How we learn medicine has changed little since the last great reform in medical education that took place in North America in the early 1900s. Since then, teaching and learning in medicine has centered on the didactic lecture, supplemented by hefty tomes and musty journal articles.
It’s time for a change.
We need to be able to teach and learn more efficiently, given the ever growing and ever more complex body of knowledge we are expected to command.
One way this may be achieved is by flipping the classroom, as advocated in a recent NEJM article written by Prober and Heath.
The idea is that with the rise of online educational media (most of which is freely available, you know the stuff — some of us like to call it FOAM) and individual interactive instruction there is often no need for a didactic ‘one way’ lecture held within the confines of a lecture hall. A better way to learn and teach is for the student to watch the video, listen to the podcast and read the blogpost even before the teaching session begins. Don’t get me wrong, this does not mean that we can dispense with teachers and simply let Scott Weingart, Amal Mattu and HQMEDED do all the didactic stuff.
Instead of the teacher holding a one way conversation, time in the medical classroom can be better spent. The teacher could lead an open discussion where students clarify issues raised from the assigned asynchronous learning resources (Socrates was onto something I reckon), or the time could be dedicated to supervised simulation sessions, or debates, or quizzes, or case-based discussions… or whatever your imagination can dream up to facilitate active contextual learning that actually works.
In some subjects such as physics, researchers have found that this flipped classroom model works better than the standard approach — even when the traditional model features lectures by a Nobel Prize-winning physicist. Interestingly, TED.com has developed a tool for teachers in schools to create customised contextualised versions of their videos so that teachers can use them for flipped learning. The flipped classroom model certainly has some enthusiastic proponents among school teachers who have tried it, such as the writer of this Edudemic article titled To Flip or Not Flip?.
Will medicine be the last to widely adopt this approach?
Perhaps it is time for us to put some velcro on the soles of our shoes and tip medical classrooms upside down?
If you’re using a flipped classroom model for medical education be sure to leave us a comment about your experience.
- Prober CG, Heath C. Lecture halls without lectures – a proposal for medical education. N Engl J Med. 2012 May 3;366(18):1657-9. PubMed PMID: 22551125.
Addendum 16th August 2012
The most recent edition of the NEJM featured correspondence to the paper by Prober and Heath. There were calls for education to be prioritised and valued by institutions to decrease the gap between evidence and educational practice, a recognition of some of the barriers to innovation, also commentary that flipping the classroom may be even more important for graduate students, and a call for a Khan Academy for medical education…