Comparative effectiveness study of flipped classroom versus online-only instruction of clinical reasoning for medical students

Fostering clinical reasoning ability in preclinical students through an illness script worksheet approach in flipped learning: a quasi-experimental study

BACKGROUND

The consensus that clinical reasoning should be explicitly addressed throughout medical training is increasing; however, studies on specific teaching methods, particularly, for preclinical students, are lacking. This study investigated the effects of an illness script worksheet approach in flipped learning on the development of clinical reasoning abilities in preclinical students. It also explored whether the impact of this intervention differed depending on clinical reasoning ability after dividing the students into high and low groups based on their pre-diagnostic thinking inventory (DTI) scores.

METHODS

This study used a one-group pre-post test design and convenience sampling. Forty-two second-year medical students were invited to participate in this study. The course, "clinical reasoning method," was redesigned as an illness script worksheet approach in flipped learning. The course was an eight-week long program. The students met once or twice per week with a different professor each time and engaged with 15 clinical cases in small groups in one classroom. Each time, one professor facilitated seven groups in a single classroom. The effectiveness of the intervention was measured using DTI before and after the intervention. A learning experience survey was conducted with post-DTI assessment.

RESULTS

Thirty-six students participated in the survey and their data were analyzed. The mean pre-DTI score was 170.4, and the mean post-DTI score was 185.2, indicating an 8.68% increase (p < .001). Significant differences were also found in both high and low groups between the pre- and post-DTI assessments. However, the low group improved much more than the high group and exhibited a significant increase in one of the DTI subscales as well. The overall average score on the learning experience survey was 3.11 out of 4.

CONCLUSION

The findings indicated that the intervention was an effective instructional method for the development of clinical reasoning in preclinical students and was more beneficial for students with a low level of clinical reasoning ability. This study demonstrated that the intervention can be a feasible and scalable method to effectively and efficiently train clinical reasoning in preclinical students in a classroom.

Application of flipped classroom teaching method based on ADDIE concept in clinical teaching for neurology residents

BACKGROUND

As an important medical personnel training system in China, standardized residency training plays an important role in enriching residents' clinical experience, improving their ability to communicate with patients and their clinical expertise. The difficulty of teaching neurology lies in the fact that there are many types of diseases, complicated conditions, and strong specialisation, which puts higher requirements on residents' independent learning ability, the cultivation of critical thinking, and the learning effect. Based on the concept of ADDIE (Analysis-Design-Development-Implementation-Evaluation), this study combines the theory and clinical practice of flipped classroom teaching method to evaluate the teaching effect, so as to provide a basis and reference for the implementation of flipped classroom in the future of neurology residency training teaching.

METHODS

The participants of the study were 90 neurology residents in standardised training in our hospital in the classes of 2019 and 2020. A total of 90 residents were divided into a control group and an observation group of 45 cases each using the random number table method. The control group used traditional teaching methods, including problem based learning (PBL), case-based learning (CBL), and lecture-based learning (LBL). The observation group adopted the flipped classroom teaching method based on the ADDIE teaching concept. A unified assessment of the learning outcomes of the residents was conducted before they left the department in the fourth week, including the assessment of theoretical and skill knowledge, the assessment of independent learning ability, the assessment of critical thinking ability, and the assessment of clinical practice ability. Finally, the overall quality of teaching was assessed.

RESULTS

The theoretical and clinical skills assessment scores achieved by the observation group were significantly higher than those of the control group, and the results were statistically significant (P < 0.001). The scores of independent learning ability and critical thinking ability of the observation group were better than those of the control group, showing statistically significant differences (P < 0.001). The observation group was better than the control group in all indicators in terms of Mini-Cex score (P < 0.05). In addition, the observation group had better teaching quality compared to the control group (P < 0.001).

CONCLUSION

Based on the concept of ADDIE combined with flipped classroom teaching method can effectively improve the teaching effect of standardized training of neurology residents, and had a positive effect on the improvement of residents' autonomous learning ability, critical thinking ability, theoretical knowledge and clinical comprehensive ability.

