5 A novel bioscience ‘capstudy’ assessment based on Universal Design for Learning (UDL)

Introduction

Almost half (49 per cent) of young people in the UK are now going to university (Ford, 2017). The growing student numbers accessing Higher Education (HE) from increasingly diverse backgrounds mean that traditional teaching, learning and assessment methods require a more inclusive approach. At De Montfort University (DMU), the number of students on the Biomedical Science (BSc) course has more than doubled from approximately 90 to 200 students in the last four years. Similarly, the Medical Science (BMedSci) course has grown from 21 students in 2014 to 50 in 2018.

Concomitant with the increase in students has been the diversification of students’ academic qualifications, demographics and personal characteristics. DMU was named as the 2018 University of the Year for Social Inclusion by The Sunday Times Good University Guide, due to the success of its diverse student population in exams and graduate job prospects. We are extremely proud that, compared to the rest of the university sector, we welcome significantly higher proportions of students from ethnic minorities, disadvantaged backgrounds and mature students. Approximately one in five DMU students also declares a disability.

The BSc and BMedSci students represent a large and highly diverse cohort. The majority come from non-A level routes, such as Business and Technology Education Council (BTEC) Level 3 diplomas, and Access to Higher Education courses. The student population is mainly comprised of Black, Asian and Minority Ethnic students, and over 20 different nationalities are represented. Approximately 60 per cent are female, and a large number are from Widening Participation backgrounds, often the first in their family to attend university. A significant number of students declare a disability or specific learning disability, including dyslexia, autism, hearing and visual impairments, and mental health difficulties.

Despite increasing diversification of the student body, the sector has been slow to respond to their learning needs and preferences (Capp, 2017). The challenge for lecturers who teach large, diverse cohorts is to engage and provide appropriate individual learning support, and to ensure that each student has an equitable opportunity to demonstrate their learning through appropriate and flexible assessment methodology. This presents an opportunity for universities to introduce innovative approaches to learning, teaching and assessment.

Universal Design for Learning

Universal Design for Learning (UDL) is an educational framework based on decades of pedagogic and neuroscience research. UDL provides flexibility and options that afford every student an equitable opportunity to learn, and to demonstrate their learning, in ways that suit their individual learning preferences and needs. This is achieved by giving students multiple means of representation, engagement, and expression of ideas and knowledge (Rose et al., 2006; Rose and Strangman, 2007).

Although UDL has been most widely applied to school classrooms, it is now gaining recognition for its benefits in HE (Capp, 2017). Rose et al. (2006) applied UDL principles to a post-graduate Education module undertaken by 93 students at the Harvard Graduate School of Education. Their approach provided a range of learning resources, including lecture recordings, alternate sensory modalities, graphics to support text, multimedia learning resources, and shared student notes. Flexible ways to learn included discussion groups, and options for face-to-face or online engagement. The assessment provided a range of means by which students could demonstrate their knowledge; being a website, this could include text, images, videos, and other resources. This UDL approach for teaching large groups of diverse university students has been shown to impact positively on student learning. Dean et al. (2016) at the University of Kentucky used a combination of four tools (i.e. PowerPoint, lecture notes, clickers (hand-held interactive voting devices), and MindTap (an internet-based multimedia learning platform) to provide classes of over 600 marketing students with multiple means of content presentation, engagement, and learning expression. Students reported that all of these tools were highly useful for learning, and that tool usage enhanced student satisfaction. Thus, UDL is a very broad and versatile concept that can be adapted and applied from small-scale up to institution wide.

UDL was introduced at DMU in 2015 and, rather than its traditional use as a deficit model targeted at levelling the playing field for disabled students (Rose et al., 2006), was launched as an innovative learning, teaching and assessment framework, designed to embed flexibility into our teaching and curricula that would provide equitable and personalised learning experiences. Since then, UDL has served as a catalyst to radically transform our teaching, learning and assessment practices, thereby benefitting every student, and producing more creative and pedagogically skilled lecturers. At DMU, the principles of UDL are to provide students with:

1. Flexible learning resources
2. Flexible ways to learn
3. Flexible ways to demonstrate their learning

This framework encourages mastery-oriented pedagogy, which pushes each student to excel and exceed their goals.

