Interviewer: I'm with Leslie King today. Thank you so much for coming.
Leslie King: You're very welcome.
Interviewer: Leslie, before we get started, could you just tell people a little bit about yourself, mainly where you work, what courses you teach, that kind of thing?
Leslie: Sure. I work at University of San Francisco in the Biology Department. I have been working there almost 20 years and I divide my time half and half between teaching courses. Main courses are human physiology, both for the nursing major, so freshmen level nursing course and also an upper division biology major human physiology course, so for junior senior level. Also I've taught general biology, so our beginning biology course for biology majors. That's the teaching component of what I do.
The other half of my workload is spent supervising and coordinating lower division lab sections, mainly general biology. We currently are running about 14 sections of labs per semester of general biology. It's a high enrollment course. We have our own graduate students teaching those labs sections and also UCSF grad students and postdocs teaching as well. I meet with those instructors once a week, plus the instructors the physiology course for which I'm the lecture instructor. Twice a week I have instructor meetings as well.
Interviewer: Wow. You don't have a personal life is what you're saying?
Leslie: Exactly, no personal life at all.
Interviewer: Just before I asked you the other questions, I want to contextualize your work a little bit for other people. As I understand it, the nursing physiology course you teach is really a killer course not as reflection on you, but for most students it's considered a very difficult course.
Leslie: Absolutely. I remember when I took physiology at UC Davis as an undergrad, I took it as a junior. Here, yes, the title is survey of human physiology, but because it is for nurses and it's the main physiology course they'll have before they take pathophysiology, which would be abnormal physiology, there are quite a few topics that I have to cover. I think just by its nature, it is very challenging not only because of the volume of information you have to cover. I always make a joke at the beginning of class, it's the human body after all. There's a lot of information. Then it's not just, for me to contrast it with anatomy, it's not just memorizing, here's this part, here's what it does and here's where it is. It's putting all the parts together and how the parts of the human body work together to create a healthy individual. It's memorizing information, but then putting it into a context. I think that becomes a challenge, especially for freshmen who haven't had that challenge yet really.
Interviewer: For today, I really wanted to talk to you about some of the work you've been doing with flipping. We'll get into some of the details of it, but why did you decide to start flipping? I know you haven't flipped, well, actually, I don't know where you are right now with it, but the last time I checked in with you, you weren't flipping a whole course, so we'll come back to that later. Just for the things that you have done, why did you decide to start flipping some class sessions and what kind of problems did it seem to solve for you?
Leslie: First of all, I was intrigued by the idea of flipping and when I initially read about it, I realized I had a misconception about what it was. Then when I learned what it was, that it was this idea of giving students more of a chance to spend time with you working at problems rather than just here's the material I was more intrigued by it. However, when I found that out, I thought, "Well, I still can't do it because the courses I teach here typically at least the lower division ones are large in terms of University of San Francisco standards. They're 80 to 100 people."
Interviewer: That's large.
Leslie: That's large. It is large in general. [crosstalk] I'm used to the UC Davis 500 person course, but I still was thinking, "How can I do this?" The tipping point for me was I realized there were several topics in physiology that really were more difficult for students than others. Typically they were the topics, as I was just talking about, that require more integration and not just memorization. I found myself in office hours spending a lot of time and having a lot of fun doing it with students, just saying, "Okay, let's create a flow chart, and look, you don't have to memorize the book. You can take this information and make it your own." I was getting lots of positive feedback from students saying, "Oh, that was great." I would tell them, "The minute you get your exam and I say, go, you're allowed to write on the exam and just take 30 seconds to offload that information and write your diagram down and deal with it that way."
I became very interested in how they were solving these problems and why multiple choice was so difficult for them. That just seemed to solve an issue. I started thinking about, "Wouldn't this be great to just have this experience with the whole class?" To be honest, maybe 10% of the class was utilizing office hours. What I decided to do was try this flipping. I still say this flipping because it's still pretty foreign to me, but tried with these two particular topics that were more difficult, which were solving problems that all nurses have to solve called acid-base or arterial blood gas problems, but it really is an acid-base situation.
