Dice, beach balls and chocolate chip cookies

Preparing the next generation of public health professionals
July 8, 2019

During the first week of class, first-year students enter a large stadium-seating classroom. Some are talking quietly or looking at their phones, but many are still trying to wake up after the previous night’s season-opening home football game. The classroom is relatively quiet, then the clock hits 8 a.m., and it is time for class to begin. What happens next is not what most would expect in a college classroom.

Active learning, a term routinely heard on campuses of higher education today, works to engage students in meaningful learning activities that move them beyond simply listening to lectures. Most faculty today experienced a very different teaching method when they were in school, where the “sage on the stage” provided all needed information, and the classroom was a relatively passive environment. As a student, Jennifer Griffith, Dr.P.H., associate dean for academic affairs and instructional associate professor at the Texas A&M School of Public Health, was exposed to the “sage on the stage” model of teaching, but realized early on teaching her own classes that active engagement was the key to meaningful interactions with students. Griffith teaches bookend courses in the Bachelor of Science in public health (BSPH) degree program, a first semester one-hour seminar course and final semester capstone course, where she employs various active learning strategies.

So what happened when the clock hit 8 a.m. that first Friday morning? “I knew I had two challenges walking into the first class—the early class time and the opening football game the night before,” Griffith said. “But I also knew that opening the class in a nontraditional way would wake students up, so I brought a giant beach ball.”

With a 24-inch diameter beach ball in hand, Griffith started the class using it as an ice-breaker to not only get to know her students, but to also have them up and moving in the classroom. It may sound like fun and games, but there is a rationale to opening the class in this manner. Students immediately realize that simply coming to class and sitting passively is not an option, even at 8 a.m. Griffith expects students to engage and interact with her and with each other.

“A quote that has been attributed to Benjamin Franklin is probably the best way to describe my approach to teaching, ‘Tell me and I forget. Teach me and I remember. Involve me and I learn,’”Griffith said. “The more students get involved, the better chance they will internalize important material to support them in the rest of the curriculum and into their careers.”

The first semester

Her approach to teaching is first experienced by many first-year public health majors during their first fall semester in PHLT 301-Public Health Concepts. The one-hour, seminar-style course provides students with foundational concepts in public health, setting the stage for future course work. This class is designed to help them “see public health” in their everyday encounters and surroundings and is a central theme to the course. Griffith routinely works to tie the known to the unknown, allowing students to link new concepts with something familiar. For example, when teaching public health core functions and essential services, she ties new concepts to the common flu, something that every student has some level of knowledge and/or experience. She then helps them transfer concepts to new examples so that they begin to apply concepts. “Seeing public health” is also pervasive in assignments students complete; they share what they see related to core public health concepts through photo journals.

“When a student submitted a picture of an Aggie football game and tied it to the essential services of public health I was elated. The student while watching Aggie Football not only saw a sporting event, but also the underlying elements of public health!” Griffith said.

Exam reviews in this predominantly first-year course are also a little different from what many experience in other courses because they are not a list of what one needs to know. “I build reviews into each session, but the students often do not realize these are reviews,” Griffith said. For example, in the course session after learning about core functions and essential services of public health, students are greeted with giant foam dice at the front of the classroom. Volunteers take turns rolling and provide answers and examples based on the number rolled, and it is not just the students who volunteer who get involved. “Those who are less inclined to be the center of attention still have a chance to engage. Ultimately, three of four examples are provided from those sitting in the audience after the volunteer rolls the dice,” Griffith said. Reviewing concepts throughout the course using strategies like giant foam dice allow Griffith to identify which concepts are easily grasped and where additional discussion or clarification is needed to ensure a concept is learned.

By midway through the semester students know to expect the unexpected, but the return of a beach ball to class does raise a few eyebrows. This time the beach ball is covered with various questions to further prepare students for their midterm exam. Students can “phone a friend” (ask their neighbor) if they catch the ball and struggle with a question, but often students realize how much they have already learned and how concepts are connected.

“The Public Health Ball is an excellent review tool,” Griffith said. “It checks knowledge of basic concepts and allows me to draw out application of those concepts in examples. Their exams will do both: check knowledge and ask them to apply concepts.”

