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Home , Histology

Pedagogical Methods for Teaching Histology in and Courses

Scott C. Sherman and Chong K. Jue Queensborough College City University of New York Bayside, NY [email protected] [email protected]

Introduction have given valuable suggestions and described useful Every year a large number of students take courses in individual techniques and strategies for teaching histology. anatomy and physiology (A&P). These are important (See list of additional resources at end of article.) gateway courses for coveted careers in the health In introducing students to histology it is important to sciences. A&P is a challenging subject that requires a include a discussion about biological stains (how and serious commitment of time and effort by the students why they are used) and to briefly review cells and their in order for them to achieve mastery of the topics and basic structure. Instructors should explain to the class academic success. Many of today’s students have large which cellular structures (plasma membranes, nuclei, and course loads, some have part-time or even full-time jobs, ) the students will see while examining and some have families to care for and financially support. slides at magnifications available on typical A&P student As a result, many students have extremely limited time laboratory . Students frequently think that to meet with tutors or peer-study groups and to use other they will be able to see all of the different that resources outside of class time that are available at the they learned about while studying cells. Drawing for the colleges. Students are frequently ill-prepared for A&P class a basic illustration of simple columnar epithelial courses and there is often a high drop-out and failure rate. tissue with the plasma membranes, nuclei, cytoplasm, At many colleges there are now no or chemistry free surface, basement membrane, and the underlying prerequisite courses required before taking A&P. Many all shown and labeled is a good way students have little or no background in science and to review aspects of basic cytology and introduce to the have not developed good language and study skills. class the structural complexities of tissues. We suggest Furthermore, many students enter A&P courses with little that instructors discuss with their classes the anatomical or no prior experience using microscopes and handling and physiological diversity of tissues, explain that slides, and consequently considerable there are four principal categories of tissues (epithelial, laboratory class time can be spent helping students use connective, muscular, and ), and explain microscopes properly. A&P courses often have large that the individual types of tissues that are classified into enrollments and class sizes. It is not uncommon for these four categories have some important characteristics laboratories to have more than 20 students with a single in common but also possess some distinguishing and instructor. These facts combined with budget limitations important structural and functional differences. For and other problems encountered at educational institutions students to understand A&P their instructors need to can cause logistical and pedagogical difficulties for help them understand the essential connections between instructors, course coordinators, departmental and college structure and . administrators, and for students. Examining tissues in the laboratory is often confusing for Histology is often considered one of the most difficult students and poses special problems for the instructor. topics in A&P. Typically, histology is covered in A&P 1 An excellent laboratory exercise that helps to introduce after the study of cells. Students need to master basic students to histology is the preparation by each student histology and retain that information throughout the of a cheek slide made by scraping cells from the remainder of their study of A&P. If a student fails to master stratified squamous epithelial tissue lining the inside of basic histology they will have great difficulty understanding their cheeks. This exercise allows students to make their how organs and systems are structured and own slide using biological stain, to have the experience of how they function. Many students have difficulty examining cells that they themselves removed from their conceptualizing and intellectually accepting that their own tissue, to see the primary structural components bodies are composed of microscopic components and that of the cells, and to have the opportunity to practice using some of those components are living and some are non- microscopes. living material. Furthermore, it is not uncommon for some students to emotionally reject the fact that our bodies We explain briefly ten different pedagogical methods for harbor a huge number of symbiotic bacteria. Various teaching histology in courses in anatomy and physiology. authors in the HAPS-EDucator and in other publications

