Flipping the classroom

On a Friday morning in March, Charles C. Duncan, M.D.; William B. Stewart, Ph.D.; and Shanta E. Kapadia, M.B.B.S., gathered in the anatomy lab to deliver a lesson on chest dissection. Stewart, associate professor of surgery (gross anatomy), explained the vessels and structures revealed, as Kapadia, lecturer in surgery (gross anatomy), dissected them. There were no students present, because they were on spring break. Instead, the three prepared a demonstration of the dissection. Duncan, professor of neurosurgery and of pediatrics, taped the rehearsed lesson so that students could view it prior to their lab.

The anatomy team’s efforts are part of a new approach to education, the “flipped classroom,” which some faculty at the School of Medicine have adopted. Instead of conveying information during class with self-study afterward, students watch a short video beforehand, then discuss the material in class. “If they come in prepared and know the material, this makes it a better learning experience,” said Duncan.

This approach stems from an effort led by Michael L. Schwartz, Ph.D., associate professor of neuroscience and associate dean for curriculum, to apply technologies that enhance learning in the classroom. The notion of videos is not new—in the 1960s and 1970s, the late Edmund S. Crelin Jr., Ph.D. ’51, an anatomy professor at Yale, shot black-and-white videos for students. The flipped classroom concept got a boost at Harvard in 1997, when physicist Eric Mazur, Ph.D., outlined this approach in Peer Instruction: A User’s Manual. The goal was to move the transfer of information out of the classroom so that students would use class time to assimilate what they’d learned. A few years later, Salman Khan based the academy that bears his name on this model.

One of the first lessons Yale educators learned when the flipped classroom approach was introduced two years ago was to keep videos short—no more than eight to 12 minutes. Schwartz set up a studio in his office and invited faculty to try out the idea. Now, in a studio in the medical library, instructional design librarian Lei Wang, M.L.S., helps faculty transform their lectures from PowerPoint presentations into bite-sized instructional videos. Wang helps faculty incorporate animation or additional images to keep viewers engaged. A simple and accessible production process is key; once Wang shows them the ropes, faculty can usually shoot and edit videos on their own after the first session.

In the flipped classroom, because the videos deliver ever-increasing amounts of information beforehand, there’s more time for hands-on practice activities that require a physical presence. “The videos generate a much richer in-class discussion than just talking at students with lecture-based content,” said Jaideep Talwalkar, M.D., HS ’04, assistant professor of medicine and of pediatrics, who uses pre-class videos for about half of the class sessions in the clinical skills course he directs. Video demonstrations of components of the physical exam allow students to spend more time practicing their skills in class.

Although this approach is more time-consuming for instructors—they produce videos and modify their lectures—Talwalkar and others are enthusiastic. Participation is voluntary, and faculty response is building, said Schwartz. Students seem to like it too, provided the videos tie in with the lectures and facilitate interactive engagement with the material. Tracking of one of the first videos made by Duncan on endoscopic treatment of hydrocephalus showed that of 104 students, about 78 had viewed the video before class.

Although the flipped classroom approach began to be integrated before his time, third-year medical student Moises Dominguez said he often finds himself viewing videos on YouTube to help him understand physiological processes. He is working with Jeremy J. Moeller, M.D., assistant professor of neurology, to adapt the model for the neurology clerkship.

“More and more, students are expecting to see things packaged digitally in a way that’s palatable,” noted Stewart. “We all have short attention spans.”