“I know trying some of these approaches might not garner desired results, but during the first semester pilot I was pleased with student attainment rates, compared to previous semesters,” Griffith added. It is important to note that she is not talking about grades, but that students are proficient or attaining the objectives outlined on the course syllabus. The distinction for her is an important one, although attainment rates goes hand in hand with a course grade.

“Several areas where students have struggled in past semesters had much higher attainment rates with this class. I share with students not only their grades, but also their attainment of course objectives because it is possible to have a good grade but still struggle on a major concept in the field.” Griffith said. This information is a way to engage and empower students in their education. Grades tell one part of the story; attainment of concepts tells them they are ready for the next course.”

The final semester

Griffith does not see most of these students again until their final semester in the BSPH degree program when they complete their undergraduate capstone course. From the beginning, the goal of the BSPH degree was to ensure students were prepared to practice public health. This meant creating a course that would mimic real-world experiences: both a challenge and an opportunity. As the program has grown, the course has morphed into a case competition, where teams of four to five students respond to a hypothetical request for interventions to address complex public health issues. Judges who are public health practice experts and subject matter experts evaluate student presentations at the end of the semester, with winning teams recognized at the school’s graduate reception.

The nature of the course is one of helping students pull together all elements of the curriculum.

“I tell students the first day of class that this is a doing class. I am not necessarily going to teach them anything new, but I will facilitate and coach them on how to pull everything in their toolbox together to tackle the challenge posed,” said Griffith.

In many ways, Griffith learns along with her students, because she purposefully chooses topics where she has limited experience and is not an expert. Learning alongside her students demonstrates what being a life-long learner looks like. When students reach this point in their curriculum they have progressed well beyond seeing public health to doing public health. Griffith has likened the course to “bumper bowling.” Students may not throw a strike, but the ball will get all the way down the lane. “I let student teams wrestle and struggle with pulling pieces together because that is what happens outside of the classroom, but if I see a team really headed in the incorrect direction I will ask pointed questions that usually get them back on track.”

However, one area that Griffith noticed most students struggled with was the concept of intervention evaluation—how they could identify what was measured and how to show that their idea had the potential to make a difference in the issue it was addressing. She turned again to an active learning strategy tied to something known by students: chocolate chip cookies.

“About midway through the semester, I knew teams were getting to the point where they started discussing how they would measure or evaluate their interventions. Many were struggling with taking concepts learned in other courses and applying them to intervention strategies they had developed. The chocolate chip cookie evaluation is not a novel idea; it has been used by many teachers in many different situations from K-12 to college courses. The trick is adapting it to lead students where you want them to end up,” Griffith said.

For this class, Griffith, wants students to use the exercise to be able to describe and measure the best chocolate chip cookie ever, then transfer the concept to describe and measure the ultimate best outcomes for their intervention. She brings four different varieties of chocolate chip cookies to class and students use different evaluation strategies to determine which cookie is best without knowing the brand or where the cookie came from. The exercise walks students through issues with ambiguity and building consensus and ultimately helps them to look at the whole cookie as well as its component parts. “I find after this exercise teams stop talking about their intervention strategies as a whole, and really talk about how the parts of their intervention lead to the ultimate goal,” she said. “It is a sweet way to make a point, but students leave that class session with a better idea of how to move forward on their projects.”

What’s next?

Griffith will be the first to tell you that active learning techniques take time and require faculty to be comfortable letting students take center stage in the classroom at times. “Active learning techniques do not work for every situation in every course, but I have found in my personal experience that the days when these techniques work, and work well, the payoff is immeasurable,” Griffith said. She routinely encourages others to try ideas in their own classes and invites them to her classes to see them in action as well as to provide feedback.

So what is next, for Griffith and her courses? In fall 2020, Texas A&M will open the 21stcentury classroom building with nine unique classroom designs to facilitate active learning, which demonstrates the university’s commitment to providing the best educational opportunities for students. “I have applied to teach PHLT 301 in one of the arena-style classrooms,” Griffith said. Imagine a circular arena where students are never more than 10 rows away from the faculty member, who stands in the middle of the room surrounded by students on all sides. “I can visualize some new ways this space will allow me to engage students with content, each other and me,” she said. “I cannot wait to see how these ideas play out and the impact it will have on me as well as the students.”

— Rae Lynn Mitchell

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