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The Flipped Classroom Improved Medical Student Performance and Satisfaction in a Pre-clinical Physiology Course

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Abstract

Recently, several articles have suggested that the flipped classroom could be an ideal model for pre-clinical medical education. The flipped classroom approach enables instructor-led time to be dedicated to integration and critical thinking exercises, while students learn foundational material outside of class via online videos or reading assignments. However, few studies have been published on the efficacy of this model for pre-clinical medial students. In this paper, we describe the implementation of a fully flipped classroom in a systems physiology course at The University of North Carolina School of Medicine. The organization of this flipped classroom aimed to keep contact hours and home-study hours equal to the hours previously used in the lecture-based course. With the implementation of the flipped classroom, both student performance on examination and student satisfaction with the course improved slightly compared to those of previous years where the curriculum was primarily delivered by lectures. This paper describes an example of a fully flipped course that demonstrated gains in performance and student course evaluations of a medical school pre-clinical course, and suggests that the flipped classroom could be a useful and successful educational approach in medical curricula.

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References

  1. Cooke M, Irby DM, Sullivan W, Ludmerer KM. American medical education 100 years after the Flexner report. N Engl J Med. 2006;355(13):1339–44. doi:10.1056/NEJMra055445.

    Article  Google Scholar 

  2. Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet. 2010;376(9756):1923–58. doi:10.1016/S0140-6736(10)61854-5.

    Article  Google Scholar 

  3. Irby DM, Cooke M, O’Brien BC. Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010. Acad Med: J Assoc Am Med Coll. 2010;85(2):220–7. doi:10.1097/ACM.0b013e3181c88449.

    Article  Google Scholar 

  4. Prober CG, Heath C. Lecture halls without lectures—a proposal for medical education. N Engl J Med. 2012;366(18):1657–9. doi:10.1056/NEJMp1202451.

    Article  Google Scholar 

  5. Bligh DA. What’s the use of lectures? San Francisco: Jossey-Bass; 2000.

    Google Scholar 

  6. Engel CE. Problem-based learning. Br J Hosp Med. 1992;48(6):325–9.

    Google Scholar 

  7. Michaelsen LK. Team-based learning for health professions education : a guide to using small groups for improving learning. 1st ed. Sterling: Stylus; 2008.

    Google Scholar 

  8. Michaelsen LK, Knight AB, Fink LD. Team-based learning : a transformative use of small groups. Westport: Praeger; 2002.

    Google Scholar 

  9. Mehta NB, Hull AL, Young JB, Stoller JK. Just imagine: new paradigms for medical education. Acad Med: J Assoc Am Med Coll. 2013;88(10):1418–23. doi:10.1097/ACM.0b013e3182a36a07.

    Article  Google Scholar 

  10. Prober CG, Khan S. Medical education reimagined: a call to action. Acad Med: J Assoc Am Med Coll. 2013;88(10):1407–10. doi:10.1097/ACM.0b013e3182a368bd.

    Article  Google Scholar 

  11. Means B, Toyama Y, Murphy R, Bakia M, Jones K. Evaluation of evidence-based practices in online learning: a meta-analysis and review of online learning studies. In: Education USDo, editor. Washington, DC: United States Department of Education; 2010.

  12. Bishop JL, Verleger MA. The flipped classroom: a survey of the results. American Society for Engineering Education Annual Conference and Exposition; Atlanta, GA2013.

  13. Missildine K, Fountain R, Summers L, Gosselin K. Flipping the classroom to improve student performance and satisfaction. J Nurs Educ. 2013;52(10):597–9. doi:10.3928/01484834-20130919-03.

    Article  Google Scholar 

  14. Tune JD, Sturek M, Basile DP. Flipped classroom model improves graduate student performance in cardiovascular, respiratory, and renal physiology. Adv Physiol Educ. 2013;37(4):316–20. doi:10.1152/advan.00091.2013.

    Article  Google Scholar 

  15. McLaughlin JE, Roth MT, Glatt DM, Gharkholonarehe N, Davidson CA, Griffin LM, et al. The flipped classroom: a course redesign to foster learning and engagement in a health professions school. Acad Med: J Assoc Am Med Coll. 2014;89(2):236–43. doi:10.1097/ACM.0000000000000086.

    Article  Google Scholar 

  16. Sharma N, Lau CS, Doherty I, Harbutt D. How we flipped the medical classroom. Medical teacher. 2014:1–4. doi:10.3109/0142159X.2014.923821.

  17. Sitticharoon C, Srisuma S, Kanavitoon S, Summachiwakij S. Exploratory study of factors related to educational scores of first preclinical year medical students. Adv Physiol Educ. 2014;38(1):25–33. doi:10.1152/advan.00162.2012.

    Article  Google Scholar 

  18. Felder E, Fauler M, Geiler S. Introducing e-learning/teaching in a physiology course for medical students: acceptance by students and subjective effect on learning. Adv Physiol Educ. 2013;37(4):337–42. doi:10.1152/advan.00158.2012.

    Article  Google Scholar 

  19. Robin BR, McNeil SG, Cook DA, Agarwal KL, Singhal GR. Preparing for the changing role of instructional technologies in medical education. Acad Med: J Assoc Am Med Coll. 2011;86(4):435–9. doi:10.1097/ACM.0b013e31820dbee4.

    Article  Google Scholar 

  20. Bowe CM, Voss J, Thomas AH. Case method teaching: an effective approach to integrate the basic and clinical sciences in the preclinical medical curriculum. Med Teach. 2009;31(9):834–41.