UDL as a framework for transforming assessment

Assessment is the area with which students are least satisfied worldwide (Medland, 2016), illustrated by National Student Survey (NSS) data. Assessment was the joint lowest-rated category in the 2018 NSS, achieving only 73 per cent student satisfaction, compared to 83 per cent overall satisfaction nationally (HEFCE, 2017).

A key problem with assessment is an over-emphasis upon summative assessment, with formative assessment and timely feedback lacking. Over-focusing on the final grade promotes surface learning, and prevents students from reflecting critically and assimilating concepts from across their programme of study. Whilst formative assessment is critical to student learning, it is often side-lined due to various factors, including pressure felt by academics to focus on summative assessments, and increasing student numbers which challenge the ability of lecturers to provide formative assessment (Yorke, 2003). Assessment for learning should be placed at the heart of the curriculum, with assessment integrated holistically, allowing students to gradually enhance and embed their learning through integrated ‘capstone’ assessments (Boud, 2010).

Couch et al. (2015) devised a capstone assessment for a large cohort of molecular biology students from across seven institutions, which allowed students to apply their knowledge and understanding from the course to contextualised novel scenarios. This approach highlighted some key misconceptions not previously identified by in-course assessments. A carefully constructed capstone assessment can demand that students use higher-order skills such as application of knowledge, critical evaluation and synthesis, which are often overlooked in bioscience course assessments in favour of more basic recall of knowledge (Krathwohl, 2002). Lecturers can achieve this by guiding students through inquiry-based learning, rather than covering discrete topics that students can simply memorise (Lord and Baviskar, 2007).

Assessments should also respond better to the diversity of the student body (Boud, 2010). The majority of assessments in Biochemistry are still closed-book examinations which, by their nature, largely test factual recall. The stressful nature of a timed examination disadvantages most students, in particular those with specific learning disabilities that may affect speed of writing or typing, memory recall or organising information.

A key principle of UDL is to provide students with flexible ways to demonstrate their knowledge and understanding. UDL encourages assessment for learning, along with the opportunity to apply knowledge to ‘real-life’ problems in which the learners see their diversity reflected. Could UDL offer a way to address the current issues surrounding assessment in HE, by providing flexible assessments built for diverse learners?

Using UDL to create a novel ‘capstudy’ assessment: What happened to Ashley Tailor?

We applied a UDL approach to redesign the assessment regime in a Level 5 (Year 2, undergraduate) 30-credit module, Research and Diagnostic Techniques, which is taught jointly to BSc and BMedSci students at DMU. The number of students enrolled on this module has grown from 84 students in 2014 to 204 students in 2018.

Previously, the module included five assessed laboratory reports linked to only one part of the lecture content. Students did not easily connect the practical and theoretical aspects of the module. The examination tested recall of some of the practical methodology, but did not stretch students to use higher-level skills such as problem solving, analysis, synthesis and critical evaluation. Formative assessment of knowledge and skills was lacking.

Using UDL as a framework, we redeveloped the module by centring the teaching, learning and assessment on the ‘Ashley Tailor’ case study. This is a fictitious student, designed to be ambiguous in terms of gender and ethnicity, to be relatable to all students. As far as we know, this is the first UDL case study of its kind. At the start of the module, students receive news that Ashley has been found unconscious and it is their task to find out why. The final coursework element of the new module requires students to analyse, interpret and integrate information about Ashley, using their knowledge and skills from practical classes, lectures and other clues from social media. We have termed this a ‘capstudy’ assessment, as it combines a case study-based approach with a capstone assessment.

