Abstract
Muddiest point and peer instruction are evidence-based instructional practices that can be used to address student learning gaps. The purpose of this study was to determine the impact of modality (face to face or online) on student perceptions of the effectiveness of combined muddiest point and peer instruction activities in community college anatomy and physiology courses. Data was collected through end of course surveys and included quantitative and qualitative results. While there
was no significant difference in student perception of anxiety or contribution to learning among face-to-face and online students, anxiety levels were low and contribution to learning was high for both groups. Both groups generally provided positive qualitative responses, but online students were more likely to provide positive feedback on muddiest point and peer instruction activities than face-to-face students. Negative responses tended to focus on wanting to work alone and dissatisfaction with classmates’ contributions. This study was supported as part of the Community College Anatomy and Physiology Education Research (CAPER) project (2111119). https://doi.org/10.21692/haps.2023.023
Key words: muddiest point, peer instruction, online learning, community college, evidence-based instructional practice Introduction
Faculty use evidence-based instructional practices like muddiest point activities to better understand where students struggle in subjects like anatomy and physiology (Hyson et al, 2021). Mackos and Tornwall (2021) found that muddiest point activities helped faculty members identify topics needing clarification in large-enrollment graduate pathophysiology courses for nursing students. Students submitted topics they didn’t understand (muddiest points) and then instructors used these to provide instruction
on the most difficult-to-understand topics. The muddiest points were examined by faculty inside the learning management system. Mackos and Tornwall (2021) found that examination scores where higher when the technique
was used compared to scores in the year before the technique was implemented. Most students in that study indicated that identifying muddiest points and receiving targeted instruction increased their understanding of pathophysiology content.
Cooperative learning, also known as peer instruction, is another practice that has been associated with positive student achievement (Johnson & Johnson, 2009). In this technique, students learned from one another through interactive activities where one student provided information to help other students learn. Crouch and Mazur (2001) found that cooperative learning increased student learning in physics classes. While Premo and colleagues
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19 • HAPS Educator Journal of the Human Anatomy and Physiology Society Volume 27, Issue 3 Winter 2023
How Delivery Method Impacts Student Perceptions of Anxiety and Learning with Combined Muddiest Point and Peer Instruction Activities in Community College Anatomy & Physiology Classes: Lessons for Faculty, Higher Education Academic Leaders, and Educational Technology Leaders
(2018) found no correlation between collaborative learning and student achievement, they did notice an increase in student engagement, which can be an important factor in improving retention and academic performance (Preszler, 2017).
Methods
Student Population
The study group consisted of students taking anatomy and physiology at a rural community college in Texas during the fall 2022 semester. Courses were taught in either a face-to-face or an asynchronous online format. Each format was either offered in a 16-week or 8-week duration. This study (IRB #1899183-1) was granted exemption from full review by the Tarleton State University Institutional Review Board along with approval from Panola College to survey students, and informed consent was obtained from all participants.
Procedure
Each week, students were assigned a muddiest point activity that was completed in an online discussion post within the learning management system (including in the face-to-face courses) where students provided their own muddiest point. As part of the activity, students identified resources to help address their muddiest point, which were also shared with other students within the discussion board activity, thus providing a level of peer instruction.
For the peer instruction/muddiest point activity, students completed online discussion posts where they provided the topic they understood least (muddiest point). Students also responded to at least two other students by providing resources that helped them better understand the concept that another student found difficult to understand.
Data Collection
Students were administered a survey at the beginning
and at the end of the semester that included Likert scale questions related to perceived anxiety caused by the use of muddiest points and peer instruction activities as well as how helpful the combination of activities was to their learning. The full set of survey questions is available in the Appendix. Students were encouraged, but not required to complete the surveys. The survey also captured qualitative responses about topics including muddiest point and peer instruction activities.
Data Analysis:
Quantitative survey responses were analyzed through descriptive statistics and mixed-model analysis of variance (ANOVA). Free response questions were analyzed using content analysis (Cavanaugh, 1997). Qualitative analysis included identifying themes and coding the data by assigning responses to themes. The percentage of time that specific themes were mentioned was compared between face-to-face and online classes.
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Engagement in classes can assist students with a sense
of belonging, course retention, and persistence in their respective degree program regardless of course delivery method. In their synthesis of the literature, McCutcheon and colleagues (2015) found no difference in learning among nursing students whether the learning environment was face-to-face or online. England et al. (2019) found that students who perceived the course as difficult (an indicator of anxiety) tended to not perform as well as students
who didn’t find the course as difficult. Sarkar et al. (2021) found that 83% of medical school students found online muddiest point activities effective. The goal of this project was to address a gap in the literature by determining if student perceptions of combined muddiest point and peer instruction activities in a community college-level anatomy and physiology course varied by delivery method and course length. This study aimed to address the follow