The impact of flipped classroom andragogy on student assessment performance and perception of learning experience in two advanced physiology subjects

Flipped classroom in neurophysiology: performance analysis of a system focusing on intrinsic students' motivation

Introduction: Teaching methodologies promoting active learning result in higher-order knowledge application, a desirable outcome in health disciplines like Physiology. Flipped-classroom (FC) promotes active learning and engagement in the classroom. Although specialized research keeps accumulating, the advantages of FC for improving academic outcome and ultimately patient care remain controversial and open to further analysis. Objective: This study evaluates the benefits of applying FC to the Neurophysiology module of a Human Physiology course. Methods:We compare final grades of students exposed to standard lecturing (five-years) vs. FC (six-years), and study the FC impact on student motivation, study time and rewards. Differing from conventional FC, we performed no pre-class/in-class assessments, relying on the students' internal motivation to experience our FC model. A printed student workbook was designed as pre-class material for each session. Reading times respect the expected daily study time of students in our system. Results and discussion: Concerning academic performance, our long-term study reports a significant increase in average scores for FC groups. Overall, students get better scores in multiple choice tests than in problem-solving questions. A more detailed analysis uncovers that our FC model helps students to obtain better scores, reducing variability in performance due to assessment methods. Based on our open-ended survey questions, most students rate the FC environment and in-class activities positively and perceive a positive effect of FC on teachers' performance. An objective automatic Sentiment analysis of open-ended answers reveals that FC is positively appreciated by students, associating positive perceptions to their understanding of physiological concepts, and negative evaluations to their time management.

Providing the choice of in-person or videoconference attendance in a clinical physiology course may harm learning outcomes for the entire cohort

Clinical Physiology 1 and 2 are flipped classes in which students watch prerecorded videos before class. During the 3-h class, students take practice assessments, work in groups on critical thinking exercises, work through case studies, and engage in drawing exercises. Due to the COVID pandemic, these courses were transitioned from in-person classes to online classes. Despite the university's return-to-class policy, some students were reluctant to return to in-person classes; therefore during the 2021-2022 academic year, Clinical Physiology 1 and 2 were offered as flipped, hybrid courses. In a hybrid format, students either attended the synchronous class in person or online. Here we evaluate the learning outcomes and the perceptions of the learning experience for students who attended Clinical Physiology 1 and 2 either online (2020-2021) or in a hybrid format (2021-2022). In addition to exam scores, in-class surveys and end of course evaluations were compiled to describe the student experience in the flipped hybrid setting. Retrospective linear mixed-model regression analysis of exam scores revealed that a hybrid modality (2021-2022) was associated with lower exam scores when controlling for sex, graduate/undergraduate status, delivery method, and the order in which the courses were taken (F test: F = 8.65, df1 = 2, df2 = 179.28, P = 0.0003). In addition, being a Black Indigenous Person of Color (BIPOC) student is associated with a lower exam score, controlling for the same previous factors (F test: F = 4.23, df1 = 1, df2 = 130.28, P = 0.04), albeit with lower confidence; the BIPOC representation in this sample is small (BIPOC: n = 144; total: n = 504). There is no significant interaction between the hybrid modality and race, meaning that BIPOC and White students are both negatively affected in a hybrid flipped course. Instructors should consider carefully about offering hybrid courses and build in extra student support.NEW & NOTEWORTHY The transition from online to in-person teaching has been as challenging as the original transition to remote teaching with the onset of the pandemic. Since not all students were ready to return to the classroom, students could choose to take this course in person or online. This arrangement provided flexibility and opportunities for innovative class activities for students but introduced tradeoffs in lower test scores from the hybrid modality than fully online or fully in-person modalities.

Reducing Student Workload Through Curricular Efficiency

OBJECTIVE

This integrative review will examine the current literature assessing student workload, outcomes of increased workload and cognitive load, and approaches to evaluate and reduce student workload. Recommendations to better inform curriculum planning efforts will be presented along with a call to action to address the dilemma of student workload and curricular efficiency efforts.

FINDINGS

Literature supports that perceptions of heavy workload can influence students' approach to learning and lead to the adoption of surface learning rather than a deep approach that involves higher-order processing and critical thinking. Additionally, ongoing evidence suggests that workload expansion affects student well-being and potential burnout in professional programs, and specifically that students perceive workload as directly related to their well-being and satisfaction. Intentional planning by faculty and programs can address this issue through streamlining classroom content, reducing lecture time, and modifying preclass work to allow for efficient learning. Even if the curriculum is lecture-based, workload perceptions can be affected by developing clearer guidance to set expectations for learners, intentionality in classroom design, and creating opportunities for student engagement.

SUMMARY

Cognitive overload is multifactorial and complicated, given the increased standards of professional education accreditation and licensure requirements. As the Academy deliberately considers methods to improve curricular efficiency, there is an opportunity to focus on curriculum delivery with an appropriate balance of breadth and depth of instruction to ensure effective assessment and cognitive load.