The new module plan involves four laboratory practicals; the first three teach students how to use the equipment, obtain and analyse data, and to write up their findings in the style of a journal article. Alongside the practical classes, students have five blocks of lectures on different topics. Each lecturer provides a problem-based learning (PBL) exercise for students to solve, which links their topic to the Ashley Tailor case study.

Integrating information based on theory and practicals from the entire module, the new capstudy assessment allows students more time to analyse and integrate information from various sources. Similar to Houston and Thompson (2017), we hoped to blend formative and summative assessment through our capstone assessment, to provide students with richer guidance and dialogue about enhancing their knowledge and skills. We also hoped that a case study-based approach would promote deeper learning and encourage students to develop their scientific and employability skills in problem solving, lateral thinking, communication, and team working. Using case studies in bioscience teaching is an active learning approach which increases student learning gains and improves performance in assessments (Bonney, 2015; Yadav and Beckerman, 2018). Students also move away from surface learning and towards deeper learning, and demonstrate a better grasp of the underpinning scientific principles (Kulak and Newton, 2015). Solving case studies promotes higher-level thinking skills, such as application of knowledge, evaluation of information, and synthesis of a conclusion based upon multiple sources.

The novel pedagogic aspects of our approach included:

1. Employing UDL to create a capstudy assessment; learners work flexibly to integrate information and skills from across the module (see Table 5.1)
2. A case study where the ethnicity and gender of the subject are ambiguous, to make the subject relatable for all learners
3. A blended learning approach using social media (i.e. Twitter)
4. Co-creation of the new assessment regime by technical staff and academics

Methodology

Curriculum redesign and constructive alignment

The curriculum, learning outcomes and assessments were reviewed and aligned together, in accordance with the principles of constructive alignment (Biggs, 2014). We used Bloom’s Taxonomy to bring in higher-order skills through students evaluating data and synthesising their own conclusions, rather than the prior focus upon learning content (Krathwohl, 2002). Formative and summative assessments were integrated into the practical sessions and linked to lecture content (see Table 5.2). All of this was co-created by the technical staff and academic staff working closely together. Using constructive alignment ensures that learners cannot merely pass the module by memorising facts, but they have to construct their own meaning from the carefully interwoven learning activities. The module staff, both academic and technical, are able to offer more useful formative feedback knowing that the learning activities are better aligned to the final assessment.

The Ashley Tailor case study

Students received the following information about the fictitious student ‘Ashley Tailor’:

The height and weight give a healthy Body Mass Index for a male or female. The name chosen is deliberately ambiguous; a Google image search for ‘Ashley Tailor’ returned images of females and males from diverse ethnic backgrounds. A fictitious newspaper article was included in the module handbook (see Figure 5.1A). The teaching staff created the Twitter profile @ashley_tailor, which contains a brief timeline of tweets and photographs which provide some clues and some ‘red herrings’ (see Figure 5.1B). Students also received a photograph of Ashley’s cupboard contents (see Figure 5.1C) along with copies of the corresponding patient information leaflets.

Problem-based learning (PBL) clues

Each lecturer was asked to provide a PBL clue to solve, which linked their teaching to the case study. Examples included Ashley’s blood glucose reading, which required conversion into appropriate units and comparison against normal range (it is at the low end of normal); genetic sequencing to look for mutations that might cause sudden cardiac death syndrome (although Ashley has a point mutation in a relevant gene, this is not deleterious); and histopathology and immunofluorescence microscopy images of Ashley’s liver cells, showing molecular signs of damage. Interpretation of these clues encouraged students to review their lecture topics and to link the taught material with the practical sessions.

Clinical data

Students were provided with reference clinical data and simulated values for Ashley in the capstone laboratory session, which required correct analysis to allow valid conclusions to be drawn. This included Ashley’s plasma paracetamol level, which the students had to derive as being in the toxic range; Ashley’s blood-alcohol level, which is moderately high but not dangerous; Ashley’s plasma caffeine level, which is high but in the non-toxic range; and analysis of the loose, unlabelled tablets reveals the unexpected presence of paracetamol in several different sources.

