000 entries in my two semester A&P textbook. Let’s say my students walk in with, oh, I don’t know, about 10% of those mastered, which I think is being very generous. That leaves a little over 3,500 terms. Let’s say that, realistically, I’m not going to cover every concept in the book. And even those I do cover, I may not cover in great detail, thus causing some terms to drop off the must-know list. Or I may not ask students to every alternate term available.

Kevin Patton: So let’s say I’m only really asking students to be using about, oh, I don’t know, two-thirds of the terms in the glossary. I just pulled that fraction out of my atmosphere. Yes, I just pulled it out of thin air. So, maybe it’s more, maybe it’s less. But if it’s in the ballpark, that leaves my students with 2,374 terms to master. Let’s just round that down to 2,000 to make it easy to discuss.

Kevin Patton: But wait, that glossary’s pretty thorough. Maybe for the sake of discussion we’ll just call it a thousand new terms, not 2000. Even so, that means that over the course of two semesters, students need to master close to 35 new terms each week. Yeah, I think that maybe I cranked it down a little bit too far. But still, it’s a lot of terms to master no matter how you slice it.

Kevin Patton: When we start learning a new language, one approach is to master a core set of words and phrases in the new language as a starting point. Honestly, when I took Spanish class and then later Latin class, I don’t think I had 35 terms a week to master. I don’t know. Maybe I did and I’ve suppressed those memories because of the trauma involved. But something we do when we learn a new language is that we get progressively better at quickly incorporating new words and fitting them into our increasingly large and complex conceptual framework. The thing is, though, that we have to start somewhere, right? And flashcards can be really helpful in getting that start. After all, if my students are going to be able to start thinking in A&P, they have to have the language mastered at least at a minimal level.

Kevin Patton: Now, I could just leave it at that, but you know me. I never just leave things at a natural stopping point. There’s always something more I have to say about things, right? Well, first of all, there are some ways to make that simple kind of flashcard learning that we all did to learn our math facts back in grade school more efficient when we’re using flashcards to learn A&P. One thing is that research has shown that most students using flashcards by themselves to study flip them over way too fast when they don’t know the term. They don’t give themselves enough time to retrieve the information from their memory. Just a few more seconds may do the trick, but they don’t give themselves that extra needed time. If they just give themselves a chance, then they’d remember and better solidify their long-term memory of that term. This is one of the three principles discussed in that article I mentioned a few minutes ago from Pooja Agarwal’s retrievalpractice.org, which, of course, is linked in the show notes in the episode page at theAPprofessor.org.

Kevin Patton: Another principle Dr. Agarwal discusses is that flashcards work better if my students shuffle and interleave the card. The method I recommend to my students is one that I call PALS, P-A-L-S. The PALS stands for Patton’s Adapted Leitner System. Now, why do I call it that with my name in it? Well, long ago, I realized that nobody’s going to name anything after me unless I do it myself, and I want to leave a legacy.

Kevin Patton: Another part of the term refers to the Leitner System, which is widely known. And that can be rather complex. But in a nutshell, the Leitner System is when you take three, or four, or five, or whatever number of boxes or partitions in a large box and that’s for your cards. And you put all the cards in the first box. Then, as you review them, those that you get correct go into the next box, box two. Those you get wrong, they stay in the first box. Then you wait some time. Maybe you even schedule certain times that you’re going to be looking at the cards in these boxes. When you go back, you try those in the first box again. And when you get a bunch of cards piled up in box two or waited a long enough time or scheduled a certain time, then you tackle those cards again, the ones that are in box two.

Kevin Patton: Now, in both cases, that is both boxes, you’re spacing out the retrieval practice, making this an exercise in spaced retrieval practice, the featured topic of the very first episode of this podcast. Now, over time, the cards move further and further along, that is from box wound to box two, and then from box two to box three, and from box three to box four, however many boxes you have and cards you have. And more and more terms are mastered for the long term as you go through this Leitner System.