Then the other topic that I really loved, but never had enough time to work with students in class on is blood pressure regulation, which it's a big thing in physiology and it's not just the circulatory system. I always wanted more time to prove to them that it wasn't just the circulatory system. I would tell them that, we get to the kidneys and go, "Remember blood pressure, we talked about that, but there was never a connection." I decided, "Well, I'm going to record these lectures and post it for them," which I had done at other points in time in my classes when I was going to be gone and just said, "Here's the lecture, listen to it."
Now I could really use this and make sure that they learned it and not have to spend lecture time teaching it to them really, but I could review and then start working with them on it. The acid-based problems, that just seemed pretty straight forward. I presented how to do it in the module that you watched and now we can start solving problems. That became the easier one, the typical one is the idea of flipping of they learned it on their own and you do the homework with them.
The blood pressure regulation became more of a challenge because there weren't problems really to solve. It was just this overall concept that I wanted them to get and I wanted them to be excited about. I felt like if they did this they would really be able to tackle this more difficult concept. For that, I recorded my whole lecture on blood pressure and presented basically just the facts in a bullet point, PowerPoint arena and posted it for them on Canvas, our learning management software that we use here at USF. They were instructed to watch this and they could listen and watch the PowerPoint at the same time.
I should actually mention, what they got to download or just they could do it electronically was a skeletonized version of the PowerPoint they were going to watch. By that I mean, they had a lot of blank lines. They couldn't just download this and bring this to class. If they didn't watch it, they would and actually fill things out they would have no idea what I was talking about once they got to the actual class session.
Interviewer: It was almost like a mini quiz presentation?
Leslie: It was a mini quiz. Yes, absolutely.
Interviewer: Presentation, take a quiz of some sort was one and the same?
Leslie: It was one and the same. I remember thinking at the time of, "How am I going to plan this class session? How am I going to know if they watch this?" The way I knew that was when I created my flow chart when I came into class. The idea was, I should clarify, they would come in and then we would create a flowchart together of, "What are some main factors that affect blood pressure? Then what are the factors that affect those factors?" My idea was in written form on a white board, that was pretty much too small to do it, but we'd try, we did it, we did our best just to create a flowchart just for them to look at and see how everything, all of these factors lead to affecting blood pressure, whether it's how much blood is pumped by the heart per minute, or how much blood is in your vessels, things like that.
My measure for, excuse me, whether or not they actually watched the lecture prior to coming to class was I asked them, "Okay, what are some main factors that affect blood pressure?" The only way they would have been able to tell me that, well, if they read the book and were able to get that themselves then that's great, but the main way I was thinking they would get this information would be to watch and listen to the lecture I'd posted and get that information from that, because I didn't put it on their skeletonized version. They would have had to write it down. To be honest, I was pleasantly surprised. They answered and more than just the usual suspects answered the questions. I could tell that they knew this was a big thing. I did emphasize to them, email-wise and verbally to them that I was not going to go over the lecture again with them. I would ask for questions, but that the main part of this was to develop this flowchart, and if they came unprepared, it would not be a good use of time. It was mainly, I just wanted to have an office hour with the entire class. That's how I felt like I could do it the best.
Interviewer: It's a nice way of conceptualizing.
Leslie: Thank you.
Interviewer: What was your impressions once you did that first class session, for you, in terms of your goals? I don't care about the students at this moment.
Leslie: I guess the first time I did it actually would have been the blood pressure one and then 'the easier one' came later, the acid-based. What did I expect to come out of it or what-
Interviewer: Maybe I asked the question poorly. Whatever you expected, what was your sense of how it went afterwards?
Interviewer: Okay. I was a little shell-shocked because I went in there having no idea how this would go because if they didn't participate, I knew-- Semester to semester classes are either chatty or they're not. This was not a particularly chatty group. They didn't ask a ton of questions. However, afterwards, I did feel like it went well. I felt like people were answering questions. It's not that they were just answering them correctly, they were at least trying to answer. Not all of their responses were correct, but at least they were participating and trying. I really liked that.