    Article  Google Scholar 

  21. Gordon JA, Brown DF, Armstrong EG. Can a simulated critical care encounter accelerate basic science learning among preclinical medical students? A pilot study. Simulation in healthcare : journal of the Society for Simulation in Healthcare. 2006;1 Spec no.:13–7.

  22. Gordon JA, Hayden EM, Ahmed RA, Pawlowski JB, Khoury KN, Oriol NE. Early bedside care during preclinical medical education: can technology-enhanced patient simulation advance the Flexnerian ideal? Acad Med: J Assoc Am Med Coll. 2010;85(2):370–7. doi:10.1097/ACM.0b013e3181c88d74.

    Article  Google Scholar 

  23. Fagen AP, Crouch CH, Mazur E. Peer Instruction: Results from a Range of Classrooms. Phys Teach. 2002;40:206–9. doi:10.1119/1.1474140.

    Article  Google Scholar 

  24. Smith MK, Wood WB, Adams WK, Wieman C, Knight JK, Guild N, et al. Why peer discussion improves student performance on in-class concept questions. Science. 2009;323(5910):122–4. doi:10.1126/science.1165919.

    Article  Google Scholar 

  25. Deslauriers L, Schelew E, Wieman C. Improved learning in a large-enrollment physics class. Science. 2011;332(6031):862–4. doi:10.1126/science.1201783.

    Article  Google Scholar 

  26. Pluta WJ, Richards BF, Mutnick A. PBL and beyond: trends in collaborative learning. Teach Learn Med. 2013;25 Suppl 1:S9–16. doi:10.1080/10401334.2013.842917.

    Article  Google Scholar 

  27. Cohen J. A Power Prime. Psychol Bull. 1992;112(1):155–9.

    Article  Google Scholar 

  28. Hashmi NR. Team Based Learning (TBL) in Undergraduate Medical Education. J Coll Phys Surg-Pak: JCPSP. 2014;24(8):553–6. doi:08.2014/JCPSP.553556.

  29. Koles PG, Stolfi A, Borges NJ, Nelson S, Parmelee DX. The impact of team-based learning on medical students’ academic performance. Acad Med: J Assoc Am Med Coll. 2010;85(11):1739–45. doi:10.1097/ACM.0b013e3181f52bed.

    Article  Google Scholar 

  30. Neville AJ. Problem-based learning and medical education forty years on. A review of its effects on knowledge and clinical performance. Med Princ Pract: Int J Kuwait Univ Health Sci Cent. 2009;18(1):1–9. doi:10.1159/000163038.

    Article  Google Scholar 

  31. Prosser M, Sze D. Problem-based learning: student learning experiences and outcomes. Clin Linguist Phon. 2014;28(1–2):131–42. doi:10.3109/02699206.2013.820351.

    Article  Google Scholar 

  32. Sisk RJ. Team-based learning: systematic research review. J Nurs Educ. 2011;50(12):665–9. doi:10.3928/01484834-20111017-01.

    Article  Google Scholar 

  33. Boehler ML, Schwind CJ, Folse R, Dunnington G, Markwell S, Dutta S. An evaluation of study habits of third-year medical students in a surgical clerkship. Am J Surg. 2001;181(3):268–71.

    Article  Google Scholar 

  34. Beale EG, Tarwater PM, Lee VH. A retrospective look at replacing face-to-face embryology instruction with online lectures in a human anatomy course. Anat Sci Educ. 2014;7(3):234–41. doi:10.1002/ase.1396.

    Article  Google Scholar 

  35. Chao SH, Brett B, Wiecha JM, Norton LE, Levine SA. Use of an online curriculum to teach delirium to fourth-year medical students: a comparison with lecture format. J Am Geriatr Soc. 2012;60(7):1328–32. doi:10.1111/j.1532-5415.2012.04035.x.

    Article  Google Scholar 

  36. Davidson MR. A phenomenological evaluation: using storytelling as a primary teaching method. Nurse Educ Pract. 2004;4(3):184–9. doi:10.1016/S1471-5953(03)00043-X.

    Article  Google Scholar 

  37. Dunkin MJ. A Review of Research on Lecturing. High Educ Res Dev. 1983;2(1):63–78.

    Article  Google Scholar 

  38. Cooper C, Orban D, Henry R, Townsend J. Teaching and storytelling: an ethnographic study of the instructional process in the college classroom. Instr Sci. 1983;12:171–90.

    Article  Google Scholar 

  39. Alamro AS, Schofield S. Supporting traditional PBL with online discussion forums: a study from Qassim Medical School. Med Teach. 2012;34 Suppl 1:S20–4. doi:10.3109/0142159X.2012.656751.

    Article  Google Scholar 

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Acknowledgments

The authors would like to thank the UNC School of Medicine class of 2017 for their willingness to participate in surveys about the flipped classroom and their open-minded approach to this new method. We would also like to thank the faculty members from the Department of Cell Biology and Physiology who were part of the flipped classroom portion of the course (Christopher Dekanney, Carol Otey, Scott Randell, and Robert Sealock). We would also like to thank Dale Krams for help designing the flipped classroom survey.

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Correspondence to Sarah E. Street.

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Street, S.E., Gilliland, K.O., McNeil, C. et al. The Flipped Classroom Improved Medical Student Performance and Satisfaction in a Pre-clinical Physiology Course. Med.Sci.Educ. 25, 35–43 (2015). https://doi.org/10.1007/s40670-014-0092-4

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