Becoming Lifelong Learners

By Sara Zifa, PGY-1 Pharmacy Practice Resident

MedStar Union Memorial Hospital

Throughout this Educational Theory Course, we have learned different educational theories that mostly revolved around rewards as motivation for learning. In most cases, this reward would come in the form of a letter grade on a transcript or report card. While this method works almost as a bribe in getting students to learn the material, it is not certain that this information will be retained for very long. This is because once the award is achieved, there is no longer any incentive to review the material, perfect the skill or remember it in the future. Pure curiosity is what motivates students to go home and keep working on a project even after a grade has already been submitted for it. Curiosity is also vital for students to become lifelong learners, which encourages them to continue to grow and seek more information well after they complete the semester or graduate. The Self-Determination Theory (SDT) predicts that a students’ motivation to learn is determined by three main factors; autonomy, competence and relatedness¹.

What is Self-Determination Theory? 

SDT proposes the idea that extrinsic rewards may weaken student’s natural interest in the topic as they become less interested in the reward². Conversely, motivation increases as autonomy and intrinsic rewards increase¹. For this reason, SDT theory encourages educators to increase options for students, allowing them to make more decisions and thus increasing their motivation to learn. When students are under the impression that they chose to do something, then they are more likely to take more responsibility for the product. One way teachers can give off the impression that students are making all the decisions is by assigning projects but giving the students the option to do it any way they like. For example if they are doing a project about the respiratory system, the project can be a poster, a paper model, a story or an essay. Students will choose which way they would like to complete the project based on their own personal interests and strengths. When they don’t feel as though they were forced into doing something then they are less likely to think of excuses as to why they cannot complete it. This also provides the students with an advantage because they can use their strengths to create a project that makes the most sense to them. For example a student who is particularly artistic may draw pictures of the lungs and then realize that he understands the respiratory system much better now.

SDT theory also states that motivation increases when students have a high perception of their own competence level¹. When students perceive themselves as being proficient at a task or perceive themselves as doing well, they are more likely to work harder and continue to learn more. Conversely, students who feel that they are not succeeding in class are more likely to lose motivation and discontinue studying. Because of this, SDT theory encourages educators to provide unexpected positive feedback to students to improve their motivation to keep learning and growing. The third component of the SDT theory is relatedness. This part of the theory suggests that students feel more motivated to succeed in school when they have a stronger connection with their instructor. This becomes very important for students during middle childhood (ages eight to twelve)³. Educators can do this by becoming more culturally competent, teaching with examples related to the students’ day-to-day life and expressing genuine concern in their students’ life.

By providing more options in the classroom setting, giving positive feedback and taking steps to better understand the students, educators can improve intrinsic motivation. Once students develop a high level of intrinsic motivation, they can go on to maximize their learning ability while in school but then also beyond graduation to become lifelong learners.

Self-Determination Theory, http://selfdeterminationtheory.org/. Accessed 24 September 2017. 

Deci, E. L., & Ryan, R. M. (1985). Intrinsic motivation and self-determination in human behavior. New York, NY: Plenum.

McCombs, B. Developing Responsible and Autonomous Learners: A Key to Motivating Students. American Psychological Association, http://www.apa.org/education/k12/learners.aspx. Accessed 24 September 2017. 

From Lectures to Team Based Learning

By Ha Phan, PGY-1 Community Pharmacy Resident

Johns Hopkins Home Care Group and Outpatient Pharmacy

The traditional lecture method has been an effective method for communicating theories and ideas to students. Lecturing is disseminating information to large groups of students. After a lecture, students may work in groups and complete discussions on the lecture content. With lecturing going out of style and other learning methods becoming more popular one alternative to the lecture is team based learning.¹

Team Based Learning Defined

Team based learning (TBL) is a strategy that has been used at multiple business schools and in higher learning settings.² During TBL activities a single instructor manages small groups simultaneously in one classroom. This method has gained interest within medical education because it is more likely to increase active learning in the classroom. TBL has been shown to increase student engagement. Thompson et al., studied the implementation of team based learning at ten different medical schools and reviewed factors that affected the use of TBL. The study found that the schools that desire to implement TBL and have the faculty/staff that support this design will continue the implementation efforts. TBL consists of three phases. The first phase is where the student reads and studies the material independently. In the second phase, learners are individually assessed on their basic understanding of the material, then assessed again in groups. Once students have grasped the topics from the first two phases, the instructor will move on to the third phase where students work in teams to apply the knowledge introduced in phases 1 and 2. The groups work on the third phase at the same time and then share their answers to the other groups.²

To relate it back to my own pharmacy school experience, at the University of Maryland School of Pharmacy (UMB SOP) team based learning has gained popularity since I first enrolled as a first year student. When I was going through the curriculum team based learning included phase 1, but I believe phase 2 was missing where students were assessed on the material from phase 1. The assessment part was the exam that came after phase 3. Phase 3 at UMB consisted of cases and real world application however cases were not worked on real time and were worked on offline and then brought back to the larger group where answers were discussed in groups and then as a larger group. Now, there are all three phases and phase 2 would include a quiz or some kind of knowledge check following phase 1. This aspect is different from when I went through the curriculum. Team based learning is able to meet different learning needs and styles by including social learning (via group work), behaviorism (grading rewards), and constructivism (working in real time as a group).

