Adv Physiol Educ 39: 209–213, 2015;
doi:10.1152/advan.00019.2015. How We Teach: Classroom And Laboratory Research Projects
Students integrate knowledge acquisition and practical work in the laboratory
E. I. Agüera,1 P. Sánchez-Hermosín,1 J. Díz-Pérez,2 P. Tovar,1 R. Camacho, and B. M. Escribano1
1
Department of Cellular Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain; and 2Department of
Statistics, University of Cordoba, Cordoba, Spain
Submitted 2 February 2015; accepted in final form 4 June 2015
Agüera EI, Sánchez-Hermosín P, Díz-Pérez J, Tovar P, Cama-
cho R, Escribano BM. Students integrate knowledge acquisition and
practical work in the laboratory. Adv Physiol Educ 39: 209 –213,
2015; doi:10.1152/advan.00019.2015.—The aim of the present work
was to transfer a wider concept of teamwork and self-learning to the
laboratory, encouraging students’ capabilities when seeking, acquir-
ing, and processing knowledge. This educational innovation was
carried out with a total of 38 students (fourth year of degree in
Biology) in the area of physiology (Advances in Reproduction course)
at University of Córdoba in Córdoba, Spain. The design of the
project’s application methodology consisted of establishing a way in
which problems would be tackled in the practical classes. For this
purpose, the different tasks were set up so that students could relate
them to the concepts learned in the theory classes. On the first day of
class, the project was presented to the students. Groups of two to three
students worked in the laboratory and set up an outline of the protocol
of the practical work that they had done. This outline was performed
individually and sent to the lecturers through a learning management
system (Moodle). The teachers gave feedback and assessed student
submissions. Upon finishing the course, students completed a survey.
The project-based learning method promotes practical self-learning on
the part of students. This methodology demonstrated to us that it
stimulates a critical and self-critical capacity in students, both indi-
vidually and in groups, and that writing didactic practical material
helped students to enhance their theory knowledge. The experiment
was a success in view of the scores obtained upon finishing the
subject.
learning-based projects; educational innovation; advances in repro-
duction; group work
STUDENTS SHOULD BE STIMULATED by their teachers to be more
confident in their self-directed learning (6). It is well known
that active methodologies provoke students to acquire knowl-
edge more effectively (10). Not only is the attitude of students
in their adaptability to lifelong learning important, but equally
the use of active learning strategies by teachers (24).
With a project-based learning method (PBL), students work
actively, planning, implementing, and evaluating projects,
which can be applied in the real world beyond the classroom
(8, 14, 16, 17).
The students look for solutions to nontrivial problems since,
according to Blumenfeld et al. (9), they learn to pose and refine
questions, debate ideas, make predictions, design plans and/or
experiments, compile and analyze data, establish conclusions,
ask new questions, and communicate their ideas and discover-
ies to others.
The present study describes a teaching experiment carried
out in the Advances in Reproduction course in the first term of
Address for reprint requests and other correspondence: E. I. Agüera, Dept.
of Cellular Biology, Univ. of Cordoba, Edificio Darwin, 2a planta, Ctra
N-IV Km 396.a Campus de rabanales, Cordoba 14071, Spain (e-mail:
ba1agbue@uco.es).
1043-4046/15 Copyright © 2015 The American Physiological Society
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the fourth year of the degree in Biology at the University of
Córdoba. The fact of beginning a newly established course in
the department led teachers to think that they did not want
students to receive a passive learning experience in which the
teacher gives explanations and the student merely listens. The
idea was that, from the first day onward, students would
receive an active teaching process in order for them to search
for the meaning of what they had learned. Active teaching
presumes that the students are active builders of their own
knowledge and that, to each learning experience, they bring
with them a store of information that, in some way, they use
while they are endeavoring to understand (11).
PBL permits real-life situations to be simulated by means of
