The Flipped Classroom in Nursing Education
These days, all the talk in education is about the “flipped classroom” and about the work of the Khan Academy. The flipped classroom is a disruptive innovation in education that takes students out of the lecture hall and, instead, provides asynchronous (i.e., whenever it’s convenient for the student) online content, and synchronous (i.e., scheduled teacher and student group) online or in-person meetings during which teachers and students work through exercises to master content.
The Khan Academy takes disruptive innovation a step further by using an adaptive learning strategy for competency-based education. Students log on at their convenience. Regular quizzes test whether students are ready to progress to the next level; if they are not, they receive alternative presentations that move them toward mastery of that level’s content.
For teachers who have enjoyed filling lecture halls with students marveling at their presentations – or holding forth in seminar salons – the flipped classroom may be an uncomfortable change.
After one university made the simple move of taping lectures to post online for students, one teacher I met complained about the diminishing percentage of students who actually attended her lectures. Of those attending, most were idling on Facebook. The teacher’s threatened response was to email the class that attendance was mandatory and viewing Facebook during lectures was prohibited. According to this teacher, discussion sections to review problem sets were hardly better, as some irritated students summarily discarded problem sets and demanded answers. The teacher snarled that Generation Xers were raised with an overabundance of positive reinforcement for simply showing up. All but holding her nose, she exhaled that students today learn differently.
On that last point, she is right – and that’s important for us to understand. The current generation of students grew up with the Internet, video games and social networking; this is their context. To successfully teach such students, we should embrace instructional design that makes the best use of new educational technology.
And let’s remember that adaptive or mastery learning is not new. In elementary school, my silent reading time was occupied with short books and questions; if we answered the questions correctly, we progressed to the next level, and if we did not, we had another short book to complete at the same level before we could move on.
What is new is the mode of delivery. Take a look at lectures on the Internet. I wish that I could have watched, paused and repeated lectures at my convenience. Consider that our students often juggle family and work. Shouldn’t we reward their desire to improve themselves with structured discussion groups that they can join online from home? Isn’t it a positive and reassuring development that they can be guided to develop and progress through competencies at their own pace? Widespread use of the Internet has facilitated the development of tools that make education more accessible – and that’s a good thing.
That said, how the flipped classroom and adaptive learning work in nursing education needs some further thought. There are topics, such as pathophysiology and pharmacology, that would seem to fit neatly with the new educational technology and adaptive learning techniques. Other topics are either less obvious fits or clearly not appropriate. Practicing manual skills and clinical interactions, for example, demands a more direct human touch.
Recently, the American Association of Colleges of Nursing, the Jonas Center for Nursing Excellence and the Khan Academy have come together to work with nursing faculty to take on these challenges. We look forward to the development of these new and exciting approaches to nursing education.