Limitations of Team Based Learning

TBL has some limitations as some faculty members do not understand the method, or do not feel that the TBL is effective.² In the Thompson, et al study, students were also resistant to peer evaluation.² To a point I think TBL is effective as I have seen components of it but there is always room for improvement. I believe TBL must be strategically scheduled as it is more work for the student than the traditional lecture based style of teaching. If too many TBL sessions are scheduled there may be fatigue and the student may not be putting forth the expected effort that it takes to upkeep TBL.  Would TBL be the only way classes are taught or is traditional lecturing still an effective way of teaching? I think there is always a need for lecturing because I think for some educators it is a better use of time when there is a large class.

As student satisfaction and participation is a limiting factor of TBL, a study done by Frame et al., looked at student perceptions of TBL. They found that TBL should be incorporated early into the curriculum before traditional lecture-based formats so that students may realize the benefits and build team work skills early on.³ I wonder if the outcome of TBL if rewards such as grades were not a part of the process – would it be as effective? I am proud to be a product of TBL, and I hope to grow my skills in facilitating these sessions as a future educator.

1. Redish EF.Teaching the Lecture Method. University of Pittsburgh. 2014. 124 p.
2. Thompson BM, Schneider VA, Haidet P, Levine RE et al,. Team-based learning at ten medical schools: two years later. Medical Education. 2007; 41: 250-257.
3. Frame TR, Cailor SM, Gryka RJ, Chen AM et al,. Student Perceptions of Team-based learning vs Traditional lecture-based learning. American Journal of Pharmaceutical Education.2015; 79 (4):1-11. 

If You’re Never Wrong, Are You Ever Right?

By Melissa Fiscus, Pharm.D.

PGY-1 Pharmacy Practice Resident

Howard County General Hospital

Almost every day in any student’s educational career, students are assessed on correctness. In elementary school, students are asked to recite the alphabet and perform simple addition. As the years progress, students are assessed on spelling, grammar, complex mathematical formulas, and reading comprehension. Frequently, students are given tests to determine how well they have mastered the topic. In the end, students receive a grade for their efforts, which is a permanent record of how much they did (or didn’t) learn about a topic.

Making mistakes and overcoming failure are natural elements of the learning process for students; however, this culture of regular testing can limit their development. Recently, I read an article by Jeff Cain entitled “The Consequences of Never Being Wrong” which wondered if pharmacy schools permitted safe failure; e.g. the idea that students could fail and learn from their mistakes without affecting their grades. As I read this article, I found myself agreeing wholeheartedly with what Cain described. Frequent testing has conditioned students to do everything to avoid being wrong. Students avoid taking learning risks due to the negative outcomes of failure. For example, if students are wrong on exams, it could hinder their selection to a competitive residency position. If a student is wrong during a class discussion, they might receive a sharp remark from the instructor or snide comments from their classmates. If students are wrong on an academic presentation, they might experience public criticism, embarrassment, and/or a poor grade.¹

With all this negativity associated with failure, it’s no surprise that students do everything to avoid being wrong. This is okay, to some extent, because students must be able to perform their jobs correctly to ensure patient safety. However, Cain notes that an overemphasis on avoiding mistakes comes at the expense of creating better learners.¹ Students may be too scared to voice their questions because they fear the negative consequences of being incorrect. However, when this occurs critical learning opportunities are lost. Good students aren’t the ones who simply know all the facts, they are the ones who know how to critically examine problems and come up with new solutions. If we discourage those students from speaking up, everyone in the classroom loses the benefit of that conversation.

        This concept of open communication and exchange of knowledge relates directly to the constructivism theory of learning. Constructivism views learning as an active, constantly ongoing process. In this theory, the educator is viewed not as an instructor, but as a guide who facilitates learning. Constructivists believe that learning builds upon existing knowledge, and students must be asked to make connections between what they already know to gain new knowledge.² In classrooms that utilize the constructivism theory of learning, students are able to ask questions, recognize their misconceptions, and learn from their mistakes in a positive learning environment.

        As educators, we must try not to stifle these creative conversations by engaging in a little constructivism ourselves. A recent study by Tulis et al. described the error management behaviors used by teachers in classrooms and how it influenced their students. In this study, the authors noted that students’ attitudes toward mistakes are associated with how their teachers manage and respond to mistakes.³ At the conclusion of this study, the authors describe four teacher-specific error management behaviors instructors can utilize to create a positive error culture within their classroom. First, instructors must be willing to acknowledge and discuss students’ mistakes. Second, student errors must be regarded as learning opportunities rather than as negative indicators for performance. Third, instructors must be patient and allow the student to correct the error by him or herself. Finally, instructors should not express annoyance or ridicule students if they make an error.³ Utilization of these techniques will allow students to explain their thought processes, gain confidence, and allow instructors to better understand what caused their miscomprehension in the first place.

        Another strategy for creating a positive error culture is providing students with many opportunities to fail safely. In order to fully grasp difficult concepts, students may need multiple opportunities to be wrong in order to receive proper instructional feedback that helps them solidify their knowledge. Cain offers some suggestions in his article, including frequent quizzes, audience response system questions, case/problem solving activities, and personal problem sets.¹ Inclusion of these strategies allows instructors to feature low-stakes learning opportunities that have little impact on student grades, but can have a large impact on student comprehension.