a problem case proposed to the students, with the necessary
information for understanding how to resolve it. Based on the
method used by Altshuler and Bosch (1), the problem case was
designed so that the students 1) do not dispose of all the
information required for the setting up of the protocols, 2)
make progress in the solution of the problem at the same time
as new information is incorporated, and 3) are permitted to
have multiple ideas and perspectives for their interpretation of
the problem.
The present work aims to transfer to the laboratory a wider
concept of team work and self-learning by fostering students’
abilities to search for, acquire, and process knowledge and
compare sources of information. All this amounts to the writ-
ing of a protocol, which describes the set of technical proce-
dures necessary to successfully perform practical sessions. In
addition, the writing of such protocols is a transferable skill
that can be used in other physiology courses. The employment
of this active learning was evaluated through a survey as well
as through personal interviews and group tutorials, which
allowed us to gauge the satisfaction of students with this
methodology.
METHODS
Students. The present study was composed of a total of 38 students
(10 men and 28 women) from the area of physiology in the first term
of the fourth year of the Biology degree who were enrolled in the
optional subject “Advances in Reproduction.” The course was rated
with 6 ECTS, meaning 60 h of face-to-face work and 90 h of
nonface-to-face work. For the perspective of teacher effort, consider-
ing that the teachers did individual corrections scoring each protocol,
the total hours spent were 0.5 h per student per protocol (19 h ⫻ 4
protocols ⫽ 76 h). Additionally, teachers answered student questions
by e-mail and met students face to face, totaling approximately
another 7 h of faculty effort. In summary, the amount of time invested
to deploy this learning method was estimated to be 83 h more than for
traditional lectures.
Due to the fact that this subject was delivered for the first time and
all students took part in the new intervention, a historical control
group did not exist. Similarly, as this was the first year that this subject
was taught, there were no previous examinations with which to enable
209
How We Teach: Classroom And Laboratory Research Projects
210 KNOWLEDGE AND PRACTICAL WORK
a comparison of the results. We intended to divide students into two
groups, one group to be examined with the traditional method and the
other group with PBL. However, students did not agree with that
intention. Taking this into account and given the small number of
students, teachers decided not to divide the group of students. Proto-
col 1 was chosen instead as a baseline with which to compare
within-subjects progress in the following protocols. Protocol 1 pro-
vided the learning framework that allowed students to reflect, use
scientific language, and develop creativity. In other words, protocol 1
helped them achieve the necessary skills to effectively develop other
protocols. The protocols increased progressively in difficulty, so that
tudents could not go on to the next protocol without having done the
previous protocol. Therefore, all students had to complete all proto-
cols from protocols 1 to 4 sequentially.
The process. The research process was explained step by step as
follows:
1. Presentation of the project to students and explanation of how it
would contribute to their final grades. (Teachers)
2. Formation of groups (of 2–3 students/group) for practical class
work and joint writing of protocol scheme. Practical class does not
mean group-working activity. (Students)
3. Execution of protocols. Once students had finished the practical
class, they set up their protocols individually and sent them to the
teacher via the learning management platform Moodle. (Students)
4. Correction and scoring of the protocols. Protocols were corrected
and sent back to the students so that they could learn from their
mistakes. (Teachers)
5. Once the process was finished, results were statistically analyzed
using version 18.0.3 of the SPSS package.
Protocols. A protocol is a demanding document that explains the
systematic procedures to be carried out in each practical class. Each
protocol should contain the objectives, the materials used, and an
appendix in which photographs are included. Both the protocols and
theory examination were scored on a scale from 0 to 10, with a score
