Flipping the Classroom with Med U STFM Conference

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Flipping the Classroom with Med. U STFM Conference on Medical Student Education January 29,

Flipping the Classroom with Med. U STFM Conference on Medical Student Education January 29, 2016 Stephen Scott, Weill Cornell Medicine-Qatar Katie Margo, University of Pennsylvania Regina Kovach, Southern Illinois University Glen Medellin, University of Texas San Antonio Jeffery Hogg, West Virginia University Leslie Fall, Geisel School of Medicine at Dartmouth

Disclosure We’ve developed cases and educator resources with support from Med. U. Stephen Scott

Disclosure We’ve developed cases and educator resources with support from Med. U. Stephen Scott – fm. CASES Katie Margo – fm. CASES Regina Kovach – SIMPLE Glen Medellin – CLIPP Jeffery Hogg – CORE Leslie Fall – Med. U Executive Director

Pre-learning • Sent via e-mail invitation: – https: //s 3 -us-west 2. amazonaws. com/medu/email/Flip_Classroom_Med.

Pre-learning • Sent via e-mail invitation: – https: //s 3 -us-west 2. amazonaws. com/medu/email/Flip_Classroom_Med. U_Pre. Learning_Resources. pdf • Or, review now… – CLIPP case 2 (card 10 & answer key) and Case 30 • http: //www. med-u. org/clipp – CDC vaccine schedule • http: //www. cdc. gov/vaccines/schedules/hcp/childadolescent. html – SHOTS! - Mobile app or online • http: //www. immunizationed. org/Shots-Mobile-App • http: //shotsonline. immunizationed. org/

Warm-up 9 -month-old baby boy comes for his well child visit – – 50

Warm-up 9 -month-old baby boy comes for his well child visit – – 50 th percentile for weight, length, and head circumference All developmental milestones met appropriately Mother has no concerns The child has previously received the following vaccines: 3 doses DTa. P 2 doses Hep. B 2 doses IPV 3 doses Hib 3 doses Rota. V 3 doses of PCV 13 No influenza vaccine Which vaccines should the child receive at today’s visit? A. B. C. D. E. Influenza, Hep. B, IPV, DTa. P Influenza, IPV Influenza, Hep. B, IPV Hep. B, DTa. P, IPV Hep B, IPV, and MMR

Warm-up 9 -month-old baby boy comes for his well child visit – – 50

Warm-up 9 -month-old baby boy comes for his well child visit – – 50 th percentile for weight, length, and head circumference All developmental milestones met appropriately Mother has no concerns The child has previously received the following vaccines: 3 doses DTa. P 2 doses Hep. B 2 doses IPV 3 doses Hib 3 doses Rota. V 3 doses of PCV 13 No influenza vaccine Which vaccines should the child receive at today’s visit? A. B. C. D. E. Influenza, Hep. B, IPV, DTa. P Influenza, IPV Influenza, Hep. B, IPV Hep. B, DTa. P, IPV Hep B, IPV, and MMR

Exercise • Form teams of 2 -3 • Together, review the question on the

Exercise • Form teams of 2 -3 • Together, review the question on the following slide • Determine your best answer

Sylvia just turned one year old and is new to your clinic. Mom doesn’t

Sylvia just turned one year old and is new to your clinic. Mom doesn’t think that she got all of her shots, but expresses concern that she has already received “so many. ” Sylvia’s DOB is 8/6/14, and today’s date is 8/15/2015. She has received the following vaccines: Which vaccines will you give today?

Follow-up question: How many vaccines can be given today? A. 3 B. 4 C.