Innovations in teaching during the COVID-19 pandemic: comparisons of the impacts of different teaching approaches in psychiatric nursing on undergraduate nursing students

BACKGROUND

Psychiatric nursing education was significantly impacted during the COVID-19 pandemic, and innovative teaching can be challenging. This study aims to compare the effectiveness of four approaches to psychiatric nursing education in the context of the pandemic.

METHODS

A quasi-experimental design was adopted. Students were subjected to different teaching designs: face-to-face teaching (Class A in 2021), blended teaching with flipped classroom using roleplay (Class B in 2021), live broadcast teaching (Class A in 2022), and online blended teaching with flipped classroom using case studies (Class B in 2022). Multivariable logistic regression was used to analyse the outcomes in terms of academic performance and course workload.

RESULTS

The number of valid data points was 270. The results indicated that compared with Class A in 2021, the two classes in 2022 achieved significantly higher academic performance scores, and Class B in 2021 exhibited a significantly lower workload. Compared with Class A in 2022, Class B in 2021 exhibited a significantly lower workload. Compared with Class B in 2022, Class B in 2021 exhibited a significantly lower workload and achieved lower academic performance scores.

CONCLUSION

This study demonstrated that innovative teaching designs for psychiatric nursing offer advantages with regard to either facilitating academic performance or optimizing learners' task loads. Furthermore, blended learning is a promising teaching approach in the context of the COVID-19 pandemic. Future teaching initiatives could adopt student-centred constructive learning designs and ensure feasible teaching.

Flipped Classrooms in Medical Education: Improving Learning Outcomes and Engaging Students in Critical Thinking Skills

The flipped classroom (FC) model involves students independently acquiring knowledge before in-person class sessions, during which they engage in active discussions and problem-solving. Various methods to implement FC are quizzes, e-content, case-based learning, problem-based learning, and reading assignments. The advantages of the FC approach included improved student preparation, active participation, and the promotion of critical thinking skills. Some disadvantages identified are technical problems like internet connection, improper planning and preparation, which increases teacher workload, and lack of self-motivation. This review underscores the potential of the FC approach to improve medical education by promoting independent learning, active participation, and deeper understanding. Consideration of factors such as curriculum design, faculty development, technological infrastructure, and student readiness is vital for successfully implementing the FC model. Balancing self-directed study with meaningful face-to-face interactions remains crucial to harnessing the full benefits of this innovative approach. By leveraging technology and student-centered methods, medical educators can create an enriched learning experience that positively influences future healthcare professionals.

Design of online formative assessment of nursing humanities curriculum during the COVID-19 pandemic: A teaching practice research

BACKGROUND

Under the digital transformation trend nursing education, online formative assessment (OFA) provides a new opportunity. However, the OFA of nursing humanities course lacks design and practice, and faces the challenge of enhancing effective communication between teachers and students, student participation and autonomous learning.

OBJECTIVES

To enhance the reliability of OFA in nursing humanities courses and provide practical experience for online teaching in the nursing profession.

DESIGN

A quantitative research approach was used.

SETTING

This study was conducted in a comprehensive university in China.

PARTICIPANTS

We conducted teaching practice on 185 nursing undergraduates, with 89 students in the experimental group, and 96 students in the control group.

METHODS

In the 2020-2021 multicultural nursing course, student learning outcomes and questionnaires were analyzed through the online learning tool Superstar Learning, student feedback and satisfaction questionnaires, and descriptive analysis and independent sample t-tests were conducted using SPSS 25.0 software.

RESULTS

The OFA of students using Superstar Learning differed in learning performance and time to receive feedback from teachers between the experimental and control groups, and both groups had higher satisfaction levels. The experimental group's instructional design contained a synchronous classroom discussion module with better participation.

CONCLUSIONS

During the COVID-19 pandemic, the use of online learning tools can support the implementation of OFA, build an environment where teachers and students participate together, have a positive impact on the continuous updating of teachers' teaching programs and students' learning outcomes. Simultaneous classroom discussions are expected to be an effective way to improve the reliability of OFA. Our instructional design, provides best practice suggestions for future online teaching and learning.