Kevin Patton: Now, the PALS variation is way simpler and it’s more portable, I think. And my students find it to be very effective. All you do is you hold your stack of cards, so no boxes are involved. Most of my students use just a rubber band to put around their stack of cards. That stack of cards is, let’s say, your weekly stack of 35, and you hold it in your hand. So, already simple. No boxes, no partitions, no nothing, just a stack of 35 cards in your hand. And then you try the first one. If you get it right, you put it at or near the very back of the stack. You want to mix it up a bit, not always putting the card right behind the last card you put at the back of the stack, thus introducing a bit of randomness to the shuffling that Pooja Agarwal recommends.

Kevin Patton: Now, if you get it wrong, then it doesn’t go to the back of the stack. It goes in the middle of the stack. It’s not in the back where all those correctly answered cards are going because, well, it wasn’t correct. You didn’t answer correctly. So you want to see it sooner, so it’s going to go in the middle of the deck and it’ll come up sooner. And remember, we’re giving ourselves enough time with each card to pull, I mean, retrieve that answer out of our memory.

Kevin Patton: Now, at this point, I tell my students to vary where in the middle of the deck they put it. If they think they’re close to getting it right the next time, then, okay, put it a bit further back in that middle section of the deck. If it’s one that they know is going to take them a while to really get it, then they put it up a little bit more to the front part of that middle section of the deck. I tell my students to carry the deck around with them, and they can. A deck of 35 cards, you can fit that in your pocket, your purse, your backpack, whatever, and just carry it around in your hand. So then you flip through some cards while waiting for class to start, waiting in line to get a cup of coffee, during commercials on TV or YouTube, whenever. A few minutes here, a few minutes there. This is very easy, and very doable, and has that valuable spacing built in, right? Just like the Leitner System, but in a way simpler approach.

Kevin Patton: Then, this gets us to Agarwal’s third and final tip for using flashcards, repeat at least three times. Or as I tell my students, practice, practice, practice. Now, I don’t specify three times around because using that changing deck of cards it kind of just happens on its own. They don’t have to think about three times. They keep going through until things are mastered.

Kevin Patton: Now, something else I recommend to my students is to throw in some cards from the decks used in previous weeks so that they get more spaced practice and don’t lose those previous terms from their mental lexicon. If students want to keep their collection of cards sorted by category, something I recommend to them, then they can number them according to chapters in the book or according to the learning objectives in the syllabus or whatever system works for them so that when they shuffle old cards into new decks they can eventually return them back to their proper place in their growing flashcard archive.

Sponsored by HAPI Online Graduate Program

Kevin Patton: The free distribution of this podcast is sponsored by the Master of Science in Human Anatomy and Physiology Instruction, the HAPPI degree. Besides the awesome training in both science and teaching, the HAPI degree program allows you to become part of a dynamic and interactive learning community of fellow A&P teachers, a network that long outlasts your time in the program. Check out this online graduate program at nycc.edu/HAPI, that’s H-A-P-I, or click the link in the show notes or episode page.

Beginning Intermediate Flashcards

Kevin Patton: Okay, so I just discussed some basics about flashcard use, including that language learning approach that my students can relate to when I tell them they might want to focus on flashcards as part of their study routine. And I want to stop right there to emphasize that I do not think this should be a student’s entire study routine, just like we don’t learn a bunch of German words and expect to get along okay among German speakers in Germany. We’d have to master some grammar, and some cultural context, and some local idioms, and, well, we have to start thinking in German if we really want to do well. So, flashcards for learning terminology is a start. The immersion in the language of A&P comes in listening to and retelling stories in the new language, in solving case studies, and doing dissections, and all manner of other learning activities. Flashcards, well, they’re just one set of tools in the toolbox.