(Continued on next page) 50 HAPS EDucator Fall 2009 We include some of the advantages and disadvantages areas on the slides, the ability to have multiple activities encountered in using each method. occurring in the classroom simultaneously, and the ability to provide the instructor’s choice of supplemental material Pedagogical Methods for Teaching for each microscope. Disadvantages include the students Histology not having the experience of setting up the microscopes and slides themselves (i.e., not having to go through the 1. Self-Guided Learning. This is the traditional method entire process of focusing the microscope and hunting for of teaching histology in the laboratory. The instructor tells and finding the correct tissue and proper field of view), the the students to get out their individual microscopes, slide possibility of students accidently moving the preset field boxes, laboratory manuals, and notebooks. The students of view, and the problem that sometimes students either are then instructed to study on their own a specific group have to wait while others are at the microscopes or they of tissues (such as epithelial tissues) within a specified feel pressure to rush through their work when they are period of time. Instructors can suggest to the students using the microscopes because other students are waiting. that they view tissues at more than one magnification, compare what they see with the information in their course 3. Learning with Image Projection. Histological book(s), and make notes and drawings of the tissues that images in the form of transparencies, PowerPoint slides, they examine. The instructors can either walk around the microscope projector images, video images, or internet laboratory visiting the students’ individual work stations or images are projected on a screen (e.g., projector screen, position themselves in a location in the room where they video monitor screen, or computer screens) in the are accessible to the students. classroom. The instructor guides all the students at the same time through a series of images of the tissues to Advantages of this method include the students’ hands-on be studied, pointing out on the images the primary and learning with microscopes, slides, individual observation, distinguishing anatomical features of each tissue. This is and biological illustration. Tactile learners may benefit an excellent opportunity for the instructor to explain the from the instructors suggestion that they draw what they physiological purposes of the anatomical features, the see. Disadvantages include the lack of direct guidance etymologies of the names of the tissues, the locations in from the instructor, the need for student self-motivation, the body where the tissues are found, and the roles that the time that this method requires when all of the students each tissue plays in bodily functions. The instructor can conscientiously do the necessary work on their own, the also ask the students to follow along with this presentation likelihood of students lacking sufficient knowledge of by referring to images in the students’ lecture textbook, , and the possibility that students will spend laboratory manual, and/or in supplemental course time studying the wrong slides and the wrong areas on material provided to the students. The instructor can ask the required slides. With self-guided learning it is not the students questions and involve them in classroom uncommon to see students mistake various things (such discussions about the tissues that they are seeing as cracks in the slide and coverslip, the adhesive that projected on the screen. affixes the coverslip to the slide, dust particles on the slide, and even parts of the manufacturer’s slide label) Advantages of this method include saving time (and for tissues. Also, the lack of direct guidance from the money) by not having the students use microscopes instructor increases the likelihood of students clandestinely and slides, focusing the students’ attention on a single text messaging and engaging in other nonproductive classroom activity guided by the instructor, providing the behavior. opportunity for students to see and hear the instructor’s explanations of the tissues, having structured classroom 2. Learning with Preset Microscopes. Microscopes are time in which students can ask questions and there set up in the laboratory with slides in place each showing can be classroom dialogue, eliminating the likelihood of a good field of view, at an appropriate magnification, students studying the wrong slides and the wrong areas of the tissues to be studied. This can be done by the on their slides, and the fact that practical examinations instructors or laboratory technicians before the laboratory can be conducted using image projection instead of class. Supplemental information can be provided at each setting up a series of individual microscopes with slides. microscope, such as illustrations, photomicrographs, Disadvantages include losing the valuable opportunity for and brief written descriptions of the important physical students to have hands-on experience with microscopy characteristics of the tissues. During the laboratory each and not being directly involved in the discovery process. student is expected to visit each preset microscope to study the slides along with any supplemental material 4. Learning with Digitized Imaging. Students are present. The students need to be instructed how to use encouraged or required to make digital images of the the fine focus adjustment on the microscopes and told not tissues that they examine by microscopy. This can be to move the slide and not to change the magnification. accomplished with microscopes coupled to a digital camera or now with the students own digital cameras and Advantages of this method include the time saved from with cell phones that possess built-in digital cameras. The not having the students setting up and putting away their students can then digitally label their images and post the individual microscopes and slides, reducing the likelihood images on the course website and into their own digital of students studying the wrong slides and the wrong (Continued on next page) Fall 2009 HAPS EDucator 51 sites (such as ePortfolio). They can also send by email tissues based on the colors resulting from the biological their images to the instructor and