Authentic learning resources and assessment (Medical and Health Sciences)

Authentic learning resources and assessment (Medical and Health Sciences)

Dr Rachelle Singleton from Medical Science in the Faculty of Medical and Health Sciences at the University of Auckland developed learning resources for teaching pathology, using H5P for undergraduate students enrolled in MEDSCI 203:Mechanisms of Disease, MEDSCI 301 Molecular Basis of Disease and MEDSCI 302 Cancer Biology. You will find this useful if teaching pathology, incorporating textbooks and assessments into online learning and teaching large cohorts. 

H5P allows authors to ensure all metadata (sharing and licensing info) on any images or external sources are linked to the content in which they have been used. University of Auckland copyright compliance guidelines were adhered to for any images, articles, textbook material incorporated into online content created for teaching purposes.


A key aim of the project was to develop and test H5P as a plugin for Canvas, thereby extending Canvas affordances beyond its baseline capabilities as a learning management system. A variety of teaching tools is needed because there is no such thing as a typical student (different abilities, needs, interests and preferred learning styles) – Canvas and H5P together can therefore extend and excite student learning (beyond the more traditional ‘transmission’ style of teaching (content transfer) to a more ‘constructionist model’, which encourages greater learner participation, providing them with multiple opportunities to actively learn skills and acquire knowledge (Freeman and Wenderoth, 2014, Bonwell and Eison 1991). The students involved were undergraduate Bachelor of Science students on various biomedical science specialisation pathways. H5P resources were developed for approximately 300 stage two students enrolled into MEDSCI 203 (Mechanisms of Disease) in the first semester and also 120 stage three students enrolled in MEDSCI 301 (Molecular Basis of Disease) and MEDSCI 302 (Cancer Biology) in the second semester. There is some overlap in content taught between MEDSCI 203 and the pathology module taken by a further 120 stage two students enrolled into the Pharmacy for Life Sciences programme (Pharmacy 211). H5P resources were incorporated into specific topics taught as part of practical laboratory classes. These included: cell injury, inflammation, cardiovascular biology, cancer biology (with a focus on colorectal and lung), skin pathology, basic immunology, kidney pathology and genetic diseases. Also developed were online revision modules based on related lecture topics that provide students with formative learning opportunities to use as revision tools prior to exams or tests.

Long before the pivot to online teaching (necessitated by COVID-19), student demographics suggested performance was impacted by their work/family commitments and long distance commutes. Students also had diverse backgrounds (different abilities, needs, interests and preferred learning styles). The need for teaching and learning flexibility and the demand for contemporary digital technologies has since been further underlined and accelerated by the pandemic. Teaching staff often have limited time during the teaching semester to grade assignments and provide individualised feedback to students, yet this is critical to acknowledging and meeting the different learning needs of students and creating a sense of belonging amongst students. Staff also acknowledge that inclusive pedagogy involves removing barriers to learning, and doing things differently and in various ways to ensure all learners can participate, both in assessment and teaching. Therefore project team members sought to make their teaching more engaging and their students’ learning more active, without increasing staff workload. The aim was to provide flexible, formative learning opportunities for students in hybrid/blended models of course delivery, thereby extending the learning environment and ensuring that taught content is more inclusive – by ensuring accessibility to students outside the classroom and circumventing known barriers to learning related to distance, time and preference.  

The specific aims were:

  •   To develop innovative ways to engage students and promote active learning
  •   To provide accessible, formative learning opportunities for our students in hybrid/blended models of course delivery
  •   To provide students with consistent and timely feedback on their practical assessments
  •   To develop H5P as a plugin for canvas, extending its affordances beyond its current capabilities as a learning management system

Design: challenges and process

The aim was to ensure that the blended learning tools and online assessments enabled students rather than create a further barrier to their learning. Inclusivity demands variety, to allow students to showcase different talents, provide students with consistent and timely feedback on their practical assessments and offer students assessment choice. Students were involved in the design process to ensure the assessment briefs and feedback/feedforward was user-friendly. The project team used feedback from student evaluations and had graduate students (from a range of disciplines) test and refine the online content (on a range of digital devices), prior to its release to enrolled students.

Figure 1a. Example of a MEDSCI 203 critical review article assignment.

Figure 1b. Example of a MEDSCI 203 critical review article assignment.

