Implementation of a flipped classroom model to teach psychopharmacotherapy to third-year Doctor of Pharmacy (PharmD) students
Keywords:Pharmacy Education, Flipped Classroom, Psychopharmacology, Active Learning, Team Based Learning
Objective: To implement a flipped classroom model centred on student-led active learning to teach psychopharmacotherapy in a third-year pharmacotherapeutics course.
Design: The psychopharmacotherapeutic module was conducted over a two week period during the 2014 spring semester and consisted of five class sessions. One hundred and four third-year professional Doctor of Pharmacy (PharmD) students were enrolled in the module which was taught by two instructors. Students were asked to view posted materials and to complete assignments prior to class. Class time was solely used for active learning with facilitation from the instructors. The course used individual and group readiness assessment tests (iRATs and gRATs, respectively), “muddiest point” reflection and repeated testing with open-ended questions to assess student mastery of core concepts. Pre- and post-module attitudinal surveys were administered to assess students’ thoughts on three main themes centring on active learning: learning style preference, working with peers, and participating in classroom discussions.
Assessment: The overall mean test scores between 2012 (traditional lecture) to 2014 (flipped class model) demonstrated no significant difference between the time periods, as hypothesised by the study authors. Greater than 85% of students completed the pre- and post-module attitudinal surveys. Students’ responses to “attitudinal questions” remained consistent in support of active learning from pre- to post-module assessment. The majority of students either “agree” or “strongly agreed” with all ten positive valence questions supporting active learning while they had mixed attitudes toward negative valence questions. Investigation of responses to “attitudinal” questions based on demographics revealed findings worth investigating in future research. Lastly, students’ felt posted reading materials and group work were valuable to their learning, they were supported by their peers and instructors during class discussions and greater than 75% of class time was used for active learning.
Conclusion: A flipped classroom model was successfully implemented to teach psychopharmacotherapeutics in a third- year pharmacy therapeutics course. Students’ attitudes were positive toward this teaching style prior to the start of this module and remained positive following completion. Students’ reported a high level of engagement and interaction with their instructors and peers.
Accreditation Council for Pharmacy Education (2011). Accreditation Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree (online). Available at: http:// www.acpe-accredit.org/pdf/FinalS2007Guidelines2.0.pdf. Accessed 13th May, 2013.
Accreditation Council for Pharmacy Education (2013). Task force reports (online). Available at: https:// www.acpe-accredit.org/deans/taskforcereports.asp. Accessed 13th May, 2013.
American Association of Colleges of Pharmacy (2004). Education Outcomes (online). Available at: http:// aacp.org/resources/education/Documents/CAPE2004.pdf. Accessed 13th May, 2013.
American College of Clinical Pharmacy (2014). Standards of Practice for Clinical Pharmacists. Pharmacotherapy, 34(8), 794–797.
Beatty, S.J., Kelley, K.A., Metzger, A.H., Bellebaum, K.L. & McAuley, J.W. (2009).
Team-based learning in therapeutics workshop sessions. American Journal of Pharmaceutical Education, 73, Article 100.
Blouin, R.A., Riffee, W.H., Robinson, E.T., Beck, D.E., Green, C., Joyner, P.U., Persky, A.M. & Pollack, G.M. (2009). Role of innovation in education delivery. American Journal of Pharmaceutical Education, 73, Article 154.
Brookfield, S.D. (1986). Understanding and Facilitating Adult Learning. San Francisco, Calif: Jossey-Bass Press.
Burton, L.J. & Mazerolle, S.M. (2011). Survey instrument validity part II: Validation of a survey instrument examining athletic trainers’ knowledge and practice beliefs regarding exertional heat stroke. Athletic Training Education Journal, 6, 36-45.
Butler, A.C. (2010). Repeated testing produces superior transfer of learning relative to repeated studying. Journal of Experimental Psychology: Learning, Memory, and Cognition, 36, 1118-1133.
Cain, J., Black, E.P. & Rohr, J. (2009). An audience response system strategy to improve student motivation, attention, and feedback. American Journal of Pharmaceutical Education, 73, Article 21.
Cheang, K.I. (2009). Effect of learner-centered teaching on motivation and learning strategies in a third-year pharmacotherapy course. American Journal of Pharmaceutical Education, 73, Article 42.
