I am a mess at making series properly. I’ll provide background, but for full context…
Modify the process, not the outcome: Assessment results. . . and hope | March 23, 2013
Modifying the process: Part one | April 3, 2013
Beyond expectations | September 9, 2013
This one time, I failed anatomy. You know how many people fail anatomy? Lots. You know how many medical students fail anatomy? Lots. As I discovered after googling “failed anatomy”. So, after that I wasn’t too fazed by my first F in university. I mean, it’s anatomy, I didn’t really even expect to come close to passing the first time, it was like the experience round.
Except then, this other time, I failed anatomy again (and social psych, the only other class I was in at the time), and I was not cool with that at all.
Then I was diagnosed with learning and attention issues, and was handed a report that literally says, in part, that I am “not suitable for visual learning” and “therefore, finding ways to have information presented through other means may be [of considerable help].” and to “[…] be mindful that subjects that require an abundant amount of visual learning, such as understanding graphs, charts, and diagrams may be a challenge […]” (Wang, 2013).
Key word there is understanding graphs, charts, and diagrams. That says nothing of the abundance of memorization and application of [memorized] knowledge required to pass Human Anatomy. Yes, a lot of people struggle with these things—anatomy is by no means an easy course for most people (there are some people who are wizards, however, and I cannot explain them). Except not only was it simply extremely difficult for me, I then learned after two terms of extreme frustration that I am pretty much not even wired to do it—especially, at least, not in the format they were providing.
help me if you can, it’s just that this is not the way i’m wired so could you please, help me understand…
the outsider, a perfect circle
I took this knowledge alongside my recent registration with Accessibility Services to chat with Dave, the Department Chair of Kinesiology. At the time, program requirements for my degree kept changing, so I made a few swap requests which he took to the departmental review committee for approval—two of the requests were approved. The swap of anatomy to physiology, though, was not, as “the department feels it’s important for all of our grads to have human anatomy”. I don’t disagree, but with documentation like the above, it sucked to hear. I had a meeting scheduled with Dave to follow the e-mails, and when I asked if we needed to keep the meeting, the Associate Dean of Kinesiology, Glen, replied, “I think we should still meet to discuss how you are going to handle the Human Anatomy requirement.”
Pause right here to note that Glen has a PhD in Human Anatomy, 30+ years of teaching experience, and a reputation for being awesome. So I was kind of like “Okay, see you Monday.”
I’m pretty sure this was the day he said for the first time “We’ll get you through anatomy, whether I have to help you through, or drag you through.” Yes, dragging apparently can be a thing. I was expecting . . . not nearly as much as he had worked out. I left the meeting with him saying, “Let’s get you through this and get you out of here.”
This was September. I started anatomy in January, for the first time with accommodations (and my iPad).
By three weeks in, I was meeting with Glen once or twice a week. He would quiz me, attempt to figure out how to make things stick in my brain. We’d go sit with a model in the athletic therapy lab, or in the anatomy lab, or around my iPad and binder of notes from the instructor. Beyond this, I was making anatomy a full time job (on top of two other classes and a part-time job, and a contract project with the Asthma Society). A week before the midterm, week 5, I texted him this picture:
Yes, that’s a 3/10 there. 30%. Despite everything we were throwing at this, well, it sucks when your best simply isn’t good enough. I met with Glen the next day—we intended to meet in the open lab session to study, but given that lab quiz result a mere three days before the exam, we took a detour and took over one of the kinesiology instructor’s offices instead.
“Well, I told you that we’d get you through this, whether I had to help you or drag you,” (yes, this was probably more dragging than anticipated) “I know you’re working hard. What’s not working? What can we do to get you through this?”
My brain isn’t working, that’s what. “If I knew, I wouldn’t be almost-failing again.”
Back to the drawing board. We talked about the lab quizzes—the big issue in previous terms, and becoming the (an) issue in this one. We’d already accommodated those by having me do the lab quizzes before lab with the lab demo before my weekly labs so that the time component (quickness required in having the models move by me too fast). Since this was my only form of assessment thus far, it was the one that needed to be addressed. We also covered what, exactly, the struggle was for me outside of processing speed: visual memory. It was just too much for me to be able to hold that information in my head, and manipulate it to get the correct answer without any sort of visual guide to work with. I tried to explain more about this, but three days before the exam I was just really stressing and emotional (I was thankful that the office we borrowed contained Kleenex). Fortunately, to an extent, he got it; he said again that he knew I was working hard, but that things just weren’t working. After three attempts, I knew that I knew more than I was able to demonstrate. Sometimes lab questions involved the model being partly covered and flipped in another direction, and being asked “Does this bone belong to the left or right side of the body?” So not only would I have to figure out the bone from it being partly covered and oriented bizarrely, I had to flip it around in my head and identify the side or structure in question.
