Student experiences across multiple flipped courses in a single curriculum

Different Methods of Teaching and Learning Dental Morphology

Dental anatomy education is traditionally structured into theoretical and practical modules to foster both cognitive and psychomotor development. The theoretical module typically involves didactic lectures where educators elucidate dental structures using visual aids. In contrast, practical modules utilize three-dimensional illustrations, extracted and plastic teeth, and tooth carving exercises on wax or soap blocks, chosen for their cost, ease of handling, and fidelity in replication. However, the efficacy of these traditional methods is increasingly questioned. The criticism in this concern is that oversized carving materials may distort students' understanding of anatomical proportions, potentially affecting the development of necessary skills for clinical practice. Lecture-driven instruction, on the other hand, is also criticized for its limitations in fostering interactive learning, resulting in a gap between pre-clinical instruction and practical patient care. In this study, we review the various educational strategies that have emerged to enhance traditional dental anatomy pedagogy by describing the effectiveness of conventional didactic lectures, wax carving exercises, the use of real and artificial teeth, the flipped classroom model, and e-learning tools. Our review aims to assess each method's contribution to improving clinical applicability and educational outcomes in dental anatomy, with a focus on developing pedagogical frameworks that align with contemporary educational needs and the evolving landscape of dental practice. We suggest that the optimal approach for teaching tooth morphology would be to integrate the digital benefits of the flipped classroom model with the practical, hands-on experience of using extracted human teeth. To address the challenges presented by this integration, the creation and standardization of three-dimensional tooth morphology educational tools, complemented with concise instructional videos for a flipped classroom setting, appears to be a highly effective strategy.

Dental students in an orthodontic course flipped classroom: A semi-experimental study on knowledge, practice, attitude, and satisfaction

OBJECTIVE

The purpose of this study was to determine the students' attitudes before and after the flipped classroom, and the effectiveness of this method to promote the students' lateral cephalograms tracing abilities, students' satisfaction and their final exam scores.

MATERIALS AND METHODS

This is a single-group quasi-experimental research conducted on dental students of Shiraz University of Medical Sciences (SUMS), Iran in 2019. The intervention was carried out in a blended learning approach with the flipped classroom model. Thirty-five fourth-year dental students participated in a flipped classroom held during a semester for the lateral cephalograms tracing course. The students were provided with the educational materials before the class time through multimedia learning tools and the class time was devoted to discussions. The students were asked to fill out four questionnaires (pretest/posttest attitudes, pretest/posttest self-assessments of theoretical knowledge and practical skills in cephalograms, posttest of satisfaction from quality of the course, and posttest of students' views about effectiveness of blended learning tools) and final exam scores of students.

RESULTS

Students' attitudes toward e-Learning were improved after the flipped classroom and the quality of this method was acceptable to the students (p < .001). Their self-assessment of theoretical knowledge and practical skills were promoted (p < .001). While all blended learning tools averaged more than the cut-off-point, short lecture (5.11 ± 0.98) and live feedback (4.98 ± 1.07) were considered to be the most efficient interactive tools.

CONCLUSION

It seems that the flipped classroom has a positive effect on increasing students' knowledge, attitude, and satisfaction. In general, this method of learning seems to be favored by dental students.

CLINICAL SIGNIFICANCE

The findings showed that blended learning had a positive effect on increasing knowledge, performance, and satisfaction among dental students. Therefore, blended learning as a reliable method might be used in training dental students.

Flipped classrooms in pharmacy education: A systematic review

Background

In recent years, flipped classrooms (FCs) have gained popularity in higher education, particularly among healthcare students. The FC model is a blended learning approach that combines online learning with in-class activity. This has prompted many instructors to assess how they teach and prepare successful graduate students for today's society. Additionally, colleges and universities have been challenged to deliver curricula that are relevant to the needs of students and to provide the rising skills and knowledge that are expected to be acquired by students.

Objective

This systematic review aims to evaluate the flipped classroom teaching approach in pharmacy education and to provide a summary of the guidance for the introduction and implementation of the flipped classroom model in pharmacy educational programs.

Method

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Eight databases were cross-screened by four reviewers, following key terms and predefined inclusion and exclusion criteria. A form was developed to extract relevant data from the reviewers. Qualitative data within the studies reporting students' and educators' perceptions and views on the FC model were also analyzed using a thematic analysis. Studies were appraised using the Medical Education Research Quality Instrument (MERSQI) and the Joanna Briggs Institute (JBI) checklist for qualitative research.

Results

The reviewers screened 330 articles, of which 35 were included in the review. The themes identified were implementation, academic performance outcomes, student satisfaction with the flipped classroom model, and long-term knowledge retention. Most studies (68%) have found that flipped learning enhances students' success and exam performance. Six (27%) studies reported no statistically significant difference in academic performance. However, two studies reported lower long-term knowledge retention in FC learning than in lecture-based learning. The students' perceptions of the FC approach were assessed in 26 studies, and the majority reported positive feedback. However, some students found the pre-class homework difficult to complete before class, and some expressed dissatisfaction with the inconsistent grading and unclear assessment questions in the FC model. Overall, the FC model was found to enhance the students' critical thinking and communication skills, self-confidence, and time management.

Conclusions

The findings of this review indicate that pharmacy students generally found the flipped classroom model preferable to traditional lectures. However, this preference is conditional on the effective implementation of this approach and alignment within the core instructional elements. The issue of increased workload for students associated with self-directed pre-class learning may present a challenge.

Faculty Process for Reviewing and Utilizing a School's Course Evaluation Comments

OBJECTIVE

This study aimed to explore faculty engagement with qualitative comments from course evaluations.

METHODS

Course faculty from the University of North Carolina Eshelman School of Pharmacy were recruited via email to participate in a 30-minute interview session. Previous course evaluation comments were adapted to create a de-identified mock evaluation. Six interviews were conducted via Zoom, consisting of a think-aloud protocol based on the mock course evaluation followed by a cognitive interview focused on goals and current utilization of comments, and common patterns and issues sought by faculty. Interview transcripts were manually cleaned and de-identified. Transcripts were inductively coded by 1 researcher using MAXQDA.

RESULTS

Three overarching themes were identified: general faculty process for reviewing comments (ie, how faculty perceive and analyze comments), comments utilization for course change (ie, how faculty utilize comments in making course changes), and faculty analysis strategy (ie, faculty approach to locating common patterns in evaluation comments). The most common subthemes included usefulness of comments, methods for tracking comment patterns, and challenges with the large number of comments each semester.

CONCLUSION

Faculty provided useful insight and feedback regarding the current state of the course evaluation process that can be used to improve the structure, organization, and utilization of course evaluations by faculty. These findings could inform the creation of the course evaluation comment automated analysis program in the next stage of an ongoing project.

