A Hybrid Model of Student-Centered Instruction Improves Physical Therapist Student Performance in Cardiopulmonary Practice Patterns by Enhancing Performance in Higher Cognitive Domains:

Flipping a biochemistry class within a medical curriculum: Impacts on perception, engagement, and attainment

The flipped classroom has gained prominence in higher education, but little has been written about its application in the Middle East. This study aimed to assess the feasibility, acceptability, and impact of flipping biochemistry classes in comparison to the traditional didactic program. The study was conducted on first-year medical students taking biochemistry at a private University in Saudi Arabia. A series of short, pre-recorded videos were used to replace traditional lectures. The scheduled lecture time was used for problem solving and discussion sessions. To gather their evaluation of the learning approach, participants completed an online survey. To study the effect of the learning approach on exam performance, the scores of the participants were compared in questions taught using the flipped classroom versus the traditional didactic method. Participants noted that the effort needed for the course was similar regardless of the learning approach. Moreover, examination performance measured using single best answer multiple-choice questions showed no difference between the two teaching methods. However, the participants did report a significantly better perception of the flipped classroom compared to the traditional approach. Although no significant improvement in examination results was noted, the participants significantly favored the flipped classroom over traditional lectures. This study has demonstrated that the flipped classroom can be used in the teaching of the biosciences within a Middle Eastern setting, resulting in an improvement in student satisfaction and engagement in the course materials.

Flipped classroom versus traditional teaching methods within musculoskeletal physical therapy: a case report

Background and Purpose: The flipped classroom method is a popular way to use technology to assist with the delivery of educational experiences. Yet there is insufficient information regarding student opinions or outcomes about the flipped classroom method within physical therapy. The purpose of this case report was to describe student opinions and outcomes of the flipped classroom teaching and traditional lecture/lab methods of teaching within musculoskeletal physical therapy.Case Description: Thirty-six (36) first-year physical therapy students enrolled at a regional physical therapy program completed an anonymous internet-based survey regarding their impressions of traditional and flipped classroom teaching methods. Flipped classroom and traditional teaching methods were both used within the same musculoskeletal course. The survey was created to aid in planning subsequent courses and asked questions about student's preferred teaching method (flipped, traditional, or both equal) across a variety of categories. Student exams scores, using the same question bank, were compared to the year prior as a quantitative outcome measure.Outcomes: Twenty-nine (29) students (81%) completed the survey. Generally, students preferred the flipped classroom. Compared to the previous year, test scores for all content areas were similar (± 4%) except cervical spine which was improved (>10%). When asked outright, 28/29 students preferred the flipped teaching method.Discussion and Conclusion: Student opinions indicate the flipped classroom is preferable to traditional methods yet objective outcomes appear similar. Physical therapy educators seeking ways to improve the student experience using technology in the classroom may consider utilizing the flipped classroom method.

Doctor of Physical Therapy Education in a Hybrid Learning Environment: Reimagining the Possibilities and Navigating a "New Normal"

Professional physical therapist education has experienced a transformation over the last few decades, moving to a doctoring profession with more autonomy and a broader scope of practice. These changes have occurred in parallel with systemic and structural changes in health care and higher education, both of which have experienced challenges with improving access and controlling costs, and have become a centerpiece of legislative and political discourse. At the same time, advances in technology have introduced new possibilities in education, with the emergence of online, blended, and "flipped" learning models that supplement or replace face-to-face instruction with distance learning. Hybrid education is a type of blended learning, utilizing both face-to-face and online instructional strategies. In a hybrid learning environment, online content may be delivered synchronously or asynchronously, replacing traditional face-to-face instructional time and reducing "seat time" for students. Recent attention has been brought to online and hybrid/blended learning in physical therapist education in the wake of the COVID-19 pandemic, as programs have been required to abruptly move from face-to-face to remote instruction. Hybrid and other forms of blended learning strategies have been described at the physical therapist education course level. However, there is no literature describing hybrid learning implementation at the physical therapist education program "levels," and there has been limited discussion on best practices for delivering hybrid, blended, and online instruction in physical therapist education. This perspective provides an overview of hybrid education, describes theoretical frameworks that guide implementation of a hybrid education curriculum, and discusses future directions for hybrid physical therapist education and educational research.