below 5 considered as a fail.
The following protocols were requested:
Protocol 1: vaginal smear of a female mouse and its interpretation
Protocol 2: collection and evaluation of mouse semen
Protocol 3: vasectomy of a male mouse and ovariectomy and
ovarian tissue transplant in a female mouse
Protocol 4: collection of embryos directly from a mouse’s uterus
(flushing)
Animals. The animals used in the present study were corpses of
mice (male and female) Mus musculus not genetically modified,
yielded by the Service of Animal Experimentation of the University of
Córdoba. We used corpses because these practices can be learned
without having to use live animals.
Survey. At the end of the course, all participants answered a
perception of instruction survey (see Tables 2 and 3). Although not a
formal control group, for comparison, the same student population
had previously completed the same survey after another class. The
previous course was led by the same instructors, with mostly the same
students (n ⫽ 42), with the only major difference being the use of
traditional teaching methods rather than PBL.
The survey was designed with eight questions and four degrees of
satisfaction on a Likert scale (none, little, quite a lot, and a lot).The
questions were as follows: 1) the teachers defined the project’s
objectives with clarity; 2) the feedback received by the teacher in a
protocol contributed to the elaboration of the following one; 3) I used
complementary assistance to set up the protocols (teachers, col-
leagues, and bibliography); 4) the theory-practical synchronization
contributed to fixing the acquisition of knowledge; 5) the practical
activities helped toward the understanding of the subject; 6) the
practical activities favored teamwork; 7) In general, I am satisfied
with the work done; and 8) the whole process of self-directed learning
provided satisfaction from the start.
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Formal ethical committee approval for educational research is not
required at the University of Córdoba; students gave informed consent
to participate.
RESULTS
Results of protocols. First, the scores of the 38 students in
the 4 practical protocols carried out were studied. Figure 1
shows a boxplot of each group of scores.
The distribution was asymmetrical for the scores of proto-
cols 2 and 3, in which the median coincided with the third
quartile, with a low outlier in protocol 2 and five low outliers
plus a high scoring outlier in protocol 3. With respect to the
boxplot of protocol 4, asymmetry and the lack of an upper
whisker can be noted, due to the third quartile coinciding with
the maximum possible score, which was 10.
Table 1 shows the means and SDs for the scores obtained by
students in each of the protocols.
In protocol 1, the mean score was a B grade (7.7). This score
progressively increased as the course advanced and students
learned from the feedback and corrections made by the teach-
ers, along with mutual help between peers (Table 1). Through-
out the course, students gave very favorable informal feedback
on the tutorials received and on the benefits of applying theory
to practice when facing the writing of the protocols.
Subsequently, inferential statistics were used to assess the
effectiveness of the procedure. For this purpose, a general
mixed-effect linear model could be proposed. This would
explain the score obtained in terms of the protocols and the
students themselves, with the latter being a random factor.
Nevertheless, the asymmetry of the data suggests lack of
normality, confirmed by a Kolmogorov-Smirnov test (P ⬍ 0.01
for each protocol). In addition, the Levene test of homogeneity
of variances based on the means was significant, taking 0.10 as
level of significance.
For these reasons, it was decided to address the problem
from the nonparametric point of view, using a repeated-mea-
sures approach. To analyze the evolution of the students’
performance, the scores obtained by them in protocol 1 were
considered as a starting point. This was because the first score
was obtained from the group when the didactic methodology
had only just begun and its effects were not yet evident. The set
of required abilities [i.e., to describe a protocol’s objectives,
11
10 101
9
ASSESSMENT
8
103
108
7
6 53
5
N= 38 38 38 38
Protocol_1 Protocol_2 Protocol_3 Protocol_4
PROTOCOL
Fig. 1. Boxplot of scores obtained in the four protocols.
 How We Teach: Classroom And Laboratory Research Projects
KNOWLEDGE AND PRACTICAL WORK 211

