Less listing. More thinking.

How we reworked questions in Anatomy & Physiology to ask students to do more with what they know

Name the three. List the four. True or false? Yes or no?

There’s nothing inherently wrong with questions like those. A&P students have a mountain of information to learn, and they need to be able to retrieve important facts without looking everything up.

I'm a big fan of retrieval practice. I devoted the very first episode of The A&P Professor (TAPP) to it and have returned to it many times since.

But while revising Anatomy & Physiology, 12th Edition, we kept running into opportunities to ask a different question:

Could this question get students to do something more useful with what they know?

Quite often, the answer was yes.

First, a word in defense of memorization

Yes, I said memorization.

Students need facts in memory. They need vocabulary. They need to know where structures are, what they do, which hormone targets what tissue, which direction something flows, and what normally happens next in a physiological process.

You can't compare two things very effectively if you don't know anything about either one. And you can't explain a mechanism if every other term has to be looked up.

So this isn't about replacing factual learning with something loftier called critical thinking. Retrieval itself strengthens learning, which is one reason I've advocated frequent retrieval practice for years. I've also discussed the relationship between memorizing and understanding in TAPP Episode 7.

Facts are the raw material for thinking.

The interesting question is what we ask students to do once they have some of those facts to work with.

Listing is sometimes only the first step

A pattern kept appearing as we worked through the 12th edition.

A question might ask students to list several things when asking them to compare those things would reveal more about what they understand. A yes-or-no question might become an explain your answer question. Instead of merely recalling an isolated feature, students could sometimes be asked to classify, distinguish, predict, interpret, or apply what they had learned.

We didn't impose a rule that every question had to march to the top of Bloom's taxonomy. Sometimes name this structure is exactly the question a beginning student needs.

But when a small revision could make a question prompt more useful thinking without wandering beyond the level of the course, we often made it. Even some in-chapter Quick CHECK questions were intentionally revised to move beyond simple listing. 

Same cells. Better question.

Here's a simple example.

An older question in the cells chapter asked students to recall cell sizes. That's factual information, and it isn't useless. But in the 12th edition, the question changed from listing cell sizes to comparing variations in cell sizes and shapes. The revision notes explicitly identify the shift as moving to a higher cognitive level. 

The student still needs knowledge about cells. But now that knowledge has to be organized. The student must notice relationships and differences rather than simply reproduce isolated facts.

The facts haven't disappeared. They're being put to work.

We made similar adjustments elsewhere. In the tissues chapter, one question that had essentially been yes-or-no now asks students to describe the functional properties of muscle tissue. Another activity invites students to organize tissue characteristics with a Venn diagram rather than merely filling a table. 

That ought to sound familiar if you read my recent post about our new laboratory manual. There, too, Venn diagrams require students to decide what belongs where—and what overlaps.

That act of sorting can help turn a collection of facts into a conceptual framework.

“What is it?” is good. “How do you know?” is better.

Visual identification is a huge part of A&P. Students have to recognize tissues, organs, anatomical structures, pathways, and all sorts of things represented in illustrations and medical images.

So asking What is this? is often entirely appropriate.

But sometimes we can follow that with another question:

How do you know?

Now the student has to identify the relevant characteristics, distinguish the object from reasonable alternatives, and explain the evidence behind the choice. That gets us closer to the kind of thinking students eventually need outside the textbook.

This same philosophy shows up in the nervous-system revisions. Questions were reworked to have students analyze how cranial nerves, peripheral nerves, and brain regions work together in speech. Another changed from a yes/no-list format toward classifying reflexes, while a rhetorical question about the patellar reflex became an actual critical-thinking problem involving different situations. 

Knowing the parts still matters enormously.

But eventually we want students thinking about what those parts do together.

Compare. Explain. Predict.

The endocrine material gave us another nice example. Rather than simply recalling facts about diabetes insipidus and diabetes mellitus, students are now asked to compare the two and explain why both are called diabetes. Another question changed from listing examples to comparing tropic and direct hormone feedback regulation.

That comparison requires the facts—but it also requires students to look at relationships, similarities, differences, and terminology.

Prediction can push the thinking in another useful direction. In the special-senses material, revised questions ask students to compare neural pathways and sensory mechanisms, analyze the blind spot, and predict what could happen when a tumor presses on the optic chiasma. 

I like prediction questions because they ask students to mentally run the model they've learned under changed conditions.

If this changes, what should happen next?

That's physiology.

And it's also pretty close to the kind of reasoning many of our students will eventually need in healthcare.

Harder wasn't the goal

There's a trap here.

We can become so enthusiastic about “higher-order thinking” that every question turns into a miniature board examination. That's not what beginning A&P students need.

They still need lots of straightforward opportunities to retrieve terminology, structures, sequences, functions, and basic relationships. In fact, asking students to perform elaborate analysis before their foundational knowledge is secure can simply add another obstacle to learning.

That's why less listing does not mean no listing.

Retrieval practice works. I've revisited that evidence and its classroom application several times in The A&P Professor, including TAPP Episode 68.

The goal isn't to make every question harder. It's to match the question to the kind of thinking we want students to practice at that point in their learning.

Sometimes that means remembering.

Sometimes it means comparing.

Sometimes explaining, classifying, interpreting, or predicting.

Questions are part of the teaching

There's a larger idea underneath these little revisions.

Textbook questions aren't merely measuring devices attached to the end of a chapter. They're part of the instruction.

A question directs attention. It signals which relationships matter. It can prompt retrieval, expose a misconception, make a student organize information differently, or reveal that something they thought they understood isn't quite as settled as they imagined.

Even an incorrectly answered question can be useful if it sends a learner back to reconstruct the concept.

That's also why some questions were revised simply because they repeated an earlier Quick CHECK without adding much. Repetition can certainly be useful for retrieval, but repeating essentially the same question isn't always the best use of another learning opportunity within the limited pages of a textbook. 

A good question should earn its place.

Less listing. More thinking.

An A&P course necessarily contains a lot of information. We're not going to wish that away—and I wouldn't want to.

But we can keep looking for ways to help students organize those facts, connect them, and eventually reason with them.

That's what we tried to do with many of the revised questions in the 12th edition.

Not fewer facts. Not thinking instead of knowing.

Knowing—and then doing something with what you know.

That seems like a pretty good direction for A&P.

If you want to explore the new Anatomy & Physiology, 12th Edition, be sure to request your complimentary examination copy today. Here's a secret: if you use the automated form to request your copy, they'll send the textbook in digital format. If you'd rather have it in the print format, simply use the sales-representative form and request that your representative to arrange for the print copy.