Using cognitive load theory to evaluate and improve preparatory materials and study time for the flipped classroom

BACKGROUND

Preclinical medical education is content-dense and time-constrained. Flipped classroom approaches promote durable learning, but challenges with unsatisfactory student preparation and high workload remain. Cognitive load theory defines instructional design as "efficient" if learners can master the presented concepts without cognitive overload. We created a PReparatory Evaluation Process (PREP) to systematically assess and measure improvement in the cognitive-load efficiency of preparatory materials and impact on study time (time-efficiency).

METHODS

We conducted this study in a flipped, multidisciplinary course for ~ 170 first year students at Harvard Medical School using a naturalistic post-test design. For each flipped session (n = 97), we assessed cognitive load and preparatory study time by administering a 3-item PREP survey embedded within a short subject-matter quiz students completed before class. Over three years (2017-2019), we evaluated cognitive load- and time- based efficiency to guide iterative revisions of the materials by content experts. The ability of PREP to detect changes to the instructional design (sensitivity) was validated through a manual audit of the materials.

RESULTS

The average survey response rate was ≥ 94%. Content expertise was not required to interpret PREP data. Initially students did not necessarily allocate the most study time to the most difficult content. Over time, the iterative changes in instructional design increased the cognitive load- and time-based efficiency of preparatory materials with large effect sizes (p < .01). Furthermore, this increased the overall alignment of cognitive load with study time: students allocated more time to difficult content away from more familiar, less difficult content without increasing workload overall.

CONCLUSIONS

Cognitive load and time constraints are important parameters to consider when designing curricula. The PREP process is learner-centered, grounded in educational theory, and works independently of content knowledge. It can provide rich and actionable insights into instructional design of flipped classes not captured by traditional satisfaction-based evaluations.

The Impact of COVID-19 Pandemic on Flipped Classroom for EFL Courses: A Systematic Literature Review

The outbreak of the COVID-19 pandemic has had a significant impact on education. The closure of schools and the cessation of face-to-face classrooms have affected schools and students worldwide. The current need is to transform the traditional classroom to adapt to the new social and educational background. The flipped classroom is usually defined as a strategy to subvert the conventional academic environment; that is, the information transmission part of the traditional face-to-face lecture is removed from the classroom time for online self-learning. The flipped classroom is a highly flexible classroom mode, which has brought significant changes to education. Therefore, this study aims to examine the studies' research trends, advantages, and challenges concerning the flipped classroom for EFL courses during the COVID-19 epidemic. For this purpose, databases including the web of Science (WOS) and Scopus were reviewed, and 15 articles were analyzed. A systematic review was used as the research methodology. The study's findings revealed the effectiveness of flipped classrooms for EFL courses during the pandemic. Based on the review, this paper puts forward suggestions for future research and points out the future development direction.

The Effect of a Flipped Classroom Learning Model Versus Traditional Lecture Model on Resident's Knowledge Acquisition for Atraumatic Back Pain in the Emergency Department

Objective

The effectiveness of lecture-based (LB) formats for residency education has recently been challenged as the gold standard. Studies suggest a flipped classroom (FC) lecture improves resident satisfaction, but evidence that showing improved knowledge acquisition is lacking. To determine whether the flipped classroom model improves knowledge acquisition compared to traditional LB model.

Methods

Emergency medicine resident physicians at 2 academic programs were included in December 2019; at Sinai-Grace Hospital, a traditional lecture was the teaching method and at Detroit Receiving Hospital, FC was utilized. Residents completed prelecture and postlecture content tests. The primary outcome was change in test results (pretest to post-test). A noninferiority design comparing the changes between intervention and control groups was utilized (1-sided t-test, noninferiority margin of -0.5; 1-sided alpha = 0.05).

Results

Results were available for 31 residents (17 controls and 14 interventions) out of 83 enrolled. There were 14 postgraduate year 1 (PGY-1), 9 PGY-2, and 8 PGY-3 residents. The mean difference in score was +0.71 (SD 1.38) and +0.77 (SD 1.48) for the FC and LB groups, respectively. This resulted in a mean difference between groups of -0.05 (lower bound of the upper 95% confidence interval -0.93 and therefore crossing the noninferiority margin of -0.05; P = .20).

Conclusions

This study of resident education at 2 training programs was unable to demonstrate noninferiority of an FC format compared to standard lecture. Surprisingly, there was little improvement in test results after both teaching formats. Larger studies are needed to power results.

Global Evidence on Flipped Learning in Higher Education

The teaching dynamic has positioned flipped learning as a pedagogical model, a methodology that helps teachers prioritize active learning during class time by assigning students reading materials and presentations to view at home or outside of class. The objective was to determine the original stages, expansion and current situation of the flipped learning methodology. A bibliometric analysis of 654 documents was carried out. The results reveal that scientific productivity follows an increasing linear trend, with the main categories being Social Sciences and Computer Science. The lines of research developed in this period related to learning, online learning, teaching, distance education, higher education and educational innovation were identified. It was found that the research topic has a growing and dynamic interest in scientific activity at the international level. The analysis documented a rapidly growing knowledge base, primarily written by scholars located in developed societies. This study supposes an analysis of the scientific production and of the actors who stimulate the investigation, as well as the identification of the lines of investigation.

From Flipped Classroom to Personalised Learning as an Innovative Teaching Methodology in the Area of Sports Management in Physical Activity and Sport Sciences

Application of new methodologies at Spanish universities is essential to improve the teaching–learning process, although their implementation for the initial training of students is not common. The aim of this study was to use the flipped classroom (FC) methodology in the sports management area of the bachelor’s degree in Physical Activity and Sport Sciences (DPASS). Students (n = 370) from private (n = 284) and public (n = 86) universities participated in different activities, ending with the completion of a survey in which the impact of an FC was analysed in three dimensions: (1) interaction, (2) learning, and (3) methodology and resources. The results show significant differences concerning ownership (private universities are more highly rated than public universities). In terms of gender (with no significant differences), the female students had a better perception of the FC. The most highly valued aspects in the dimensions were as follows: (1) they are more likely to collaborate with their classmates (3.95 + 1.05); (2) learning is more active and experiential (3.69 + 0.86); and (3) with an FC, they spent more time than in other subjects. The most used device was laptop (68.4%). This pioneering study is of relevance to faculty members in the field of sports as it enhances students’ engagement with their learning development.

Effectiveness of a combined problem-based learning and flipped classroom teaching method in ophthalmic clinical skill training

BACKGROUND

Previous studies have primarily implemented problem-based learning (PBL) or flipped classroom (FC) teaching models in different majors; however, research on the combined PBL-FC teaching method in clinical medicine is scarce. Therefore, we investigated the combined PBL-FC teaching method in teaching ocular trauma on students' competencies.

METHOD

About 75 ophthalmology postgraduates were randomly divided into PBL-FC and traditional teaching groups. Students completed pre-and post-class theoretical examinations, skills evaluation, learning ability scales, and feedback questionnaires.