        As educators, it’s important we don’t equate correctness with true learning. At the conclusion of pharmacy school, we want our students to be knowledgeable clinicians, critical thinkers, and creative problem solvers. Unfortunately, these skills can’t always be learned from reading a textbook or choosing the correct answer on a test. As Cain reminds us at the end of his article, “School should not be a place where students are expected to be right most of the time. School should be a place where you learn to be right. Teaching students how to be right might just mean letting them be wrong even more.”¹

References:

1.   Cain J. The Consequences of Never Being Wrong [Internet]. Pulses. 2017. Available from: https://cptlpulses.com/2017/06/22/consequencesneverwrong/

2.   Kaufman DM. Applying educational theory in practice. BMJ 2003; 326: 213-216.

3.   Tulis M. Error management behavior in classrooms: Teachers’ responses to student mistakes. Teach Teach Educ. 2013; 33: 56-68. Available from: http://www.sciencedirect.com/science/article/pii/S0742051X13000255

Online Schooling

Saba Mahdavi, Pharm.D., Carroll Hospital PGY1 Pharmacy Resident

Online schooling and online courses are controversial educational topics of twenty-first century. As the name implies, online schools provide virtual classes instead of traditional live classroom settings. Technology plays an important role in our lives and it has become an essential mean of teaching in the past decade. For example, instructors continue to use PowerPoint presentations, educational videos, and pre-recorded lectures. A study was done on 64 students enrolled in criminology classes at Carnegie University.¹ These students were randomly enrolled in either the online course or traditional (live) course. This study found that there was no significant difference between exam scores and student evaluations.¹

Traditional versus Online Course

When talking about online schooling there are many advantages and disadvantages to consider. Students must have well-developed time-management skills and be able to balance work, family/friends, and school to be successful in online courses.¹ An important factor contributing to the success of online classes is students’ characteristics. For example, age, marital status, maturity, and learning styles can impact the outcome.²  Finally, to understand which classroom setting is more effective, we need to look at students’ learning outcomes in each setting.

Online School: Not for Everyone

One of the advantages of online courses is that students are able to manage their time and schedule. They can spend as much time as they need to complete a course work without worrying about slowing down other students. In addition, online courses typically cost less than traditional class settings.³ Also, textbooks may also be provided online, making it even easier and more cost-effective to have access to the course material. Student would not need to spend time and money for transportation as well. Although these are all potential advantages of online courses, they can also be disadvantages for some - students who need re-enforcement and encouragement from the instructor would benefit from being in a traditional classroom. Students might have “fixed” mindsets, especially earlier on in their educations, making it more difficult to use online classes.

Lack of student-teacher interaction can affect students’ outcomes. For some students it might be easier and more effective to ask questions while the instructor is explaining the material in a live setting. While it’s always possible to email the instructor when taking an online course, this can delay the learning process, since the student needs to wait for the instructor’s response. It is also more difficult for instructors to perform an audience analysis in an online course, since instructor does not meet the students face-to-face. In traditional settings, instructors have the opportunity to tailor course material and change their teaching techniques based on more immediate feedback from students in order to improve their learning outcomes.

Traditional School: Not for Everyone

Some students find it helpful to sit in a classroom where they are expected to learn a certain subject at a certain time.¹ Some students will benefit from live classroom settings where they have peers to interact with in the learning environment. Online schools/courses usually require students to communicate with each other through discussion boards or other modalities and students do not have the opportunity to meet each other in person.³

Online courses and assignments can be done anytime. If the student needs to spend more time completing them or has a day job then he/she can start anytime of the day and finish at his/her pace. Some students may lack self-confidence or be too intimidated to participate in discussions or other activities in the face-to-face classroom, and this may detract from their learning experience.

My Experience

Throughout my education I attended different class settings; traditional classrooms, online courses, blended learning, and practical and laboratory classes. Some of the online classes I took were easy to follow and I had reading assignments and discussion boards to participate in. On the other hand, I struggled through other online courses. For example, I took Calculus II online, which was challenging since I didn’t have live classes with a teacher explaining the material. Another example is Medical Ethics online course that I took and I didn’t feel the need of live sessions. I think it all depends on the course and how hands-on the material is.

For instance, patient care ability labs in pharmacy school needs a live environment. These labs usually involve demonstrations provided by the instructors. Also, students benefit from instructors’ feedback when they do the assigned activities. But there are classes that can be presented online, for instance patient communications would be suitable online course since all the assignments and teachings can be done in a virtual environment.

References:

¹ Stack, Steven. (2015) Learning Outcomes in an Online vs Traditional Course, 9(1), accessed online on September 16, 2017, (http://digitalcommons.georgiasouthern.edu/cgi/viewcontent.cgi?article=1491&context=ij-sotl).

² Means, B., Toyama, Y., Murphy, R., Bakia, M., Jones, K. (2010). Evaluation of evidence based practices in online learning: A meta-analysis and review of online learning studies. Washington: U.S. Department of Education.

³ Shachar, M., Neumann, Y. (2003) Differences between traditional and distance education academic performances: A meta-analysis approach. International Review of Research in Open and Distance Education, 4(2), accessed online on September 16, 2017, (http://www.irrodl.org/index.php/irrodl/article/view/153/234). 

