This transcript has been lightly edited for length and clarity.

APTA: Welcome to this APTA Podcast. Welcome to the PTJ Podcast, where you can get the story behind the research with insights into clinical application, study design, and future projects planned. Now here’s PTJ social media student lead Gaylan Randle.

Gaylan Randle: Hello everyone, I'm Gaylan. I'm a DPT student at Bowling Green. I'm thrilled to be joined by two of the leading researchers behind a recent study just published in PTJ. Their work has shed light on equitable grading practice in PT education, which has important implications for our field. So we're going to dive into the details of their research, explore its impact, and learn more about what inspired them to pursue this study. So I want to thank you both for being here today, and you can go ahead and introduce yourselves.

Kimberly Varnado: Hi Gaylan, thank you so much for having us. I'm Kim Varnado. I'm the program director of the College of St. Mary's Doctor of Physical Therapy program located in Omaha, Nebraska. I've been in this role for a little over six years. I'm also the president of the American Council of Academic Physical Therapy, so I wear a few different hats. It's so great to be here.

Shannon Richardson: Yeah, and also I want to thank you for having us here today. So I'm Shannon Richardson. I'm an assistant professor also at the College of St. Mary in Omaha, Nebraska. I've been here for about five years now and been getting into research, so excited to be able to share and talk to you about these things today.

Randle: Awesome. Well, I'm super excited to have you guys here.

So I'll go ahead and start with my first question. What inspired you and your team to transition from traditional grading to equitable grading, and how did you address initial resistance from faculty or students?

Varnado: Thank you for that question. Initially, you know, if you think about just the makeup of our faculty, just for your listeners, we're about 73% members from historically marginalized communities. And so we came into this place, if you think about the mission of The College of St. Mary DPT program, we're here to prepare competent physical therapists who can treat medically underserved and diverse patient populations. And so that's like the mission, our core. And so we recruited faculty who had similar perspectives. But when we were taking them through their curriculum, one thing that we identified as a program director and the faculty identified as well is we were still sometimes having the same issues with attrition.

So you were having students go through the curriculum. Let's say, if you had a student that had performed poorly on one or two assessments, well, it's really impossible for that student to then recover and be able to pass the course. So we were still having those same challenges that you would have in a traditional program.

So I remember speaking to the faculty about it, some one-on-one conversations and some things that came up was, well, you know, ‘I did the traditional — it’s a traditional bell curve. You know, I averaged the grades out.’ It's the same thing that we've typically done in DPT programs. And I just thought, you know, maybe it's the system.

So whenever I don't know something, I go read. I'm like a huge bookworm. And so I was reading a book one night on universal design for learning. And they happened to mention an author I've been following. Her name is Zaretta Hammond on cultural responsive pedagogy. And then they mentioned another author named Joe Feldman. I was like, who is this Joe Feldman guy? And he wrote a book called equitable grading [“Grading for Equity: What It Is, Why It Matters, and How It Can Transform Schools and Classrooms”]. I was like, equitable grading, maybe that's it.

So I went and I read his book and it was amazing. And I thought, you know, I had no idea that the grading practices that we were using were over a hundred years old and rooted really in discriminatory practices. So I thought, well, how do I present this to the faculty? Because you know, this has been enlightening for me, but we've all come through this exact same grading process and almost probably feel like it's a rite of passage in order to make it to this particular place in our lives.

And so I remember thinking, well, I knew Dr. Richardson was a huge student advocate and he really is a strong influencer on our team. And so I just kind of gently slid the book. I was like, ‘Hey, Dr. Richardson, I read this book on equitable grading practices. Have you heard about this?’ And he was like, no. He read the book and caught on fire and I'll let him share his part of the story. But that was kind of my way of trying to figure out a way, how do I get this into the hands of our faculty to get them to read it so they can kind of come to their own conclusion. And I kind of knew from the people I was working with that perhaps they would probably come to that space.

But I would say too, as a leader, you can’t force something on people. You have to really give them an opportunity to embrace it and to see if it's something that they resonate with.

