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Flipping the Classroom: Is Anyone Getting this Right?

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1 Flipping the Classroom: Is Anyone Getting this Right?
Connie Barbour, MSN, RN Georgia Highlands College Doctoral candidate, EdD Program, University of West Georgia Dr. Jack Yensen, BSc (Hons), PhD, RN, MN Visiting Professor, University of West Georgia

2 Why Teachers Matter More in a Flipped Classroom - by Jon Bergmann (pioneer in the Flipped Class Movement) “Teaching is fundamentally about human interactions, and that can’t be replaced by technology.” I was once asked by a group of educational state representatives if the flipped classroom would allow them to hire less teachers.  They surmised that in this day and age where you can find virtually anything on the Internet, and any subject taught on YouTube, what is the value of the classroom teacher?  When I heard this question, I came unglued. They had missed the point of the flipped classroom.  They had the misguided notion that teaching is the pouring out of information from one person (the teacher) into another (the student). Fortunately, I was able to explain how teachers are in fact more valuable when they teach using a flipped approach.  If all teachers did was deliver content, then maybe the legislators were right.  But I believe students need teachers physically there. This is because we humans are, as a whole, relational beings.  And teaching is a social interaction between teacher and students and students and students.  Our students need us more than they need a video made by someone they don’t know teaching them something they may or may not want to learn about. Teaching is fundamentally about human interactions and that can’t be replaced by technology. The reason Flipped Learning makes teachers more valuable is that it changes the dynamic of the classroom.  No longer is content delivery the focus of the class, nor is the teacher’s main responsibility the dissemination of knowledge. Instead, teachers take on the role of a facilitator of learning.  They are able to work with students in small groups and have more one-on-one interactions.  The simple act of removing the direct instruction (lecture) from the whole group changes the dynamic of the room and allows the teacher to personalize and individualize the learning for each student. Each student gets his/her own education which is tailored to his/her needs.  Instead of a one size fits all education-each student gets just what they need when they need it.

3 Introduction Classroom – practice gap exists
Institute of Medicine (2011) and the National League for Nursing (2005) Evident by graduate nurses struggle with the transition from school to practice

4 Introduction Didactic lecture or legacy model used by the educator promotes: Passive learning This method of teaching can make it difficult for students to transfer their knowledge from classroom to the clinical setting Promoting student-centered learning using active learning strategies in the classroom can be used to promote clinical judgment and address the classroom – practice gap

5 Introduction Use of the “flipped classroom” promotes the use of active learning strategies Active learning strategies promote application, analysis, evaluation, and synthesis of knowledge

6 Description of the Learning Environment
Flipped Classroom Been used in the K12 and college settings effectively Content that was previously delivered using a traditional lecture is now completed outside the classroom as “homework” The time spent in the classroom remains the same; however, active learning strategies are now the focus Benefits increased test scores increased levels of learner engagement increased awareness of personal learning and metacognitive skills as well as creating more meaningful interaction with the course content , teacher, and student Literature reviewed referred to college courses taught in statistics, physics, chemistry, biology, pharmacology, physical therapy, and medicine Active learning strategies can include (but not limited to) cooperative learning, use of audience response systems, case study analysis, simulation, small group work, and role-playing

7 Description of the Learning Environment
Why the Flipped Classroom Challenges nursing students to use higher order thinking which is necessary to improve their critical thinking skills Critical thinking skills are primary in building the necessary clinical judgment skills used by nurses critical thinking in nursing students can be increased by using active learning strategies Hoffman (2008) stresses that active learning strategies “equip students in learning ‘how’ to find the answers, not merely ‘what’ are the answers” (p. 234). The “flipped classroom” is considered different in some ways than a blended or hybrid course (Fulton, 2012; McCown, 2010). However, the literature reveals that these terms (inverted, flipped, blended, and hybrid) are used interchangeably and often the differences are only distinguishable after reading about the teaching strategy used (Haden et al., 2009; Hsu, 2011; Sung, Kwon, & Ryu, 2008). Overall, the term blended or hybrid often refers to the entire course design in which a certain portion of the content is provided exclusively online, and the other portion is provided exclusively in the classroom.

8 Things to Consider with Implementation
Online content = relevant to classroom learning Online lecture material = audiovisual and interactive/engaging Online pre-testing or pre-activity Classroom content = active learning strategies employed Classroom formative assessments used Technology requirements and familiarity with technology Use with a small class size Use with a large class size Subject matter Student demographics

9 Things to Consider Personally
Self-efficacy with technology Drive to be innovative Perception of the change process Type of program teaching in Personal teaching philosophy Personal beliefs about the learner

10 Research Gaps and Future Nursing Education Research
Flipped classroom has been successfully used in K12 and higher education settings “flipped classrooms” in the nursing literature – only 2 studies exist Flipped classroom method needs to be studied in pre licensure nursing programs to teach content topics such as fundamentals, pharmacology, and medical-surgical concepts Future research needs to clarify the differences between blended, hybrid, and flipped methods of presenting course content Nurse educators need to determine the best methods to implemented with pre-licensure core nursing concepts to provide effective instruction that adequately prepares graduate nurses for practice.