Clauson, K.A., Alkhateeb, F.M. & Singh-Franco, D. (2012). Concurrent use of an audience response system at a multi-campus college of pharmacy. American Journal of Pharmaceutical Education, 76, Article 6.
Crawford, S.Y., Alhreish, S.K. & Popovich, N.G. (2012). Comparison of learning styles of pharmacy students and faculty members. American Journal of Pharmaceutical Education, 76, Article 192.
DaRosa, D.A., Skeff, K., Friedland, J.A., Coburn, M. Cox, S. Pollart, S., O’Connell, M. & Smith, S. (2011). Barriers to effective teaching. Academic Medicine, 86, 453-459.
Estus, E.L., Hume, A.L. & Owens, N.J. (2010). An active-learning course model to teach pharmacotherapy in geriatrics. American Journal of Pharmaceutical Education, 74, Article 38.
Farland, M.Z., Sicat, B.L., Franks, A.S., Pater, K.S., Medina, M.S. & Persky, A.M. (2013). Best practices for implementing team-based learning in pharmacy education. American Journal of Pharmaceutical Education, 77, Article 177.
Ferreri, S.P. & O’Connor, S.K. (2013). Redesign of a large lecture course into a small-group learning course. American Journal of Pharmaceutical Education, 77, Article 13.
Gleason, B.L., Peeters, M.J., Resman-Targoff, B.H., Karr, S., McBane,S., Kelley, K., Thomas, T. & Denetclaw, T.H. (2011). An active-learning strategies primer for achieving ability-based educational outcomes. American Journal of Pharmaceutical Education, 75, Article 186.
Goldberg, L.R. (1992). The development of markers for the Big-Five factor structure. Psychological Assessment, 4, 26-42.
Grady, S.E. (2011). Team-based learning in pharmacotherapeutics. American Journal of Pharmaceutical Education, 75, Article 136.
￼Graham, C.R., Tripp, T.R., Seawright, L. & Joeckel III, G.L. (2007). Empowering or compellin g reluctant participators using audience response systems. Active Learning in Higher Education, 8, 233-258.
Haidet, P., Morgan, R.O., O’Malley, K., Moran, B.J. & Richards, B.F. (2004). A controlled tiral of active versus passive learning strategies in a large group setting. Advances in Health Sciences Education, 9, 15-27.
Kolluru, S., Roesch, D.M. & de la Feunte, A.A. (2012). A multi-instructor, team-based, active-learning exercise to integrate basic and clinical sciences content. American Journal of Pharmaceutical Education, 76, Article 33.
Knowles, M. (1990). The Adult Learner: A Neglected Species. 4th ed. Houston, TX: Gulf Publishing Company.
Larsen, D.P., Butler, A.C. & Roediger III, H.L. (2008). Test-enhanced learning in medical education. Medical Education, 42, 959-966.
Larson, D.P., Butler, A.C. & Roediger, H.L. (2009). Repeated testing improves long-term retention relative to repeated study: A randomized, controlled trial. Medical Education, 43, 1174-1181.
Letassy, N.A., Fugate, S.E., Medina, M.S., Stroup, J.S. & Britton, M.L. (2008). Using team-based learning in an endocrine module taught across two campuses. American Journal of Pharmaceutical Education, 72, Article 103.
Lucas, K.H., Testman, J.A., Hoyland, M.N., Kimble, A.M. & Euler, M.L. (2013). Correlation between active- learning coursework and student retention of core content during advanced pharmacy practice experiences. American Journal of Pharmaceutical Education, 77, Article 171.
McDaniel, M.A., Roediger III, H.L. & McDermott, K.B. (2007). Generalizing test-enhanced learning from the laboratory to the classroom. Psychonomic Bulletin & Review, 14, 200-206.
McLaughlin, J.E., Griffin, L.M., Esserman, D.A., Davidson, C.A., Glatt, D.M., Roth, M.T. Gharkholonarehe, N. & Mumper, R.J. (2013). Pharmacy student engagement, performance, and perception in a flipped satellite classroom. American Journal of Pharmaceutical Education, 77, Article 196.
McLaughlin, J.E., Roth, M.T., Glatt, D.M., Gharkholonarehe, N., Davidson, C.A., Griffin, L.M., Esserman, D.A. & Mumper, R.J. (2014). The flipped classroom: A course redesign to foster learning and engagement in a health professions school. Academic Medicine, 89, 1-8.