A variety of interactive digital activities were developed to replace existing written (summative) assessments. New online modules with interactive (formative) activities were also developed to complement and reinforce the existing lecture material provided to students. Two critical review article assignments were created (quiz question set style summative assessments integrated with the Canvas gradebook). Students read a prescribed review article, on a topic related to lecture material. They answer questions online in canvas (in a wide variety of differing formats; fill in the blanks, image and text-based drag and drop, mark the word). Grading and feedback is automated and synced to canvas gradebook. Students completed these assignments (on topics closely related to lecture and practical lab material) in their own time and submitted them online (within Canvas). Quiz questions were created in a wide variety of formats: fill in the blanks, image and text-based drag and drop, mark the word and interactive video. Grading of these quiz assessments and the feedback provided to students was automated and immediately received by learners within Canvas. Students also received a hard-copy lab manual with screenshots of the digital quiz questions/assignment at the start of the semester, so that they could work through the material offline before committing their answers in Canvas for grading and feedback. Grading and feedback is automated and synced to Canvas gradebook. A digital learning resource was designed (lab presentation with interactive slides and formative learning activities) for students to follow along with autonomously during the practical lab (accessed on computers provided in the lab space). These interactive slides encouraged student engagement with the content e.g. microscopic analysis of histopathology slides and 3D macroscopic specimens with identification of regions of interest (hotspots; roll-over information; animation) and associated quiz questions. Students could revise these interactive slides after the lab session (access made available via Canvas) to aid in their completion of the assessed component (lab report).


Figure 2a. Example of a MEDSCI 203 interactive lab manual (course presentation with embedded interactions).

Figure 2b. Example of a MEDSCI 203 interactive lab manual (course presentation with embedded interactions).

 A large canvas module was developed that linked concepts taught in lectures to real-world case studies. The Canvas module contained many ungraded/formative H5P activities. Using H5P as a plugin for Canvas allowed staff to monitor student interactions with these module integrated H5P activities (number of attempts, scores on each attempt and time taken for each attempt). This module provided students with accessible, formative learning opportunities outside of the face-to-face classroom and prepared them for the face-to-face laboratory on the same topic. Delivering content in this way (flipped and online) allowed staff to better utilise the time spent in class with students, observing the physical pathology specimens.

Figure 3b. Example of a MEDSCI 302 online colorectal cancer module (Canvas modules with embedded H5P interactions).

Figure 3a. Example of a MEDSCI 302 online colorectal cancer module (Canvas modules with embedded H5P interactions).


Pre- and post-lab quizzes were designed (with rich histology content) to assess students pre-knowledge (before the lab) and practical content learnt (post lab). In these courses staff can’t always assume students’ prior knowledge before coming to a practical session, so there is a need to start with something familiar (previous years content/revision). Pre-lab modules with quiz elements can also build student confidence before they attend a face-to-face teaching session. Staff can then use this confidence as a starting point to get them thinking critically in the practical lab. Post-lab quizzes allowed fast turn-around of feedback before the exam study period for practical labs scheduled in the final week of teaching. During the pivot to online teaching (arising due to COVID-19 restrictions) staff recorded lectures as a series of shorter 10-15 minute segments and made these recordings interactive by overlaying quiz elements (true-false, drag and drop, multiple choice questions, free text boxes). This allowed staff to observe who was watching the lecture videos in the asynchronous delivery setting and to view how students were responding to the formative questions that were provided. Follow up live zoom tutorials could then be arranged based on the topics students found most challenging (i.e. those where students answered poorly to interactive elements).

Implementation and evaluation

Rachelle reflects: “As a 2019 CLeaR fellow, I was allocated a 0.2 FTE time release over a 12-month period to participate in the CLeaR fellowship programme. Implementation of H5P content was greatly facilitated by my role as course coordinator, on the courses that I primarily teach. As a SEED grant recipient I was also able to fund a teaching/research assistant that allowed for extra contracted teaching-related hours, beyond normal allocation. This teaching assistant helped develop and test formative learning activities in H5P over the summer in the lead up to the semester I start date. The SEED grant also enabled us to test (paid license service) as a plugin for Canvas.” Overall this project has been a very positive experience. Integration of H5P content within Canvas course materials has provided opportunities for students as learners to think critically about what they are being taught. The project team successfully increased student engagement, learner participation and excitement about taught content and have observed a cohort of students who are able to ‘see’ the relevance of pathology to their intended professional practice as graduates.

