Academic journal article American Journal of Pharmaceutical Education

Student Engagement with a Flipped Classroom Teaching Design Affects Pharmacology Examination Performance in a Manner Dependent on Question Type

Academic journal article American Journal of Pharmaceutical Education

Student Engagement with a Flipped Classroom Teaching Design Affects Pharmacology Examination Performance in a Manner Dependent on Question Type

Article excerpt


Today's students face intense cognitive challenges. Learning outcomes that increasingly address higher levels within Bloom's cognitive domain require students to develop skills and attitudes needed to solve problems, predict outcomes, and deal with novel clinical scenarios. (1) Teaching methods must therefore be adapted to effectively prepare students.

Carefully designed instructional approaches can help students meet various aspects of the problem-solving process. These include: defining and understanding a problem, researching for information, delineating new terms and analyzing relationships between variables, hypothesizing or planning solutions to the problem, and checking that the proposed solution is consistent with all elements of the scenario. The flipped classroom approach offers a teaching design that can assist students to do many of these tasks. The basic premise of the approach to a flipped or inverted classroom is to require students to study content prior to class so that class time can be devoted to active learning activities. (2,3) Pre-learning and related feedback can help with defining terms (developing the language of the new area), and understanding the problem. In-class active learning approaches in which students tackle problems and apply, analyze and synthesize have been proven to improve student performance. (4-6) Specific approaches that ask students to produce diagram representations of their understanding such as concept mapping can assist with comprehension of the inter-relationships between variables. (7) The flipped classroom approach proposes that students engage with pre-class activities that prepare them for in-class active learning. Thus, there is a proposed synergistic relationship between student preparation for class and in-class active learning (8) that could be seen in assessments.

Within the flipped classroom environment, there are many different approaches to in-class activity design, depending on the nature of the intended learning outcomes. Scenario-based learning is a method that is based on the principle of situated cognition, (9) which states that "knowledge is situated, being in part a product of the activity, context, and culture in which it is developed and used." Scenario-based learning can help students learn problem-solving strategies by exposing them to the requisite variety and complexity of novel scenarios and problems that they might face as employed graduates. In this environment, students can learn to propose new hypotheses to solve novel scenarios and to evaluate outcomes to test whether their proposed solution fits all elements of the scenario.

The theoretical framework for our work combines instructional approaches that invoke Brown's situated cognition (9) as the specific arm of a social constructivist approach pioneered by Vygotsky. (10) Ausubel and Novak's meaningful learning theory offers an effective and behavioral viewpoint as it considers students' attitudes to and motivation for learning. (11) The important requirements for deep meaningful learning proposed by Ausubel and Novak are connection of new information to what a learner already knows (prior knowledge); relevance of new concepts; and active integration of new concepts into a learner's cognitive structure (learner's choice). This theory stresses the active role of the learner in knowledge construction.

We aimed to investigate the relationship between student engagement with the key elements of a flipped classroom approach (preparation and attendance), their attitudes to learning, including strategy development, and their performance on two types of examination questions (knowledge recall and providing rational predictions when faced with novel scenarios). We predicted that students would develop strategies to solve novel problems if they prepared for and attended classes because the instructional approach would help them define terms, understand the problem and inter-relationships between variables, and develop skills in producing and testing hypotheses to solve the problem. …

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