11 Closing the Gap The IOM (2011) has challenged nurse educators to close the classroom – practice gap Nurse educators can no longer rely on delivering content laden curriculums using traditional lecture style delivery methods This flipped classroom method will Implement active learning strategies congruent with andragogical principles to improve clinical judgment nursing students The learning activities will bring clinical experience into the classroom, provide nursing students with the opportunity to practice making clinical judgments Address the classroom-practice gap

12 References Berry, J. (2009). Technology support in nursing education: Clickers in the classroom. Nursing Education Perspectives, 30(5), 295–298. Beyer, D. A. (2011). Reverse Case Study: To Think like a Nurse. Journal of Nursing Education, 50(1), 48–50. doi: Bleich, M. R. (2011). IOM report, The future of nursing: Leading change, advancing health: Milestones and challenges in expanding nursing science. Research in Nursing & Health, 34(3), 169–170. doi: /nur.20433 Bowles, D. J. (2006). Active Learning Strategies... Not for the Birds! International Journal of nursing education scholarship, 3(1). Retrieved from Brancato, V. C. (2007). Psychological empowerment and use of empowering teaching behaviors among baccalaureate nursing faculty. Journal of Nursing Education, 46(12), 537–544. Edwards, S. L. (2007). Critical thinking: A two-phase framework. Nurse Education in Practice, 7(5), 303–314. doi: Filer, D. (2010). Everyone’s answering: Using technology to increase classroom participation. Nursing education perspectives, 31(4), 247–250. Fulton, K. (2012). Upside down and inside out: Flip Your Classroom to Improve Student Learning. Learning & Leading with Technology, 39(8), 12–17.

13 References Haden, C., Flikkema, P., Weller, T., Frolik, J., Verrei-Berenback, W., & Shiroma, W. (2009). Assessment of a hybrid, online/in-class course developed at multiple universities. In 2009 ASEE Annual Conference. Austin, TX, June (pp. 14–17). Retrieved from Hidayat, L., Patel, S., & Veltri, K. (2012). Active-Learning Implementation in an Advanced Elective Course on Infectious Diseases. American Journal of Pharmaceutical Education, 76(5), 87. Hoffman, J. J. (2008). Teaching Strategies to Facilitate Nursing Students’ Critical Thinking. Annual Review of Nursing Education, 6, 225–X. Hsu, L.-L. (2011). Blended learning in ethics education: A survey of nursing students. Nursing Ethics, 18(3), 418–30. doi: Hughes, H. (2012). Introduction to flipping the college classroom. In World Conference on Educational Multimedia, Hypermedia and Telecommunications (Vol. 2012, pp. 2434–2438). Retrieved from IOM (Institute of Medicine). (2011). The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press. Johnson, N., List-Ivankovic, J., Eboh, W. O., Ireland, J., Adams, D., Mowatt, E., & Martindale, S. (2010). Research and evidence based practice: Using a blended approach to teaching and learning in undergraduate nurse education. Nurse Education in Practice, 10(1), 43–7. doi: Knowles, M. S., Holton, E. F., & Swanson, R. A. (2011). The Adult Learner, Seventh Edition: The Definitive Classic in Adult Education and Human Resource Development. Oxford, UK: Elsevier. Lee, S. T., & Dapremont, J. A. (2012). Innovation CENTER: Engaging nursing students through integration of the audience response system. Nursing Education Perspectives, 33(1), 55 – 57.

14 References McCown, L. J. (2010). Blended Courses: The Best of Online and Traditional Formats. Clinical Laboratory Science, 23(4), 205–11. Sadaghiani, H. R. (2012). Online Prelectures: An Alternative to Textbook Reading Assignments. Physics Teacher, 50(5), 301–303. Schaefer, K. M., & Zygmont, D. (2003). Analyzing the teaching style of nursing faculty: Does it promote a student-centered or teacher-centered learning environment? Nursing Education Perspectives, 24(5), 238–45. Shovein, J., Huston, C., Fox, S., & Damazo, B. (2005). Challenging Traditional Teaching and Learning Paradigms: Online Learning and Emancipatory Teaching. Nursing Education Perspectives, 26(6), 340–3. Stein, P. S., Challman, S. D., & Brueckner, J. K. (2006). Using Audience Response Technology for Pretest Reviews in an Undergraduate Nursing Course. Journal of Nursing Education, 45(11), 469–73. Strayer, J. F. (2012). How learning in an inverted classroom influences cooperation, innovation and task orientation. Learning Environments Research, 15(2), 171–193. doi: /s Sung, Y. H., Kwon, I. G., & Ryu, E. (2008). Blended learning on medication administration for new nurses: Integration of e-learning and face-to- face instruction in the classroom. Nurse Education Today, 28(8). Retrieved from Talbert, R. (2012). Inverted Classroom. Colleagues, 9(1), 7. Taylor, J., & Wros, P. (2007). Concept Mapping: A Nursing Model for Care Planning. Journal of Nursing Education, 46(5), 211–6. Zygmont, D. M., & Schaefer, K. M. (2005). Chapter 8: Making the Transition from Teacher-Centered to Student-Centered Instruction: A Journey Taken by Two Educators. Annual Review of Nursing Education, 3, 125–142.


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