The case for dynamic classrooms in medical education

Guest post by David Lenihan, Ph.D., president of the Ponce Health Sciences University

Harvard Medical School recently made news by announcing "major" changes in its curriculum. Professors will "flip" the classroom, giving students access to the lectures in advance of class--so that professors and students can use precious time together to foster deeper learning, rather than simply to transmit content.

Conceived in the mid-90s as bandwidth began permitting online transmission of video, the flipped classroom was popularized by Sal Khan, who launched Khan Academy after observing the benefits of video lectures for a young cousin he was tutoring. The benefits of the flipped classroom are increasingly clear: When professors and students take responsibility for engaging with basic materials before class, the learning environment becomes livelier and more enjoyable.

In the medical school context, flipping the classroom is relatively easy to do, once faculty are convinced it's both effective and non-threatening to their jobs. But it represents only the first step in transforming teaching and learning--and improving outcomes.

Today, we're moving beyond simply flipping the classroom, toward the use of real-time analytics from outside class activities that inform instructional design and decision-making. When students engage with academic content outside of the classroom, it creates an opportunity to pinpoint challenges before they set foot in class. 

In using this approach at Ponce, we integrate short, online formative assessments into the video lectures to provide professors with a clear idea of topics that warrant classroom time. When professors come to class armed with a more granular understanding of student challenges, they can allocate classroom time to focus on developing better and deeper understanding of critical concepts or issues.

A dynamic classroom moves beyond the flipped classroom by "livestreaming" feedback from students as the class unfolds. Through in-class response technology, including the use of omnipresent smartphones, faculty are able to gather instant, targeted feedback from students, even in a large lecture environment.

Of course, technology is only the starting point. By reallocating energy away from rote lectures, we have time to break students into teams to collaborate on critical questions. Teamwork is, after all, how medicine is actually practiced. In their teams, students talk, explain and teach each other. That's where real active learning happens. Depending on the difficulty of the question, the team discussion should take between 30 and 120 seconds. After team discussions, the professor re-asks the question and students are given 30 seconds to answer.

Observers of the dynamic classroom notice that, in many cases, the professor says very little. Rather than lecture, the professor listens. If student responses continue to demonstrate a lack of understanding, the professor will approach the topic based on what  he or she has overheard from the team discussions.

Often, students come up with the right answer through faulty reasoning. Professors who listen recognize this, and make adjustments to instill fundamental understanding, which ultimately enables better retention of critical information. 

The byproduct of this work is data, and herein lies the potential for truly transformative improvement. The dynamic classroom provides us with a deeper understanding of student learning through thousands data points from formative instruments and classroom responses.

At Ponce we are now beginning to use this student data through predictive analytics efforts, comparing students to standard norms and refining our approach and systems over time.

Using big data, we are able to assign value to certain types of test items or concepts based on their relevance to the boards and spot emerging trends to improve instruction or the reliability of our assessments. In doing so, we move beyond historic binary point values (e.g., 90 percent, 80 percent, 70 percent) to gain more precise insights into student--and faculty--performance.

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