I do remember that one student came up, everybody has a phone, and she took a picture of the flowchart that was written out. She said, "I wrote it down but I just want to make sure I wrote it down correctly." The feedback I got for them later in the next class was positive. I feel pretty good about it. There were times where I didn't know where it was going. I didn't know if I had enough room on the whiteboard. That was frankly my main concern.
I used to do my classes on a chalkboard, we all did, all the time. Now, I've been delivering lectures in PowerPoint for a while, and it had been a while since I'd had to think about space, not just on a big chalkboard but a smaller whiteboard, which is what we had available. I should say too, is that I also wanted time to project multiple choice questions for them at the end. Actually I'd forgotten about that, to see if they could use this flowchart to answer the multiple-choice questions that I would typically put.
Interviewer: That's actually really important [crosstalk] the whole scheme of things because you not only gave them the flowchart, took them through how to do that but then right away, them having practice in how to use the visual model to figure out stuff, essentially.
Leslie: Absolutely. So thinking about creating the flowchart I forgot about that. I guess that would be one area that this next semester I plan to do the same topic, same idea. I didn't have enough time at the end. I remember looking and there were like two minutes left to do this whole thing. I had passed around questions for them to look at, just a couple of typical multiple-choice questions that they would see, and just had them talk with each other, figure it out, and I just had to truncate that.
I think I gave them a minute, and then I projected, not all the questions, maybe one question, and I took them through each answer choice and tried to help them follow through with the flowchart. That's why I wanted to do the flowchart on a whiteboard and have them be able to see that and look at the multiple-choice as well. I think that did help them. I wish I'd had more time to do it because it just felt very rushed at the end.
Interviewer: Well, and it's different for you.
Leslie: It's different for me, absolutely.
Interviewer: It sounds really cool. Now on the 'easier approach' and how did that go? Did that seem to work equally well or was that a different experience for the students and yourself?
Leslie: I think it worked really well with the students. It was much easier for me because it was more known. I had solved a billion problems like this with students, and I knew how to do it. Now I just did it in front of all of them. The flowchart, I had done flowcharts with students in office hours, but it's very informal. I feel like solving problems, it's very organized. You describe that to one student, to me, mostly the same way you describe it to 80 students, but creating a flowchart with somebody in your office hours is a lot different than trying to methodically get through this in 50 minutes with 80 people.
I think the solving problems, the acid-based problems, for me was easier to do. I think because it was less challenging, it wasn't as exciting that time, but I felt it was valuable. That was a topic that I usually didn't have time to do in-lecture. I shunted it to the lab, which the lab instructors were great at doing it, but I got a lot of students coming to me in office hours, just to double-check. "Now, we heard this in lab."
For the most part they were fine, but then I realized I missed teaching them how to do these problems because I like doing these problems. How can I do that myself and then do something maybe more meaningful in-lab that's more lab-based, like analyzing urine? That's where this all comes in, is the kidneys. That actually solved that issue. We could do more lab stuff in-lab and then I could deal with solving these problems. That actually went much more straight. It was a straightforward exercise, I felt, that flipping.
Interviewer: Got you. The obvious question is, okay, so you've done two of these, why not flip your whole course? I'm not asking that as a challenge. You've carefully thought about all this. There's some reason or reasons that you've made the decisions you've made. I think other people who are considering flipping would be really interested in how you made those decisions.
Leslie: Absolutely. I definitely see the value of flipping a whole course. For me, part of it is selfish. I really like being there. I like teaching them and presenting the information for the first time. It may sound corny, but there are some things I can't wait to show them and tell the and they're so interested in it. Even the ones who are taking it because they have to, well, they all have to but some of them more feel like they have to than others, I know that there are some things they're just going to be hooked on, and I want to be there for that. Part of that is a selfish thing. I want to be there and I want to teach that to them.
For me, personally, I still feel like there are some things, because it's not just presenting fact after fact after fact, to me, I don't feel like that would be successful teaching if you flip the whole thing because it is so integrative. Anatomy is really hard. I'm not saying that, "Oh, yes, you can completely flip an anatomy course." It's not like looking at a diagram of the body and going, "Okay, yes, there's the liver. There's the heart. There's the spleen. Got it." It's really having somebody up there in front of you to help you figure out what all those organs do and how they work together.