RESULTS

Both groups showed significantly higher theoretical scores and improved learning ability. Feedback questionnaire scores of the PBL-FC group's postgraduates without clinical experience were significantly higher than the traditional group's for some items; there was no difference between groups in postgraduates with clinical experience. PBL-FC group's pre-class preparation time was significantly longer than the traditional group's, but the post-class review time was significantly shorter. PBL-FC group's post-class theoretical performance was significantly higher than the traditional group's. There was no statistical difference between the groups regarding skill operation. Among postgraduates without clinical experience, the PBL-FC group's skill operation performance was significantly higher than the traditional group's; for postgraduates with clinical experience, the traditional group's skill operation performance was significantly higher than the PBL-FC group's.

CONCLUSIONS

PBL-FC teaching is better for students without clinical experience or knowledge of ophthalmic diseases. Meanwhile, traditional teaching is a good choice for students with clinical experience who need more relevant knowledge.

Using the Teaching Career Enhancement Award from the American Physiological Society to train faculty to successfully implement flipped teaching

Flipped teaching (FT) is a student-centered instructional method that shifts lectures out of the classroom and uses a variety of activities to apply content during class time. FT has gained attention among educators as a student-centered instructional method. However, many faculty still lack the skills, knowledge, confidence, and expertise to implement FT in their classrooms. Therefore, course-specific training and focused mentorship are critical in successfully implementing FT. Four faculty members, from an adjunct professor to a full professor, from four diverse institutions around the country, were recruited and funded through the American Physiological Society's Teaching Career Enhancement Award to receive training in the implementation of FT in their courses. This study aimed to provide specific tools and strategies to engage students in deeper learning through activities in the participants' courses. A course was built using the Blackboard Learning Management System for the participants to receive relevant readings to be completed prior to the FT workshop. Upon completing this training, the participants examined the design and execution of FT in their classrooms and, subsequently, reflected on and refined their future course offerings. The facilitator mentored the participants throughout the process, including an on-site observation of a live FT session. Both qualitative and quantitative data were collected before and after their FT experiences. Based on the survey results, this study helped improve the FT knowledge and self-efficacy of all participants. In conclusion, the faculty utilized the training and mentoring to implement FT in their classrooms successfully and disseminate their experiences and findings.

The Impact of Flipped Classroom: Evaluation of Cognitive Level and Attitude of Undergraduate Medical Students

BACKGROUND

Anatomy is a core component of the basic health sciences and a structural foundation for higher clinical courses. Mastering this foundational science is an essential competency for health care providers. Some medical schools still adopt the traditional teacher-centered methods for teaching anatomy with the disadvantages of lacking the students' opportunity to practice higher levels of thinking such as application, interpretation, or analysis during class. One of the promising teaching strategies that enhance student engagement is the flipped classroom (FC). The present study explored the students' achievement during the anatomy FC, compared with traditional classroom for the first time in Qassim College of Medicine.

METHODS

Online educational materials were uploaded on the Blackboard in the form of electronic textbooks, PowerPoint presentations, online websites, journal articles and multimedia in the pre-class phase of the FC. The in-class phase included open discussion and problem-solving activities were based upon the digitalized resources. Students' attendance was recorded during the in-class sessions. Comparison between the students' scores of the pre-and post-tests for both the FC and traditional classroom. A computed students' survey towards the FC was analysed.

RESULTS

The mean students' scores of the lower and higher-order thinking questions of the FC in the pre-tests were significantly increased in the pre-tests (4.40±1.18 and 1.39±0.53 respectively), compared with that of the traditional classroom (1.44±1.09 and 0.41±0.51 respectively) as well as in the post-tests (5.73±1.03 and 2.14±0.71), compared with that of the traditional classroom (5.07±1.2 and 1.66±0.93 respectively). The absence rate of the students during the FC was lower by 16.13%. Students' survey conveyed their satisfaction towards the FC. Cronbach's alpha test revealed high reliability of all students' survey items and their correlation coefficient was positive.

CONCLUSION

The current work concluded that the educational outcome gained from the technology-enhanced active learning (TEAL), through the implementation of the anatomy FC, enhanced the students' achievement and commitment and suggested the upgrading of the anatomy teaching methods and exploring the long-term effects of the FC.

Effectiveness and Dissemination of the Interprofessional Pediatric Pain PRN Curriculum

INTRODUCTION

Cultural transformation is needed for health care to be sensitive to children's pain. The Pediatric Pain Practice Registered Nurses (PRN) Curriculum is the first free, open access, downloadable, interprofessional pain continuing education (IPPCE) curriculum developed to empower health care professionals to translate evidence-based pain care into clinical practice. To evaluate the curriculum and its experiential flipped-learning strategies, we used a mixed methods approach.

METHODS

Interprofessional pediatric teams from eight health care systems evaluated the curriculum after attending Pediatric Pain PRN Courses in the Fall of 2017 (N = 90). Qualitative methods were used to evaluate the acceptability, feasibility, and utility of the curriculum and IPPCE strategies. Pain knowledge and attitudes were measured pre-IPPCE/post-IPPCE with the Pediatric Healthcare Provider's Knowledge & Attitude Survey Regarding Pain (PHPKAS). Web analytics were used to describe dissemination for the first year after the curriculum's webpage launch.

RESULTS

Learners rated their achievement of course objectives as moderate-great. PHPKAS scores significantly increased (P < .0005); but significant differences in physician and nurse PHPKAS question responses pre-IPPCE/post-IPPCE were found. Within 2 years of the IPPCE, three health care systems were certified as Childkind Hospitals, five Pediatric Pain PRN Programs were established, and various practice changes and improved patient outcomes, such as decreased hospital lengths of stay and emergency department returns for pain, were realized. Curriculum dissemination was global.

DISCUSSION

Results support the acceptability, effectiveness, feasibility, utility, and global dissemination of the curriculum and IPPCE strategies. More rigorous patient outcome data are needed; however, this study demonstrated the benefit of a free, open-access, downloadable, interprofessional health care provider continuing education curriculum.

Multilevel factor analysis of flipped classroom in dental education: A 3-year randomized controlled trial

Purpose

Previous studies have rarely attempted to test the confounding factors that may affect learning outcomes of the flipped classroom. The purpose of this study was to assess how flipped classrooms affect the acquisition of knowledge in clinical dental education based on multilevel factor analysis.

Method

The authors conducted a 3-year (2017, 2018, and 2019) randomized controlled trial in a series of introductory prosthodontics courses in dental education. A total of 137 participants were randomly assigned to flipped classroom (n = 70, 51%) or lecture (n = 67, 49%) formats. The flipped group was instructed to self-learn knowledge-based content through online preparation materials, including videos and text, while the lecture group was given text only. Both groups were provided with the same study content and opportunities for different styles of learning. The session attendance rate and number of times the materials were accessed were monitored. Individual and team readiness assurance tests (IRAT/TRAT) were conducted to evaluate knowledge acquisition. A multilevel linear regression analysis was conducted on both instructional styles (flipped vs. lecture) as an intervention factor, and confounding factors that could affect the outcomes were implemented.