Knowing Your Audience with the Myers-Briggs Type Indicator

by Tejas Patel, PGY-1 Pharmacy Resident, 

MedStar Union Memorial Hospital

Throughout our lifespan we will undoubtedly encounter a variety of personality types. Some we can relate with, others not so much. Psychiatrist Carl Jung theorized that we all have innate preferences, and that differences in these preferences is what sets us apart from others. He believed that we have natural, preferred ways of using our minds and directing energy. In addition, he believed behavioral habits develop as a result of people using their preferences.¹

From Jung’s theory of psychological types came about an instrument for applying his theories called the Myers-Briggs Type Indicator (MBTI). It is a questionnaire that qualitatively assesses an individual’s psychological type when it comes to perception of information and decision-making. There are 16 mutually exclusive personality types, taking into account four different dimensions of personality:

• extroversion vs. introversion
• sensing vs. intuition
• thinking vs. feeling
• judging vs. perceiving²

These four dimensions help answer where we focus/gather our energy, how we take in information, how we make evaluate information to make decisions, and how we organize the external world.³

When it comes to where we get our energy, extroverts pull it from an active environment and feel more energized when they are around other people.² These types are seen as outgoing, comfortable working in groups and like to jump into action. Introverts on the other hand derive their energy from within. They are seen more as reflective or reserved, and are comfortable completing tasks on their own.

When it comes to how we receive sensory input, those with a sensing preference pay more attention to information that they can physically observe through the five senses (seeing, hearing, touching, tasting, and smelling).² Facts, details, experiences and living in the present are key features of this type. The intuition type is interested in new things and future-oriented. This type enjoys starting off seeing the big picture, and would be more interested in theories or symbols as a means to receiving information.

When it comes to making decisions, those with a thinking preference like to analyze options, put emphasis on logic, and are task-oriented. As a result, decisions are made with the head. The feeling personality type takes into account the point-of-view of all persons involved in the situation, where decisions are made with the heart. The feeling personality type are individuals who are good at understanding people, human values, compassion, and empathy.²

Lastly, orientation to the outer world and lifestyle makes up our personality type. Those with a judging preference are more structured, plan ahead, and make lists. As a result, they tend to be more organized and can get unnerved if things do not go according to plan. The perceiving personality type tend to be more spontaneous, flexible, and adaptable to situations or changes. They like to stay open to new experiences and go with the flow.

In the realm of teaching and education, knowing your audience is a key component to effectively conveying information. In the specific scenario of pharmacy students, a majority of students comprise of the ISTJ personality type.⁴ That is to say they tend to have personality types that are more introverted, sensing, thinking and judging in nature. In reality, an instructor could administer an anonymous MBTI-esque assessment at the start of the semester. In turn, the instructor could obtain a better idea of the different personalities that comprise the class. From there, classes could be structured to incorporate differing levels of interactive vs. lecture-based learning. An instructor could also tailor his or her lectures to address both big-picture and detail-oriented aspects to relay the information to their audience. In the end, it is important to incorporate a fair balance in order to hit all the dimension types appropriately. However, better knowing the personality types of your students can help guide you to getting the most potential out of their learning abilities.

References:

1. The Myers & Briggs Foundation. MBTI Basics. http://www.myersbriggs.org/my-mbti-personality-type/mbti-basics/. Accessed 2017 Sept 14.
2. The Myers & Briggs Foundation. My MBTI Results. http://www.myersbriggs.org/my-mbti-personality-type/my-mbti-results/home.htm?bhcp=1. Accessed 2017 Sept 14.
3. MBTI. The Power of Personality. https://www.mbtionline.com/AbouttheMBTI. Accessed 2017 Sept 14.
4. Shuck AA and Phillips CR. Assessing Pharmacy Students’ Learning Styles and Personality Types: A Ten-Year analysis. Am J Pharm Educ. 1999; 63: 27-33.

Empowerment of Students

By Rachel Dewberry, PharmD

PGY1 Pharmacy Resident, MedStar Union Memorial Hospital 

What is empowerment?  Empowerment is defined as providing a student with a “sense of confidence, capability, competence, and self-esteem to meet life’s challenges”.¹

We often see students approach learning as an unbearable task, a task that will be incredibly difficult, with a topic where students worry that they are not smart enough to comprehend.¹ How can teachers reverse these thoughts and turn these students into empowered students?

Student empowerment starts with inspiration, encouragement, and recognition from educators.¹ When students gain recognition from educators, students will feel more capable, competent, and willing to continue the path of learning.¹ 

Some literature notes that there are certain strategies of empowerment, backed with research, that impact academic performance.¹ One of these strategies is reinforcement and recognition.¹ We often hear in classrooms the, “good job!” or “way to go!” to show a teachers satisfaction with a students performance. However, research shows this strategy does not work.¹ This strategy lacks explanation of what exactly the student did well on.  Instead, research shows that reinforcement/recognition connected with a standard of achievement, like grades, provides more empowerment to a student. Recognition that is clearly defined, measurable, and that is connected with a grade where a student can recognize their fault is more empowering than the “good job!” model.¹

Further, sometimes as educators, we need to step back and empower our students to take charge of their own learning. Students know their own selves better than any teacher could. They are aware of the things they are confident in, and things that challenge them, along with the dreams they have.² With that said, there are 5 strategies that can help to empower students at any age.

The first strategy is choice.² As educators it is our job to make sure students accomplish certain goals/expectations. However, a teacher could set the end goal for a student and allow the student the choice on which path to take to accomplish the end goal. This allows the students to be their own guide.² Bumps in the road may ensue, but the best type of learning comes from mistakes and corrections.² By identifying the mistakes and acknowledging how to not make the mistake a second time is truly empowering in itself.²

The second strategy is reflection.² Students who actively engage in the learning process need time to reflect on their knowledge and connections. This is essential to retention of material.  Reflection also allows for closure to situations, conversation on what went well and what went wrong, with a lesson naturally being taught in the reflection.² Reflection empowers students to make sense of what they are learning.²

The third strategy is allowing students to be teachers.² By allowing students to be teachers, they will have the opportunity to articulate their knowledge. Students are then given the chance to help others understand a concept, and by doing so, suggests and empowers the student that they too can be the expert on the topic.²

The last strategy is student voice.² “The most valuable voice in the learning environment is that of the student”.² The student is the consumer of the material being taught, and the consumer can provide feedback in regards to if their needs are being met.² By taking students feedback into account, a teacher can build a students trusts and empower the student to think critically about the information they are consuming.²

Students are our future. By empowering students today, we are investing in our future. It can be a challenge to empower students, however, these strategies can help to provide the first step of investing into our future.