The other thing I would say too, as a leader, it's important to have resources so that in case you have a teammate that's just like, ‘Listen, I read the book. I'm not buying it. But I took one of his courses on equitable grading practices.’ So then I was like, let's make sure we have resources available. So if people want to go through the course, I can send them through it. So I would say that from a program director perspective, that's how I kind of managed it. But Dr. Richardson, please share your perspective.

Richardson: No, I think that that's really accurate. Kim certainly, she kind of gave me the book and I cannot remember the last time I read a book so quickly. I'm not kidding you with this. It's very much a page turner. It's very compelling when you open up a book and it's a really easy read.

So basically what it comes down to, when you become a faculty member there's not really a handbook. There's trainings, there's people that can give you guidance. And fortunately, I had some mentorship coming into this role. But I always felt that in some way that there just was always — that I didn't feel grades aligned with people's performance on things, whether that's labs, simulations, or what have you. I kind of felt that way as a student, and I certainly felt that way once I kind of read this book and as a faculty member. Seeing like, okay, this person got this grade. I don't feel that it's necessarily reflective of what they know or don't know from what I've seen them doing over the course of this semester in their labs and classes.

And so in reading Feldman's book, I say it's almost like a disinfection. It's like this viral thing. Like I can't unsee this once I've seen and realized these things. He really paints a clear picture and kind of talks about the inequities that exist in kind of that traditional grading paradigm that there is. And so being in that equitable lens, that's really how we started to kind of make these changes and address things.

Now, I will say that like any change, the way that Kim went about it really made it a little bit easier. She didn't say, ‘Hey, we're doing this now.’ Here, I read this book. It's interesting. Take a look at this and see. I read the book and I took up the cause, I think would be putting it lightly. And I said, like, hey, I would shout this if anybody would listen. You've got to read this book. You've got to see this and see what he's talking about and see these types of things. And for starters, I think that's how you kind of create some change.

So we didn't have a ton of resistance internally from the faculty. I think some of us were early adopters with any new technology or new kind of idea. Some of us were more on board at first. But I think that our enthusiasm and our belief and knowing that we all have that similar sensibility and wanting to do the best thing by our students really eventually got the entire team on board as they became more exposed to Feldman's text. But just also kind of the overall concept by the book as it did align with our mission and goals as an institution.

Now, to your other part of the question about kind of resistance from faculty and students, we did have a misstep and we kind of will talk about this more. We kind of made the changes. We didn't do as much. We started to implement the things, but we didn't get the buy-in from the students in too much. We didn't explain to them initially, hey, we're doing these things to make it better for you, to make it more equitable for you. And what some students saw is, hey, you're just making these changes to the grading practices. And like any change, you want to get buy and you want to make sure that everybody's on the same page.

And so there was some resistance. To be quite frank with you, some students didn't feel, ‘Hey, I got an A on this the first time. Why did this person get more support or a second chance to be able to do this? I should be able to get a higher score than that person.’ And there were some people that we could go really into this. I don't want you to get in the weeds, but your grade is very much a part of your identity. There's people that, I have to get an A on everything. Everybody has probably known that student, or maybe you are that student. No shade towards anybody. I don't get an A in this class. It's upsetting. I got a 92.8. Why did I not get an A in this? And that's very, very challenging and frustrating for some people. But rounding for grading is another concept or topic.

But that's where we kind of did see some challenges. But basically talking to people, and then in subsequent cohorts, we did share, hey, we've made these changes. This is the way that we're doing our grading practices. These are the reasons that we're doing these things, is to make it more fair for you, to give you more space, to close any gaps that you had at the start of the semester. All we care about: what do you know at the end of this semester? And you're not going to be punished for having a different starting point where you didn't have as strong of an undergraduate background. Maybe you didn't have a tutor. You didn't have an extra anatomy course. You didn't work as a tech. You don't have a parent that's an orthopedic surgeon that gave you a background in these types of things. And so that's what we really worked to try to kind of address those things when we started off.

Randle: It sounds like you guys did a great job of kind of introducing and then implementing versus forcing it. So it sounds like you guys did a really great job with that.

My next question is, could you elaborate on the long-term impacts of this style for learner retention and academic performance? And particularly for those who initially struggled with traditional grading?