The capstudy assessment: Putting it all together

Students worked in self-determined groups of four to complete the practical work. In the final dry practical session, students performed analysis and interpretation of the simulated clinical data. The students then had to compile and submit their final report, containing results of data analysis, a wider discussion of the results and a final conclusion of what happened to Ashley Tailor, and the implications. The conclusion should include findings to indicate that Ashley’s paracetamol level was in the toxic range, and therefore the most probable reason for Ashley’s state of unconsciousness was a paracetamol overdose. The conclusion should, hopefully, discuss the unexpected sources of paracetamol. The calibration data given to the different groups of students were subtly different, to avoid plagiarism, but gave the same dose effect response such that all groups derived the paracetamol overdose situation.

Results and discussion

The end-of-module feedback survey deployed through the e-learning portal Blackboard revealed that all students who completed the survey (n=33) agreed with the statement, ‘The Ashley Tailor case study was an interesting and useful component of the module’ (see Figure 5.2). This was noteworthy, as some students had initially found the exercise very challenging because it relied upon problem-solving and lateral thinking, as opposed to factual recall. We were pleased to see that, by the end of the module, the learners appreciated the pedagogic benefits of the capstudy. However, only 21 per cent of the cohort completed the survey, and therefore not all learners’ viewpoints were captured. A low response rate is a common problem encountered in student surveys, particularly those deployed electronically, and non-response is more common among Black and Minority Ethnic students, and students from lower socio-economic backgrounds (Porter and Whitcomb, 2005).

We were concerned that our capstudy assessment, being much more challenging than the previous assessment, requiring higher-order cognitive skills, might decrease the module pass rate and average mark. However, these measures (88 and 52 per cent, respectively) remained comparable with the other two Level 5 modules taught to the same cohort (pass rate 82/89 per cent, mean average 49/55 per cent, respectively). This was a very positive result, in light of the more challenging nature of the new module assessment and the diversification of the student cohort.

Informal comments from students and colleagues indicated that Ashley Tailor was highly relatable to different individuals. Interestingly, people often aligned Ashley’s identity with some aspect of their own; typically gender and/or ethnicity. One female staff member commented, “I just know that she has curly hair.” One male student commented, “I think Ali is an Asian male”, whereas a female student said, “When I think of Ashley Tailor, I think of an Afro-Caribbean woman”. In terms of being accessible to all students, we noticed that students with declared disabilities were equally able to succeed and did not require reasonable adjustments, extensions or deferrals.

The capstudy yielded several unexpected benefits. First, many students became interested in their own habits concerning ingestion of caffeine and paracetamol, and conducted research during the final session which compared Ashley’s results to their own habits. Some students also expressed their surprise at finding paracetamol in so many different sources and commented that they would pay more attention in future to the frequent occurrence of paracetamol in over-the-counter medications. Second, students fully embraced the opportunity to conduct their investigation as a group. Many groups allocated sub-team leaders and delegated different tasks to different team members, thereby developing valuable transferrable skills around project management and team working. Finally, students expressed that this capstudy had actually increased their resilience when faced with a challenge, and many felt more confident about approaching final year modules and dissertation projects as a result. Students enjoyed the realistic nature of the assignment and felt that it related well to their potential career options.

The social media aspect of the case study was very popular and many students created professional Twitter profiles as a result of engaging with the @ashleytailor account. The limited time frame for developing the module meant that the Twitter profile was less in-depth than we would have liked. In future, we would recommend creating a more in-depth social media profile across multiple platforms including Twitter, Instagram and Facebook.

One issue was the variable engagement from the module team. Most staff bought into the Ashley Tailor capstudy and gladly supplied PBL exercises that linked their lecture content to the assignment. However, some staff were reticent to engage, citing a lack of time to prepare a PBL task. Consequently the module leader had to prepare some clues for the teaching team. We felt that some staff were nervous about this new approach. Now that this approach has been embedded into the programme, other modules are now adopting similar approaches and staff feel more confident to engage.