1.   Denti L. Proactive Classroom Management [Internet].  Monterey Bay, (CA): Corwin: c2012. Proactive Teaching and Empowering Students: [cited 2017 April 17]; Available from: https://uk.sagepub.com/sites/default/files/upm-binaries/46479_denti_ch_1.pdf

2.   Brennan C. Empower Students: 5 Powerful Strategies [Internet]. Cheny, (WA): The Whole Child Blog; 2012 March 16. Available from: http://www.wholechildeducation.org/blog/empower-students-5-powerful-strategies

3.   Nichols JD. Empowerment and relationships: A classroom model to enhance student motivation. Springer; 2006 Oct 6; 9(2):149-161

Formative and Summative Assessment of Active Learning Activities

by Alex Accinelli, PGY1 Pharmacy Practice Resident, Sinai Hospital

This past July I had the opportunity to attend the AACP annual teaching seminar in Nashville, Tennessee. The main objective of the conference was to define, develop and evaluate active learning and its utility in pharmacy curricula. Active learning is defined as a process where students are engaged in learning activities that promote analysis, synthesis, and evaluation of class content¹. Active learning has become more popular in recent years because it has been shown to improve long-term memory retention when used in conjunction with traditional didactic learning activities¹. While the potential benefits of active learning have been well documented, accurate and consistent methods to measure its efficacy have not been clearly established. One of the more interesting sessions of the teaching seminar, presented by Dr. Adam Persky (University of North Carolina) and Dr. Melissa Medina (University of Oklahoma) focused on the use of formative and summative assessment as a tool to reward student participation and to evaluate the effectiveness of active learning activities.

          

How do we grade participation? 

        Often times, active learning incorporates participation-based activities that are difficult to grade because of their subjective nature². When describing her thought process about how to grade her first-ever active learning course, Dr. Medina recalled the difficult decision about how to award points for these assignments to promote student participation. “Should I just take attendance and give everyone the points or should I write down all of the students that responded? What if I don’t know everyone’s name? Also, how do I grade students when no one participates or if the same person answers all of the questions? It was gut wrenching. Somehow I made it through the semester but those participation points haunted me and in the end I gave all of the students all of the points because I felt it was the only fair thing to do.”³ Dr. Medina learned a lot from that early teaching experience and with each semester she learned better ways to assess active learning, including when and how to award points, what to avoid when grading active learning, and when points aren’t really needed. 

Formative or Summative? 

          The presentation began by discussing the general differences between formative and summative assessments, and then went on to explain when to use each type. To best identify when to award points for active learning, one of the most important factors to consider is the ultimate goal of the assessment³. If the goal is to provide ongoing feedback to help students monitor and improve their learning, then low stake, formative types of assessment should be used with little to no points for the activity. Formative assessment can be used for or during the active learning activity because it is diagnostic and helps students identify their strengths and weaknesses.  Often time’s students really want this kind of formative feedback but they need to be motivated (given a few points) to participate.  In contrast, if the goal is to evaluate student learning at the end of the content area or course to be compared against standards or benchmarks and determine achievement of a final product, then summative assessment is the best choice.  Summative assessments are high stakes and are associated with high points that contribute to a final grade such as on a midterm, final exam, project, presentation, or report.  

          The speakers then focused on sharing examples of types of formative assessment for active learning. Dr. Medina explained how the majority of active learning assessments should be formative in nature, with the goal to make student thinking visible and then give them feedback. Examples of formative assessment include quizzes, clicker questions, minute papers, concept maps, and think-pair-share activities. Pre/post quizzes are great for providing students feedback about how much knowledge they gained during the activity. Clickers are useful for helping students monitor their learning during instruction. Minute papers allow students to summarize the most important points of the activity. And concept maps and think-pair share activities allow students to organize the material and determine the relationships between all concepts learned. Concept maps can be graded based on the number of cells and connections created. No points are typically needed for think-pair share activities.

Training for Instructors

          Interspersed throughout the days presentations were scheduled active learning activities. The activity for this presentation was to create a minute paper about which assessment strategy we are most likely to use and why (choices were quizzes, clickers, minute papers, concept maps, or think pair share). I chose quizzing because it I think it is a fast and effective way to provide students feedback about how much knowledge they gained during the activity. Low stakes quizzing also promotes participation and preparation. I thought the use of active learning to “teach” active learning was a really cool and effective way to present the lecture material. The presentation ended with a summary of the pros and cons of case-based and team-based learning and discussed the use of rubrics that are clear and explicit to assess case responses in formative or summative scenarios, giving examples of each.