Varnado: Shannon, if you don't mind, I'll start off. And then I'll start from more of the historical perspective. And then if you don't mind, kind of more of the day-to-day.

Gaylan, one thing that really inspired me as we were developing the program was that if you look traditionally at our U.S. education system, it is inequity by design. So you have some learners that come from an education system that has been overly resourced. And you have learners that have different identities that come from really educational systems that have been purposely under-resourced.

So then you bring those learners into a classroom. And other part, too, just to share a little bit of background about myself, my research interest has always been kind of more related to faculty development. And one thing to just know, and I think a lot of students don't know this, is that when we go to school to become physical therapists and physical therapist assistants, we go to school to become clinicians.

When we transition into academia, that's a whole different occupation. It's not the same thing. And so you have people come into an academic environment, hopefully they are skilled clinicians. We hope that that is for sure who we're recruiting. But these are individuals who are clinicians, they are not academics. They're not educators, I would say. And so having people who really don't know how to teach, because that is really a different skill set in and of itself, you have to get trained in doing that or have an education of a you know a formal curriculum. And then having learners with different needs come into the classroom, it's just, it’s a lot to manage, I would say. Especially if you've not had appropriate mentorship or appropriate training. So I would say the long-term impacts of having equitable grading practices is, let's say, for instance, you're a new educator and you've written your very first exam. Trust me, it's not going to be good. It is going to have some challenges.

And then if you're using traditional grading practices, now basically the learners have come in with different skill sets based on a system that they have no choice in some cases, may have not had any choice in how they ended up getting through the education system or what was put on them. They now have, in some cases, you can say like the burden of the skill set of the person who's designed the assessment and who's also using whatever traditional grading practice that they're using to then grade the performance of that particular learner.

So if you have somebody who knows what they're doing, it's great. But if you have someone who's really new to the process, it really does fall, I would say, the brunt of it falls on the learner. Because if things don't go well, if they happen to score poorly on that assessment, and if it's graded and it's, you know, and the grading scale, the way it's weighted, they are the ones that are taking the biggest risk. If you think about how much money we pay for student loans and how much, you know, PT education costs.

And so I would say from the retention standpoint, this gives the learner an opportunity to actually learn the information without steep penalties associated with them, you know, going through the process, the natural process of learning. And that also, I think, can contribute to them having maybe stronger confidence in how they perform on assessments, you know, knowing that I have an opportunity to demonstrate what I know. That I'm not going to be penalized in some cases. Or have a weight attached to a grade that has nothing to do with whether or not I know the information.

And so I just started off there. And Dr. Richardson, you can take it on.

Richardson: Yeah, I think Dr. Varnado certainly kind of elaborated on an important point about it's kind of changing the paradigm shift in the way that you look at things.

So I think starting off, and maybe you've experienced this, Gaylan, faculty or teachers in general, I feel like there's this general perspective, this is not everybody by any means, but when people don't do well in the class, it's the student's fault, it's not my fault. I'm fine as a teacher, despite me not having maybe any formal training on how to be a teacher or do assessment, they didn't do well in this, it must be their fault, rather than it being me. And I think that this forced us to do some kind of introspection and reflection, and how we kind of go through these practices. So that's a huge long-term impact on the faculty.

From the student side, I think a big thing is, like, we're still very early in this. And I will say this is an iterative process. This isn't something where, oh, we are equitable in our grading practices. This is kind of a pursuit that we're just going to be ongoing. And we've been through a lot of different changes as we're going through this. So it hasn't been perfect, that smooth process, but I think that it's kind of taking into consideration and really looking at things. And it shifted the lens of all of us.

So for a lot of students, I think the biggest thing is, it's really shown them that when we say that we want you to be successful, and we want you to be supported as a student, the students really start to feel that. Because we're putting our money where our mouth is. I think a lot of times there's a perspective from students, and I think also faculty, I've literally heard people say this, is that there's, like, weeder classes. This class is to try to get this person out, or to see is this person really fit to do this. Whether or not it's really correlated with becoming a good physical therapist or a knowledgeable physical therapist, it's more just kind of a weeder class.