Table 1. Means and SDs of the scores of the 38 students in 25

22
the different protocols
20

STUDENTS
Mean SD
15
Protocol 1 7.6 0.6 11
Protocol 2 8.0 0.8 10
Protocol 3 8.7 0.7
Protocol 4 9.3 0.6 4
5
Total 8.4 0.9
0
planning, organization, formal writing style (clear and con- MERIT VERY GOOD GOOD SUFFICIENT

cisely), students notes, and supplementary material] was re- SCORES

peatedly examinated across protocols 1– 4 and on the final
exam.
Friedman’s test that data from each of the four protocols
were significatively nonhomogeneous (P ⬍ 0.001). After this,
multiple comparison between protocol 1 and each protocol of
the rest were made through a Wilcoxon test with a Bonferroni
correction; there were significative differences between the
scores obtained in protocols 2– 4 compared with protocol 1 as
a control, and, in every case, P ⬍ 0.005.
Despite the objections mentioned on the parametric treat-
ment of inference, ANOVA and subsequent post hoc Dunnett
analysis led to the same conclusions.
Results of theory examination and final course grades.
Figure 2 shows the scores obtained by the 37 students in the
final theory examination, indicating that all students success-
fully completed the course (note that one student was absent
from the final exam). Furthermore, Fig. 3 shows the grade
distribution for the course including scores on the final exam
and graded protocols, again indicating that all students suc-
cessfully completed the program.
Survey results. The results of the survey taken from the
students participating in the PBL method (Table 2) showed that
most of them were highly satisfied with the objectives achieved
in the practice exercises, with their self-learning and the ease
with which they understood the subject. Students were satisfied
with their progressive evolution in the setting up of protocols
and were especially favorable regarding practice opportunity
and faculty feedback. Faculty corrections, which commented
on and discussed the aspects to be improved with a view to the
development of the following protocol, were felt to be
benefit to students in learning from their errors and in doing
the following protocol better. For comparison, the survey
refering to a previous course with a traditional teaching style
showed a higher degree of dissatisfaction in all aspects
surveyed (Table 3).
25
22
20
STUDENTS
Fig. 3. Distribution of final course grades.
DISCUSSION
The aim of the present application of PBL was to enable
students to work in groups, stimulating their capability to
search for, acquire, and process knowledge. We agree with
Molina Ortiz et al. (18) on the fact that this methodology
develops constancy, observations, and attitudes not reached
with traditional teaching. Although this technique is not new in
teaching (3, 4, 19, 21, 22, 17), the teachers at the University of
Córdoba wanted to adopt it since it is being used in other
Spanish universities (18, 15, 17) to promote students’ creativ-
ity, individual responsibility, work in collaboration, critical
capacity, decision making, efficiency, and ability to express
personal opinions. In view of the results obtained in the final
exam scores, students and faculty members considered that all
these benefits had been acquired by the students.
Upon examining the results, we noted that the average
scores of the students in the different protocols increased and
also that significant differences were established as to how they
went on improving their ability to prepare the protocols
throughout the term.
One of the factors attributed by the authors to this fact was
the interest demonstrated by the students who regularly at-
tended the theory and practical classes, which permitted this
learning method to give good results. However, in the literature
consulted, authors like Sainz de Abajo et al. (23), when using
this technique in an optional course in technical engineering
studies, did not obtain good results, precisely because the
students enrolled in it did not attend classes assiduously.
Furthermore, in 1992, Norman and Schmith (19), in their
review of research on a similar approach of PBL, concluded
that there was no evidence of the an increase general problem-
solving skills with PBL.
In the present study, teachers did one-to-one correction and
scoring of the protocols and sent feedback to the students so
that they could learn from their mistakes. Hattie (13), in a
review of 87 meta-analyses of studies, explained that feedback

15
makes a difference to student achievement. Likewise, Black
11 and Williams (7) emphasized that feedback has consistent
10 positive effects on learning compared with other aspects of
teaching.
4
5 When we compared the sexes, we found that there was no
significant difference in learning gains over time. Reynolds
0 (22) did an initial experience of interprofessional PBL, taking
MERIT VERY GOOD GOOD SUFFICIENT
into account a comparison of male and female students. This
SCORES author also concluded that sex differences were not substantial,
Fig. 2. Student scores on the final theory examination. in agreement with our results.

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How We Teach: Classroom And Laboratory Research Projects
212 KNOWLEDGE AND PRACTICAL WORK

Table 2. Results of the survey related to the problem-based learning method

None A Little Quite a Lot A Lot

Number of Number of Number of Number of

students % students % students % students %

Question 1. The teachers defined the

project’s objectives with clarity. 38 100
Question 2. The feedback received by
the teacher in a protocol contributed
to the elaboration of the following
one. 6 15.8 32 84.2
Question 3. I used complementary
assistance to set up the protocols
(teachers, colleagues, bibliography,
etc.). 10 26.3 28 73.7
Question 4. The theory-practice
synchronization contributed to fixing
the acquisition of knowledge. 4 10.55 21 55.3 13 34.2
Question 5. The practice activities
helped toward the understanding of
the subject. 9 23.7 29 76.3
Question 6. The practical activities
favored teamwork. 5 13.1 33 86.4
Question 7. In general, I am satisfied
with the work done 1 2.6 37 97.4
Question 8. The whole process of self-
directed learning provided
satisfaction from the start. 6 15.8 32 84.2