Results

The average number of online accesses was 2.5 times per session in the flipped group and 1.2 in the lecture group, with a significant difference (p < .05). The average IRAT score was significantly higher in the flipped than in the lecture group (effect size [ES] 0.58, p < .001). The number of online accesses was significantly and positively correlated with IRAT scores (0.6 [0.4, 0.8]). The instructional style was significantly and positively correlated with TRAT scores (coefficient [95% confidence interval]: 4.6 [2.0, 7.3]), but it was not correlated with IRAT (4.3 [-0.45, 9.0]).

Conclusions

The flipped classroom was more effective than the lecture format regarding knowledge acquisition; however, the decisive factor was not the instructional style but the number of individual learning occasions. The employment of the flipped classroom was the decisive factor for team-based learning outcomes.

Three Weeks of Team-Based Leaning Do Not Overload Undergraduate Students

CONTEXT

Team-based learning (TBL) is a flipped-classroom approach requiring students to study before class. Fully flipped curricula usually have fewer in-class hours. However, for practical reasons, several programs implement a few weeks of TBL without adjusting the semester timetable. Students fear that they will be overloaded by the individual and collaborative study hours needed to prepare for TBL.

METHODS

We implemented three consecutive weeks of TBL in a 15-week lecture-based course on the renal system. In-class time and assessments were unchanged for all courses. Four hundred fifty-nine first-year undergraduate medical students (229 in 2018; 230 in 2019) were invited to complete weekly logs of their individual and collaborative study hours during lectures and TBL, along with questionnaires on cognitive load and perception of the course. Our program changed from A to E grading in 2018 to pass-fail grading in 2019.

RESULTS

Participants (n = 324) spent a similar number of hours studying for TBL vs. lectures with a mean of 3.1 h/week. Collaborative study was minimal outside class (median 0.1 h/week). Results remained similar with pass-fail grading. If in-class time were reduced, 18% of participants said they would have used freed-up time to study for TBL. Studying for TBL generated similar extraneous cognitive load and lower intrinsic load compared to studying for lectures; students were less stressed, and maintained high levels of motivation and self-perceived learning.

CONCLUSIONS

Three weeks of lectures were replaced by TBL without reducing in-class time. Students did not report overload in study hours or in cognitive load.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-021-01314-x.

Flipped classroom versus traditional teaching methods within musculoskeletal physical therapy: a case report

Background and Purpose: The flipped classroom method is a popular way to use technology to assist with the delivery of educational experiences. Yet there is insufficient information regarding student opinions or outcomes about the flipped classroom method within physical therapy. The purpose of this case report was to describe student opinions and outcomes of the flipped classroom teaching and traditional lecture/lab methods of teaching within musculoskeletal physical therapy.Case Description: Thirty-six (36) first-year physical therapy students enrolled at a regional physical therapy program completed an anonymous internet-based survey regarding their impressions of traditional and flipped classroom teaching methods. Flipped classroom and traditional teaching methods were both used within the same musculoskeletal course. The survey was created to aid in planning subsequent courses and asked questions about student's preferred teaching method (flipped, traditional, or both equal) across a variety of categories. Student exams scores, using the same question bank, were compared to the year prior as a quantitative outcome measure.Outcomes: Twenty-nine (29) students (81%) completed the survey. Generally, students preferred the flipped classroom. Compared to the previous year, test scores for all content areas were similar (± 4%) except cervical spine which was improved (>10%). When asked outright, 28/29 students preferred the flipped teaching method.Discussion and Conclusion: Student opinions indicate the flipped classroom is preferable to traditional methods yet objective outcomes appear similar. Physical therapy educators seeking ways to improve the student experience using technology in the classroom may consider utilizing the flipped classroom method.

Video learning strategies affecting achievement, learning approach, and lifelong learning in a flipped periodontology course

OBJECTIVE

To explore how video learning strategies influence students' Flipped learning (FL) achievement, deep approach to learning (DAL) and lifelong learning (LL) orientations and how DAL and LL can be promoted.

METHODS

Data were collected from 65 dental students enrolled in a 21-week clinical periodontology course. Partial least squares structural equation modeling was conducted to investigate factors and pathways affecting FL achievement, DAL, and LL.

RESULTS

FL achievement was predicted by repeated and in-advance video learning strategies. In-advance, meticulous, and expanded video learning strategies directly influenced DAL, and indirectly influenced LL via DAL. LL was not affected by any of the video learning strategies but by the DAL.

CONCLUSION

This study implies that mere implementation of FL may not guarantee more developed DAL and enhanced LL. Redesigning a course with FL should entail revisiting and revising student assessment. LL is an inclusive approach that requires the long-term cultivation of meaning, experience, insight, learning, and practice.

How Can Flipped Classroom Approach Support the Development of University Students’ Working Life Skills?—University Teachers’ Viewpoint

Higher education students need both generic skills and field-specific knowledge in order to cope with the diverse demands of working life. The aim of this study was to gain a better understanding of the development of university students’ working life skills and of how these skills can be developed in learning environments utilizing the flipped classroom approach. The focus was on the experiences and thoughts of higher education teachers concerning which learning environment features support the development of working life skills. Altogether, 22 higher education teachers from a Finnish university were interviewed with semistructured interviews, and the data was subjected to content analysis. The results indicated that teachers identified several generic and field-specific working life skills, the most important of which were collaboration, communication, information literacy, and skills related to career and responsibilities. The flipped classroom appeared to support students’ active role and facilitate versatile ways of learning. Especially, cooperative and active learning were identified to be the key means to support the development of students’ working life skills in flipped classroom environments. Facilitating students’ opportunities to develop their working life skills can be seen as an integral part of flipped classroom environments in many ways. However, it is important that the opportunities are actively promoted, and conceptual and practical tools are provided for the student through university studies.

A Review of Flipped Classroom and Cooperative Learning Method Within the Context of Vygotsky Theory

In the flipped classroom method, which is accepted as one of the blended learning approaches, the traditional teaching process takes place outside of the classroom through videos. Activities, projects, and homework related to upper-level cognitive field steps are carried out during classroom time. Research and interest in the flipped classroom are increasing steadily. Employing a cooperative learning method is suggested for using class time in the flipped classroom method. However, there has not been sufficient research on the implemented results of those suggestions. Moreover, there is no clear roadmap on how to incorporate cooperative learning methods into the flipped classroom. This research reviews theoretical infrastructures of flipped classroom and cooperative learning methods according to the Vygotsky theory and makes various suggestions for implementation and implementers.

The role of online learning in pharmacy education: A nationwide survey of student pharmacists

INTRODUCTION

Student pharmacists have significant exposure to online learning methods in their pre-pharmacy educational experiences. With decreasing resources and faculty shortages in pharmacy education, online delivery of course content is an efficient way to deliver pharmacy curricula while optimizing classroom time for active learning strategies. The purpose of this study was to assess student preferences associated with the utility of online learning methods such as online platforms, social media, and handheld devices.

METHODS

An anonymous, voluntary 43-question online survey was delivered to students at colleges and schools of pharmacy in the United States (US). Frequency statistics were used to establish prevalence of student preferences.