And there's prerequisites to do the same thing. And so when we kind of talk about implementing these types of practices, I think that some of those students that have maybe struggled, they now start to feel and see, like, okay, if I have a misstep, I have a little bit of a challenging time, I don't do as well in the beginning of the semester, I have time to be able to make this up or to be able to learn this. If I don't have it in week four, I can get till week nine, 10, 11, 12, what have you, to be able to kind of master some of this content.

By the same token, it is important, I think, to emphasize that we have not lowered or changed the standards. It's actually made for a more clear picture in terms of what the students know when we're doing this. So it's been more helpful for those individuals that have maybe struggled. We've seen better retention with students. We haven't seen as many students, for example, going on academic probation or having as many challenges. It hasn't magically – it's not a panacea. It hasn't meant that every student is perfect and everybody gets As in classes now. It's really changed those things. But I think it's certainly made our grading more accurate as a whole in terms of what people know and what they don't know. And their grade actually being more reflective in that.

I mean, we could go further into that to see in terms of how accurate the grading becomes, but my argument is that equitable grading, when implemented correctly and accurately, shows up and gives a more accurate product than just traditional grading, because it's only based on your assessments and what you know. And there is no fluff or buffer in terms of participation, attendance, just assignments, just practice opportunities. It's basically your summative assessments at the end of units or the end of semesters, which look at what you know and what you can do.

Randle: So I had a question that popped up in my head as you guys were answering the previous question. So in my program, one of the big things we do after exams is we do self-reflection as a student. So as a faculty member and as a grader, what is that reflection like for you guys?

Richardson: I just want to clarify, you mean like reflection practice that we have for students or you're talking about reflections that we have for ourselves and what we've done?

Randle: So on the student —  like the students, we reflect on how we performed on the exam, how we prepared and performed on the exam. As a person that administered the exam, how do you guys reflect on how those students performed on the exam?

Richardson: Yeah, I would say that's a big part of any process. I'm a big person of looking at like, how are things going? And I think you should reassess and do self-studies, like self-scout yourself, so to speak, and see where these kind of issues are. We kind of have a statistical analysis and breakdown of every single test that we are anxiously awaiting those things before we publish any grades. But go back and look at kind of do a self-audit to see. So that's kind of that reflective process starting there. That's initially, even before we do administer an exam, that exam has already been looked at by at least one other faculty member to kind of see.

So we try to be proactive in that, but we don't always get it right. And so there's times when, nope, that question is just going to be, it's too muddy. We didn't clarify this clearly. If the water is muddy, we try to make it so there's not even where a person's trying to come back and fight and get points. Not that we're opposed to that, but we don't even let it get to that point. This was not a clear question. This was not fair. So we try to remove that. We don't have that happen as often because we've done this a number of times now, but that's part of that reflection.

And for example, we look and, hey, 95% of the class got this question incorrect. So what is more likely? All 95% of the students in the class didn't get this or we didn't teach it well. So there's different ways to look at that. Like I'm going to default. Hm. There's 30 people, 28 of the people got this question wrong. Regardless, even if we did teach it in class, we clearly did not do this well enough. This was not clear for the students. And so you take those things into consideration.

And it's not a magical number. Where's that number at? But it's just, I have a conversation. If you teach a class with another person and I look at it, I look at the content of the lecture and see, and you kind of make those decisions based on those types of things. So just as we encourage students to look at where your deficits went well, what didn't, what went well, we do the same thing. And we try to make those changes with those exams moving forward. But exams change from term to term sometimes. And we're constantly trying to kind of improve and enhance those things.

So I'd say the reflection is a huge part of it. Just as we ask the students to do a midterm or end-of-semester reflection for migrating practices. And I know a lot of my colleagues, that's a big part of my process in general with administering assessments.

Varnado: I don't really have much to add to what Shannon already shared. I just did it this semester. There was a question that is frequently missed. And I'm like, you know what, it's probably not the students. I need to go clean up this slide because it is not clear. So — and I think that that's just a natural process, I think, of growing as an educator. I was preparing to submit my dossier for promotion and one of the things I was writing was, you know, as an educator, one of the coolest things is having this ability to kind of grow as a person. I'm still a learner, too, in the classroom.