Verbal feedback during a post-module evaluation meeting revealed that the technical team found the capstudy approach highly beneficial, as students were more attentive, inquisitive and asked more questions during the practical sessions. The technicians also felt more involved in the module from the outset; being part of the module team and planning the practicals and assignment with the academics was a great improvement. Likewise, the academics benefitted greatly from taking more time to listen to the technical team’s expertise. However, the capstudy approach did increase the technicians’ workload and more time was needed for the practical classes. The large cohort size meant that the laboratory classes of 40 students were limited by the availability of equipment. In future, a ‘three-ring circus’ setup might be better, in which the chromatography and spectroscopy equipment could also be available in the same practical session, to avoid groups of students waiting to use equipment; however, this would be more labour intensive from a staffing point of view. The large cohort size also played a part in deciding to mark the final assignment as a piece of group work. An individual assessment may provide a more personalised experience; this could be peer-marked to make this time efficient.

Conclusion

The Ashley Tailor capstudy was a novel and effective way to engage and challenge a diverse cohort of students, in a way that allowed them to utilise higher-order thinking skills to develop a range of scientific and transferrable skills.

Since we designed the Ashley Tailor capstudy in 2015, the principles of UDL have been applied to other undergraduate science programmes. A UDL approach introduced by a chemistry faculty at Ball State University (Indiana, USA) encouraged open-mindedness, supportive communication and analysis of the laboratory curriculum to minimise students’ stress in laboratory practical classes (Miller and Lang, 2016). However, UDL is still at the very early stages of permeating into HE curricula and teaching. Scanlon et al. (2018) reviewed three post-secondary chemistry curricula and found that certain aspects of UDL were well represented; flexible ways of illustrating and displaying information, vocabulary and symbols.

Moreover, UDL is still widely considered to be a deficit approach that is associated with providing additional support for disabled students. King-Sears et al. (2015) looked at the potential benefits of using this ‘traditional’ UDL approach to secondary school chemistry students, with and without disabilities. Surprisingly the UDL approach seemed only to benefit students with disabilities, whilst having a negative impact on non-disabled students, which may reflect the nature of the UDL approach taken; if UDL was used to supply additional materials which all students were required to employ, then this might have slowed the learning pace for non-disabled students. At DMU, we advocate the opposite use of UDL; to provide extra challenge for all students by allowing them to choose the way in which they engage with, and demonstrate, their learning.

The use of social media in teaching, learning and assessment is slowly gaining momentum. The University of Plymouth asked 450 nursing students to create and use a Twitter account as an assessed component of their first year. Here, the focus was more on developing the students’ ‘digital professionalism’ and facilitating connections with the wider community, which most students found useful (Jones et al., 2016). At Monash University (Melbourne), 297 first-year biomedical science students completing a public health module were asked to use Twitter to post relevant comments and resources related to their module learning. Those students who completed the Twitter-based assignment scored higher overall grades, and felt that Twitter was a useful curriculum tool which facilitated peer collaboration and public health promotion (Diug et al., 2016). Nonetheless, the authors point out that only 13 per cent of their students were already Twitter users, highlighting the need for students to be trained in social media platforms and for academics not to assume that all ‘Generation-Y’ students are digitally literate.

Future Perspectives

To further improve the capstudy, we would recommend:

1. Broadening the subject’s social media presence to integrate clues from Instagram and Facebook
2. Employing final year student interns as co-creators to build the case study
3. Using a crime scene house to mock up Ashley Tailor’s bedroom
4. Providing a guide book for technical and academic staff as well as a workshop on asking effective questions, to ensure that staff can encourage inquiry-based learning without giving away answers (Vale, 2013)
5. Introducing a mini-capstudy in Year 1 to familiarise students with the approach