Flipping the Class: Death to “Death By Powerpoint”. | The KP EM Residency

Flipping the Class: Death to “Death By Powerpoint”.

Its not all going to be medical here. As July 2014 approches, will throw a little faculty development & edu pearls in the mix. ‘Twas discussed at the residency meeting this past week and wanted to share some info on the “Flipped Classroom”. So, why do we care? What’s wrong with powerpoint and lectures? That’s how we all learned? Thats what made us the great critical thinkers that we are today, no? “Bueller, bueller, bueller”…

We are at a critical crossroads in the evolution of medicine, education and technology. There is just too much information out there for any of us to know it all. In training, we were all in awe of that grey haired doc who could spout on for hours about anything… This is one of the things that makes us nervous as future educators… “How will we be like him?” (or her, to be PC). I argue that we learned little as he stood in front of that lecture hall and went on, and on, and on… as our attention wained (evidence shows attention dwindles after 15-18 minutes- 3 for me) and we lost track of the 20 course educational meal that was being served up (evidence shows retention of no more than 3-5 points in a given lecture), the opportunity to teach and learn was lost. Nor did you leave that lecture excited to learn more about the topic at hand.

Given the ever growing and more complex body of knowledge we are expected to command, we need to be able to teach and learn more efficiently… we need to teach our residents how to be information managers, not encyclopedias of knowledge. We also need to teach them to be life long learners… to ask questions and go out and find answers for themselves. Fortunately the internet and mobile technology lend themselves to exactly these notions… we now have the ability to search, filter and serve enormous quantities of information in a matter of milliseconds. The internet also serves up “Free Open Access MedEd”(FOAMed) by way of blogs, podcasts, and videos) as well as apps and mobile websites to engage and excite learners and facilitate learning on the fly.

Below you will find 1) a poster explaining the ‘how’s and what’s’ of the flipped class, 2) a you tube video explaining much the same, and 3) a NEJM article (login required, lest the Copyright police hall me away).

How I see the flipped class being used:

  • Use 1 of the 5 hours of weekly conference for ‘individualized learning’ to be spent at home doing ‘pre-homework’.
  • Provide a clinical scenario and 3-5 questions for residents to answer in advance, (essentially the learning objectives that would have been delivered in PPT format).
  • Provide some electronic resources (can use conventional edu resources or FOAMed) for residents to learn/find answers to the questions.
  • In the classroom (replaces 1-2 lectures a week): discuss the case and questions. Educator becomes a facilitator. If more comfortable, educator can deliver a “mini-PPT” going over questions, but some/most of the time is spent allowing residents to discuss their learnings. Can break down by PGY level or integrate… depends on topic.
  • For those that want to play along, a case…

A 68 yo M with a history of coronary artery disease, DM and paroxysmal Afib presents with palpitations. His vitals on arrival: 102/62, 165, 16, 96%. What are some open ended questions that you might ask residents prior to a ‘flipped class’ discussion that would allow them to learn about afib and meet the objectives of information you would otherwise have served up in a lecture? Please place questions in the comments field below? 



Created by Knewton and Column Five Media




Posted in SDMEDED Blog Posts
2 comments on “Flipping the Class: Death to “Death By Powerpoint”.
  1. mattsilver74 says:

    Cardioversion: Why would you or would you not want to cardiovert this patient? Leads to discussion on:
    Rate vs Rhythm control.
    Risks of cardioversion (sedation, stroke).
    48 hr timeframe. Need for TEE/anticoagulation.
    Rates of spontaneous conversion to NSR approximately 50% of time.
    Absolute indications for cardioversion.

  2. wckrauss says:

    This would also lead to a brief discussion on pros/cons of chemical cardioversion (IV or “pill in pocket”) vs. electrical.

    Nice example. Thanks. Will begin to build this into weekly conference schedule.
    As the year’s progress, senior residents could help and/or lead facilitation.