Why Flip the Medical Classroom

What content is best learned individually vs. in groups?

The schools set up by the Greek philosophers required participants to read the scrolls of great theorists, then come together to debate, compare and question in order to further understand the content of the scrolls. In this approach, learning required participation by several people in order to get a depth of vision that is rarely possible from one unchallenged individual. This is a great example of flipping the classroom that was lost during the industrial schooling experiment.
To really conceptualize flipping the medical classroom, you have to have a clear understanding of what students can best learn independently and what requires interaction with other students. Neither of these approaches mean that professors/instructors are not an integral component in the process.
012.JPG To explore the meaning behind the title question, I’m going to take you back to early childhood when you learned to walk, talk, eat, and play. You learned these tasks by watching others and then practicing them over and over until they became automatic. Obviously learning skills and procedures is best done individually. Parents provided role models, tools, supportive feedback and a safe environment to learn. Children whose parents don’t provide these necessary components have lifelong learning issues.
What about material that needs to be remembered? Traditionally that has been learned in classrooms but is that tradition more about the historical lack of resources such as books, writing materials and educated people or because classrooms really help people remember. My first experience with the idea that classrooms might not be the best place to learn content happened when a young man in my Grade 10 class said he could learn more in the library than listening to our boring teacher. He stopped attending class and had an average of 95%.
So what helps people remember content?
1. Good, available resources
2. Relevance/engagement
3. Chunking (short term memory holds about 7 items at a time)
4. Pattern making (A>F but not E)
5. Repetition
6. Feedback
Nothing in this list requires the presence of other students.
What about material that needs to be understood, analyzed, compared; in other words the higher order thinking skills?
Classrooms are the ideal place to use memorized content to improve understanding but this only happens when the minds of individuals rub up against the minds of other individuals. Cases, debates, problem solving are all ways of thinking critically about content but they also help students build patterns and connections that ensure memory long term and the group and facilitator acts as a counterpoint for correcting errors.
So take a look at your curriculum. If the objectives say describe, list, or identify think about how individual students can learn that content using online resources, books and/or recorded lectures.

6 thoughts on “Why Flip the Medical Classroom

  1. I agree that discussion groups is a better way of learning complex material but you need teachers who have breadth of knowledge about the material and experience which I think is the major problem at many institutions.

    • Yes faculty development and continuing medical education are an important part of developing new approaches to teaching. You are lucky that UTHSC has a medical education department.

  2. I’ve often used class time to demonstrate patterns and connections as a framework into which memorized stuff can then be placed by the student(s). It explains why I ask them to memorize some things in a certain order that isn’t intuitive. I wonder about the impact of asking them to do that memory work first, devoid of context that will come later.

      • Very good question. Learning needs to be built on prior knowledge so how can we expect people to learn if they don’t have the background or framework such as Sheila presents in class. But there is a way to lead up to that as Deirdre suggests. We need to figure out what they already know and what the next step(s) might be in the journey to the clotting cascade!

  3. Whatever method you choose in learning it is more important that you provide nothing but the best for you children. Because fro all we know education is the best key to success.

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