Why the flipped classroom works in medical education

For hundreds of years, medical content has been delivered in a mostly traditional style—with an instructor lecturing and learners passively taking in the information, and then studying or completing assignments at home. In the flipped classroom model, the traditional class and at-home activities of learning are switched. Now, digital learning tools like video give the learner the ability to review lecture in theory content at home, which allows time for practicing more hands-on skills during class or in the clinic, where teachers are available for discussions and questions.

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For hundreds of years medical content has been delivered in a mostly traditional style. With an instructor lecturing, a learner passively taking in the information, and then studying or completing assignments at home. In the flipped classroom model, the in-class and at home activities of learning are switched.

Now digital learning tools like video give the learner the ability to review lecture in theory content at home, which allows time for practicing more hands on skills during class or in clinic, where teachers are available for discussions and questions. So here at Medmastery, why do we practice and advocate for flipped classrooms or flipped medical education?

As educators, it is important to keep learner preferences and the future direction of teaching in mind. Not only have we personally witnessed how flipped classrooms enhance student learning, there is evidence from Hew and Lo in BMC medical education that there is a statistically significant improvement in learner performance in flipped classrooms, over traditional classrooms.

Flipped classroom models also allow for more tailored or personalized learning experience, and increase learner satisfaction and motivation to learn. Digital media has changed the game in education, making learning more fun and engaging, and allowing learners to self-study more effectively.

Abeysekera and Dawson report that flipped classrooms create a tailored learning experience that allows learners to self-pace, thereby reducing their cognitive load. Cognitive load is your brain's processing power. It's essentially like your computer's working memory. When you have too many apps open on your computer, you'll overwhelm its working memory which will cause it to stop working.

When you overload your learner's working memory with too much input, the same thing happens. In flipped classrooms learners have more control of their own learning, which can be helpful when learners have diverse educational needs and naturally advance at different paces. As opposed to a traditional lecture with the materials presented live once and the learner may miss key concepts, a flipped classroom model provides learners the opportunity to skip content they are more comfortable with, speed up videos if they want to go through them faster, and spend longer time reviewing material that they may be struggling to grasp.

Tin and colleagues found that learners also find flipped classrooms more fun and engaging and prefer them over traditional lecture based classrooms. The use in video to study material before class, quizzes to test their knowledge and motivate them to prepare, in case spaced applications and exercises takes a lot of learning from theoretical, to hands on and gets learners more directly involved in their own learning. So what are some things you need to keep in mind when flipping your classroom?

Think about who your learners are. What material will serve them best? Are they pre-medical students, or busy clinicians? If you're teaching suturing to students, for example, a short video instruction on suturing followed by an application exercise for them to practice and ask questions can be much more effective than assigning a reading or simply having them watch someone else.

If you're teaching clinician colleagues bedside point-of-care ultrasound, a quick video highlighting the most important buttons on the machine they need to know, and how to orient the probe to obtain the images they desire may be perfect, giving them enough foundation and confidence to pick up the probe and practice on their own in the clinic.

The amount of time learners need to spend prepping in a flipped classroom model affects their overall motivation to learn and satisfaction with this teaching method. Hew and Lo found that when required pre-class preparation time is too long, learner satisfaction levels fall and learners actually prefer traditional lectures.

So it's important that you prepare content specifically for flipped classrooms, and not simply provide hour long lecture recordings for students to watch. For ideal learner satisfaction and better engagement with your content, keep all prep materials to less than 20 minutes, and each individual video to less than six minutes, which has been suggested by Philip Gao from edX who looked at learner engagement and online videos. Make your learners prep time enjoyable so that when they go to the clinic it's easier for them to learn on the job and apply the skills they've learned.