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
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