RESULTS

Overall, 1873 students from 29 schools of pharmacy completed the survey. Of these students, 30% preferred a blended course structure (with online and classroom components) throughout the curriculum, as compared to 47% of students who preferred live lectures exclusively. Approximately 57% of students found smart phones very or extremely valuable for their academic success. Approximately 61% of students reported using their smart phones and 37% reported using their tablets "always" or "often" during the past year for academic activities; however, only 31% of students found paper textbooks very or extremely valuable for their academic success, with approximately 26% using them "always" or "often."

CONCLUSIONS

US pharmacy students prefer a blend of traditional classroom and online learning methods. When updating and revising pharmacy curricula, colleges and schools of pharmacy should consider the inclusion of technology and online learning methodologies.

Effectiveness of flipped classroom combined with team-, case-, lecture- and evidence-based learning on ophthalmology teaching for eight-year program students

BACKGROUND

This study aimed to investigate the benefits and challenges of the flipped classroom combined with team-, case-, lecture- and evidence-based learning (FC-TCLEBL) for ophthalmology teaching for eight-year program students.

METHODS

FC-TCLEBL and the traditional lecture-based classroom (LBC) were compared based on student and teacher feedback questionnaires, student learning burden, and scores on standardized tests as well as their effects on the abilities of clinical thinking, scientific research, active-learning, practical application, humanistic care and communication with patients.

RESULTS

Both the students and teachers were more satisfied with the FC-TCLEBL model. More students in the FC-TCLEBL group agreed that the course helped them to develop skills in creative thinking, problem solving, and teamwork. Students in the FC-TCLEBL group spent significantly more time preparing for class than those in the LBC group, but the time spent on review was significantly lower in the FC-TCLEBL group. The students from the FC-TCLEBL group performed better in a post-test on diabetic retinopathy (DR) as compared to the LBC group.

CONCLUSIONS

FC-TCLEBL teaching model is effective and suitable for ophthalmology teaching.

Teaching "Shock Pathophysiology" by Flipped Classroom

Objective

To assess usefulness of flipped style of teaching conducted as small-group format in Cardiovascular and Respiration module for Year-I undergraduate medical students at Aga Khan University.

Methods

The study was planned and conducted over a period of eight months from March to October 2017 including the time taken for planning, mock run, execution followed by analysis and dissemination. It was carried out at the Aga Khan University Medical College, Karachi. Pre and post test scores of students after flipped class room sessions was compared. Moreover, perception of students was assessed on Likert scale (0-4) by a pretested validated questionnaire.

Results

The mean pre-test scores of the students was 4.86 ± 0.91 which improved to 6.09 ± 0.81 (p = 0.021) after attending the flipped class session. Students approved that the frame work helped to promote their learning motivation and engagement with improvement in understanding of the course materials and enhancement of learning during Face to Face activity.

Conclusions

The flipped classroom approach showed promise in teaching and learning of 'Pathophysiology of Shock' by clinical scenarios in small group discussions. Implementation of flipped class room activity on a wider scale however needs careful selection of course objectives and logistics.

Medical Students' Knowledge About Children With Disabilities, Special Education Laws, and Social Services: A Preliminary Scale Development and Pilot Study

Context

In order to design undergraduate medical education responsive to the American Academy of Pediatrics' recommendation that physicians learn about special education law and practices, it is important to understand medical students' baseline knowledge about children with disabilities, special education law, available services, and the sources of this information.

Objectives

To develop an instrument to measure what second-year medical students know about children with disabilities, special education law, and available services; to determine the most common sources of this information; and to establish a baseline on which to design curricula that address this topic.

Methods

This study adopted a survey design. The survey took place in 1 school of osteopathic medicine in a Northeastern state of the United States. One hundred fifty medical students in their second year of full-time enrollment were invited to complete the survey. The instrument designed by the authors consisted of 30 items organized into a demographics section and 3 domains: (1) perceived level of knowledge about children with disabilities, (2) sources of information about children with disabilities, and (3) actual knowledge about children with disabilities and special education.

Results

Ninety-eight students (65%) participated. Although students were accurate in self-assessment, their source of knowledge was limited. Medical students who identified personal experiences (t=1.64) and coursework as their source of knowledge had more correct responses (t=2.62).

Conclusion

This preliminary study demonstrated a lack of knowledge among second-year medical students with regard to children with disabilities, special education laws, and social services. Curricula emphasizing disabilities and special education along with longitudinal experiential training may be effective methods to deliver these topics.

Learning Outcomes and Student Preferences with Flipped vs Lecture/Case Teaching Model in a Block Curriculum

Objective. To assess the impact of using a flipped classroom instructional approach on Doctor of Pharmacy (PharmD) students' learning outcomes and instructional preferences in a pharmacotherapy course within a block curriculum. Methods. Select topics in a gastrointestinal and liver pharmacotherapy course were taught using a flipped classroom method that required students to view lecture modules and respond to self-assessment questions prior to class. Classroom time included quizzes, application exercises, and discussion. The following year, teaching of these topics was switched back to a lecture/case format, and different topics were taught in the flipped classroom format, Student performance under each teaching method was examined, and student preferences and study habits were collected via a survey administered before and after experiencing the flipped classroom. Results. Combined mean formal assessment scores were higher for all four topics taught using the flipped classroom format compared to the lecture/case format. This pattern persisted when topics were examined individually, except for scores on one review topic. Survey responses reflected acknowledgement by about half of the students that the flipped format was more beneficial than traditional methods, but they still clearly preferred live lectures over prerecorded lectures. The majority of students reported that the amount of preparation time required for the flipped classroom was appropriate and that they had a positive or neutral experience with the flipped classroom overall. Conclusion. This study supports use of the flipped classroom method for teaching standard pharmacotherapy topics within a block curriculum, but underscores some of the resistance expressed by students despite understanding the potential benefits of the flipped format.

The Flipped Classroom: A Critical Appraisal

Introduction

The objective of this study was to review and critically appraise the medical education literature pertaining to a flipped-classroom (FC) education model, and to highlight influential papers that inform our current understanding of the role of the FC in medical education.

Methods

A search of the English-language literature querying Education Resources Information Center (ERIC), PsychINFO, PubMed, and Scopus identified 296 papers related to the FC using either quantitative, qualitative, or review methods. Two reviewers independently screened each category of publications using previously established exclusion criteria. Eight reviewers then independently scored the remaining 54 publications using either a qualitative, quantitative, or review-paper scoring system. Each scoring system consisted of nine criteria and used parallel metrics that have been previously used in critical appraisals of education research.

Results

A total of 54 papers (33 quantitative, four qualitative, and 17 review) on FC met a priori criteria for inclusion and were critically appraised and reviewed. The top 10 highest scoring articles (five quantitative studies, two qualitative studies, and three review papers) are summarized in this article.

Conclusion

This installment of the Council of Emergency Medicine Residency Directors (CORD) Academy Critical Appraisal series highlights 10 papers that describe the current state of literature on the flipped classroom, including an analysis of the benefits and drawbacks of an FC approach, practical implications for emergency medicine educators, and next steps for future research.

