Finding Time to Teach

Finding Time to Teach

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 as well as an in-class assessment component to identify lecture material that was not well understood. 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 patient case approach” saves faculty preparation time and provides students an opportunity to apply their clinical knowledge.

i-Human Case Flipped: The steps for a flipped classroom simulated patient encounter include:

  1. 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).
  2. Oral presentations: Each team describes their reasoning process and diagnosis (5 min each).
  3. 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.
  4. Preparation time for the instructor – Zero

Below are some examples of the type of team analytical data the instructor could be used for discussions:

  • Differential Diagnosis List: Note, all teams (n=4) did get the final diagnosis on their differential list (endocarditis), but there were significant diagnoses missing. Correct diagnoses are highlighted in green where incorrect diagnoses are highlighted in pink.

Differential Diagnosis List

  • Tests Ordered: Note in this case all teams (n=4) ordered 5 or the 7 required tests (green) but also ordered many that were not appropriate for the diagnoses on the list (pink).

Tests Ordered

Chart extraction: Key findings lists allow instructors to assess the efficacy of the team chart extraction of information and the team management plans are immediately available for discussion and comparison purposes.

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