Gail Wortmann discovered that qualified teachers struggle to find the time and energy to design courses that are not required for graduation. As Iowa Teacher of the Year, Mrs. Wortmann was given a year's leave from classroom activities to travel around the state to help improve the quality of education for Iowa students. During that time she researched the Iowa teacher shortage. She found that many schools, especially those in rural Iowa, had difficulty finding, hiring and retaining qualified science teachers to teach specialized courses like anatomy and physiology despite increasing demands for students in health related fields.

To help address this concern Mrs. Wortmann spent an additional year working with Iowa Learning Online and Iowa Public Television to develop a web-based anatomy and physiology course to provide access to these courses for all Iowa high school students. She designed the course to be flexible. Students could choose to take the online class independently from Mrs. Wortmann, or life science teachers could use course materials to teach a group of students without taking on the additional responsibility of prepping a new course. Through these efforts more Iowa students will be able to take a foundational high school course that would prepare them for further study in health, science and medicine.
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WHAT:

"YOU are a teleintern! During this course, you will be using your new science knowledge and skills to do problem solving based on fictitious patients created to help meet Anatomy and Physiology standards and benchmarks. To make the patients and their situations more realistic, you will be interfacing with them as if they were long-distance patients, just like I am interfacing with you as long-distance students in this class." (Wortmann: Course Introduction)

Gail Wortmann's Anatomy and Physiology course was designed for high school students interested in medical (or related) health care careers, and/or those who want to become better personal decision makers in the own health care. The course emphasizes breadth over depth —the goal being to expose students to the general functions and structure of the human body using a systems approach. Similar to Mrs. Wortmann's face-to-face classes, her online course promotes active student learning. Students engage in critical thinking and problem solving around physiology and anatomy concepts to complete course activities that simulate telemedicine practice —the use of a variety of communication technologies that enable health care professionals to provide care for patients who are geographically distant from the caregiver.

For example, patients in remote areas can contact a telemedic using the telephone or Internet, provide necessary medical information (e.g., heart rate, temperature, blood sugar levels, etc.) and receive diagnoses and treatment instructions without leaving his or her home. Students in Mrs. Wortman's course participate in simulated telemedicine activities as they interact with virtual "patients" who need medical services. These are complex, authentic cases in which, as in real life, there is often no single correct solution for a given patient's condition. Students engage in problem solving to research, diagnose, and provide treatment recommendations for the various scenarios using the available information.

In one such activity students receive bone density readings and personal information about a female patient in an isolated community in rural New Mexico. The woman had difficulty getting medical care because doctors and facilities were over a hundred miles away and she had to rely on relatives for transportation. In working on this case students use a variety of information resources, including their textbook and targeted web sites, to research possible medical conditions that are consistent with her data profile and make a diagnosis. When they complete their research they make a recommendation for treatment —keeping the patient's personal situation in mind. Unlike students in many online science classes, Mrs. Wortmann's students engage in contextualized, ill-structured problem-based learning that requires them to engage in authentic medical professional activities (see Anatomy & Physiology - Nature of Science Introduction-pdf file).

A colleague who developed an online course gave me access to go in and look at her work.  Her course had a little bit of lab, but not what I considered to be enough. I did learn a lot from looking at how she approached things, how she made things appealing to students, and how she timed things. I trust her judgment, but her online class was lacking in hands-on science. (Wortmann: Interview)

In her own class, Mrs. Wortmann provides an activity called Autopsy of a Dill Pickle (see Anatomy & Physiology - Lesson 7 - pdf file). In this activity students have a hands-on learning experience in a distance learning class. The goal of the activity is to have students learn the difference between clinical and forensic autopsies and to learn to correctly use anatomical terminology. Students obtain a large dill pickle and follow directions on how to dissect it. When they have completed the procedure they take a digital picture of their dissected pickle and upload it to WebCT so the instructor can assess the activity and confirm student participation.

Through this and many other activities Mrs. Wortmann has brought her considerable experience and expertise to bear in developing this online course. Students construct their understandings of anatomy and physiology concepts through activities that draw on a variety of pedagogical approaches. She provides a virtual environment in which students engage with content, the instructor, and each other in meaningful ways.

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HOW?

