A Flipped Classroom: Team-Based Learning in P430 Self-Care Therapeutics Tami Remington, PharmD Clinical Associate Professor College of Pharmacy

Objectives

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 Learning An 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

Traditional lecture Team-based learning Introduce information Synthesize/ integrate Apply Lecture in classroom Homework/ self-study Exam Self-study/ readiness assurance Classroom activities Lab/ exam Difficulty/complexity

Course faculty “Guide on the Side” “Sage on the Stage”

Students Passive – Zzzzz…. Active!

Overview Phase 1 Preparation Phase 2 Readiness assurance Phase 3 Application 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 treatment 4. Counsel self-treating patients on recommended therapies 5. Monitor for efficacy and safety of treatment 6. 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

Tuesday (discussion) Thursday (discussion) Friday (lab) Orientation, approach to self-treating patient Group formation Unit 1 HeadacheDysmenorrhea Musculoskeletal painFever/Cold Allergic rhinitisCough Unit 2 Constipation Exam 1 Diarrhea Intestinal gas/ anorectal disorders Heartburn Unit 3 Acne Fungal and bacterial skin infections Exam 2 Spring Break Pediculosis Dermatoses (contact, diaper and atopic) WartsBug bites and stings Unit 4 Ophthalmic healthOtic healthExam 3 Oral healthDietary supplements NutritionExercise/Weight loss Exam 4

Individual performance75%  Individual readiness assessment tests 10%  Lab activities 15%  Unit examinations 35%  Final examination 15% Team performance20%  Team readiness assessment tests 10%  Recitation activities 10% Peer evaluation of team participation5% TOTAL100% 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)

N=19

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 questions Closed book 10 questions Answer both on test and answer sheet Submit answer sheet Submit answer sheet Team Test (10 min) Team Test (10 min) Closed book same test Place answers on IF-AT answer sheet Submit team answer sheet Appeals (by end of class) Appeals (by end of class) Open book Show evidence from reading Q&A (10 min) Q&A (10 min) Clarify 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