For me, I would love to see how somebody did this. I can't figure out how you could flip that, because I like to ask students questions. "We've already talked about the heart's contribution to blood pressure. If we bring it back to that, what's one main factor that's important for us to have a constant blood pressure?" If somebody says, "Constant blood volume," I'll be, "Great. This is where we can talk about the kidneys." To me, that's what gets lost in flipping a course like the one I'm teaching.
That's why I wanted to pick just these particular topics that, one is,"Jjust here's how to solve problems, and then here's a check-in, do we all know how to solve these problems? Great." The other was just, yes, I could talk to them about, "Here are the three main factors about blood pressure and this and that and the other," but why not just give them those facts and then flip it and have the discussion with them. That's why.
Interviewer: It's so interesting because people take different approaches to flipping, but you took this really targeted. If I remember you talking about it, you were also identifying what were particularly difficult concepts or skills for your students. You weren't wasting your time trying to flip things that were already really easy for them. You were creating that extra in-class time for things that they really needed more expert massaging in the real-life situation.
Leslie: Definitely, absolutely.
Interviewer: I know you talked about this a little bit. I heard it. I'm sorry if I repeat it a little bit, but really, one of the most common questions I hear from faculty or concerns from faculty about flipping is, how do you get your students to complete their flipped homework before coming to class? That tends to be a significant barrier conceptually for people. You've described that a little bit in the sessions that you've done. I think people still are a little nervous that students could still cheat out of class and look at what somebody else did.
Leslie: Absolutely. Sure.
Interviewer: I know nothing's perfect, but were you happy with how the students responded to the out-of-class learning situation, responding to the quizzes and even if there was maybe some cheating somewhere along the line, it was nowhere at a level that it would concern you?
Leslie: Yes, I was really satisfied with that. Also, I was not giving them any quizzes that were worth any points beforehand. If they decided to just grab, "Oh, you watched that? Can I just fill out what you did?" Part of me is, you're right, it's not perfect and maybe just maybe somebody who did that would realize and come to class and think, "Oh, maybe I should have watched this." I think there's that factor as well. Yes, you want them all to watch it. Actually, as a little aside, I checked because remember, I posted this to our learning management software Canvas. You can see how many people have watched it and how many times they've watched your lecture and who has and who hasn't. I had an idea in the beginning that most people have watched it. Since then I've learned how to go in and figure out what particular part of that lecture gets the most viewing.
Interviewer: Really?
Leslie: Yes, it's very interesting. [laughs]
Interviewer: That's cool.
Leslie: Yes. Anyhow, there was all that that you can look at, but also for me, I could tell so many stories on this, but for me the two topics I chose to flip were in the last half of the course. I feel by then-
Interviewer: They already had a foundation working with you?
Leslie: They already had a foundation working with me and I felt like if I told them they needed to do this, they would trust me that they needed to do this. They knew that if I said, "I am not here to re-explain the material, of course, I'm happy to clarify, it's confusing," but they knew that I wasn't going to give just the lecture all over again. I feel part of that is just a trust that you can build with your class if you choose to flip topics, even a third of the way through the course you've got them.
I already do that. When I post just on my regular lectures I'll post the PowerPoint notes for them, but they're all skeletonized. They're all lines filled in but by the time we do get to the kidneys, which are really the more difficult, that's probably going to be my next flipped project, but they're probably the most difficult organs to teach and to understand. By the time I get to those, it's November in an August to December semester. I just give them the notes ahead of time and they all still come to class because they know that coming to class is going to help them. I think for me the flipping I did choose topics that were more difficult, but I did choose ones that I knew were later in the course and I would hopefully have a rapport with them already.
Interviewer: Exactly. Unfortunately, if about a third of the way through the course if you don't have them you're not going to get them?
Leslie: Yes, exactly.
Interviewer: You lightly talk about and you put together these things that they would watch. I know you're in the Biology department, but would you describe yourself as a techie person or? For some people that are a little shy putting together these things, how difficult was that for you to do and did you have a lot of expertise before you did this?