to their classmates. stains. Some students are shy or uncomfortable during The instructor can have the entire class work together cooperative learning and recede from group interactions. to make a course digital histology atlas, or the students Often one student will dominate the group and from our can be divided into groups and instructed to assemble experience these dominant individuals are often the most unique group digital atlases, or the students can be told gregarious people and not necessarily the better students. to create their own personal digital atlases. The students would have the ability to make computer printouts of their 6. Problem-Based Learning. The instructor devises labeled and unlabeled histological images. The labeled problems that are appropriate for their classes and help and unlabeled digital images and the printed copies can to achieve the course learning objectives. The students conveniently be used by the students for review and self- can be instructed to work on the problems individually or testing. in cooperative-learning groups. There are many different possible problems and techniques that instructors can Advantages of this method include involving students use, and the problems can be presented to the students with the production of course material (many students in a variety of different ways. Students can be given feel motivated to try to produce good quality digital written and verbal problems to solve and case studies of images to share with their classmates and to post on the various complexities. In the laboratory the instructor can course website and their personal sites) and having the use microscope slides that lack written labels or that have students experience identifying tissues and structures their labels securely covered. These slides need to be by digitally labeling their images prior to their classroom easily identifiable by the instructor and for this purpose we examinations. Disadvantages include the possibility that suggest that each slide receives an identification number. the students will spend more of their time involved in The students can be asked to identify the tissues and/or the technology (making, electronically distributing, and to classify them (e.g., into the four principal categories of posting the digital images) than actually learning about tissues; or as either simple or stratified epithelial tissues; histology, the likelihood that students will mislabel their or into connective tissue proper, , osseous tissue, digital images and that these mislabeled images will and ). These types of problem-based exercises then be posted to the course website and distributed by can be done with preset microscopes, or with each email to classmates without being factually correct, and student working individually with a microscope, or as the concern that email attachments may contain harmful cooperative-learning exercises. Similar exercises can computer viruses. also be accomplished without microscopes by projecting unlabeled histological images on a screen or by furnishing 5. Cooperative Learning. The students are divided into the students with handouts of unlabeled histological cooperative-learning groups, usually composed of 2 - 5 illustrations and photomicrographs. Additionally, when individuals. The groups are instructed to carry out specific illustrations and photomicrographs are used the students cooperative-learning exercises. These exercises can be can label the different parts of the tissues directly on the unique for each group or all groups can be given the same handouts. exercises to perform. The instructor can either limit the cooperative learning to the members within each group The principal advantages of this method are involving or can require different groups to engage with each other students in critical thinking and problem solving. in intergroup cooperative-learning exercises. Each group Instructors can also use Methods 1–5 and 8–10 in can be required to hand in to the instructor some specified conjunction with this method. The disadvantages in form of group work. The instructor can also require each A&P are that many students find this method difficult and group to give a brief presentation of the results of their frustrating because they have little or no prior experience group exercises to the entire class or this information with this teaching method and often lack sufficient can be shared in some other way. An example of a type scientific knowledge to draw reasonable conclusions and of cooperative-learning laboratory exercise is to have all solve on their own many types of problems. members of a group examine a specified tissue and then the students within the group discuss between themselves 7. Motor-Based Learning. Students are encouraged the characteristics of the tissue that they examined. or required to draw the tissues that they need to know for the class and to correctly label the structures illustrated Advantages of this method include providing the students in their drawings. This is usually done while the students the opportunity to formulate their thoughts in order to are examining tissues on their individual microscopes verbally communicate their ideas to their classmates. or on a series of preset microscopes. The students Some students feel motivated in cooperative learning should be encouraged to consult their course books but environments. The instructor can also incorporate into discouraged from copying the figures that are in those this pedagogical method aspects of Methods 2, 4, 6, 7, 9, books. The instructor should draw and label at least one and, 10. Disadvantages include quality control because illustration (such as