Follow-up question: How many vaccines can be given today? A. 3 B. 4 C. 5 D. 7 E. 9

Case Exercise Concepts • Key learning objective – Develop an immunization strategy for child

Case Exercise Concepts • Key learning objective – Develop an immunization strategy for child delayed on immunizations (clinical practice). • Generalizable concepts & principles – Vaccine periodicity: Routine vaccines are administered according to a schedule of periodicity. – Missed opportunities: Providers should not miss opportunities to immunize children

What is the flipped classroom? • Students learn facts or concepts prior to class

What is the flipped classroom? • Students learn facts or concepts prior to class – Text, video, PP – under 1 hour • Classroom time is devoted to – Application – Integration – Reinforcement

Myths and Realities • What it is NOT – Just online videos (started by

Myths and Realities • What it is NOT – Just online videos (started by Khan Academy) – Replacing teachers – Students just working on their own • What it IS – Increase interaction with other students and teachers – Teacher as guide – Increase engagement of students – Allows teacher to monitor what students need

Science • Active learning/learner centered – Reflecting helps learning – Tests help learning and

Science • Active learning/learner centered – Reflecting helps learning – Tests help learning and retention – Spaced out and varied learning = better retention – More effort= better learning! – Consolidation to long term memory, then retrieval • Make it stick, The Science of Successful Learning by Brown, Roediger and Mc. Daniel

Team-Based Learning • Prescribed method of flipped classroom – Pre-learning – Individual test –

Team-Based Learning • Prescribed method of flipped classroom – Pre-learning – Individual test – Group test – Competition and scoring – Then application exercises • Lots of examples on FMDRL, etc. • Thompson article: need champion, teacher training, start students early, not add to curriculum – should replace something

Literature on Active Learning • Ob-gyn paper (Morgan) – took less time for content,

Literature on Active Learning • Ob-gyn paper (Morgan) – took less time for content, high satisfaction, more chance for discussion and questions, no change shelf • Surgery paper (Liebert) – took less faculty time, no change shelf scores, high student satisfaction, higher career interest • Radiology paper (Belfi) – improved scores, high student interest • Anatomy paper (Mc. Nulty) – practice exams slightly increase exam scores. • fm. CASES SAQ paper – use of SAQs increases score on fm. CASES exam! (come to our presentation!)

Med. U Educator Resources • • Questions for further consideration Case analysis tool CLIPP

Med. U Educator Resources • • Questions for further consideration Case analysis tool CLIPP active learning modules CORE classroom flipping workshops • http: //www. med-u. org/educator-community

Questions for further consideration • Team-based learning “light” – Assign the QFC (higher order

Questions for further consideration • Team-based learning “light” – Assign the QFC (higher order Bloom’s taxonomy question) to teams – Assign similar QFCs to different groups. Have the students teach other at the end • Variation: Question pairs – Students develop questions during pre-work – Assign and work on during active learning session

Case analysis tool • Staged, structured process • Assess student’s clinical reasoning and provide

Case analysis tool • Staged, structured process • Assess student’s clinical reasoning and provide individualized feedback • Multiple approaches – Use with a Med. U case – Apply to real case or challenging patient presentation – Complete individually or with groups

CLIPP Active Learning Modules • Application exercises for educators to use with students in

CLIPP Active Learning Modules • Application exercises for educators to use with students in small or large group settings • Designed to minimize teacher preparation time and maximize learner engagement • Core concepts – Pediatric immunizations – Fever – Important dermatologic problems – Prescription writing/Patient safety – Child development: Identifying and classifying speech delay

Active learning modules • Apply core concepts to new and more complex scenarios •

Active learning modules • Apply core concepts to new and more complex scenarios • 1 -3 case vignettes, or “application exercises” • 1 -4 questions that do one or more of: – React to a clinical scenario – Interpret laboratory or other diagnostic data – Respond to previously unseen information • Can only be answered by synthesizing and applying the information learned

CORE Classroom Flipping Workshops • Instructor powerpoint presentation and application questions for each CORE

CORE Classroom Flipping Workshops • Instructor powerpoint presentation and application questions for each CORE case • Applies content of CORE case to new patient case scenarios • Workshops have been developed and published for each of the 17 CORE cases

https: //www. youtube. com/watch? v=s. Dm. CK 9 l. MLSE&feature=youtu. be

https: //www. youtube. com/watch? v=s. Dm. CK 9 l. MLSE&feature=youtu. be

Q&A • Where are your greatest challenges in teaching third-year students about family medicine?

Q&A • Where are your greatest challenges in teaching third-year students about family medicine? • Which tools would be most helpful for fm. CASES? • Would you like to join us in this work?