Finding Time to Teach
Stepping Outside of the Classroom:
The flipped classroom is an alternative educational approach in which the typical lecture and homework elements are “flipped”. The students receive prerecorded lectures to view outside of the classroom, and in-class time is devoted to alternate activities such as structured exercises, projects, discussions or team-based challenges. These activities frequently have an in-class assessment component to identify lecture material that was not understood and will be the focus of discussions. In addition, the faculty must also be prepared to have alternative discussion topics should they not identify group deficiencies. Thus what used to be a 50 minute lecture presented real-time, is now: 1) a pre-recorded lecture, 2) a group content assessment tool with grading rubric and 3) preparation of additional discussion topics with visuals. This substantially increases faculty preparation time but does nothing to provide the students any opportunity to apply their knowledge in a clinical situation. That is until i-Human patient encounter simulations were incorporated into this flipped classroom approach. A “flipped i-Human approach” saves faculty preparation time and provides students an opportunity to apply their clinical knowledge in a patient encounter.
i-Human Case Flipped: The steps for a flipped classroom simulated patient encounter include:
- Team based learning: In class, the students are divided into small groups (2-4) and play the case in HPO TEST mode as a team. [In HPO the history and physical exam findings are provided.] The teams focus on: 1) developing a differential diagnosis list, 2) ordering tests, 3) interpreting test results and 4) selecting a final diagnosis with treatment plan (30 min).
- Oral presentations: Each team describes their reasoning process and diagnosis (5 min each).
- Instructor facilitated class discussion: For the last 15 minutes of the class, the instructor reviews the “most frequently missed” concepts from the team case play analytics.
- Preparation time for the instructor – Zero: Classroom discussion is based on the team performance analytics that just took place in class.
Below are some examples of the type of team analytical data the instructor could be used for discussions:
- Differential Diagnosis List: Note in this case all teams did get the final diagnosis on their differential list, but there were significant diagnoses missing (ones in green should have been on the list) and many additional ones on the list that could not be supported by the history or physical exam (pink).
- Tests Ordered: The instructor might want to use these results to explain why the tests ordered (highlighted in pink) were NOT deemed essential. Having the students explain their rationale might assist the instructor in identifying misconceptions about specific tests, their sensitivity or specificity.
- 21 Sep, 2017
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