Developing Cognitive Skills Through Active Learning: A Systematic Review of Health Care Professions

Objective

To systematically review current literature to determine whether active learning is more successful than passive learning at producing cognitive skills in health care professions students.

Data Sources

An electronic search was conducted in 4 databases: EBSCO-CINAHL, EBSCO-Sport Discus, Educational Resources Information Center, and PubMed. Search terms included: millennial AND health education, active learning AND knowledge retention, flipped classroom AND learning outcomes, problem based learning AND learning outcomes, problem based learning AND student confidence, active learning AND critical thinking, higher order thinking AND active learning.

Study Selection

We included studies if they were published in English between 2007 and 2017 and evaluated outcomes of an active learning intervention. Studies of nonhealth care disciplines, practicing health care practitioners, or studies that did not address the primary research questions were excluded.

Data Extraction

Study design, health care discipline, intervention used, assessment measures, outcome(s) measures, main results, and conclusions were extracted from each article, as appropriate.

Data Synthesis

Articles were categorized based on capacity to answer 1 or both of the research questions. Conclusions were summarized according to the learning technique used and its effectiveness in regard to studied learning outcome. Out of 85 studies on lower-order cognition, 61 (72%) indicated active learning techniques were effective at achieving improved recall, understanding, and/or application of course material. Of 69 studies on higher-order cognition, 58 (84%) supported active learning over passive instruction for improving students' confidence in or performance of analytical, evaluative, and creative skills.

Conclusions

Active learning produces gains to both lower- and higher-order cognition at levels equal to, and more often, greater than the use of passive learning methods. Despite this evidence, we believe more high-quality, well-designed prospective studies using validated assessment measures are needed to endorse the value of these methods in producing cognitive skills.

Pre-Class Learning Methods for Flipped Classrooms

Objective. To review the types of pre-class learning modalities used in flipped classrooms (FC) and team-based learning (TBL) and determine best practices. Findings. Forty-eight articles were included. Reading materials or video lectures were used most often as the primary modality to deliver the pre-class learning. Students favored assignments that have clear objectives, provide guidance, are guided, and are brief. Summary. This study describes how pharmacy schools and colleges are implementing FC into their curricula and the types of pre-class learning that are being developed and assigned with the implementation. More research should be done in comparing the impact of different types of pre-class material on learning outcomes, such as knowledge retention. This is especially important in FC settings because the in-class learning and higher order activities are built upon having a good foundational knowledge, which comes from the pre-class learning.

Effect of a Flipped Classroom on Knowledge Acquisition and Retention in an Internal Medicine Residency Program

BACKGROUND

The flipped classroom is a teaching approach with strong evidence for effectiveness in undergraduate medical education. Objective data for its implementation in graduate medical education are limited.

OBJECTIVE

We assessed the efficacy of the flipped classroom compared with standard approaches on knowledge acquisition and retention in residency education.

METHODS

During academic year 2016-2017, 63 medical interns in a large academic internal medical residency program on their ambulatory block were randomized to a flipped classroom or standard classroom during a 6-hour cardiovascular prevention curriculum. The primary outcome was performance on a 51-question knowledge test at preintervention, immediate postintervention, and 3- to 6-month postintervention (delayed postintervention). Secondary outcomes included satisfaction with the instructional method and preparation time for the flipped classroom versus standard approach. We also examined feasibility and barriers to the flipped classroom experience.

RESULTS

All 63 interns (100%) responded during the preintervention period, 59 of 63 (94%) responded during the postintervention period, and 36 of 63 (57%) responded during the delayed postintervention. The flipped classroom approach significantly improved knowledge acquisition immediately after the curriculum compared with the standard approach (knowledge test scores 77% versus 65%, P < .0001). This effect was sustained several months later (70% versus 62%, P = .0007). Participants were equally satisfied with the flipped classroom and standard classroom.

CONCLUSIONS

A flipped classroom showed greater effectiveness in knowledge gain compared with a standard approach in an ambulatory residency environment.

Enhancement of student perceptions of learner-centeredness and community of inquiry in flipped classrooms

BACKGROUND

Flipped classrooms (FC) are expected to create a more student-centered, active learning environment than traditional lectures. This study assessed the effectiveness of FC in promoting a student-centered, active learning environment by examining the changes in student perceptions of the learning environment of FC in terms of student-centeredness and sense of community of inquiry (COI), which represents the elements of a successful learning environment.

METHODS

Questionnaires were given to a cohort of Year 2 students in a six-year undergraduate medical education program, who had taken an introduction to medicine course in a FC format. The questionnaire included 7 items on the teaching orientation (i.e., teacher-centered vs. student-centered) and 34 items from the Community of Inquiry Survey Instrument, which consisted of three sub-scales - teaching, social, and cognitive presences. The questionnaires were administered in pre- and post-test format during the first and last week of the semester.

RESULTS

A total of 55 students returned the questionnaires (100% response rate). The student perceptions of student-centeredness of FC increased significantly over time (p < 0.001), and their perceptions of COI in FC also increased significantly in all three presences (p < 0.001). The student perceptions of student-centeredness and sense of COI in FC increased significantly in both high-achieving and low-achieving students (p < 0.01).

CONCLUSIONS

This study indicates that the flipped classroom model is an effective approach to fostering a learner-centered learning environment and developing a community of inquiry among medical students.

Flipping the Dental Anatomy Classroom

The development of cognitive knowledge, motor skills, and artistic sense in order to restore lost tooth structure is fundamental for dental professionals. The course of dental anatomy is taught in the initial years of dental school, and is a component of the basic core sciences program in the faculties of dentistry. The learning objectives of the dental anatomy course include identifying anatomical and morphological characteristics of human primary and permanent teeth; identifying and reproducing tooth surface details in order to recognize and diagnose anatomical changes; and developing student’s psychomotor skills for restoring teeth with proper form and function. The majority of dental schools rely on traditional methods to teach dental anatomy, using lectures to convey the theoretical component; whereas the practical component uses two-dimensional drawing of teeth, identification of anatomical features in samples of preserved teeth, and carving of teeth. The aim of the present literature review is to summarize different educational strategies proposed or implemented to challenge the traditional approaches of teaching dental anatomy, specifically the flipped classroom educational model. The goal is to promote this approach as a promising strategy to teaching dental anatomy, in order to foster active learning, critical thinking, and engagement among dental students.

Does a blended learning environment suit advanced practice training for pharmacists in a Middle East setting?

OBJECTIVES

The transfer of pedagogies and instructional techniques outside their contexts of origin may not be always be suitable for intended learners. The aim of this study was to explore the experiences of Middle East pharmacists enrolled in advanced pharmacy practice courses delivered through a blended learning environment (BLE).