So just as the learners are learning information, I’m learning about them, learning information from them, but then also learning about ways that I can be a better communicator. Especially when it comes to writing assessments.

Richardson: And I just want to add one quick thing to that too, is tests are an assessment piece. And to me, the way that the students perform in a test is very much a reflection of your teaching and what you did in the class. You need to make sure that that test actually reflects and assesses the things that are the standards and objectives in the class, and they align with what you've been teaching. That's not always the case.

It sounds very simple. And as Kim said, there's times when we look at this, huh, they keep messing this up. I need to go back, then not just change the question. Maybe I need to look at these slides or this presentation or change the way in the resources that I offer. And that should be kind of a natural process. Just like a student. Hey, you haven't mastered this evaluation section. Go back and relook at these materials and this content here. We try to do the same thing. And I think that that's only fair, but there's times when I think that that's forgotten and a test can become a static thing where it should be changing.

There's going to be a point where you're not going to change it dramatically, but there should be some evolution in what you're presenting. And if every year the students keep messing up this section, maybe you need to take a look at the way that you're teaching it to see if you can make it better.

Randle: So my last question for you guys is what advice would you give to other institutions that are considering transitioning to this style of grading?

Varnado: I think it’s the same thing with people who decide that they want to change their — you know, we want to increase diversity. You know, I always go, what's your mission? You know, what's your intent behind doing it? I think you need to start with a good why as to ‘why’ you think it is something that you need to do. There are plenty of reasons why read Joe Feldman's book, read our paper, you know, things are inequitable and it's not something that you want to continue to support. Then that's a good why, but definitely start there. Because don't just jump into doing this because I think that that could present some internal resistance along the way.

For institutions that want to consider this first, I think starting off by, you know, definitely having good conversations, good, honest conversations, one with yourself, but then also with your colleagues. To get out on the table what people already think about grading. Because sometimes there's just lots of things that have been done to us that we actually think are the way things are supposed to be just because it was done to us. Not knowing why or where that came from. Like most things that we're probably engaged in are from things that were created by someone who may not have had your best interests at heart.

The other thing I would say is, you know, definitely I think starting off by reading the paper, but then, you know, looking at the resources that we provide. You know, read Joe Feldman's book. He's got a great course that he offers along with it. I don't work for Joe. Don't get any kickback. But I highly recommend his book, especially the second edition that just dropped. It's on Audible. You know, you can take a look at that. Even as a class that's pretty inexpensive. So that you can learn more about what it is that we've been all engaging in. Also the things that have been done to us and if we want to continue to perpetuate that.

I think after reading his book, you'll see that perhaps you don't want to continue to uphold those systems that continue to marginalize populations that have already been marginalized. Also, after reading the book, talk it through with your colleagues. I'll let Shannon share what we're doing here at The College of St. Mary because I think that's a great way to get to spread the word. Once we read the book and we started implementing some of the practices, I went to my assistant dean and went to the vice president of academic affairs and said, I got this extra copy of [Feldman’s book]. I recognize that this is something that we've been struggling with at the university level. Maybe you might want to read this and maybe share it with other programs.

And so it began to catch on and spread around. So you can change practice. You know, it doesn't have to start off really big and start off in a program with one faculty member, grow from a faculty, then continue to grow to different programs and then spread it to different institutions. But I think it starts with first educating yourself.

Richardson: Yeah. And I think that Kim hit on — I love what you said there. It's always have your why. I think that that's a big thing. And if you notice the way that she described it, it's similar to what happened with the team. If you have a why that can kind of be your north star for when you're driving these types of things, it gives you something to kind of fall back on. Why are we doing this?

And then also with all change within an organization, if you look at organizational change, the concepts and the theories behind that, you have to create buy-in from people. Change works much better when it is something that is grassroots or intrinsic versus it being a mandate from the top down. Certainly those things do happen and they work, but it's very different if I've inspired you to do this and you do this because you believe in this mission and ideal versus you're doing this because I told you, you have to do it. So when you do it that way, I don't need to be told, like we're naturally reading and trying to find other resources and information on this.