          Overall, I really enjoyed the teaching seminar and thought that a lot of the active learning session topic presentations were really interesting. As a student, I know I was much more engaged with content material when active learning activities were utilized. As a future educator I think there is still a lot of room to improve the organization and use of effective active learning activities in the pharmacy curricula. The utility and theoretical basis of active learning has been briefly discussed throughout this course. However, recommendations for how to organize, assess and evaluate these activities have not been as well defined. This presentation provided important information for future educators to consider when designing courses that will be utilizing active learning activities. I believe that the implementation of these strategies will improve student participation by exhibiting clear rules for how and when to grade participation in active learning sessions. I recommend that all future pharmacy educators try to attend AACPs annual conference as it is aimed at improving pharmacy education and has many unique exhibits that I believe future educators will find very valuable.

         

References:

1)   Ambrose et al., 2010, How Learning Works. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3557656/

2)   Gibson K. and Shaw C. 2010, Assessment of Active Learning.

http://webs.wichita.edu/depttools/depttoolsmemberfiles/carolynshaw/Gibson%20Shaw%20compendium.pdf

Medina. 2017. Formative & Summative Assessment of Active Learning. University of Oklahoma Colleg

How Millennial Learners are Making Educators “Flip-Out”

Sarah Fillman, PharmD, Sinai Hospital of Baltimore PGY1 Resident

Generational diversity is a hot-button issue that has gained increased attention in recent years particularly when discussing the millennial generation. For some, this topic is nothing more than entertaining internet banter, but truly understanding this concept is vital for the successful education of this cohort. Differences between generational cohorts can be applied to help educators understand how their students will learn best. A significant amount of research in this area has been published over the years focusing on the millennial generation. One particularly interesting concept is the application of an instructional model called the “flipped classroom” and the success it has had for educating millennial students.

So what exactly is a “flipped classroom”?

The concept of the flipped classroom has been around for many years, with some of the earliest work starting in the 1990s. Its development was influenced by the desire for educators to move away from the traditional lecture and to incorporate teaching styles that would accommodate students with all types of learning styles. To do this, educators would need significantly more contact time with students, which has been made possible with advances in multimedia and internet-based resources. The flipped classroom ultimately works by taking the lecture activities normally done inside the classroom and swapping them with the conceptual practice typically done outside of the classroom. Students are expected to come to class prepared with content knowledge they obtain through materials viewed outside of class, including pre-recorded lectures, PowerPoints, textbook readings and a variety of other modalities. Once in class, they are engaged through a multitude of different educational techniques to help them apply the concepts with the help of the instructors and classmates.¹

What do millennials have to do with this?

          The flipped classroom instructional model may be used in many settings and can be adapted to all types of learners. In fact, one the key benefits of the flipped classroom is the ability to engage people with all types of learning styles by allowing them to use whatever method works best for them to obtain content knowledge via self-directed efforts.¹ The millennial generation, identified as individuals born between 1983 and 2002, has been characterized by some as tech-savvy individuals who may prefer team projects and could potentially have difficulty thinking individually.² Roberts et al. have provided tips to teach these students, which include a focus on team dynamics and encouraging collaboration.³ However, there is not complete agreement on this characterization of millennials, nor on the use of one particular teaching style. DiLullo et al. have stated that this singular view of millennial learners is not supported by current evidence. Instead, they found that the statistics show considerable diversity in the millennial cohort that ultimately results in a variety of preferred learning styles.⁴ Regardless of this incongruence in defining the millennial learner, the flipped classroom is an adaptive instructional model that has been proven efficacious in these learners, with a significant volume of research focusing on its use in the instruction of healthcare professionals.

How does this apply to healthcare education?

At this point in time, almost all millennials have completed high school and many are currently enrolled in higher educational programs at all levels. The flipped classroom model has been studied in a variety of educational settings, with researchers finding that it resonates well with millennial students. Lucardie et al. described the implementation of this instructional model in the training of millennial-aged medical residents, concluding that the high level of interaction and collaboration is advantageous for this cohort of students.⁵ Numerous studies have documented the effectiveness of the flipped classroom in healthcare professionals in terms of improved grades and student perception of the educational experience. Examples of this include how Galway et al. demonstrated a significant improvement in mean examination scores between public health students enrolled in a flipped classroom course compared to the previous year’s students who learned via traditional lecture.⁶ McLaughlin et al. evaluated pharmacy student perceptions of the instructional modal, finding that 89.5% of students said they preferred the instructional format after completing the course.⁷ McLean et al. went on to show that the flipped classroom is not only efficacious in these surface level evaluations, but that medical science students reported improved development of their own independent learning style and enhanced deep or active learning engagement.⁸ This multitude of evidence supporting the use of the flipped classroom model in the instruction of millennial healthcare professionals is compelling enough for many educators to want to jump right in to this instructional model, however, there are several caveats to its real-world implementation.

What are the practical implications of implementing the flipped classroom model?

          Before jumping in to designing a flipped classroom, there are a multitude of limitations to consider. This instructional model requires a significant amount of contact time between instructors and students, making it much harder to implement with particularly large classroom sizes. While millennial students are of the Internet generation, being significantly more tech-savvy than their predecessors, there are limitations to the use of technology for dissemination of learning materials. Advances in technology are costly and not every student will have equal access, nor the experience to manage them effectively. Additionally, there is a significant time-investment for educators in developing a multitude of educational materials ahead of time.¹ Finally, it is important to understand that generational diversity is only one type of diversity that will influence the classroom. For instance, Moraros et al. found that international students were more likely to rate the flipped classroom model as being effective than American students.⁹ With these considerations in mind, educators can begin to assess the practicality and net benefits of implementing a flipped classroom instructional model based on the type of students they will be instructing and the ultimate goals of their educational experience.