METHODS

Seventeen students and graduates from a BLE in Qatar participated in focus group interviews. A topic guide was developed to elicit these pharmacists' perspectives on perceived barriers to completing the courses and facilitating factors for content engagement and overall satisfaction. Discussions were recorded, transcribed verbatim and text analysed using thematic content analysis.

KEY FINDINGS

We identified three predominant themes in our analysis of these discussions: (1) relevance, (2) motivation and (3) communication. Participants favourably endorsed any programme aspect that linked with their workplace care responsibilities, but found it challenging to adapt to high-fidelity testing environments. The on-campus sessions were key for sustaining motivation and recommitting to time management and organisation with the distance-based content. Although these students expressed difficulty in understanding posted assignment instructions and feedback and occasionally faced technological issues, they were overwhelmingly satisfied with how the programme contributed to advancing their practice capabilities.

CONCLUSIONS

Pharmacists enrolled in BLE advanced pharmacy practice courses in Qatar identified barriers and facilitators like those experienced by professional learners elsewhere. However, we found that instructional design and communication approaches merit some special consideration for Arab students for optimal engagement in BLE.

Using reusable learning objects (RLOs) in wound care education: Undergraduate student nurse's evaluation of their learning gain

BACKGROUND

Both nationally and internationally concerns have been expressed over the adequacy of preparation of undergraduate nurses for the clinical skill of wound care. This project describes the educational evaluation of a series of Reusable Learning Objects (RLOs) as a blended learning approach to facilitate undergraduate nursing students learning of wound care for competence development. Constructivism Learning Theory and Cognitive Theory of Multimedia Learning informed the design of the RLOs, promoting active learner approaches. Clinically based case studies and visual data from two large university teaching hospitals provided the authentic learning materials required. Interactive exercises and formative feedback were incorporated into the educational resource.

METHODS

Evaluation of student perceived learning gains in terms of knowledge, ability and attitudes were measured using a quantitative pre and posttest Wound Care Competency Outcomes Questionnaire. The RLO CETL Questionnaire was used to identify perceived learning enablers. Statistical and deductive thematic analyses inform the findings.

RESULTS

Students (n=192) reported that their ability to meet the competency outcomes for wound care had increased significantly after engaging with the RLOs. Students rated the RLOs highly across all categories of perceived usefulness, impact, access and integration.

CONCLUSION

These findings provide evidence that the use of RLOs for both knowledge-based and performance-based learning is effective. RLOs when designed using clinically real case scenarios reflect the true complexities of wound care and offer innovative interventions in nursing curricula.

Replacing Lectures with Small Groups: The Impact of Flipping the Residency Conference Day

The flipped classroom, an educational alternative to the traditional lecture, has been widely adopted by educators at all levels of education and across many disciplines. In the flipped classroom, learners prepare in advance of the face-to-face meeting by learning content material on their own. Classroom time is reserved for application of the learned content to solving problems or discussing cases. Over the past year, we replaced most residency program lectures with small-group discussions using the flipped-classroom model, case-based learning, simulation and procedure labs. In the new model, residents prepared for conference by reviewing a patient case and studying suggested learning materials. Conference day was set aside for facilitated small-group discussions about the case. This is a cross-cohort study of emergency medicine residents who experienced the lecture-based curriculum to residents in the new flipped-classroom curriculum using paired comparisons (independent t-tests) on in-training exam scores while controlling for program year level. We also compared results of the evaluation of various program components. We observed no differences between cohorts on in-training examination scores. Small-group methods were rated the same across program years. Two program components in the new curriculum, an updated format of both adult and pediatric case conferences, were rated significantly higher on program quality. In preparation for didactics, residents in the new curriculum report spending more time on average with outside learning materials, including almost twice as much time reviewing textbooks. Residents found the new format of the case conferences to be of higher quality because of the inclusion of rapid-fire case discussions with targeted learning points.

Improved Learning Outcomes After Flipping a Therapeutics Module: Results of a Controlled Trial

PURPOSE

To evaluate the impact on learning outcomes of flipping a pain management module in a doctor of pharmacy curriculum.

METHOD

In a required first-professional-year pharmacology and therapeutics course at the University of Maryland School of Pharmacy, the pain therapeutics content of the pain management module was flipped. This redesign transformed the module from a largely lecture-based, instructor-centered model to a learner-centered model that included a variety of preclass activities and in-class active learning exercises. In spring 2015, the module was taught using the traditional model; in spring 2016, it was taught using the flipped model. The same end-of-module objective structured clinical exam (OSCE) and multiple-choice exam were administered in 2015 to the traditional cohort (TC; n = 156) and in 2016 to the flipped cohort (FC; n = 162). Cohort performance was compared.

RESULTS

Learning outcomes improved significantly in the FC: The mean OSCE score improved by 12.33/100 points (P < .0001; 95% CI 10.28-14.38; effect size 1.33), and performance on the multiple-choice exam's therapeutics content improved by 5.07 percentage points (P < .0001; 95% CI 2.56-7.59; effect size 0.45). Student performance on exam items assessing higher cognitive levels significantly improved under the flipped model. Grade distribution on both exams shifted, with significantly more FC students earning an A or B and significantly fewer earning a D or F compared with TC students.

CONCLUSIONS

Student performance on knowledge- and skill-based assessments improved significantly after flipping the therapeutics content of a pain management module.

Curated Collection for Educators: Five Key Papers about the Flipped Classroom Methodology

The flipped classroom (FC) pedagogy is becoming increasingly popular in medical education due to its appeal to the millennial learner and potential benefits in knowledge acquisition. Despite its popularity and effectiveness, the FC educational method is not without challenges. In this article, we identify and summarize several key papers relevant to medical educators interested in exploring the FC teaching methodology.

The authors identified an extensive list of papers relevant to FC pedagogy via online discussions within the Academic Life in Emergency Medicine (ALiEM) Faculty Incubator. This list was augmented by an open call on Twitter (utilizing the #meded, #FOAMed, and #flippedclassroom hashtags) yielding a list of 33 papers. We then conducted a three-round modified Delphi process within the authorship group, which included both junior and senior clinician educators, to identify the most impactful papers for educators interested in FC pedagogy.

The three-round modified Delphi process ranked all of the selected papers and selected the five most highly-rated papers for inclusion. The authorship group reviewed and summarized these papers with specific consideration given to their value to junior faculty educators and faculty developers interested in the flipped classroom approach.

The list of papers featured in this article serves as a key reading list for junior clinician educators and faculty developers interested in the flipped classroom technique. The associated commentaries contextualize the importance of these papers for medical educators aiming to optimize their understanding and implementation of the flipped classroom methodology in their teaching and through faculty development.