Circumstantial information from students indicated that both
male and female students were equally satisfied with the new
method. Additionally anecdotal reports from teachers indicated
satisfaction with the process because all students implemented
their protocols, presenting them on time and in the correct
format, and students apparently learned from their errors, as
demonstrated in the evolution of scores between protocols. All
students enrolled took the final examination without any dif-
ficulty, and, as shown in Fig. 2, none of them failed it.
Student opinions were assessed with the survey taken at the
end of the course. From the results obtained, 97% of the
students were satisfied with the work done, 76% thought that
this way of working helped them to understand the subject
matter, and 73% considered that this type of work favored their
self-learning abilities. Similarly, Anzar et al. (2) reported that
from a survey taken related to skills acquired, 64% of the
respondents perceived that the PBL methodology was highly
important in self-learning. We agree with those authors in that
PBL assists students in their learning and acquisition of skills
with respect to traditional teaching methods. When we com-
pared both surveys (PBL and traditional learning style), we
noticed that 61% of the students were dissatisfied with the
work done in the traditional course format, but no students
expressed dissatisfaction with the PBL experience.

Table 3. Results of the survey related to traditional learning style

None A Little Quite a Lot A Lot

Number of Number of Number of Number of

students % students % students % students %

Question 1. The teachers defined the project’s

objectives with clarity. 25 65.8 13 34.2 —
Question 2. The feedback received by the teacher
in a protocol contributed to the elaboration of
the following one. 18 47.4 17 44.7 3 7.9
Question 3. I used complementary assistance to
set up the protocols (teachers, colleagues,
bibliography, etc.). 11 28.9 29 76.3 —
Question 4. The theory-practice synchronization
contributed to fixing the acquisition of
knowledge. 16 42.1 22 57.9
Question 5. The practice activities helped toward
the understanding of the subject. 17 44.7 6 15.8 15 39.5
Question 6. The practical activities favored
teamwork. 27 71.1 11 28.9
Question 7. In general, I am satisfied with the
work done. 23 60.5 15 39.5
Question 8. The whole process of self-directed
learning provided satisfaction from the start. 21 55.3 17 44.7

