Academic journal article American Journal of Pharmaceutical Education

Combination of a Flipped Classroom Format and a Virtual Patient Case to Enhance Active Learning in a Required Therapeutics Course

Academic journal article American Journal of Pharmaceutical Education

Combination of a Flipped Classroom Format and a Virtual Patient Case to Enhance Active Learning in a Required Therapeutics Course

Article excerpt


Educational outcomes and accreditation standards in pharmacy education urge faculty members to replace traditional lecture-based formats with active-learning strategies that promote higher cognitive learning. (1,2) While a lecture allows faculty members to disseminate information to a large number of students, it does not provide students with the opportunity to practice higher-order cognitive skills such as application, analysis, and synthesis. (3,4) Engaging students in active learning affords students the opportunity to practice higher-order cognitive skills, fosters critical-thinking and problem-solving skills, and leads to a better degree of understanding. (3,5,6) Moreover, active-learning strategies prompt students to explore their personal attitude towards learning, and foster the motivation to acquire more knowledge. (6) In response to the recommendations set forth by accreditation and education councils, schools of pharmacy have sought to integrate innovative, active-learning strategies to promote inductive reasoning and self-directed learning. (4)

Two examples of active-learning strategies include the flipped classroom and virtual patients. The flipped classroom is a student-centered pedagogy in which students complete pre-class work to gain basic knowledge, and class time is dedicated to activities that promote application and mastery of this knowledge. (7) Flipped classrooms have been successfully implemented at the kindergarten to 12th grade educational level as well as within higher education, including health professionals education. (7) Instructors at several different pharmacy schools have integrated flipped classrooms into their curricula. (8-14) Within flipped classrooms in pharmacy education, preclass work typically consists of readings (textbook, Web-based, or literature) or videos that students can complete or watch at a pace suitable to their own learning needs. Class time in this model is interactive, requiring students to develop their knowledge and skills through active-learning strategies, including small-group problem solving, debates, role-play, student presentations, small-group sharing, and case-based activities. Students have indicated that they value this classroom structure because it promotes engagement in the material and the development of higher-order cognitive skills like reasoning and problem-solving. (8,10,14)

Virtual patients have been used effectively in the training of students in different healthcare disciplines, including medicine, dental medicine, nursing, and pharmacy. (15-18) Virtual patients simulate lifelike clinical scenarios in which the learner becomes the healthcare professional, making clinical decisions in a safe environment. (19) This technology provides opportunities for students to practically apply course learning objectives, and it can be programmed to provide immediate feedback to the learner. (16,19) Implementation of virtual patients into curricula has been associated with achievement in knowledge, clinical reasoning, and skill outcomes, although qualitative research to date has not definitively demonstrated superior outcomes compared to other educational interventions. (16,20)

Both flipped classrooms and virtual patients have been implemented into courses at the University of Pittsburgh School of Pharmacy to enhance the overall learning experience for students. (21-24) However, to our knowledge, combining these active-learning strategies had not been attempted. Our study assessed the design, implementation, and evaluation of a novel approach that integrated a virtual patient activity in a therapeutics course that already used a flipped classroom model of learning.


Gastroenterology and Nutrition is a required two-credit hour course for second-year doctor of pharmacy (PharmD) students at the University of Pittsburgh School of Pharmacy that is a part of the therapeutics learning sequence. …

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