Kevin Patton: Right now, I want to talk about bringing flashcards to bear in those additional steps in learning A&P, advanced flashcards, or at least intermediate flashcards for now. We’ll get to the advanced stuff later on. First of all, there’s the question of whether it’s better to use flashcards prepared by the teacher, or by educational publishers, or do you use flashcards a student makes themselves. Well, in my opinion, the answer is yes. I think both kinds of flashcards work. I mean, after all, they’re both forms of spaced and interleaved retrieval practice, right? And we know that works.

Kevin Patton: However, I do have a preference for handwritten flashcards, and that’s because I think there’s an extra level of learning that occurs when we do a little cognition, that is a little thinking, in figuring out what to write on each side of the flashcard. Then there’s the motor activity, employing motor senses in the process of writing something out by hand. Besides that being an added kind of experience beyond reading, it also, well, it kind of slows things down as we take the extra time to write it out. That means we’re spending a little more initial learning time with each term and its definition or description.

Kevin Patton: And what about the question of traditional paper flashcards versus flashcard programs or apps, such as Quizlet, or Anki, or the bajillion other options available? Same answer, yes. These work, too, because, well, they’re spaced interleaved retrieval practice and we know that works, and then we know that it works well.

Kevin Patton: One thing, though, about any of these approaches is that we, meaning both the instructor and the student, ought to be very, very careful about accuracy or our students will be learning incorrect information. This is an especially big deal when we have students share their cards, whether on paper or in an app that allows sharing. I always suggest that my students study in groups and share their study materials with each other. But those cards, or copies of cards, they get from other students, or from unreliable sources, or made by us for our students, they’re all likely to contain errors. Hopefully small, insignificant errors, but who knows? So, double-checking accuracy might be a good step to add to the process of using flashcards.

Kevin Patton: The basic way to use a flashcard for terminology is to write the new term on one side of a three inch by five inch card and the definition or description on the other side. Okay, so here’s where we can look at a more advanced technique. At first, I usually suggest that a student put the most basic definition they have available. Usually it’s straight from the glossary. Glossary definitions are usually very broad and generalized, so that works well for an introduction to the term. Once they get that memorized, then we can always add layers of understanding later. So, I tell my students to learn the basics first. Then, as they learn more about each concept represented by those terms, just add that to your flashcards and review them again. The students are then making their own little paper wiki. Well, like the Wikipedia of Kevin, or the Wikipedia of Keisha, or the Wikipedia of Kim. Each personalized for that one student. Hey, who said individualized learning has to be complicated or difficult?

Kevin Patton: Uh-oh. I feel a story coming on. Yep. Yep, there it is. I think the only way to get it out of my head is to get it out of my brain and into the microphone. So, here it is. The first time I learned that flashcards are great tools for college science students was as an undergraduate in an ecology course. The course was interesting, and the teacher, Steve Dina, was phenomenal. And even though I studied, I blew the first test. I mean, like blown up and sunk to the bottom.

Kevin Patton: So, a study buddy of mine who was in the same boat, that is the boat that had blown up and sunk to the bottom, he grabbed my arm and said, “We’re going to Dr. Dina’s office.” And I’m like, “What? Go to the professor’s office? Won’t that be like a bother to him.” My buddy said, “Well, so what? You know how much we’re paying for this experience? You know how much tuition is? Let’s not let being a bother stop us.” So, okay, we went to his office and he … Well, he seemed genuinely glad to see us. Go figure. And he spent time chatting with us. I realize now that this had led straight into him asking questions that were really diagnostic probes to see where we were falling down or blowing up. We all quickly realized that we hadn’t mastered the terminology, at least not fully. Our studying and Dr. Dina’s fascinating lectures had given us familiarity with the terminology and the concepts behind them but that gave us a false confidence that this familiarity was the same thing as mastery.