a field of view of students at this level usually lack the knowledge to provide with the lacunae, chondrocytes, plasma membranes, quality information to their classmates about the tissues cytoplasm, nuclei, elastic fibers, , and that they examined. They frequently describe the tissues possibly the perichondrium shown and labeled) for the incorrectly, omit valuable information, and describe the (Continued on next page) 52 HAPS EDucator Fall 2009 class as a demonstration of the level of quality that the instructed to raise their hands when they believe they have students are expected to strive to achieve in their own the required structure in position on their microscopes. drawings. An effective technique is to simultaneously The instructor then goes to the students’ work stations project on a screen the image of the same field of view to check the accuracy of the students’ work. If a student that is being drawn by the instructor. The students are fails to find the correct structure, as is frequently the case, then able to watch the process of the instructor drawing the instructor has the option to: (1) guide the student and labeling the tissue while at the same time directly by various pedagogical techniques to locate the proper comparing the instructor’s illustration with the actual field structure, (2) simply tell the student that they did not place of view projected on a screen. This technique enables the the ocular pointer on the correct structure and to try again instructor to point out and explain any differences between to locate and identify the structure, or (3) as is sometimes the illustration and the actual field of view, and it provides necessary, to place the ocular pointer on the structure for the opportunity for an exchange of questions and answers the student. After all of the students have correctly found between the instructor and the students. Instructors can the required structure (or have had the structure found for have their students work individually or in cooperative- them by the instructor) the instructor can tell the class to learning groups and can require the students to create find a different structure on the same slide or to remove individual or group learning portfolios that include the the slide and put a slide of the next specified tissue on illustrated and labeled drawings, along with short written their microscope stage. From there the above outlined descriptions of each tissue. When this method is used procedure is repeated. as a cooperative-learning exercise each student within a group should be given the responsibility for drawing and Advantages of this method include the fact the students labeling a specified number of tissues. This attempts to receive the instructor’s direct supervision and guidance ensure that each student in the class is directly involved in at each step in the discovery process, the instructor and the motor-based learning. After students have completed each student have a one-on-one interaction with each their assigned drawings the labeled illustrations are other and the instructor can therefore easily identify shared, discussed, and edited by the group members. students who are having difficulties with the subject The illustrations can then be assembled into the group’s and difficulties using a microscope, the instructor can learning portfolio. These learning portfolios can be turned engage the students with individually tailored questions to in to the instructor and/or shared between the group access each student’s progress and comprehension on members after photocopying or digitally scanning the the material, and the instructor can incorporate into this included material. pedagogical method aspects of Methods 3–7 and 9–10. Disadvantages include the fact that this method is very The advantages of this method are not limited to tactile time consuming, requires the instructor to be continually learners and students with artistic talents. An advantage moving from one student’s work station to another and of this method is that students need to closely observe therefore requires good mobility and endurance on the the tissues to draw them properly. When the drawings part of the instructor, and even a single student if not are done properly, this method often helps students retain managed properly can disrupt and hold back the forward mental images of the tissues and learn their distinguishing progress of the entire class. We have found that with anatomical features. Disadvantages include the large some students it is necessary for the instructor to find amount of time needed by most conscientious students the tissues and structures for them; otherwise, the class to draw the tissues and the likelihood that students will progress comes to a halt (it is usually quickly apparent mislabel their illustrations and that some students will which students need this type of help). simply copy figures from a book or from a classmate instead of making their own drawings. An additional 9. Organ-Based Learning. This method is best common problem is that many students make very fast, employed after the students have concluded their primary poorly done drawings that do not resemble the tissues study of the different individual types of tissues and as they examined and are therefore of little or no value to part of learning about specific organs. In this method them. the students are asked to identify the individual tissues that compose bodily organs and, depending on their 8. Instructor-Guided Learning. In this method the level of knowledge, to either hypothesize or explain instructor guides the students in a step-by-step fashion as the likely function or functions of each of