Developing Cognitive Skills Through Active Learning: A Systematic Review of Health Care Professions

Objective

To systematically review current literature to determine whether active learning is more successful than passive learning at producing cognitive skills in health care professions students.

Data Sources

An electronic search was conducted in 4 databases: EBSCO-CINAHL, EBSCO-Sport Discus, Educational Resources Information Center, and PubMed. Search terms included: millennial AND health education, active learning AND knowledge retention, flipped classroom AND learning outcomes, problem based learning AND learning outcomes, problem based learning AND student confidence, active learning AND critical thinking, higher order thinking AND active learning.

Study Selection

We included studies if they were published in English between 2007 and 2017 and evaluated outcomes of an active learning intervention. Studies of nonhealth care disciplines, practicing health care practitioners, or studies that did not address the primary research questions were excluded.

Data Extraction

Study design, health care discipline, intervention used, assessment measures, outcome(s) measures, main results, and conclusions were extracted from each article, as appropriate.

Data Synthesis

Articles were categorized based on capacity to answer 1 or both of the research questions. Conclusions were summarized according to the learning technique used and its effectiveness in regard to studied learning outcome. Out of 85 studies on lower-order cognition, 61 (72%) indicated active learning techniques were effective at achieving improved recall, understanding, and/or application of course material. Of 69 studies on higher-order cognition, 58 (84%) supported active learning over passive instruction for improving students' confidence in or performance of analytical, evaluative, and creative skills.

Conclusions

Active learning produces gains to both lower- and higher-order cognition at levels equal to, and more often, greater than the use of passive learning methods. Despite this evidence, we believe more high-quality, well-designed prospective studies using validated assessment measures are needed to endorse the value of these methods in producing cognitive skills.

Academic outcomes of flipped classroom learning: a meta-analysis

CONTEXT

The flipped classroom (FC), reversing lecture and homework elements of a course, is popular in medical education. The FC uses technology-enhanced pre-class learning to transmit knowledge, incorporating in-class interaction to enhance higher cognitive learning. However, the FC model is expensive and research on its effectiveness remains inconclusive. The aim of this study was to compare the efficacy of the FC model over traditional lecture-based (LB) learning by meta-analysis.

METHODS

We systematically searched MEDLINE, PubMed, ERIC, CINAHL, EMBASE, reference lists and Association for Medical Education in Europe (AMEE) conference books. Controlled trials comparing academic outcomes between the FC and LB approaches in higher education were considered eligible. The main findings were pooled using a random-effects model when appropriate.

RESULTS

Forty-six studies (9026 participants) were included, comprising four randomised controlled trials (RCTs), 19 quasi-experimental studies and 23 cohort studies. Study populations were health science (n = 32) and non health science (n = 14) students. The risk of bias was high (36/37 articles). Meta-analyses revealed that the FC had significantly better outcomes than the LB method in examination scores (post-intervention and pre-post change) and course grades, but not in objective structured clinical examination scores. Subgroup analyses showed the advantage of the FC was not observed in RCTs, non-USA countries, nursing and other health science disciplines and earlier publication years (2013 and 2014). Cumulative analysis and meta-regression suggested a tendency for progressively better outcomes by year. Outcome assessments rarely focused on behaviour change.

CONCLUSIONS

The FC method is associated with greater academic achievement than the LB approach for higher-level learning outcomes, which has become more obvious in recent years. However, results should be interpreted with caution because of the high methodological diversity, statistical heterogeneity and risk of bias in the studies used. Future studies should have high methodological rigour, a standardised FC format and utilise assessment tools evaluating higher cognitive learning and behaviour change to further examine differences between FC and LB learning.

Perspectives on pediatric physical therapy education

PURPOSE

The Section on Pediatrics convened an Education Summit in July 2012 to examine, discuss, and respond to documented inconsistencies and challenges in teaching pediatric physical therapy content in entry-level professional education programs. This lecture was designed to provide attendees with the history of pediatric physical therapy education, stemming from the author's early involvement with the Section on Pediatrics and as a long-standing academician.

SUMMARY OF KEY POINTS

The limited literature on pediatric physical therapy education was reviewed and used to highlight the continued variability across programs. The challenge was presented to build upon attendees' scholarship of teaching and learning.

STATEMENT OF CONCLUSIONS

These remarks were designed to help understand the growth and development in pediatric physical therapy education over the past 40 years and to encourage others to use what has been learned to build a stronger foundation for the future.