References

1.    Lage M, Platt G, Treglia M. Inverting the Classroom: A Gateway to Creating an Inclusive Learning Environment. J Econ Edu. 2000;31(1)30-43.

2.    Johnson SA, Romanello ML. Generational diversity: teaching and learning approaches. Nurse Educ [Internet]. 2005 Sep-Oct [cited 2017 Sep 9];30(5):212-6. Available from: https://www.chw.org/~/media/Files/Medical%20Professionals/Nursing%20Students/Preceptors/generational%20diversity%20teaching%20and%20learning%20approaches.pdf

3.    Roberts DH, Newman LR, Schwartzstein RM. Twelve tips for facilitating Millennials' learning. Med Teach [Internet]. 2012 [cited 2017 Sep 9];34(4):274-8. Available from: http://www.xyoaa.org/sites/all/modules/ckeditor/ckfinder/ckfinder/userfiles/files/education_materials/Millennials%27%20Learning%20Tips.pdf  doi: 10.3109/0142159X.2011.613498

4.    DiLullo C, McGee P, Kriebel RM. Demystifying the Millennial student: a reassessment in measures of character and engagement in professional education. Anat Sci Educ [Internet]. 2011 Jul-Aug [cited 2017 Sep 9];4(4):214-26. Available from: https://www.ncbi.nlm.nih.gov/pubmed/?term=10.1002%2Fase.240 doi: 10.1002/ase.240

5.    Lucardie AT, Berkenbosch L, van den Berg J, et al. Flipping the classroom to teach Millennial residents medical leadership: a proof of concept. Adv Med Educ Pract [Internet]. 2017 Jan 13 [cited 2017 Sep 9];8:57-61. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5245808/ doi: 10.2147/AMEP.S123215

6.    Galway LP, Corbett KK, Takaro TK, et al. A novel integration of online and flipped classroom instructional models in public health higher education. BMC Med Educ [Internet]. 2014 Aug 29 [cited 2017 Sep 9];14:181. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4167261/ doi: 10.1186/1472-6920-14-181

7.    McLaughlin JE, Griffin LM, Esserman DA, et al. Pharmacy student engagement, performance, and perception in a flipped satellite classroom. Am J Pharm Educ [Internet]. 2013 Nov 12 [cited 2017 Sep 9];77(9):196. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3831407/ doi: 10.5688/ajpe779196

8.    McLean S, Attardi SM, Faden L, et al. Flipped classrooms and student learning: not just surface gains. Adv Physiol Educ [Internet]. 2016 Mar [cited 2017 Sep 9];40(1):47-55. Available from: http://advan.physiology.org/content/40/1/47.long doi: 10.1152/advan.00098.2015

9.    Moraros J, Islam A, Yu S, et al. Flipping for success: evaluating the effectiveness of a novel teaching approach in a graduate level setting. BMC Med Educ [Internet]. 2015 Feb 28 [cited 2017 Sep 9];15:27. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4363198/ doi: 10.1186/s12909-015-0317-2

Learning From the Best

By Rafah Saad, PGY-2 Geriatric Pharmacy Resident, 

University of Maryland School of Pharmacy

‘Teaching occurs only when learning takes place.'

Being part of a large academic center, I knew teaching was a major component of my residency program. Not having much teaching experience in the past in addition to not being a student for over ten years, I began looking for ways to learn how to teach. In my search for means to build upon my teaching skills, I came across this book ‘What the Best College Teachers Do' by Ken Bain for some insight. This book is based on extensive research on teaching. In his pursuit to find out what the best college teachers do, he conducted a study of 63 of the best college professors from 40 different disciplines to see what they do. His research lasted about 15 years. Most of the teachers he interviewed mainly taught undergraduate students with a few graduate professors.  He chose the teachers to be included in the study by interviewing students that were highly satisfied with their teachers. He also searched for teaching award winners. He sought out professors with exceptional reputations who were recommended by other professors. He questioned what they understood about learning, how they prepared for classes, how they evaluated themselves and their relationship with their students, and many other aspects of teaching and learning. In this post I chose a few of his findings that resonated with me.

Bain found that the best college professors are truly passionate about their work, they are enthusiastic, and want to share their knowledge with their students. They try to instill their passion into the classroom since they believe that students learn best when they are also passionate and curious about the subject matter. They also know their subject matter extremely well and know how to explain it in a way that is more conversational than a typical lecture. I have had teachers in the past that just do the bare minimum, have no motivation and just lecture for an hour and leave. This teaching style had left me feeling just as unmotivated and that I was learning the material just to pass the exam. I have also had teachers who loved what they were teaching and wanted every student to be just as passionate as they were. These were the teachers and the subjects that I remember.

The way most successful teachers plan their teaching sessions plays a significant role in teaching and learning. It is imperative for the teachers to know their students and build strong, trusting relationships. To become a great teacher, one must understand what motivates their students to learn, what helps them learn better, and which teaching style to use. They design their classes by focusing on the students and what they need to learn. In teaching complex subjects, they start with simple concepts and move towards the more complicated. They concentrate on the teaching objectives and then plan backward starting with the desired results and assess the students’ comprehension based on those learning objectives. They also modify the lesson plan to fit the needs of the students better and are not held to a set lesson plan. Most of my education occurred in a lecture-based classes where the teachers had their established lesson plans and just explained the subject matter without considering the needs of the students. I felt most of my learning was self-directed, attempting to understand the subject matter on my own. I would like to develop a more facilitative role as teacher to help students to take responsibility for their learning. 

