Medical school experiments with ‘flipped classroom’ teaching model

Walk into a School of Medicine class and you likely won’t find a stern professor lecturing students in front of a projector. Instead, groups of medical students may be scattered across the room, working together on activities ranging from case studies to simulations.

This “flipped classroom” approach of teaching is part of the newly formed Stanford Medical Interactive Learning Initiatives (SMILI), which emphasizes interactive learning through technology and supports faculty who are interested in developing new strategies to improve their effectiveness in classrooms as teachers.

According to Charles Prober, senior associate dean for medical education at the School of Medicine, this has led to two main changes in the classroom: the delivery of the content and how students spend their time in a classroom. Rather than the traditional lecture model, material is delivered through small video lectures for students to watch on their own time, while class time is reserved for working on problems with their peers.

“The videos give the information, and the classroom is where we put principles into practice. We did a little pilot last year, which was well received by students,” said Neil Gesundheit, who teaches an endocrinology module.

The School of Medicine has been recording its lectures and posting them online for over 20 years, but SMILI intends to utilize the advantages of placing content into videos to present course material in a more purposeful way.

“[SMILI’s concept of teaching is] more dynamic and makes the material more live, relevant and engaging,” Prober said. “It makes a bigger impact and becomes more memorable.”

“When you teach these things the same way in a lecture format for 30 hours a week for many weeks at a time, it gets monotonous and not very exciting. In-class activities force the student to be an active learner,” he added.

Prober also added that the program has been popular among students.

“The feedback we have heard from students is that it is more dynamic and motivational than the older, more passive way of teaching,” he said.

Prober first became very interested in the flipped classroom model a year and a half ago, when he noticed that online courses were extremely impactful simply because of the way the information was packaged and delivered. He was interested in looking at the model in a medical context and subsequently wrote a paper on the subject for the New England Journal of Medicine.

The paper discussed the pilot SMILI course, which was the Medical School’s core biochemistry course. In the 2011-12 school year, the class was redesigned to follow a flipped classroom model. As a result, positive student reviews increased substantially and class attendance rose from 30 percent to 80 percent.

The SMILI initiative only officially began four months ago, but according to Prober the group of supporters has been increasingly growing, made up not only of faculty but also of residents and practicing physicians.

SMILI is not confined to Stanford. Prober has also spoken with Sal Khan, founder of Khan Academy, who was interested in supporting the Medical School’s efforts. The School of Medicine meets with the Khan Academy on a regular basis. After the content is created, Khan Academy works with the creators to revise the presentation until both parties are satisfied. The videos are then placed on Khan Academy’s platform, where they are shared openly.

“This partnership would be really exploratory, a good way to increase our visibility — lots of students would like access to a well-taught biochem course,” Prober said.

However, like most new initiatives, SMILI faces challenges, mainly from the faculty.

“There are faculty that do not find large classroom halls very gratifying and like more student contact with the interactive learning sessions, and there are faculty that teach better in a more impersonal format,” Gesundheit said. “I think it depends on the instructor’s teaching style and personality more than anything.”

Morgan Theis, a fifth-year medical student, mentioned that there are criticisms from the student population as well.

“Some people just like going to class and the accountability of it. They also sometimes feel isolated when they have to watch the material on their own,” she explained. “One person didn’t like it because with the interactive class sessions, it’s more required class time, whereas in the lectures, you can opt to go or not.”

While the Medical School does not mandate that instructors reformat their classes, more courses are taking an interactive approach. For example, new pilots are being added constantly, and soon the medical school courses on genetics and women’s health will be taught in the same interactive format.

“This requires a lot of new energy to make video content and to conduct interactive lessons,” Prober said. “It will be very labor intensive in the beginning — switching from the other format — but over time it will become more efficient.”

About Catherine Zaw

Catherine Zaw is the Managing Editor of News at The Stanford Daily. She is a junior from Miami, FL, double majoring in biology and linguistics. To contact her, please email czaw13@stanford.edu.