Flipping Out:
Using Principles of Inverted Teaching
in Medical Education
Leigh Patterson, MD
LaToya Griffin, PhD
Learning Goals
1. Define the modality of inverted teaching
commonly called the “Flipped Classroom”.
2. Explore the advantages, challenges, and costs
of inverting your teaching.
3. Develop plans to teach a lesson using an
inverted approach.
Counting Vowels in 45 seconds
How accurate are you?
Count all of the vowels
in the words on the next slide.
Slides from Sandra McGuire, Louisiana State University
Dollar Bill
Dice
Tricycle
Four-leaf Clover
Hand
Six-Pack
Seven-Up
Octopus
Cat Lives
Bowling Pins
Football Team
Dozen Eggs
Unlucky Friday
Valentine’s Day
Quarter Hour
NOW LIST ALL OF THE WORDS
FROM THE PREVIOUS SLIDE IN 2 MINUTES.
HOW SUCCESSFUL WERE YOU?
How Do We Learn?
• As teachers, we must:
– provide learners with clear instructions and expectations.
– frame the content in a way that students understand its relevance.
– assess their learning in a manner that is consistent with the content delivered
(e.g. exam material should match lecture/slide content)
– give them multiple no/low-stakes opportunities to develop and demonstrate
mastery of material.
• What could I have done differently in your pop quiz?
• What could you have done differently to help you better retain the words?
– Read the words out loud
– Rewrite the words
– Split the words with your neighbor, look for trends and explain how your
words represent a number.
Dollar Bill
Dice
Tricycle
Four-leaf Clover
Hand
Six-Pack
Seven-Up
Octopus
Cat Lives
Bowling Pins
Football Team
Dozen Eggs
Unlucky Friday
Valentine’s Day
Quarter Hour
How Do We Learn?
Mastery
Level
LOWEST
HIGHEST
Average Retention Rate
Why the Flipped Classroom?
• Strengthens team-based skills.
• Encourages engagement AND attendance .
• Promotes higher level classroom discussion.
What Does The Flipped Classroom
Look Like?
During Class
Before Class
Get familiar with basic
concepts and
definitions by doing
background reading
and/or viewing brief
videos.
Projects, problemsolving, small-group
discussions, case
studies, clicker
questions.
Create
Create
Create
Evaluate
Evaluate
Evaluate
Analyze
Analyze
Analyze
Apply
Apply
Apply
Understand
Understand
Understand
Remember
Remember
Remember
After Class
Study, review key
concepts, additional
readings, practice
tests/quizzes.
A Case Study:
Basic Pharmaceutics (PHCY 411)
UNC Eshelman School of Pharmacy
Key Findings:
1. Students felt that active student engagement was
encouraged by the instructor.
2. 90% of students indicated that they found the course
material to be helpful.
3. 93% of students indicated that the inverted classroom
promoted their understanding of key concepts.
4. Attendance was higher.
5. Students felt that the out-of-class assignments improved
their learning.
Pros and Cons of Inverting the
Classroom
Advantages
Disadvantages
• Promotes attendance.
• Keeps students and instructors
engaged and focused.
• Gives instructors the ability to
check learners’ understanding
at multiple steps.
• Helps instructors develop
relationships with students,
even in large settings.
• Promotes collaborative
learning and deters unhealthy
competition.
• May exacerbate isolation of
students who don’t attend
class.
• Student success depends
heavily on their intrinsic
motivation.
• May pose a challenge in teamtaught course.
• May not be suitable across an
entire curriculum.
• Costly upfront with respect to
time and money.
Estimated Costs of Flipping PHCY 411
1TA
time
1Instructor
2Cost
Time
2011
Traditional
2012
Flipped
2013
Flipped Continued
140
270
250
110
297
143
$5,965
$14,728
$8,622
1.
McLaughlin JE, Roth MT, Glatt DM, et al. The flipped classroom: A course redesign to foster learning and
engagement in a health professions school. Supplemental digital content. Acad Med. 2014;89
2.
John Spangler, MD, MPH; Department of Family and Community Medicine, Wake Forest School of Medicine
(Letter to the Editor of Acad Med)
Inverting Your Class
• Assess your Lecture
• Pre-work assignment
– Knowledge Acquisition
• Classroom Transition
– Measure Understanding
• Engaging Assignment
– Application/Analysis
• Follow-up
1. Assess your Lecture
• What are the goals and objectives?
• What are the key points – definitions, dates,
ideas, concepts, formulas?
• Can you sort the points by complexity?
• Do any of the concepts build on each other?
2. Create Pre-work
• What definitions, ideas, concepts can your
learners grasp on their own?
What will they need help understanding?
• Are their existing resources you can use or do
you need to create something new?
– Articles, chapters, podcasts, blogs, case reports,
mini-lectures
3. Transition to the Classroom
• How can you ensure that your students are
ready to engage in an interactive assignment?
– Measure pre-work knowledge
• Pretest? Questioning in Pairs? 60 second paper?
– Facilitate comprehension of more complicated
topics
• Discussion? Guided Q&A session?
• Poll-discuss-repoll?
• Muddy points?
Interactive Group Assignment
• What should your students be able to DO with
the key concepts you are trying to teach?
– Problem Solving
• Cases
• Clinical Decision Protocols
– Illness Scripts
– Critique alternatives
Follow up
• How will you circle back with your learners to
monitor understanding, retention and
creativity?
– Muddy Points
– Portfolios
– Standardized Exams
– Outcomes
Debriefing