Finding Time to Teach

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.” Students receive pre-recorded lectures to view outside of the classroom. 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. What used to be a 50 minute lecture presented real-time is now a:

  1. pre-recorded lecture,
  2. group content assessment tool with grading rubric and
  3. preparation of additional discussion topics with visuals.

This substantially increases faculty preparation time but does not provide students an opportunity to apply their knowledge in a clinical situation. That is until i-Human patient clinical encounter simulations are incorporated into the flipped classroom approach. A “flipped i-Human patient case” saves faculty preparation time and provides students an opportunity to apply their clinical knowledge.

i-Human Patient Encounter Flipped: 

  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.] Teams focus on:
    1. Developing a differential diagnosis list
    2. Ordering tests
    3. Interpreting test results
    4. Selecting a final diagnosis with treatment plan (30 minutes).
  2. Oral presentations: Each team describes their reasoning process and diagnosis (5 minutes each).
  3. Instructor facilitated class discussion: For the last 15 minutes of the class, the instructor reviews the diagnostic reasoning and correct final diagnosis while commenting on the “most frequently missed” concepts provided in the 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 (ones in green should have been on the list) and additional ones on the list that were not correct (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