Next, Dr. Hausmann and colleagues implemented an intervention in the form of a one-hour faculty development workshop designed to increase active learning via a flipped classroom approach. This approach involved learners receiving a pre-lecture assignment with required reading of an article or chapter prior to the lecture. At the time of the lecture, faculty would serve as guides to learners while they completed interactive cases. Classroom time was devoted to inquiry, application and assessment. At the end of the lecture, the faculty member would give each learner a recommended assignment to help consolidate the learning.
In a published article on this project, the intervention of the faculty development workshop increased the average active learning score for lectures and led fellows and faculty to report a largely positive experience with the process and outcomes. Faculty did note that they spent about one to two extra hours preparing their PowerPoint presentations to ensure these lectures were geared toward active learning. Nevertheless, faculty satisfaction with the process remained high.3
With some evidence emerging that the flipped classroom concept may work for increasing engagement and the success for learners, it’s worth asking why this may be the case. One positive element of the flipped classroom is the concept of retrieval, namely the way in which trainees must remember what they have learned prior to the lecture and apply the knowledge to teaching cases in real time. This process requires not just rote memorization of facts, but rather, the learning of facts followed by a process of self-assessment that challenges the learner to retrieve that knowledge in a practical manner.
When compared with traditional lectures, research has shown active learning improved test scores and decreased failure rates.
Improving Lectures
Dr. Hausmann explained that even traditional lectures can benefit from incorporating elements that spur active learning and improve retention of knowledge for trainees. He noted that faculty can use the four-question technique, which asks:
- What one important concept, research finding, theory or idea did you learn?
- Why do you believe this concept is important?
- How does what you learned apply to some aspect of your life?
- What questions has this activity raised for you, and what are you still wondering about?
Faculty can ask learners to generate their own questions after lectures and use these questions to test their fellow trainees.
For questions asked by faculty to trainees, Dr. Hausmann stated that not all questions are of equal value. Example: Questions that require a trainee to remember a discrete fact (e.g., What is the most common cause of uveitis?) are not as helpful as questions that require learners to analyze (e.g., How would the treatment plan differ if the patient had an active malignancy?), evaluate (e.g., What is the evidence to support your treatment plan?) or create (e.g., Based on the pathophysiology of rheumatoid arthritis, how would you design a new medication to decrease synovitis and improve patient outcomes?).