Now, all of that said, this is a tremendous change. As I mentioned before, it's part of students' identities, looking at their grades and their numbers. And faculty, this — grading is one of the most significant societal metrics that we have. It's tied to so many things from your ability to get into a graduate school, the ability — if you're eligible to play in a sport or participate in an activity, to get scholarships, to get into residency, to get into fellowship. A lot of these things will look at your grades. How many times have you had to send your transcripts for something when you've applied for something to see? It's not just, did you have your diploma or your degree? They want to see, what are the grades? How did you do when you did these different types of things?

And so it's an important thing and it's a part of people's identity. So it's a big shift when you're asking somebody to change the way that they do that. That said, this was a big change. To anyone that's looking to implement this, this is not easy. This is not something that is going to be perfect. There are going to be some bumps along the way. There's going to be some things that don't go well. But if you are dedicated to that why, you'll kind of stay the course. And when you get to — there's not just a finite or discrete destination – but as you start to get to the other side of this process and you start to have some of the groundwork laid, you'll begin to see the fruits of your labor and you'll see a lot of positive returns.

But it's hard. I would really say that if you are really doing the work of being a faculty member where you are implementing equitable grading practices, you're being inclusive, you're using cultural responsiveness in your teaching, it's a lot of work. It takes a lot of time to grade and do these things and create stuff and give productive feedback to students. I'm happy to do that, but I think that's what we should be doing because the ultimate goal is to get people to learn things and prepare them to go into this profession. And that's what I'm happy to spend my time doing that type of stuff. Some people don't like doing those things, but it's not always about doing research or these other things.

And different people have different requirements at different institutions and spaces, but just in the terms of pedagogy and teaching, a lot of time should be doing feedback and refining your assessments and making sure that the students know the things that they're supposed to know. And that you are doing things correctly on your end in terms of modifying those assessments that are my practices helping everybody accomplish the goals that we want. So it's challenging, but I think to kind of close that, it is certainly worth the extra work and effort and time that will come with that.

Varnado: Can I add to what Shannon just shared? I think it's kind of important to think about with your question, Gaylan, is something that's happened more frequently now that I've been a program director since we've launched our program, I get emails from students who've been dismissed from programs. And that's the part that people don't really think about or even consider, is that sometimes you can have students, let's say you get them in the door. These are students you've been trying to recruit. You want to come into the profession. They're in a program. They get a score that is so low, which is unnecessary sometimes, because if you're going to fail an exam, a 50 is good enough. It doesn't have to be a 30, because you can't make your way back up from a 30 sometimes.

But let's say a student, unfortunately, has not performed well on an assessment, an assessment which, in some cases, is just a snapshot of how they performed in that one instance. Anything could have happened, and they performed not so well. Now you have a learner who has, in some cases, let's say they've come from an inequitable U.S. education system. They're in your classroom. They finally make it in. And you're using this traditional grading practices, and things don't go well. Now this person has a large amount of debt. They may not be able to pay back. So actually, you're continuing to perpetuate inequities that exist.

It's not helpful. It's very harmful in many ways. And so I would just encourage programs, especially those that are struggling with attrition of members from historically marginalized communities to really look at, you know, are you doing them a service by continuing to use traditional grading practices? Are you continuing to basically further harm communities that have been harmed due to things that have nothing to do with them, just based on how they identify? Because you're using practices that were never designed to benefit them in the first place but only really to benefit a particular population.

So those are just some things I would think about. Because when a student spent two years in PT school, and they can't graduate, that's heartbreaking. And it shouldn't happen. So just something else to consider.

Randle: Well, you guys have been beyond awesome. And it's been such an awesome time just getting to sit with you guys and listen and hear you guys talk about your work. That's all we have time for today. Appreciate you guys.

Richardson: Thanks for having us.

Varnado: Yeah, thanks for having us.

APTA: You can find more APTA podcasts like this one on Apple Podcasts, Google Play, and Spotify, or by visiting apta.org/podcast. Thanks for listening.