Michaelsen, L.K., Parmelee, D.X., McMahon, K. & Levine, R.E. (2007). Team-based learning for health professions education: A guide to using small groups for improving learning. Sterling, VA: Stylus.
Novak, S., Shah, S., Wilson, J.P., Lawson, K.A. & Salzman, R.D. (2006). Pharmacy students’ learning styles before and after a problem-based learning experience. American Journal of Pharmaceutical Education, 70, Article 74.
Ofstad, W. & Brunner, L.J. (2013) Team-based learning in pharmacy education. American Journal of Pharmaceutical Education, 77, Article 70.
Parmelee, D.X., DeStephen, D. & Borges, N.J. (2009). Medical students’ attitudes about team-based learning in a pre-clinical curriculum. Medicine Education
Online, 14, 1-7.
Patel, V.L., Yoskowitz, N.A. & Arocha, J.F. (2009). Towards effective evaluation and reform in medical education: A cognitive and learning sciences perspective. Advances in Health Sciences Education, 14, 791-812.
Persky, A.M. (2008). Multi-faceted approach to improve learning in pharmacokinetics. American Journal of Pharmaceutical Education, 72, Article 36.
Persky, A.M. & Pollack, G.M. (2010). Transforming a large-class lecture course to a smaller-group interactive course. American Journal of Pharmaceutical Education, 74, Article 170.
Persky, A.M. & Pollack, G.M. (2011). A modified team- based learning physiology course. American Journal of Pharmaceutical Education, 75, Article 204.
Piascik, P., Pittenger, A., Soltis, R., Schwarz, L., Medina, M., Bouldin, A., Rose, R., Scott, S., Creekmore, F.M. & Hammer, D. (2011). An evidence basis for assessing excellence in pharmacy teaching. Currents in Pharmacy Teaching and Learning, 3, 238-248.
Pierce, R. & Fox, J. (2012). Vodcasts and active-learning exercises in a “flipped classroom” model of renal pharmacotherapy module. American Journal of Pharmaceutical Education, 76, Article 196.
Roediger III, H.L. & Butler, A.C. (2011). The critical role of retrieval practice in long-term retention. Trends in Cognitive Science, 15, 20-27.
Roth, M.T., Mumper, R.J., Singleton, S.F., Lee, C.R., Rodgers, P.T., Cox, W.C., McLaughlin, J.E., Joyner, P. & Blouin, R.A. (2014). A renaissance in pharmacy education at the University of North Carolina at Chapel Hill. North Carolina Medical Journal, 75, 48-52.
Stewart, D.W., Brown, S.D., Clavier, C.W. & Wyatt, J. (2011). Active-learning processes used in US pharmacy education. American Journal of Pharmaceutical Education, 75, Article 68.
Stewart, D., Panus, P., Hagemeier, N., Thigpen, J. & Brooks, L. (2014). Pharmacy student self-testing as a predictor of examination performance. American Journal of Pharmaceutical Education, 78, Article 32.
Tune, J.D. Sturek, M. & Basile, D.P. (2013). Flipped classroom model improves graduate student performance in cardiovascular, respiratory, and renal physiology. Advances in Physiology Education, 37, 316-320.
Van Amburgh, J.A., Devlin, J.W., Kirwin, J.L. & Qualters, D.M. (2007). A tool for measuring active learning in the classroom. American Journal of Pharmaceutical Education, American Journal of Pharmaceutical Education, Article 85.
Vlasses, P.H., Patel, N., Rouse, M.J., Ray, M.D., Smith, G.H. & Beardsley, R.S. (2013). Employer expectations of new pharmacy graduates: Implications for the pharmacy degree accreditation standards. American Journal of Pharmaceutical Education, Article 47.
Zellmer, W.A., Beardsley, R.S. & Vlasses, P.H. (2013). Recommendations for the next generation of accreditation standards for doctor of pharmacy education. American Journal of Pharmaceutical Education, 77, Article 45.
Zgheib, N.K., Simaan, J.A. & Sabra, R. (2010). Using team-based learning to teach pharmacology to second year medical students improves student performance. Medical Teacher, 32, 130-135.
Zingone, M.M., Franks, A.S., Guirguis, A.B., George, C.M., Howard-Thompson, A. & Heidel, R.E. (2010). Comparing team-based and mixed active-learning methods in an ambulatory care elective course. American Journal of Pharmaceutical Education, 74, Article 160.