  In his research, Bain found that great teachers provide a safe non-judgmental environment where questions are welcome. I am not usually comfortable asking questions and speaking my mind in large classrooms, so I learn best in a classroom that feels open and safe from criticism. 

Finally, they are always striving to better themselves. They are continuously evaluating themselves and making appropriate changes accordingly. I still remember my biochemistry professor that had taught me almost fifteen years ago; I went to his office to ask a question and saw a book on his desk that he was reading on how to be a better teacher. He was in his seventies and had been teaching for decades. I asked him why he was reading that book and he said he would never stop learning and will never stop trying to be a more effective teacher.

Conclusion:

I know these professors are the exceptions and not the rule.  I am still in the process of finding my teaching style and trying to learn as much as I can from teachers that motivate. But what I do know is that I strive to be a teacher that inspires students to learn.

References:

Bain, Ken. What the Best College Teacher Do. Harvard University Press, 2004.

Testing as a Form of Learning in the Classroom

by Alison Blackman, PGY-1 Pharmacy Practice Resident, University of Maryland Medical Center

       

        Testing and assessing student knowledge appropriately in the classroom is an area of education that I feel is often subjective and left up to the opinion of the educator. Having completed my higher education, I have seen a multitude of different testing strategies – some that I felt were successful, while others I did not view as effective. Testing is inevitable in the classroom. However, I believe it should be an extension of education rather than solely being viewed as a grade. Herein, I will be discussing various ways testing can be creatively integrated into the classroom as a learning tool.

Pre-Tests

        There are many techniques discussed for how testing can be incorporated in the classroom. One article discusses three ways to use testing as a learning tool.¹ Some of these strategies include handing out pre-tests, spacing out information/exams, and utilization of recitation activities such as “think pair share” and other activities outside of lecture. The strategy that I found most interesting revolved around the idea of pre-tests. The article highlights the following, “The mere act of guessing engages your mind in a different and more demanding way than straight memorization or being fed answers.” Another article hypothesizes further that pre-tests may enhance learning by acting as tools to prime the brain for what is important and providing multiple possible answers for the tester to second guess themselves in order to truly assess their knowlege.² Getting information wrong by guessing helps the brain recall information more rapidly. ² This particular article highlights that “failure” is a tool that aids the mind in memorization.

Exam Questions: Open-ended vs. closed-ended

Another area of contention that I found in my search was the utilization of open-ended exam questions versus close-ended questions. One study analyzed the use of open-ended questions in an engineering program.³ The authors of the study point out that closed-ended questions require only one correct answer, whereas open ended questions require critical thinking and an in-depth understanding of the subject. What was interesting to me is that the authors of the study suggested that open-ended questions should make up 10-20% of a final exam – recognizing this is not a well-studied suggestion. I pose a counter question as to why an educator should not make up an exam that is all open-ended questions. It was the open-ended exams during my pharmacy school education that I retained the most information and still recall that information today. However, it should be noted that this is an opinion of the writer and it is recognized that the logistics of this testing method may be difficult in a large classroom setting and opens the door for students to criticize that the teacher had biases while grading. On the other hand, the article by Carey suggests that exposing students to multiple-choice exams allows the student to question whether they truly know that answer by seeing other options.² Regarding final assessment, and in the context of pharmacy school, I disagree with the overuse of multiple-choice exam questions. I see where the author is coming from in that if I student confidently knew the answer, they would select it correctly; however, I think that multiple choice exams limit the amount of information to be tested and are not always an accurate measure of students’ knowledge on the subject.

Another testing strategy that I found interesting, especially in the context of pharmacy school was an article that focused on a team, case-based examination in a patient safety and informatics course.⁴ Rather than the traditional test, professor developed higher level activities. Utilizing previous strategies discussed, the course also administered a pre- and post- survey for students to self-reflect upon their ability to perform what was taught in the class. Overall, the mean score on the exam was 93.6% and 81% of the students reflected that the exam was beneficial for their learning. It is recognized that this mode of testing is not feasible in the majority of subjects, but may be an option in lab or more “hands-on” courses.

       

Overall, there are many ways to test student knowledge. Some ways promote learning over others. When discussing teaching, educators being aware of various student learning styles is often a hot topic. It seems to me that testing is something that should fall under this category, however it is not often emphasized. I believe that educators should be aware of student assessment styles as well as strategically select appropriate testing strategies in order to enrich student learning. Optimal assessment of knowledge will always be an area that is debated as education evolves. As a future teacher, whether it is in the classroom or as a preceptor, I will try my best to incorporate creativity and be aware of testing options that promote learning rather than fear of a grade.

References

1. Pillars W. 3 ways to use testing as a learning tool. Education Week. 2015. Accessed September 2, 2017 <http://www.edweek.org/tm/articles/

2015/05/12/3-ways-to-use-testing-as-a.html>

2. Carey B. Why flunking exams is actually a good thing. The New York Times Magazine. 2014. Accessed September 2, 2017 < https://www.nyt

imes.com/2014/09/07/magazine/why-flunking-exams-is-actually-a-good-thing.html?_r=0>

3. Husain H, Bais B, Hussain A, et al. How to construct open ended questions. Social and Behavioral Sciences. 2012;60:456-462

4. Beckett RD, Etheridge K, DeLellis T. A team, case0based examination and its impact on student performance in a patient safety and informatics course. The American Journal of Pharmaceutical Education. 2017;81(6):Article 117