Individualized formative assessment in online module improves learning of glomerular filtration

While capillary filtration is a fundamental physiology topic, students report that this material is difficult to master. In addition, overall exam performance in related courses does not correlate with performance on questions regarding capillary filtration. A module that presents capillary filtration in the context of glomerular filtration has been developed and incorporated into the curriculum of the Harvard-MIT Division of Health Sciences and Technology renal pathophysiology course. Water is a major constituent of the human body. Exchange of fluids between different body systems, therefore, is an important process to understand. Capillary filtration plays a fundamental role in all physiology¹. This is a complex topic, requiring understanding of foundations in fluid and vascular mechanics. These topics are important but have generally proven difficult for students in medical physiology classes to master. To relay the material in a renal physiology class we develop a module concerning glomerular filtration. The glomerulus is a capillary bed that acts as the main filtration unit of the kidney. The module is based on the principles outlined in How People Learr?. These include creating a learningcentered environment, focusing on core concepts and big ideas in the learning environment, being assessment centered to help students' thinking become more visible to both themselves and the instructors. Previously, it has been shown in our and others' work that an HPL-informed instruction strategy improves student learning of material^3,4. The module replaces traditional instruction, which consisted of an in-class lecture followed by a problem set and assigned textbook reading. The module replaces both the problem set and textbook reading with two interactive online exercises that introduce core content and provide real time formative assessment to students. The first exercise is assigned before the lecture and presents basic concepts including hydrostatic and oncotic pressure. Student performance and feedback collected during this exercise allows the lecturer to tailor the lecture to the learners. A novel Java simulation of glomerular filtration that permits manipulation of independent variables while displaying the dependent variables is projected during the lecture. The second online exercise is assigned after the lecture and reviews and extends the concepts presented in the lecture. To improve student understanding, the newest version of the module includes adaptive feedback; described in more detail below. Also this year we analyzed the patterns of incorrect responses in the past iterations of both online exercises and developed specific feedback for common mistakes, to help students revise their specific misconceptions about the material, which the majority of students found to be helpful. Knowledge based outcomes demonstrate that students who used the module have improved mastery of the three learning objectives compared to those taught using traditional techniques. While the majority of all students prefer the new module to a traditional problem set, we have found that both student undergraduate major and student graduate program had an impact on their preference of learning tools. Future efforts will focus on dissemination to other programs as well as continued improvements to ensure that students from all backgrounds find the module useful.