Flipping for Pharmaceutics
Room 104 is buzzing as members of the first-year pharmacy class gather. Conversation is at a fever pitch. By the start of the spring semester, classmates are accustomed to being together for class, but not here. Sanchez, a building assigned to the College of Education, is located on the far southern boundary of the Forty Acres – blocks away from the pharmacy complex. The room is one of only a handful across campus that can accommodate the new format of this pharmaceutics class. Casual observers may note the noise level, the white coats, and the classroom full of students so early on a Friday morning, but the significant occurrence taking place may not be as immediately apparent – a revolutionary approach to teaching and learning known as a flipped classroom.
A form of blended learning, the flipped classroom requires students to complete assigned readings drawn from textbooks and other scholarly works prior to class. Instead of a traditional lecture format, class is devoted to practical application of the information in exercises that might traditionally be assigned as homework. Students are grouped into teams of five members to apply the material to a case study by examining a drug product profile and developing a pharmaceutical development action plan. Pharmaceutics I (PHR 356C) represents the college's first full-blown, flipped classroom approach. Drs. Bill Williams and Hugh Smyth are the faculty pioneers who are leading the way.
Williams steps to the front of the massive room. Approximately one-quarter of the students sit at cluster tables in the lower, center portion of the space while the remainder of students are situated in elevated, curved seating similar to that found in a stadium or performance venue.
The chatter quietens as he advises the class to put away assorted electronic devices – smart phones, computers, iPads, etc. – and pick up devices referred to as "clickers." It's quiz time. This opening exercise is designed to assess whether the students have adequately absorbed the information from the advance readings. The computerized testing system displays one question at a time on a large screen at the front of the classroom. Students are given time to use their clickers to electronically record their response among the true/false or multiple-choice options.
Two or three students burst through the classroom doors shortly after the quiz begins. Backpacks and purses in tow, white coats somewhat askew, they enter with clickers in hand. Just inside the classroom, they pause, read the question on the screen, and record their answer before moving to their seats.
The system collects student answers, provides immediate verification that everyone has logged a response, and tallies the percentage of students indicating a correct answer. Quiz concluded, Williams addresses the questions, discusses responses, and reviews material connected to any questions in which a significant percentage of students record a wrong answer.
It's Smyth's turn and he briefly presents the first case. Topic for the week is transdermal patches. As he concludes, he informs the class that today's study is now available for download in an electronic software called Canvas. The large screen at the front of the classroom displays a digital clock displaying one hour – the time the teams have to develop their action plan. Seconds tick away.
Students are grouped into teams at the first of the semester and work within these groups for the duration of the class. Each of the 26 teams must research the case and put together an action plan that must be electronically submitted before the end of the hour. Teams develop strategies for developing the case report with work split among members. The groups sit together for each class, but their locations within the classroom vary from week to week.
"The teams on the lower floor level are seated around a table making it easier to confer with one another," Smyth explained. "Teams in the other seating have to make accommodations to confer with members standing in front of the tabletop where a team mate is seated. To be fair, we rotate the team locations from week to week." Students, he added, requested the rotating seating assignments to help assure fairness. Tabletop signs display team numbers and indicate the seating assignment for each class period.
"The team approach is real-world experience," Williams explained. "As professionals they will be working in teams with other health care providers – pharmacists, physicians, nurses – to determine the best therapies for patients. They will work with people with different levels of knowledge, different approaches to the problem, and with various personality traits. It's important to learn to work with these differences toward the common goal of helping the patient."
Teams go to work. Students are advised that if they do not understand any aspect of the case for more than 5 minutes, they should seek help from a member of the instructional team by raising their hand. Faculty and teaching assistants move about the room, responding to students with raised hands. They offer guidance and interaction based upon need by asking a series of their own questions to guide the student to arrive at his or her own conclusion.
The buzz returns to the classroom, but this time, laughter is replaced with the click of computer keyboards as students search the literature on their specially designed web portal, confer with their teammates and enter their portion of the research for the report.
Work required for the case studies evolves as the semester progresses with students first learning to gather basic information such as active ingredients in drugs and how to conduct literature searches. As the semester progresses, product information is often provided in the case outline and more challenging questions or situations within the case provoke students to dive deeper into their understanding.
"In a traditional lecture, the focus is mostly on facts and information from text," said Amanda Bui, a P4 PharmD student in the spring who started her PhD studies this summer with Williams. "In the flipped-classroom format, the student is given a real-life situation and must apply the knowledge they have learned from the readings. This format provides the benefit of gaining a deeper understanding of information by engaging the students to apply their knowledge."
Ashkan Yazdi, Pharm.D. '11 and a graduate teaching assistant studying with Smyth, warns the class that time for the first case study is nearing conclusion.
Conversation levels pick up again as class members conclude their portion of the research and begin consultation with team members to develop the team report. Before the time expires, each team will upload their completed case study. Over the next few days, the teaching assistants will review the submitted studies, assigning a grade to each.
"I love this," said Williams as he leaves one raised hand and makes his way to another. The course covers the same material as it did in its lecture format, but countless hours have been devoted to working the material into the new structure. Williams and Smyth make sure that the outside readings provide the students with everything they need to address the case studies. The studies themselves are now the center focus of the classroom, and Williams, Smyth and the student teaching assistants have devoted a significant portion of the planning time making sure that all aspects of the complicated studies work. Despite their best efforts, minor adjustments have been necessary as the semester evolved.
"It is unimaginable the amount of time and coordination that it takes for a class like this to run smoothly," said Yazdi. "For any class to go through the flip process, the professor(s) need to be flexible enough to fine tune the teaching plan and take their students' feedback seriously."
Yazdi said he admired the successful manner in which Williams and Smyth flipped the pharmaceutics class. "I witnessed the metamorphosis of the class," he said.
In addition to the grades students earned for the team reports from the in-class studies, the course also included mid-term and final exams. For the mid-term exam, Williams and Smyth split the questions with half coming directly from questions used on exams under the old format and half drawn from the case studies the students completed this semester.
"We wanted to test how students under this concept scored compared to students learning the material in the more traditional lecture design," he continued. "The students under this format did better. By requiring immediate application of the material, students seem to better grasp the concepts.".
"This has been a great semester for this course, but we (he and Smyth) could not have done it without the teaching assistants," Williams reflected as the last class of the semester draws to a close. "They have done a great job."
The teaching team met weekly to discuss the procession of the class and to iron out issues in the format..
In addition to Williams, Smyth and Yazdi and Bui, the team also includes Zachary Warnken, a P4 PharmD/PhD student whose PhD program begins this summer under the joint supervision of Williams and Smyth; Leena Prasad, a current PhD student in Williams' lab; and Kristen Haas, a third-year PharmD student serving as an Advanced Academic Assistant (AAA).
Yazdi participated in the same pharmaceutics class in 2008 as a first year pharmacy student. "This format is engaging the students on a much deeper level (than the format used when he took the class)," he said.
"Information can be easily found and learned with the help of the Internet," Bui said, adding that with each student bringing at least one, and sometimes several electronic devices to class, they have increased the bandwidth capabilities of the room several times over the course of the semester to handle the volume of information being sought via electronic devices. "The flipped-classroom format teaches students how to find reliable information, how to decipher it, and how to apply it to a particular case. Team-based learning is the future of education."