Detecting latent topics and trends in blended learning using LDA topic modeling

With the rapid application of blended learning around the world, a large amount of literature has been accumulated. The analysis of the main research topics and development trends based on a large amount of literature is of great significance. To address this issue, this paper collected abstracts from 3772 eligible papers published between 2003 and 2021 from the Web of Science core collection. Through LDA topic modeling, abstract text content was analyzed, then 7 well-defined research topics were obtained. According to the topic development trends analysis results, the emphasis of topic research shifted from the initial courses about health, medicine, nursing, chemistry and mathematics to learning key elements such as learning outcomes, teacher factors, and presences. Among 7 research topics, the popularity of presences increased significantly, while formative assessment was a rare topic requiring careful intervention. The other five topics had no significant increase or decrease trends, but still accounted for a considerable proportion. Through word cloud analysis technology, the keyword characteristics of each stage and research focus changes of research were obtained. This study provides useful insights and implications for blended learning related research.

A Survey of College Students on the Preference for Online Teaching Videos of Variable Durations in Online Flipped Classroom

In the spring semester of 2020, online flipped classroom was used to replace offline face-to-face teaching of the physiology course at Xiangya School of Medicine. In order to analyze the preferences and utilization of different teaching resources by students, registered questionnaire was applied to investigate the preference divergence of the students on the duration of different teaching videos used in the online flipped classroom model. One hundred forty-seven students of clinical medicine in grade 2018 of Xiangya School of Medicine were selected as the research objects. Three formal surveys were conducted in total. The results showed that there were significant divergences in preference of students for different durations in the first two surveys. 56.43 and 50.00% of the students preferred 15 min mini-video, whereas 43.57 and 50.00% preferred 45 min complete video. Meanwhile, students showed a significant preference for mini-video in active learning before class, with 65.00 and 59.29% watched only mini-video, 17.14 and 25.71% watched only complete videos, and 17.86 and 15.00% watched both mini and complete videos. Although most students preferred to watch mini-video in active learning before class, there was a significant proportion of students who watched complete video before class. The results suggested that the individualization of student in the online flipped classroom is prominent. Multiple logistic regression analysis showed that the selection of videos with different durations at different time points (before, in and after class) was significantly associated with the characteristics of the videos themselves. Therefore, the construction of online teaching resources and the application of teaching methods should consider the requirements of different student groups and provide a variety of online curriculum resources.

Enhancing the effectiveness of flipped classroom in health science education: a state-of-the-art review

BACKGROUND

In a flipped classroom, students acquire knowledge before class and deepen and apply this knowledge during class. This way, lower-order learning goals are achieved before class and higher-order skills are reached during class. This study aims to provide an overview of the factors that contribute to the effectiveness of the flipped classroom and how these factors can be stimulated. The effectiveness of the flipped classroom is conceptualized in this study as test scores, the achievement of higher learning goals, and student perceptions.

METHODS

A state-of-the-art review was conducted. The databases MEDLINE, PsycINFO, PubMed, Web of Science, and Scopus were consulted. The timeframe is 2016 till 2020. The studies were qualitatively analyzed according to the grounded theory method.

RESULTS

After screening the studies based on the inclusion-and exclusion criteria, 88 studies were included in this review. The qualitative analysis of these studies revealed six main factors that affect the effectiveness of the flipped classroom: student characteristics, teacher characteristics, implementation, task characteristics, out-of-class activities, and in-class activities. Mediating factors are, amongst other factors, the learner's level of self-regulated learning, teacher's role and motivation, assessment approach, and guidance during self-study by means of prompts or feedback. These factors can be positively stimulated by structuring the learning process and focusing the teacher training on competencies and learning-and teaching approaches that are essential for the flipped classroom.

CONCLUSION

This paper provides insight into the factors that contribute to the effectiveness of the flipped classroom and how these factors could be stimulated. In order to stimulate the effectiveness of the flipped classroom, the positively and negatively affecting factors and mediating factors should be taken into account in the design of the flipped classroom. The interventions mentioned in this paper could also be used to enhance the effectiveness.

Altered Visual Cortical Excitability Is Associated With Psychopathological Symptoms in Major Depressive Disorder

Previous studies suggest that in people with major depressive disorder (MDD), there exists a perturbation of the normal balance between the excitatory and inhibitory neurotransmitter systems in the visual cortex, indicating the possibility of altered visual cortical excitability. However, investigations into the neural activities of the visual cortex in MDD patients yielded inconsistent findings. The present study aimed to evaluate the visual cortical excitability utilizing a paired-pulse stimulation paradigm in patients with MDD and to access the paired-pulse behavior of recording visual evoked potentials (VEPs) as a marker of MDD. We analyzed the amplitudes of VEPs and paired-pulse suppression (PPS) at four different stimulus onset asynchronies (SOAs) spanning 93 ms to 133 ms. Further, the relationship between PPS and the symptom severity of depression was investigated using Spearman's correlation. We found that, whereas the first VEP amplitude remained unchanged, the second VEP amplitude was significantly higher in the MDD group compared to the healthy controls. As a result, the amplitude ratio (second VEP amplitude/first VEP amplitude) increased, indicating reduced PPS and thus increased excitability in the visual cortex. Moreover, we found the amplitude ratios had a significantly positive correlation with the symptom severity of depression in MDD, indicating a clinically useful biomarker for MDD. Our findings provide new insights into the changes in the excitation-inhibition balance of visual cortex in MDD, which could pave the way for specific clinical interventions.