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The Flipped Classroom: A Course Redesign to Foster Learning and Engagement in a Health Professions School
The Flipped Classroom: A Course Redesign to Foster Learning and Engagement in a Health Professions School
McLaughlin, Jacqueline E. PhD, MS; Roth, Mary T. PharmD, MHS; Glatt, Dylan M.; Gharkholonarehe, Nastaran PharmD; Davidson, Christopher A. ME; Griffin, LaToya M. PhD; Esserman, Denise A. PhD; Mumper, Russell J. PhD
Student-centered learning in a first year required pharmaceutics course.
With prerecorded integrated learning accelerator module (iLAMs) and assigned textbook and background readings designated as preparatory tools for students prior to class, every in-class period was devoted to student-centered learning exercises designed to assess their knowledge, promote critical thinking, and stimulate discussion. In general, each 75-minute class accommodated the following activities (see Figure 1).
Activity #1 (audience response and open questions).28,29 We assessed students’ understanding of the basic concepts presented in the assigned iLAMs and readings at the beginning of class using clicker (or audience response) questions and open questions. The UNC Eshelman School of Pharmacy requires that all students purchase a clicker on acceptance into the program. During class, the instructor gave students approximately 30 seconds to respond to each of 7 to 10 questions. The instructor then analyzed the responses and provided immediate feedback and perspective. Following the clicker questions, the instructor invited questions from students that addressed content provided in the iLAMs, readings, or other related sources.
Activity #3 (student presentations and discussion). In this activity, one group of four or five students was responsible for presenting a summary and interpretation of the assigned readings and answering other students’ questions about material related to that class’s topic. For each class, up to three groups were asked to prepare and submit presentation materials. By a dice roll, the instructor randomly selected one of those three groups to present and lead the in-class discussion. All groups were graded on their presentation materials regardless of whether they were selected to present, and all students in each group received the same grade. Groups were required to prepare presentation materials twice during the semester, and the average total work for each student was three to five hours for each preparation. The majority of groups presented once; only two groups were chosen to present twice
Microlectures.32 A critical component of the PHCY 411 flipped classroom was the microlecture, used by the instructor to reinforce and, if needed, redirect students’ learning. These microlectures were typically one to three minutes in length and were incorporated when needed on the basis of classroom dynamics. Not only did the microlectures provide an opportunity for the instructor to bring the students back to a “good place” from the chaos of an active learning environment but they also reinforced the idea that students could, in fact, explore and extend themselves knowing that the instructor would provide clarity and perspective when confusion ensued.
Activity #2 (pair & share activities).28,29 Each class included one of three different types of pair & share activities: rapid, reflective, or proactive. In rapid pair & share activities, the instructor presented a discussion question in class and gave students time to pair together and share ideas with one another. The students then presented their ideas to the class as requested by the instructor, who then followed up with feedback, perspective, and expanded discussion. In contrast, the instructor posted reflective pair & share questions online 24 to 36 hours before class in the forum section of the course Web site, and students were required to provide a structured and well-thought-out answer (<400 words, with references if needed) prior to the next class. The instructor selected certain responses to reflective pair & share questions and presented them for discussion during class. Finally, student volunteers prepared proactive pair & share questions. In this exercise, one or two students, with input from the instructor, were responsible for designing, preparing, and moderating a discussion related to the class topic. In essence, they functioned as the instructor during the corresponding in-class exercise. Total execution of the proactive pair & share exercise took 5 to 7 hours.
Activity #4 (individual or paired quiz). At the end of each class, the instructor administered a 10-question multiple-choice quiz on paper; then, he selected the quizzes from eight classes to grade based on overall student workload and exam schedule. At the time the quiz was administered, the instructor notified the students whether it would contribute to their final grade. Each quiz covered only that class’s material, and, in some cases, students were permitted to work in pairs and openly discuss the questions. This activity encouraged students to stay current with the course content and learn from one another, and provided valuable feedback to the instructor as the course progressed.
Appropriate assessment.
Appropriate assessment was a central tenet of the course redesign. Active engagement activities, like clicker questions and pair & share activities, enabled instructors to make real-time, formative assessments of students’ learning and provide immediate feedback concerning misconceptions or gaps in students’ knowledge. Students’ presentations (worth 1.6% of the final grade), eight graded quizzes (worth a total of 12.9%), three scheduled examinations (each worth 16.1%), and one comprehensive and cumulative final examination (worth 32.3%) assessed students’ understanding of the course content and measured students’ ability to achieve desired learning outcomes and objectives.
Two projects assigned at the beginning of the semester provided additional practice opportunities, encouraged higher-order thinking, and assessed students’ ability to analyze, synthesize, and evaluate material, consistent with the top of Bloom’s Taxonomy of Learning.33,34 The first project (package insert analysis, worth 4.8%) required students to apply the concepts they learned in PHCY 410 and PHCY 411 to the prescribing information of a Food and Drug Administration–approved product. The second project (clinical pharmaceutics proposal outline) asked students to identify a clinical shortcoming, design a dosage form for treatment, and write a three-page research proposal outline. However, prior to the end of the course, we converted this second project to an optional bonus exercise worth up to an additional 3.2%. At the beginning of the course, the instructor posted examples of both projects to the course Web site.
Finally, students received bonus points for responding online to reflective pair & share questions (worth up to an additional 1.6%) or facilitating a proactive pair & share activity (worth up to an additional 3.2%).
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