Seamless integration of these H5P activities with Canvas Gradebook provided learners with automatic feedback that was more comprehensive and consistent than previously. Student engagement and achievement was easily tracked for both formative and assessed activities. Assessment results and analytics have informed teachers how to more effectively use their contact teaching time. The new activities have also reduced marking load at peak times during the semester. H5P interfaced with Canvas has provided staff with greater flexibility for teaching and encouraged greater learner participation. It has ensured content is more accessible to students outside the classroom, potentially circumventing known barriers to learning related to distance, time and preference. The learning through this project and the content developed has proven extremely beneficial in the rapid pivot to online teaching during the pandemic.

What worked well? 

Figure 4. SET digital student course evaluation results

Students were evaluated at the end of each semester using hard-copy Likert scaled evaluation forms, administered during compulsory practical lab sessions (>90% response rates) and as standard digital course SET evaluations (~20% response rates). Open ended evaluation comments on the H5P assignments were positive. Students found the feedback provided on assessed work useful. They thought assignment marking was timely and grading was fair. Students also, importantly, learnt from the lab sessions and assignments provided. Students also felt that the resources (including digital resources) in this course helped them to learn and were satisfied with the quality of the small-group teaching (e.g., tutorial, laboratory, seminar) – SET course evaluation.

What would be done differently? 

Rachelle ponders: “If I were to do this again, I would view course assessments more holistically. I would like to have assessments build on previous ones and link to the next one more and ensure student self-reflection points are built into each assessment. To enable this I would like to work more holistically with my teaching team. Creating H5P content does take time and effort and this should not be left to one person (or a few isolated topics) on large courses. All staff teaching on our courses could be equipped and able to develop their own online learning resources. H5P authors can easily track student engagement (detailed student reports are created for all student interactions with H5P) and staff could use their assessment results and analytics to inform how to more effectively use their contact teaching time. I have started to develop some ‘self-help’ resources that might enable new H5P users. I have also facilitated workshops on ‘How to create H5P content for active learning’ (SoTEL – Scholarship of Technology Enhanced Learning, AUT University (City Campus), 19-20th Feb 2020). I also plan to start a community of interest of current H5P users within the Faculty of Medical and Health Sciences. Building a dedicated community of interest for H5P users within the faculty is a positive way to share knowledge and experience as well as grow staff capability around the effective use of future-focused educational technologies. It is hoped that our community of H5P users will lead the dissemination of effective teaching practice within the Faculty Teaching and Learning Community.”

Testing online content out on graduate teaching assistants and refining that content before release to enrolled students was extremely useful. Many times the teaching assistants would highlight discrepancies, errors or ways in which the project team could make assessment instructions clearer. The more people you can test out your online content on beforehand, the better. Having the content tested on a range of digital devices (iPad, phones and desktop computers (mac and pc), plus using different browsers, was also informative. Luckily H5P content is compatible with all of these formats, but sometimes Canvas was not!

The project team learnt that having very clear instructions for whether an activity is purely formative or an assessed component of the course is really important. It was quickly realised that students like to know exactly how many points each online interaction is worth (if summative), its overall weighting, any specific question format rules and the relevance to course or module learning outcomes. Whilst this may seem logical, some of our previous paper-based assessment types did not always seem to require as much work to prepare (although the paper based assessments were limited to either MCQ or short answer formats which students are traditionally more familiar with). Shifting assessments online and changing the style/format of the questions (as well as provision of immediate grading and feedback without moderation prior to release) meant staff had to be hyper aware of ensuring online instructions were explicit.

Project resources

You can listen to the FMHS Teaching and Learning Community presentation: ‘A new canvas for teaching and learning with H5P’ (Dr Rachelle singleton – CLeaR Fellowship and SEED grant recipient for 2019). Note: this recording is embedded within the FMHS Teaching and Learning Community Canvas page. To enrol in the canvas page and listen to this recording please email On this Canvas course you will also be able to view examples of H5P learning activities and how they integrate with canvas;

Further Resources:

Presentation at UoA Learning Design Community of Interest – Use of H5P to support active learning