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 How We Teach: Classroom And Laboratory Research Projects
KNOWLEDGE AND PRACTICAL WORK
Conclusions. The following conclusions were drawn from
the results of the present study:
1. There was an increase in performance between protocols.
This means that students gradually acquired their skills of how
to use scientific language, how to plan their work, summarized
the knowledge acquired in class, and reinforcing their self-
learning.
2. When we comparing the sexes, no difference between
male and female students was found.
3. Considering the final results of the subject, both students
and teachers felt that the experiment was a success.
4. In general, PBL promotes practical self-learning on the
part of the student.
ACKNOWLEDGMENTS
The authors are grateful to all participants of the study.
DISCLOSURES
No conflicts of interest, financial or otherwise, are declared by the author(s).
AUTHOR CONTRIBUTIONS
Author contributions: E.I.A. and B.M.E. conception and design of research;
E.I.A. and P.S.-H. performed experiments; E.I.A., P.S.-H., and J.D.-P. ana-
lyzed data; E.I.A. and J.D.-P. interpreted results of experiments; E.I.A.,
P.S.-H., and J.D.-P. prepared figures; E.I.A. and B.M.E. drafted manuscript;
E.I.A., P.T., and B.M.E. edited and revised manuscript; E.I.A., P.S.-H., J.D.-P.,
P.T., and B.M.E. approved final version of manuscript.
REFERENCES
1. Altshuler Bosch LS. Problem-based learning in social work education. J
Teach Social Work 23: 201–215, 2003.
2. Aznar F, Pujol M, Sempere M, Rizo R. Adquisición de Competencias
Mediante Aprendizaje Basado en Proyectos Como Metodología Docente:
Valoración del Alumnado (online). http://web.ua.es/es/ice/jornadas-redes-
2012/documentos/posters/245822.pdf [11 June 2015].
3. Barrwos HS. A taxonomy of problem based learning methods. Med Educ
20: 481– 486, 1986.
4. Barrows HS. Problem-based learning in medicine and beyond: a brief
overview. In: Bringing Problem-Based Learning to Higher Education:
Theory and Practice, edited by Wilkerson L, Gijselaers WH. San Fran-
cisco, CA: Jossey-Bass, 1996, p. 3–123.
5. Bartolomé A. Blended learning. Conceptos básicos. Revista Med Educ
23: 7–20, 2004.
6. Berg RM. Physiological curiosity of the week. A teaching tool to facilitate
self-direct learning and student preparation during a cardiovascular phys-
iology course. Adv Physiol Ed 36: 356 –357, 2012.
Advances in Physiology Education • doi:10.1152/advan.00019.2015 • http://advan.physiology.org
Downloaded from www.physiology.org/journal/advances (089.216.103.223) on July 20, 2019.
213
7. Black P, William D. Assessment a classroom learning. Assess Educ 5:
7–74. 1998.
8. Blank W. Authentic instruction. In: Promising Practices for Connecting
High School to the Real World, edited by Blank WE, Harwell S. Tampa,
FL: Univ. of South Florida, 1997, p. 15–21.
9. Blumenfeld P, Soloway E, Marx R, Krajcik J, Guzdial M, Palincsar A.
Motivating project-based learning: sustaining the doing, supporting the
learning. Educ Psychol 26: 369 –398, 1991.
10. Brunning RH, Schraw GJ, Roning RR. Cognitive Psychology and
Instruction (2nd ed.). Englewoods Cliffs, NJ: Merrill, 1995.
11. Freed SA. Para estimular el aprendizaje activo. Revista Educ Adventista
6: 6 –10, 1997.
12. Galeana L. Aprendizaje Basado en Proyectos (online). http://ceupromed.
ucol.mx/revista/PdfArt/1/27.pdf [11 June 2015].
13. Hattie JA. Identifying the salient facets of a model of student learning: a
synthesis of a meta-analyses. Int J Educ Res 11: 187–212. 1987.
14. Harwell S. Project-based learning. In: Promising Practices for Connect-
ing High School to the Real World, edited by Blank WE, Harwell S.
Tampa, FL: Univ. of South Florida, 1997, p. 23–28.
15. Labra JE, Fernández D, Salvador JC, Cernuda del Rio A. Una
Experiencia de Aprendizaje Basado en Proyectos Utilizando Herramien-
tas Colaborativas de Desarrollo de Software Libre (online). http://bioinfo.
uib.es/⬃joemiro/aenui/procJenui/Jen2006/prDef0050_34173cb38f.pdf
[11 June 2015].
16. Lohfeld LN. PBL in undergraduate medical education: a qualitative study
of the views of Canadian residents. Adv Health Sci Educ 10: 189 –214,
2005.
17. Martí E, Gil D, Julià C. Una Experiencia de ABP en la Docencia de la
Asignatura Gráficos por Computador en Ingeniería Informática. Vallado-
did: Jornadas de Aprendizaje Cooperativo (JAC’07), 2007, p. 95–103.
18. Molina Ortiz JA, González AG, Marcos y Ma AP, Nardiz VA.
Aprendizaje Basado en Problemas: una Alternativa al Método Tradicional
(online). http://campus.usal.es/⬃ofeees/NUEVAS_METODOLOGIAS/
ABP/molina.pdf [11 June 2015].
19. Norman GR, Smith HG. The physiological basis of problem-based
learning. A review of evidence. Academia Med 67: 557–565, 1992.
20. Rebollo Aranda S. Aprendizaje basado en proyectos. Revista Innovación
Experiencias Educ 24: 1– 6, 2009.
21. Rhem J. The National Teaching & Learning Forum. Problem-Based
Learning: an Introduction (onine). http://www.udel.edu/pbl/deu-
june2006/supplemental/NTLF-PBL-introduction.pdf [11 June 2015].
22. Reynolds F. Initial experience of interprofessional problem-based learn-
ing: a comparison of male and female student’s view. J Interprof Care 17:
35– 44, 2003.
23. Sainz de Abajo B, De La Torre Díez I, López-Coronado M. Aplicación
de la Metodología ABP. Ventajas del Aprendizaje Autodirigido (online).
http://giac.upc.es/JAC10/09/Doc_35.pdf [11 June 2015].
24. Thaman RG, Arora AK. Adopting role plays/skits to enhance the
learning of clinical respiratory physiology. Adv Physiol Educ 36: 358 –
359, 2012.