With the arrival of SARS-CoV2 (COVID-19) in North America, programs are facing the need to reconsider how they deliver didactic education to their learners. The ACGME only allows for 20% of the curriculum to be delivered in an asynchronous fashion. The remainder is delivered through traditional didactic means, including “small-group sessions, such as break-out groups, serially repeated conference sessions, practicum sessions, or large-group planned educational activities.” With mandatory social distancing likely to become standard practice, we present multiple solutions to bridge the gap between live, in-person conferences and asynchronous materials.
Weekly emergency medicine (EM) residency conferences are not exempt from the #CancelEverything movement as a result of the COVID-19 pandemic. Residency program leaders are in uncharted water, quickly pivoting to find alternative solutions to live, in-person conference sessions. We at ALiEM emphathize with these hardships and want to help. We announce ALiEM Connect, a live educational telecast with a concurrent moderated backchannel discussion on HIPAA-compliant Slack. We want to help.
You are an attending working with a fourth-year medical student on their emergency medicine clerkship. The student sees a patient with the chief complaint of dizziness. After an initial assessment, the student says that there are no red flags in the history and the patient has a normal neurological exam. In the back of your mind you are thinking, “Does this student know the risk factors, comorbidities, and red flags? Was a thorough neurological exam performed?” How do you know the trainee should be trusted?
We put the call out, and *wow* did the MedEd community respond! We were beyond excited this year about the quality of our applicants for the 2020-2021 ALiEM Faculty Incubator.
This next cohort will include educators from across the globe and from all arenas of medicine including pre-clinical educators and our first nurse practitioner!
Many of you are asked to take a leadership role in leading a team, whether it’s for research, administration, or even clinical. It is easy to feel unprepared for these roles, and there are many pitfalls waiting to sabotage your team’s productivity. The ALiEM Faculty Incubator has created a series of 10 case-based teaming problems to provide you with evidence-based advice and solutions for tackling some of the more common problems encountered in our professional team experiences.
Now more than ever, medical educators are excited about the flipped classroom, defined by Bishop and Verleger as “a new pedagogical method, which employs asynchronous video lectures and practice problems as homework, and active, group-based problem-solving activities in the classroom” . The premise is that students will learn basic concepts during self-study, at their own pace, and come to the classroom ready to dive into small groups and problem-based application .
This approach may be unfamiliar and you may find yourself asking:
- Why should I care?
- How do I get the most out of it?
Let’s begin with the first question. Several studies looking at the flipped classroom conclude it is good for your learning. Though it may initially be perceived as extra work, once the student realizes that the work just replaces the after-class homework they used to do, students’ report a generally high satisfaction, and high engagement with the in-class activity [3-6]. The flipped classroom can make you a more effective “lifelong learner.” While assessing learning efficacy is challenging, some studies have shown improvements in analytical and problem-solving skills in students who come prepared and fully engage in the in-class activities [3,7].
As for the second question, to ensure that you get the best flipped classroom experience, we compiled a list of must-do steps to engage with this educational strategy successfully.
Tips and Tricks:
Prepare (yes, really)
The proverbial wisdom that “by failing to prepare, you are preparing to fail” holds true with this pedagogy. Don’t walk through the door if you haven’t done the prep work. Assigned videos and podcasts are not just “suggestions,” but rather the building blocks for your in-class time. The point of the flipped classroom is for you to do the “easy stuff” at home and the harder, application-type activities, with your educator present. It’s essential that you complete them prior to class. Think of it as doing the classwork at home, and the homework in class! By reviewing material ahead of time you will be ready to ask clarifying questions and grasp higher-level concepts, in order to make the best use of your teacher’s direct attention.
Don’t skip ahead (or you’ll end up behind)
With access to the learning material online, you may be tempted to “skip ahead” to answers. However, the course will often build on itself and part of the learning process will be to work through application problems with only the information you have at the moment. Future sessions may allow a second-look with a new lens, so staying true to the current schedule is best. Similarly, allowing yourself to fall behind and expecting to catch up later will put you at a disadvantage during the in-person sessions.
Commitment (like any good relationship)
In order to bring a complex topic to a class, there are often multiple moving parts for a flipped classroom activity. If you’re set up in a team, designate 1-2 classmates to hold the rest of your team accountable for the work that you need to get done and the deadlines that you need to complete. Rotating responsibilities part of the way through the course will allow every member to experience different roles. If you’re not working in a team, find an accountability buddy and commit to keeping each other on task and on schedule, so that you can come to your in-class sessions as prepared as you can be.
Feedback (talk to me!)
Let’s face it, you’ve spent a lot of time searching for useful learning resources and have probably found some gems. Instructors may not have known about a great new video or podcast when the material was compiled. Let them know what you’ve found and why you think that it’s a helpful resource for your classmates. Sometimes what you’ve found will help make the next class better, or can be added as supplemental material. Remember that you appreciate high-quality feedback and your instructors aren’t much different.
How do you get to Carnegie Hall? (Answer: practice, practice, practice)
It may be the case that concepts being discussed during a flipped classroom setting seem far removed from clinical practice, especially in the pre-clinical years when you are fully immersed in the basic sciences. The key is practice. In the flipped classroom, the skills acquired through dedicated medical topics, learning how to navigate the vast amount of resources available, working as a team, and dissecting problem-solving challenges will help you in the clinical setting. Be intentional about the skillset you’ve acquired and apply it to past/present/future patients.
For example, if you learned about risk stratification tools for chest pain during a class, the next time you encounter a virtual case, a standardized patient, or a real patient with chest pain you’ll know if you can apply the TIMI/HEART/Well’s/PERC scores and how to access them online. After calculating the score, you will be able to convey to your attending, admitting team, and consultants your clinical decision-making and application of evidence-based medicine. Bringing your knowledge to the bedside helps solidify the classroom learning and connect it to real live patients which will help you grow as a clinician.
Want to learn more about the pedagogy of the flipped classroom? And here’s a great example of curated resources for an emergency medicine intern level flipped classroom by @EMFundamentals.
What do you think? Are there other ways that you as a student have made flipped classroom successful for you? Leave us a comment below or @ALiEMFac on Twitter to let us know!
Blog post edited and curated by:
Mark Ramzy, DO
Faculty Incubator Multimedia and Communications Editor
- Bishop, J., & Verleger, M. A. (2013). The Flipped Classroom: A Survey of the Research. In 2013 ASEE Annual Conference & Exposition. Atlanta, Georgia.
- Huu Anh Vuong, Nguyen et al. Students’ Perceived Challenges of Attending a Flipped EFL Classroom in Viet Nam. Theory and Practice in Language Studies. 2018.
- Sait MS,et al. Advances in medical education and practice: student perceptions of the flipped classroom. Adv Med Educ Pract. Published May 2017; PMID: 28496377
- Young TP, et al. The Flipped Classroom: A Modality for Mixed Asynchronous and Synchronous Learning in a Residency Program. West J Emerg Med. 2014. PMID: 25493157
- King AM, et al. Flipping the Classroom in Graduate Medical Education: A Systematic Review. J Grad Med Educ. Feb 2019; PMID: 30805092
- Smallhorn, M. The flipped classroom: A learning model to increase student engagement not academic achievement. Student Success, 2017.
- White PJ, et al. Student Engagement with a Flipped Classroom Teaching Design Affects Pharmacology Examination Performance in a Manner Dependent on Question Type. Am J Pharm Educ. 2017; PMID: 29302082