The old adage, ‘you learn by doing,’ holds true for many disciplines, including medical education. Of course, a medical student can sit through a 2-hour lecture about cardiomyopathy, but they may learn more efficiently by performing a focused physical examination on a patient suffering from ventricular tachycardia. Recently, there has been a movement in medical education towards a more problem-based learning environment. This paradigm shift has been coined ‘flipped classroom,’ a learning approach focused more on team-based learning and less on long lectures constructed from mandatory reading assignments, during which large groups of students passively absorb information.
To learn more about the flipped classroom environment and its impact on medical education, we spoke with Tim Dang, a 4th year medical student at Stanford University School of Medicine, and Sheryl-vi Rico, a graduate of Johns Hopkins School of Medicine. Stanford and Johns Hopkins are two of many US-based medical schools implementing this non-traditional approach to learning.
What are the benefits of a flipped classroom?
A flipped classroom forces instructors to think more critically about what to present and how to present it. According to Tim, “when instructors flip some of the content, they need to develop a robust, sustainable learning tool (e.g., video) that requires more preparation than just lecturing off the cuff.” Much of the time this means using multimedia, and when used correctly, flipped classrooms help students develop critical thinking skills that can’t be learned from books. Interactive activities, like reviewing histology slides and clinical cases in small group settings has been effective for learners like Tim and Sheryl, and they appreciate the option to put their knowledge into practice.
Other benefits of a flipped classroom include:
- A more interactive classroom. Students can go through interactive cases together in small group settings, and come up with diagnoses based on the patient’s chief complaint.
- The ability for students to learn at their own pace. Students can take time to read additional materials if needed, and slow down or speed up at certain points, if necessary.
- Reviewing material in a stepwise manner, which leads to better recall later on.
What are some flipped classroom shortcomings?
While there are many benefits to a flipped classroom, there are also shortcomings. Tim suggests that “if the materials are not flipped with care, instructors could just end up with a video made by sticking a microphone in front of a lecturer who hasn’t modified any material in the slide deck in years.” According to Sheryl, “some instructors would use the flipped classroom time as additional lecture time – cramming more topics into a specific time period, which is not beneficial to learning.”
If flipping the classroom doesn’t maintain time neutrality, it’s unfair to curricular time protection. From Sheryl’s perspective “there is often an assumption that after the classroom time, all students possess sufficient mastery of the subject – often without testing how well the topic was learned or taught. The element of re-assessing after a classroom session is a lost opportunity in a certain ‘flipped’ environment.” For students to master subjects, flipped classrooms require a lot of energy and time from the instructor implementing the learning model, but it also requires buy-in from the students, especially since a main feature is more interactive small group sessions.
Are lectures still important?
At Stanford, classrooms are only partially flipped because the instructors feel there is still a strong need for lectures. While Tim loves a flipped classroom, he feels “lectures are still a necessary part of medical education, especially for content that requires more interaction – working through patient cases in a dynamic way, where students ask questions about the history, formulate a differential diagnosis in real time and change it in accordance to new information.”
How can a flipped classroom help medical students study more efficiently?
Lecturers who put the effort into implementing the flipped classroom model simply make better lectures, so students don’t have to relearn content – they’ve already done better on the first pass. Tim suggests that “if learning is done via multimedia, watching videos at 2x (or even faster for some students) saves significant amounts of time. While time can be sped up on videos, it can also be slowed down for the trickier parts before students get lost as the lecturer moves forward.”
How can AMBOSS help?
Tim has used AMBOSS as a study resource for his Shelf and Step exams and thinks of it as a ‘use as much as you want’ platform. “Because AMBOSS integrates Learning Cards so well, students can pause where they want to and dive deeply into the material when they need to – mimicking a flipped classroom. For example, you could be doing a Qbank session and want to just push through 20 questions, but then on question 14 you realize that you really need to learn more about melanoma. With AMBOSS, you can pause your Qbank session to interact with the platform more dynamically by opening the Learning Cards. No other platform offers this feature.”
Sheryl thinks AMBOSS is a great resource to help prepare students for flipped classroom portions (beforehand), especially “when the materials that the instructor chose were not comprehensive enough or excessively complicated.” She additionally likes that “AMBOSS provides both high-yield points as well as detailed information on the Learning Cards. It’s an excellent tool to use after the classroom session to interrogate your knowledge after attending the classroom portion.”
Whether flipped classrooms are a fad or are here to stay, it seems that more and more medical schools are jumping on board. A recent University of Vermont headline reads, “Become a doctor, no lectures required.” With this new approach, medical educators will lecture less and engage with students more. Lectures are now being replaced with multimedia to enhance students’ learning experience. Many aspects of the flipped classroom replicate the way medical students will learn on the wards - by doing.
While medical education is at the very beginning stages of the flipped classroom model, the endpoint is in sight – to train outstanding and capable physicians. Striving for something better, medical educators are opting for a new approach to learning. Flipped classrooms seem to be the future of medical education.