the tissues in they examine individually or in small groups the tissues those organs. To accomplish this the students will need to be studied. This method is similar to Method 1 except to examine carefully the microanatomy of organs on that the instructor directs the class step-by-step in the microscope slides, or on histological images projected process of examining the tissue slides. The instructor on a screen, or on printed histological photomicrographs tells the students exactly what slide to examine, tells them (in books, on handouts, and on computer printouts). The to find a specific tissue on the slide (many slides contain availability of well-drawn illustrations for the students more than one tissue), and tells them to then find and to review can be an excellent supplement to slides and place the ocular pointer on a specific structure (such as histological images and photomicrographs. The instructor a nucleus, collagenous fiber bundle, chondrocyte, etc.) can devise a variety of different projects and assignments while using a specified magnification. The students are (Continued on next page)

Fall 2009 HAPS EDucator 53 for their classes and can have the students work the amount of available time dedicated in the course to individually or in cooperative-learning groups. As part histology, the availability of equipment and other materials of this method some instructors may want their students in the classroom, institutional budgetary constraints, and to have the hands-on experience of making their own the instructor’s mobility and preferences. Each instructor microscope slides. may employ one or more of these different methods to supplement their own teaching styles, enhancing the The advantage of this method is that it integrates the learning experience and comprehension of the students. students’ knowledge of histology into their experience of learning about the structural organization and Acknowledgments physiology of the body’s organs. This method can be used with a variety of different strategies, techniques, We thank our Queensborough Community College and teaching styles. The first eight methods described colleagues Drs. Sharon S. Ellerton, Bryn J. Mader, above can be easily and productively incorporated into and Richard D. Pollak for the helpful discussions about this method. Disadvantages include that some students histology. We are grateful to our colleague Dr. Eugene become confused and often frustrated trying to decipher E. Harris for his kind help in obtaining for us needed the structural complexities of organs and attempting to literature. differentiate and identify the individual tissues. Additional Resources 10. Organ System-Based Learning. This method is best used when the students are studying the body’s Bartlett D. 2005. Histology charades, p. 10. In: R. organ systems. In this method the students, working Meehan and R. Faircloth, EDU-Snippets: Form and either independently or in cooperative-learning groups, function. HAPS-EDucator 9 (4):10–11. are required to analyze the histological structure, macroanatomy, and functions of the major organs of one Bavis RW, Seveyka J, Shigeoka CA. 2000. Another or more of the body’s organ systems. The instructor strategy for teaching histology to A&P students: should tell the students to consider in their analyses the Classification versus memorization. American Biology overall functions of the organ systems and the functional Teacher 62(5):365–369. roles played by the different individual types of tissues and by the organs. As in Method 9, the students will Belzer WR, Eggleton KH. 1988. More efficient and be required to examine carefully the microanatomy of effective histology instruction. The Anatomist/ the organs. Many of the strategies and techniques that Physiologist: A National Newsletter for Instructors of instructors can employ in Method 9 can be incorporated Human Anatomy and Physiology 1(2):4–5. successfully into this method. Instructors can require Chapman ES. 2005. The “micro” and “macro” of tissues. that each student or cooperative-learning group prepare HAPS-EDucator 10 (1):17. a written or verbal report or a PowerPoint presentation giving the results of their integrative analyses. Cohen BJ, Benfer D. 1997. Human histology slides on the internet. HAPS-EDucator 1 (3):12, 16. Advantages of this method are that it stimulates the students to use a variety of important skills; to analyze Cotter JR. 1997. Computer-assisted instruction for the tissues, organs, and organ systems; and to think about medical histology course at SUNY at Buffalo. Academic and discuss the functional roles that tissues and organs 72 (10):S124–S126. perform in our body’s organ systems. This method helps students to better understand the anatomy and physiology Cotter JR. 1997. Histology on the World Wide Web: A of the organ systems and their constituent parts, while digest of resources for students and teachers. Medical simultaneously using, reinforcing, and expanding their Teacher 19(3):180–184. knowledge and understanding of histology. Instructors can use Methods 1–8 in conjunction with this method. Cotter JR. 2001. Laboratory instruction in histology Disadvantages include the fact that this method often at the University at Buffalo: Recent replacement of requires a considerable amount of time and that some microscope exercises with computer applications. students may not be able to carry out the necessary Anatomical Record Part B: The New Anatomist integrative analyses. 265(5):212–221. Deniz H, Cakir H. 2006. Design principles for computer- Conclusions assisted instruction in histology education: An exploratory study. 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