The flipped classroom method of teaching has recently received much attention across higher education as a means to increase active learning in the classroom environment. At its core, flipped classroom requires assigning students pre-work (such as required reading) before they attend class. The time in class is then spent reinforcing the basic concepts, particularly through activities and scenarios that require critical thinking. In this article, we will examine how we deployed this methodology in a large enrollment first-year veterinary course.
Dr. Shannon Washburn, Clinical Associate Professor at Texas A&M University College of Veterinary Medicine & Biomedical Sciences, teaches about the hypothalamus-pituitary-adrenal (HPA) axis as part of a team-taught physiology course. The class consists of approximately 140 students, composed of both first-year veterinary students and physiology graduate students. The HPA topic has traditionally been delivered in lecture format. However, she found that students in the third and fourth years of the curriculum were struggling to recall and apply their knowledge of HPA physiology in the third year medicine courses, as well as on fourth year clinical rotations. Her goal was to utilize a new instructional approach to present the material in a manner that would be more accessible to students, utilizing a clinical perspective. Additionally, she hoped to create a resource that could be utilized again later in the curriculum to help build upon the basic physiology foundation established in the first year of the curriculum.
Dr. Jordan Tayce, Instructional Assistant Professor, and the team at the Center for Educational Technologies worked with Dr. Washburn to create a learning activity utilizing a flipped classroom design. The students are first assigned an online module (approximately 30 minutes of instructional material) that presents pertinent anatomy and physiology pertaining to the hypothalamus-pituitary-adrenal system. In the second part of the module, students are introduced to the endocrine feedback system using a series of humorous animated videos that compare the functions of the HPA axis to the operation of a fast food restaurant. The animations are designed to hold students’ attention and to simplify a complex physiologic process using a relatable every-day analogy. The important concepts are reinforced through formative assessment questions, which provide students the opportunity to test their understanding of the material without penalty of failure. The entire module is supplemented with printable notes.
To further strengthen the application of knowledge inherent to the flipped classroom approach, a follow-up module is currently in development. This activity will introduce clinical disease associated with the hypothalamus-pituitary-adrenal axis. It will depict diagnostic testing of Cushing’s and Addison’s diseases drawing upon the same analogy of the fast food restaurant. After watching this material on their own time, students will attend class to participate in group activities designed to help them apply the information. Through a series of case scenarios, students will interpret diagnostic tests and consider higher-level topics.
These modules will then be available to the students throughout their veterinary school career, to serve as review prior to courses in subsequent years that will build on the information. For example, first year physiology students will learn that Addison’s disease can be treated with glucocorticoids. Students will then be encouraged to review the online physiology module during the pharmacology course in their second year, where they will discuss the differences between various glucocorticoids (e.g., prednisone vs. prednisolone). Likewise, students will continue to upon their physiology foundation in their third year, when they learn the ideal circumstances in which to select diagnostic tests (e.g., ACTH stimulation test vs. low-dose dexamethasone suppression test). Using this approach, the team hopes to foster greater integration across pre-clinical and clinical courses in the curriculum.
Qualitative data obtained from student reviews revealed several key themes. When asked what they found most helpful about the learning activity, students frequently commented on the videos.
“I really liked the video scenarios, it [sic] really helped explain each situation in a way that I will probably remember.”
—First year student
Many students also commented on the flexible nature of the web-based assignment.
“I liked that this module allowed me to go at my own pace, ensuring that I understood the concept before I moved on to the next one.”
—First year student
Finally, a number of students complimented the formative assessment opportunities, reinforcing the importance of providing low-stakes assessment to facilitate learning.
“The online quizzes were an excellent self-check to make sure I understood the material.”
—First year student
The Instructor’s Perspective
Dr. Washburn enjoys using the flipped classroom approach to teach the HPA axis. She believes this new instructional method gives students an opportunity to actively engage in their learning, rather than assuming the more passive role of listening to her lecture.
“Being able to teach dynamic processes with videos instead of static images provides a much clearer understanding of the processes. The students enjoy the change in format instead of just having another lecture, as well as the flexibility to work on it at home. They can go at their own pace and review it as many times as they want.”
Collaborating with faculty at other points in the curriculum has also been a rewarding experience. By working closely with clinical faculty on this project, Dr. Washburn was able to align her learning outcomes with the material that is taught in subsequent years, a process that she believes will ultimately improve the students’ educational experience by providing more opportunities for students to apply their basic science knowledge in a clinical context. Likewise, the clinical faculty have expressed excitement about using teaching time more efficiently, as they will no longer be required to review foundational physiology material in their clinical courses.
The flipped classroom model can be an effective means of teaching, and its product can be vertically integrated across a curriculum. Student acceptance rates were high and the majority of students reported that this learning activity improved their understanding of the material. The project team plans to collect additional data upon implementation of the second online module in order to further refine the learning activity.
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Strayer, Jeremy F. “How learning in an inverted classroom influences cooperation, innovation and task orientation.” Learning Environments Research 15.2 (2012): 171-193.