Implementation of a “Flipped Classroom” for Neurosurgery Resident Education

Introduction: Engaging residents across a multiyear training spectrum is challenging given the heterogeneity of experience and limited time available for educational activities. A “flipped classroom” model, in which residents prepare ahead of time for mentored topic discussions, has potential advantages. Methods: We implemented a curriculum consisting of topics distributed across the specialty. Weekly, each resident was randomly assigned to research a specific aspect of an assigned topic appropriate to his or her level of experience: junior residents about what characterizes each clinical entity, midlevel residents about when to intervene, and chief residents about how to administer treatment. Residents completed an anonymous survey 6 months after implementation. Board examination performance was assessed before and after implementation. Results: A total of 12 residents participated in the program. Weekly, 1.75±0.40 hours were spent in preparation, with senior residents reporting less time than junior residents. All residents indicated that the accumulation of experience across 7 years of residency was a major advantage of this program, and all preferred it to lectures. Performance on the board examination significantly increased after implementation (from 316±36 to 468±45, p<0.05). Conclusions: The flipped classroom is a viable approach to resident education and is associated with increased engagement and improved performance using validated knowledge-assessment tools.

Design, Implementation, and Outcomes of a Three-week Pharmacy Bridging Course

Objective. To evaluate the design, implementation, and outcomes of a three-week pharmacy bridging course (PBC) covering five math and science areas for first-year doctor of pharmacy students in fall 2015. Methods. Each topic was taught as a separate module. All five modules used pre- and post-module assessments to measure student knowledge and confidence. Course grades for subsequent first-year courses (PY1) were collected to examine relationships between PBC and PY1 courses. Results. Scores on the post-knowledge assessments increased for all five subject areas compared to scores on pre-PBC knowledge assessments. Student confidence also increased pre-/post- in applied mathematics, biostatistics, and organic chemistry. Students agreed that PBC enhanced their level of academic preparation and increased their motivation to continue in the program. PBC performance was strongly correlated with first-year grade point average. Conclusion. A bridging course is both feasible and effective for helping students prepare for and transition into a doctor of pharmacy degree program.

The Flipped Classroom - From Theory to Practice in Health Professional Education

The flipped classroom is growing in popularity in health professional education. As such, instructors are experiencing various growing pains in functionalizing this model, from justifying the approach to managing time inside and outside of class to assessing impact on learning. This review focuses on some key theories that support the flipped model and translates those key theories into practice across core aspects of the flipped classroom: pre-class preparation, in-class activities, after-class activities and assessment of student learning.

Influence of Reading Material Characteristics on Study Time for Pre-Class Quizzes in a Flipped Classroom

Objective. To examine how instructor-developed reading material relates to pre-class time spent preparing for the readiness assurance process (RAP) in a team-based learning (TBL) course. Methods. Students within pharmacokinetics and physiology were asked to self-report the amount of time spent studying for the RAP. Correlation analysis and multilevel linear regression techniques were used to identify factors within the pre-class reading material that contribute to self-reported study time. Results. On average students spent 3.2 hours preparing for a section of material in the TBL format. The ratio of predicted reading time, based on reading speed and word count, and self-reported study time was greater than 1:3. Self-reported study time was positively correlated with word count, number of tables and figures, and overall page length. For predictors of self-reported study time, topic difficulty and number of figures were negative predictors whereas word count and number of self-assessments were positive predictors. Conclusion. Factors related to reading material are moderate predictors of self-reported student study time for an accountability assessment. A more significant finding is student self-reported study time is much greater than the time predicted by simple word count.

The "flipped classroom" approach: Stimulating positive learning attitudes and improving mastery of histology among medical students

Traditional medical education methodologies have been dramatically impacted by the introduction of new teaching approaches over the past few decades. In particular, the "flipped classroom" format has drawn a great deal of attention. However, evidence regarding the effectiveness of the flipped model remains limited due to a lack of outcome-based studies. In the present study, a pilot histology curriculum of the organ systems was implemented among 24 Traditional Chinese Medicine (TCM) students in a flipped classroom format at Jinan University. As a control, another 87 TCM students followed a conventional histology curriculum. The academic performance of the two groups was compared. In addition, a questionnaire was administered to the flipped classroom group. The test scores for the flipped classroom participants were found to be significantly higher compared to non-participants in the control group. These results suggest that students may benefit from using the flipped classroom format. Follow-up questionnaires also revealed that most of the flipped classroom participants undertook relatively more earnest preparations before class and were actively involved in classroom learning activities. The teachers were also found to have more class time for leading discussions and delivering quizzes rather than repeating rote didactics. Consequently, the increased teaching and learning activities contributed to a better performance among the flipped classroom group. This pilot study suggests that a flipped classroom approach can be used to improve histology education among medical students. However, future studies employing randomization, larger numbers of students, and more precise tracking methods are needed before definitive conclusions can be drawn. Anat Sci Educ 10: 317-327. © 2016 American Association of Anatomists.

The Case-Based Collaborative Learning Peer Observation Worksheet and Compendium: An Evaluation Tool for Flipped Classroom Facilitators

INTRODUCTION

In a flipped classroom, students learn basic concepts before class, allowing them time during class to apply newly gained knowledge to problem sets and cases. Harvard Medical School (HMS) has introduced a form of flipped classroom, called case-based collaborative learning (CBCL), during preclinical curricula. Finding few published resources, the HMS Academy's Peer Observation of Teaching Interest Group developed a guide for observations and feedback to CBCL facilitators.

METHODS

After conducting an extensive literature search, speaking to flipped classroom methodology experts, and observing 14 facilitators using CBCL methods, the interest group identified specific teaching behaviors that optimize student interaction and knowledge application. The group next engaged in several rounds of the modified Delphi method to develop the CBCL peer observation worksheet and compendium and then tested these materials' effectiveness in capturing CBCL teaching behaviors and providing feedback to CBCL faculty facilitators.

RESULTS

Seventy-three percent of faculty rated the worksheet and compendium as extremely helpful or helpful in identifying new teaching techniques. Moreover, 90% found the CBCL peer observation and debriefing to be extremely helpful or helpful, and 90% were extremely likely or likely to incorporate peer suggestions in future teaching sessions.

DISCUSSION

Medical schools have begun to embrace flipped classroom methods to eliminate passive, lecture-style instruction during the preclinical years of the MD curriculum. This tool identifies specific in-classroom approaches that engage students in active learning, guides peer observers in offering targeted feedback to faculty on teaching strategies, and presents consensus-based resources for use during CBCL faculty development and training.

Qualitative Analysis of Student Perceptions Comparing Team-based Learning and Traditional Lecture in a Pharmacotherapeutics Course

Objective. To qualitatively compare students' attitudes and perceptions regarding team-based learning (TBL) and lecture. Design. Students were exposed to TBL and lecture in an elective pharmacotherapeutics course in a randomized, prospective, cross-over design. After completing the course, students provided their attitudes and perceptions through a written self-reflection and narrative questions on the end-of-course evaluation. Student responses were reviewed using a grounded theory coding method. Assessment. Students' responses yielded five major themes: impact of TBL on learning, perceptions about TBL learning methods, changes in approaches to learning, building skills for professional practice, and enduring challenges. Overall, students report TBL enhances their learning of course content (knowledge and application), teamwork skills, and lifelong learning skills. Conclusion. Students' attitudes and perceptions support TBL as a viable pedagogy for teaching pharmacotherapeutics.