He rolled with it. He first contemplated with me whether oral quizzes would be better—except, writing’s not the problem (he’s seen this blog—he knows that now :]). Well, if writing’s not the problem, then, it was decided we’d eliminate the lab quiz aspect altogether, and then assess me in a way that worked with that. He took the reigns and simply pulled me from lab quizzes—the grades thus far were thrown out. Instead, I submitted weekly 1-2 page papers on an aspect we covered in anatomy that week to cover that portion of my grade. We also agreed that I would be allowed to sign out the lab models to work more with them at home, because by my 4:30-6:30 lab time, with all the potential chaos on lab, I simply wasn’t able to absorb enough in that allotted time to make a difference.
Then, of course, I was brought back to earth with, “This doesn’t help that you have a midterm on Friday.”
“Yeah, I have one tomorrow too that I haven’t even started studying for, since I’ve been trying to keep my head above water in anatomy.”
With that he told me he was deferring my midterm and to “get the hell out of lab and go study”, and he would talk to my instructor about the new plan of action. He met me briefly outside the lab after I’d gotten my stuff to discuss when I’d write the midterm (since the next week was Reading Week), but since I had test accommodations with Accessibility Services, I didn’t need anybody to invigilate so I got the “Oh, you can write whenever you want!” response again (like I’d gotten in the Fall when my instructor approved a midterm deferral in Sport in the Ancient World because once-upon-a-time-my-uterus-tried-to kill-me-except-it-failed). We also briefly discussed that we’d have to figure out how we were handling the final lab exam, but we’d deal with that after the midterm. Tutoring was also basically off the table (which we hadn’t implemented yet aside from working with Glen), as were my study sessions with Glen beyond if I had specific questions. In reality, if the sessions with him weren’t working, I think we’d be hard-pressed to find many tutors who could help. As much as this man knows anatomy, he’s an educator through-and-through in my perspective :).
I wrote the midterm a week after the rest of my class, on the Thursday of Reading Week (since I had a project deadline the Sunday of Reading Week with the Asthma Society). I got my test mark back a couple weeks later—53%.
I was all
My instructor was all “How do you feel about that?” “AWESOME. I PASSED.”
These people really didn’t understand I was serious when I said “I just want a D.”
Glen, however, wasn’t quite as enthusiastic as I was (I mean, I maybe was overzealously excited about my bare-pass, but SO?):
[Note: The charts are torture.]I have looked at you midterm exam and it is unfortunate to see that you were not able to score better (42/80). […]You had difficulty with almost every part of the exam except for the short answer questions. You had the most difficultly with the Charts section which gave you one or two clues from which you had to determine the anatomical structure being asked for. Similarly you had difficulty with the diagram section which I would have thought you have done well with given the drawing you were doing on your iPad.[This] exam is challenging in that it calls for information that is gained by memorization, visualization, conceptualization and functionality. I think you did well in the functionality portion of the exam (short answers) but had the most trouble with the visualization aspect (relation of now structure to the other, charts based on one or two clues, diagrams).Not sure where we go from here. Do you have any suggestions? Who in disability services are you working with?
Of course, I was like “WHAT I DID AWESOME” (there’s no punctuation in my brain), and told him that. Except at this point, we not only moved forward with the alternative assessment in labs, we got Accessibility Services in on the shenanigans once more, and Jess had a lot of good suggestions on how we could work with the lab component for the final. For the finals, we eventually decided that we’d do a modified format to both the final written [lecture] and lab [bellringer] exams (more on that shortly).