One of the most important aspects of an online course is good communication. Regular communication makes online courses real; lack of communication undermines them. "Listening" online means making comments and thoughtful contributions regularly. In this course, a recurring certainty is that knowledge grows only when it is shared. Therefore, we will work together often —even though we are at a distance. (Wortmann: Course Introduction)

The core of Mrs. Wortmann's online anatomy and physiology course is the online learning activities outlined in the "What" section. Her activities are specifically designed to take advantage of the World Wide Web as an information resource. Students seek information from real web sites to address authentic problems. Through activities students learn information literacy skills like identifying when information is needed to solve a problem, the ability to identify relevant and reputable information, and how to use that information to address the problem at hand. Mrs. Wortmann has incorporated the power of the World Wide Web as an essential tool for her students' learning.

Successful online teaching depends in part on the instructor's ability to choose the right technology to complete particular tasks —like her use of textbooks and the Web for locating information. Mrs. Wortmann chose to use WebCT, an online course management tool, to structure her virtual classroom. In WebCT, she communicates with students in an open forum by posting messages on a discussion board or confidentially through individual email accounts. She also organizes and monitors student communication, uploads informational documents, links students directly to other online resources, and has students upload projects and assignments to share with her and/or their peers.

WebCT provides tools for both synchronous and asynchronous communication. When activities require students to be thoughtful and reflective in their discussions, Mrs. Wortmann has them use electronic discussion boards. When activities require students to work in groups to reach consensus, they use chat rooms. More importantly, Mrs. Wortmann recognizes that successful online teaching involves both conceptual learning activities and the creation of a supportive, safe, and highly interactive learning environment. This is accomplished through a combination of communication technologies and face-to-face interaction.

The sense of isolation many online learners experience is a frequently cited barrier to successful online learning¹. Mrs. Wortmann used telecommunication tools to structure her course so that students develop a sense of community —both with her and with each other. In the first lesson for the course students develop personal web pages to share information about themselves with their classmates and instructor (See Anatomy & Physiology - Lesson 1 - pdf file). In the second lesson students use electronic discussion boards to interview each other to get some personal information about each of their classmates (See Anatomy & Physiology - Lesson 2 - pdf file). Not only do these activities facilitate the development of a sense of community within the class, they also help students develop skills in using electronic tools to effectively communicate online.

A learning community is also strengthened when students feel a strong connection to the instructor¹. To further facilitate communication and develop a personal relationship between herself and her students, Ms Wortmann uses the Iowa Communications Network (ICN)—a two-way interactive audio-video system with studio classrooms at schools in all Iowa school districts. Students who need extra assistance with an activity or who want to voice questions or concerns arrange to meet with Mrs. Wortmann in a face-to-face format during regularly scheduled "office hours" using the ICN.

However, not all learning activities in the course can be accomplished at a distance. Studies indicate that some face-to-face interaction improves student success rates in online learning courses² . Students in Mrs. Wortmann's Anatomy and Physiology class meet at regional sites to participate in more advanced lab activities twice during each semester. Further, students at each school site are provided with a coach . The coach is a certified teacher (although not necessarily in the content area) who provides students with assistance in using the technology or in understanding the particulars of an assignment. Instructions, hints, background information, and suggestions are provided to coaches to support them in helping students complete activities and to ensure safety during lab activities.

Moving from traditional classroom teaching to online teaching is a difficult challenge for many educators. The unique characteristics of online learning environments make it difficult for many teachers to implement their classroom-based pedagogy in this context. What makes Mrs. Wortmann's online Anatomy and Physiology course exceptional is that she has successfully incorporated her core pedagogical beliefs about teaching and learning in science into the online environment.

Footnotes:
1. Abrami, P. & Bures, E., (1996). Computer-supported collaborative learning and distance education. The American Journal of Distance Education, 10 (2), 37-42.

2. Robyler, M. D. & Marchell, J. C. (2002). Predicting success of Virtual High School Students: Preliminary Results form an Educational Success Prediction Instrument. Journal of Research on Technology in Education , 35(2) 241-255.

Thanks to Gail Wortmann and Iowa Learning Online for their help.

This case developed by:
Dale Niederhauser, Ph. D. and Denise Lindstrom, M. S.
Center for Technology in Learning and Teaching
Iowa State University

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Case Studies
Web Links:
Iowa Communications Network (ICN): http://www.icn.state.ia.us/
WebCT Learning Environment: http://www.webct.com/
Iowa Learning Online: http://www.iowalearningonline.org
Iowa Public Television: http://www.iptv.org
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Last updated: January 2005