Leslie: I did not have really any expertise before this. I had had experience recording lectures but even when I started doing that, I got help with it. I'm not particularly techie. I don't know how to use audio equipment still, even though-- I just use the microphone on my computer and I'm told by our ITS department, "Oh, you should have used a microphone," but it seemed to work fine. For me, no. I would say I'm maybe beginning to intermediate techie. I can post, I know what a link is. I know all that. For me, that was never an issue. I thought, "Well, I know we have services here to help me." It really wasn't hard at all. You can just talk right into your computer, hit start, hit stop.
Interviewer: Write a deal.
Leslie: Yes. The hardest thing was to lecture to no one. You sit in your office and record and make sure your phones turned off and all of that. I guess I understand the hesitation, absolutely, about the technology. Once you do it you'll never go back. It's a great way to just, "Oh, I'm going to be gone," you can still give your lecture. It's great. I already had that. Now it was just the flipping that I had to work on.
Interviewer: Fantastic. Well, let's see. I've asked the best questions I could, but there might be some key issues or considerations or maybe misunderstandings about flipping that you have some insight in but I haven't tapped into because I didn't ask the right questions. Are there any other things about flipping you'd like to convey to faculty?
Leslie: I guess, for me, I came in and this actually will maybe prove to people I wasn't that techie, I'm not that in the know, the whole idea of a MOOC, which is-- I still can't remember, is that, Massive Online-
Interviewer: [laughs] Orange Crate.
Leslie: Yes, Orange Crate, exactly and flipping classes I just thought, "Oh. No, that's just delivering online course and just canning it." I literally classified all of that. I thought MOOC and flipping and all of that were exactly the same thing until I read-
Interviewer: They were all evil. [laughs]
Leslie: They were all evil. I really did. Then I read an article in The New Yorker and there was a very clear definition of what a flipped classroom is and I thought, "Oh, well that's a very good idea." I really did. I guess just to clarify, the way I conceive it and I think what it is is-- i think the definition is the students learn the material on their own. What I would say is, the students are given the facts or whatever you want to give them you would in a regular class period on their own, whether it's a handout or a recording. It doesn't have to be recorded, you could just give them a handout. That could be another way. Then instead of doing that in the classroom, in the classroom you do the homework with them. That's the traditional way of flipping or doing classwork with them. That's why it's called flipped. For me, I guess that would be just to get that across.
Maybe everybody knew this, whoever is listening to this, but I had no concept. I thought it was just all online, massive, teaching to 1,000 people, which I think has its time and its place, but I thought, "Oh, I can't deliver my whole class online." For me, once I understood what it was, that's when I thought this could be a really great thing to do it. Also, I guess, any advice I'd give is once I thought about this, the immediate mistake and it was a very quick lived one, thank goodness, I thought is, "I'm just going to flip seven topics." I would highly recommend not doing that just so you can really focus on two or one even. I just think it's really great and then see how it goes.
Interviewer: You can take baby steps?
Leslie: You can take baby steps and you can even make it. I think I did I do this with the blood pressure one last year is I scheduled it, it was also just kind of serendipitous. I scheduled it where they were listening to and watching the recorded lecture at a time where I was actually out of town. That was a class period is this is the class period and then our next class period is going to be the flipped experience of going over that. You don't have to do that.
The other one, the acid-base was they watched it on their own out of class time. They didn't get a canceled class in place of it. Then we spent the classroom time doing it. I would say that to clarify, it's not just this online experience. It's exactly the opposite, and to only try one or two topics if that's what you want to do. Flipping a whole class is, at least for my use, I don't ever see doing that but I do see the value in it. I think if I taught math or statistics, I think that would be great. You could just problem solve with your students all the time. Now, I'm not a mathematician so I could be not knowing what I'm talking about. To me, that seems just like a clear place you could start building a flipped class.
Interviewer: Well, Leslie, thank you so much for the generosity of your time.
Leslie: You're welcome.
Interviewer: This is really fantastic and really interesting and I think it will be actually extremely useful to some faculty here.
Leslie: I'm happy to help. Thank you. 
Interviewer: Great. Thank you.
[00:29:57] [END OF AUDIO]


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