I kept pushing through—I had, fortunately, also made two friends in the course, helpful in working through the labs with and teaching each other, and also having people to study with outside of labs (…”The articulating end of the radius is conCAVE because that’s where the radial bear lives!” Merry: It clearly worked!). I studied my ass off, with Merry and Ashley, and by myself: with a pile of pencil crayons and coloured pens, many killed trees (sorry trees, blame anatomy), Quizlet and other online flashcards, and $50+ worth of iPad apps to try to get smart things into my brain one last time. I asked initially if there was a way I could get into the lab to use the models more often (since we had so few open lab sessions in a term and were only really allowed to use models during our lab times) but with limited availability of people to provide supervision, I ended up getting permission to take models home. I’d like to say it helped, but I’m also realistic about the amount of information from visual input my brain actually is useful for.
With a now 175% time accommodation for tests, I asked if I could write one exam Monday [two days before the day my class was scheduled to write] and one on Wednesday [the same day as the rest of the class], as otherwise I’d be writing for like 9 hours on a single day, which all parties agreed to—I was no longer writing the same exams as my class, so this was no longer an issue. I did my lab exam in a way similar to the class, except through flash cards and without a per-question time limit, and formatted in multiple choice to reduce the number of variables in front of me (the traditional bellringer allows students one minute per station with an open-ended question and most times a sticker on the model identifying the structure in question. The model can’t be touched). For the lecture exam, I was provided a multiple choice/fill-in-the-blank/true-false exam created by Glen and based on the class exam, and allowed a very simple, un-detailed, un-labelled diagram to use simply to orient myself to the questions.
(I spent much of the night before my final lab exam doing this, above—I have no clue if it helped, though!)
The lecture exam went okay, or so I thought, except for the amount of lower-body questions (what we had covered on the midterm) that I hadn’t realized were going to be on there. The lab exam? I was freaking out even prior to it starting, because of my difficulty on the lecture exam. The epitome of all this? If I failed anatomy, I wouldn’t graduate in June. From Facebook, Jess in accessibility services knew how hard I’d been working, and told me so while I was waiting—she asked me how I was doing and when I almost broke down, she asked if I wanted to go talk in her office. I basically knew if I did this, I’d lose it and declined, so she said to come see her or go take a walk during the exam if I needed to. Of course, the exam was kind of an emotional disaster—I have never cried during an exam before, but this was the one. I spent some time staring at the ceiling and eating a Rice Krispie square to calm myself down; I knew I could leave and take a break, but I also knew if I did, I wouldn’t want to go back in, so I kept going.
I finished the exam, and went to see Jess, who got the whole anatomy-related breakdown (and was awesome about it, because she’s always awesome), and assured me that if I didn’t pass we’d figure things out, and regardless I’d worked really hard. I went out for lunch and then as I was waiting for the bus, got a text from Glen saying “Check your e-mail – good news :)”.
Turns out, four minutes was too long for him to wait for a reply to his e-mail.
77% on the bell ringer? Yeah, my brain just about exploded because that’s the thing I’ve failed hardcore the last two times.
Final grade? C+.
Yes, I had some pretty awesome people on my team. Some very awesome people. But, I didn’t work any less hard than I worked other terms: in fact, I probably worked harder, but also more effectively. The style of my assessment was heavily modified, of course, but in no way was I handed this grade: after the exam, I texted Glen to thank him for all of the work and hours he invested in me, he replied “No thanks required, you earned it” (thanks were still totally required); he told me the same when I took him cupcakes one day in May to [attempt to!] thank him. Not only did I potentially work harder than many of my classmates (who possibly received better grades), I worked that much harder for the second time (the first time through was the first time through, really—many people have two attempts at anatomy).
Accommodations don’t give an advantage—they level the playing field. I know this, and the people on my team know this. I just hope that other people realize it, too. Sometimes, students would ask about certain things, accommodations I had, and say “I wish I had that”—I wish I could use the instructor’s notes/have a volunteer note-taker; I wish I could write tests in a private space; I wish I had electronic textbooks. An honest response, yes, but one that is not well thought out: I wish that I could spend the normal amount of time reading a chapter and taking notes, not one or the other; I wish I had a GPA higher than 2.8; I wish I knew the right technology to access earlier.
Mostly, I wish I knew earlier what I know now. That I have a learning disability and ADHD, that it’s a part of who I am, and that I can work with this.
Maybe it took a bit more time, but I accomplished what I set out to accomplish—and that’s what is important: learning and attention issues or not.
My cousin Dean and I—I still got to graduate 24 hours before him.
Photo credit to Linda Mikulik.