Kevin Patton: So, we asked him, “How did you do it as a beginning student?” He got this big smile on his face, I can still see it, and he pulled out a drawer full of 3×5 cards. He explained that using flashcards worked so well for him, both for initial study and for later refreshing, that even these many years later he still used them. He explained that there are always new terms he encounters. So he keeps a stack of empty cards in his pocket and jots down a new flashcard with the new information. And he carries it around a couple of weeks reviewing it from time to time, and then it goes into his master library. We didn’t use the word wiki back in those days, so, yeah, it was his library.

Kevin Patton: He also said that by filing them in an organized way he could go back to any card and add to it when he found something else important he wanted to learn about that concept. Then he’d carry the updated card around for a while. So not only did I learn that when you visit a professor to not assume that you’ll be skewered for failing, I also learned that, yes, flashcards for college students and college professors can help.

Kevin Patton: Another thing that I often have my students do is add a pronunciation guide to the card. Either side’ll work. So, I tell my students to experiment and see which works best for them. Then, I tell them to say the term out loud. Don’t just read it when using the flashcards. I think this has several benefits. One is that by saying it out loud, it slows us down. Remember, there’s research that says most students need to slow down when they’re using their flashcards. Another is that we’re learning the term both with our reading functions, and our hearing, and our spoken language functions. Now we’re incorporating more information in more areas of our neural systems, right? Just like we do when we’re learning German or any other language.

Kevin Patton: That leads to another benefit. When we read the textbook, listen to the lectures, read other course materials, work through active learning scenarios, write our notes, and so on, we don’t stumble over those complex terms like, well, you know, say it with me, carbaminohemoglobin. If we’re already familiar with carbaminohemoglobin, and we’ve already said it out loud, and we’ve already practiced it, then when we run into it in the other stages of learning, it’s not going to be a barrier. We’re not going to have to stop and stumble over it. And we all do it. Admit it. There’s some unfamiliar, intimidating term in some article we’re reading, and we sometimes find ourselves either just registering it as carba-something and not really absorbing it or we stop dead in our tracks and parse out the word several times and then resume our reading only to find out that we’ve lost the whole thread of the story we’re reading. But if we’ve done all that as prep work with our flashcards, then we’ll be less likely to have those problems. This is what new language learners do. This is what I did in the primary grades when I was learning how to be a better reader in my native language. Of course it works.

Kevin Patton: Sort of along the same lines, I suggest that students experiment with putting the word parts on the flashcards. Some of them write this out separately. Some just use little lines, or slashes, or different colors of highlighter to parse out the term into its word parts. The goal here is just to be aware of the word parts, not make that the primary goal of learning, just something they look at when they’re considering each term. The more they do this, the more natural seeing terms as phrases made up of word parts becomes and the more comfortable they get with scientific language.

Kevin Patton: It’s true that this is just a bit too much for some students, especially those with reading issues or are cognitively atypical. Well, okay, then these students are better off not using this technique, but it’s there for those who will be helped by it.

Kevin Patton: Oh, wow. I’ve just gone on, and on, and on about flashcards, haven’t I? I’ve taken the flash right out of flashcards. And you know what? I’ve only just barely started the intermediate stage of flashcard use. Well, that’s okay. There’s another episode coming, and that’s when we’ll pick up some additional flashcard skills, like the levitating flashcard, sawing a flashcard in half, turning a flashcard into a tiger, and other wonders to behold. All that and more in the next episode.

Staying Connected

Kevin Patton: Hey, don’t forget that I always put links in the show notes and at the episode page at theAPprofessor.org in case you want to further explore any ideas mentioned in this podcast or if you want to visit our sponsors. And you’re always encouraged to call in with your questions, comments, and ideas at the podcast hotline. That’s 1-833-LION-DEN or 1-833-546-6336. Or send a recording or written message to podcast@theAPprofessor.org. I’ll see you down the road.

Aileen: The A&P Professor is hosted by Dr. Kevin Patton, an award-winning professor and textbook author in human anatomy and physiology.

Kevin Patton: This podcast is not a savings account and is not insured by the Federal Deposit Insurance Corporation, so don’t send money.

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