A Flipped Classroom:

Team-Based Learning

in P430 Self-Care Therapeutics

Tami Remington, PharmDClinical Associate ProfessorCollege of Pharmacy

Objectives

Impetus for change

Team-based learning

Learners outcomes

Course improvements

Why change? Learning is not persistent

Recall in future courses is not optimal Performance in clinical training is not

optimal Job market is more competitive Class size is substantially larger

A “new” pedagogy:

Team-Based LearningAn approach to teaching in which

small groups of students interact as in-class teams

to apply content to simple and complex problems

with the feedback of the instructor as the content expert

Traditionallecture

Team-based learning

Introduceinformation

Synthesize/integrate

Apply

Lecture inclassroom

Homework/self-study Exam

Self-study/readiness assurance

Classroomactivities

Lab/exam

Diffi

cult

y/c

om

ple

xit

y

Course faculty“Guide

on the Side”

“Sage

on the Stage”

Students

Passive – Zzzzz….

Active!

OverviewPhase

1Preparation

Phase 2Readiness assurance

Phase 3Application

Before class

•Guided self-study

Recitation •Individual test•Team test•Appeals•Faculty feedback

•Problems•Peer feedback•Faculty feedback

Lab •Role-playing and other activities•Peer feedback•Faculty feedback•Individual exam

Relation to course objectives

1. Quickly assess patients 2. Triage patients appropriately 3. Recommend appropriate non-prescription or

nonpharmacologic treatment4. Counsel self-treating patients on recommended

therapies5. Monitor for efficacy and safety of treatment6. Know mechanisms of action, doses/formulations,

common side effects and their management, and common drug interactions and their management for self-care products

7. Communicate with patients empathically and respectfully; appreciate barriers to pharmacist-patient communication and adapt communications accordingly

8. Participate constructively in teams, using skills such as advocacy and inquiry to ensure optimal team functioning

9. Act as an effective team leader, demonstrating ability to encourage balanced participation from all team members and foster healthy team dynamic

Phase 3

Phase 1, 2

Phase 3

Phases 2, 3

Phases 2, 3

  Tuesday(discussion)

Thursday(discussion)

Friday(lab)

    Orientation, approach to self-treating patient

Group formation

Unit 1

Headache Dysmenorrhea  

Musculoskeletal pain Fever/Cold  

Allergic rhinitis Cough  

Unit 2

Constipation Constipation Exam 1

Diarrhea Intestinal gas/anorectal disorders

 

Heartburn Heartburn  

Unit 3

Acne Fungal and bacterial skin infections

Exam 2

Spring Break

Pediculosis Dermatoses (contact, diaper and atopic)

 

Dermatoses (contact, diaper and atopic)

Dermatoses (contact, diaper and atopic)

 

Warts Bug bites and stings  

Unit 4

Ophthalmic health Otic health Exam 3

Oral health Dietary supplements  

Nutrition Exercise/Weight loss  

  Exam 4    

Individual performance 75%

Individual readiness assessment tests 10%

Lab activities 15%

Unit examinations 35%

Final examination 15%

Team performance 20%

Team readiness assessment tests 10%

Recitation activities 10%

Peer evaluation of team participation 5%

TOTAL 100%

Course assessment

CRLT MSF

TBL is useful because:

• It provides more interaction• It fosters real learning and

independence• Students learn from each other• Case studies seem real• It allows for direct application

of knowledge• It provides instant feedback…• We learn there can be more

than 1 right answer• We are more prepared for class• We learn teamwork• TRATs foster deep discussion of

material

Improvements that could be made include:

• Making closer connections between case studies and exams

• Making labs more efficient• Rebalancing time allotted for

each unit (more time for some topics, less for others)

50 55 60 65 70 75 80 85 90 95 10050

55

60

65

70

75

80

85

90

95

100

IRAT

EX

AM

A B C D0

10

20

30

40

50

60

70

Individual assessmentsOverall grade

P431

(T

BL)

P532

(lec

ture

)0

20

40

60

80

100

Overall

P431

(T

BL)

P532

(lec

ture

)0

10

20

30

40

Essay questions

OTC Counseling

P2 were betterP2 about the same as P3P3 were better

N=19

Knowledge Application Team skills0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

5

Performance on Community IPPE

P2 (TBL) P3 (lecture)N=18

Improvements in process… Targeting pre-work to learning

objectives Less frequent RAP where appropriate More individual assessments in lab Fine-tuning peer assessments Name tags

Plans

Phase 1 - Preparation Guided self-study

Reading Worksheets Formulary

Must be completed before class Independent work will produce better

learning

Phase 2 – Readiness assurance

Individual Test

(10 min)

Individual Test

(10 min)

Closed book 10 questionsClosed book 10 questions

Answer both on test and

answer sheet

Answer both on test and

answer sheet

Submitanswer sheet

Submitanswer sheet

Team Test

(10 min)

Team Test

(10 min)

Closed book same test

Closed book same test

Place answers on IF-AT

answer sheet

Place answers on IF-AT

answer sheet

Submit team answer sheetSubmit team answer sheet

Appeals

(by end of class)

Appeals

(by end of class)

Open bookOpen book

Show evidence from

reading

Show evidence from

reading

Q&A

(10 min)

Q&A

(10 min)

Clarify issuesClarify issues

Phase 3 - Application Instructor-designed cases to promote

synthesis and application of course content Teams work on problems and reach

consensus Teams prepare written defense for some

problems and submit for grading

Reporting of answers Whole class discussion of problems