flipping dental education
TRANSCRIPT
Beyond PBL:
Flipping Dental Education
The 9th International Conference on Problem-Based Learning in Dentistry
June 25-26, 2016
JIHYUN LEE
Seoul National University
CONTENTS
1. PBL
3.
Future Directions to Dental Education
2. Flipped Learning
4.
Finding Proper Mix
CONTENTS
1. PBL
3.
Future Directions to Dental Education
2. Flipped Learning
4.
Finding Proper Mix
CONTENTS
1. PBL
3.
Future Directions to Dental Education
2. Flipped Learning
4.
Finding Proper Mix
CONTENTS
1. PBL
3.
Future Directions to Dental Education
2. Flipped Learning
4.
Finding Proper Mix
FLPBL Future DirectionMix
Problem-based Learning:
History
What is it?
Features
Educational Paradigm Behind PBL
Effectiveness
Issues
FLPBL Future DirectionMix
Historical Review on Problem-based Learning
1969 Initially developed and applied in a medical education McMaster University in Canada.
Dissatisfaction with medical education (Barrows, 1996)
• Large numbers of lectures from the front of a lecture theatre with limited student interaction
• Passive bored students (contrast: students during residency)
Dissatisfaction with medical education (Barrows, 1996)
FLPBL Future DirectionMix
Historical Review on Problem-based Learning
A lecture at the University of Bologna in
Italy in the mid-14C.
The lecturer reads from a text on the
lectern while students in the back sleep.
FLPBL Future DirectionMix
Historical Review on Problem-based Learning
1969 Initially developed and applied in a medical education McMaster University in Canada.
Dissatisfaction with medical education (Barrows, 1996)
• Large numbers of lectures from the front of a lecture theatre with limited student interaction
• Passive bored students (contrast: students during residency)
• Minimal integration between basic sciences and clinical subjects
• Little chance for applying knowledge in relevant situations and for developing clinical reasoning ability
FLPBL Future DirectionMix
Historical Review on Problem-based Learning
1969 Initially developed and applied in a medical education McMaster University in Canada.
1984 The dental school at Malmö in Sweden was closed.
1990 The dental school at Malmö was reopened with revised curriculum employing PBL.
2007 All of Australian dental schools had adopted PBL (Winning & Townsend, 2007)
2009 Almost half of US. and Canadian schools had adopted PBL (Bassir et al., 2013)
FLPBL Future DirectionMix
Problem-based Learning:
the assumption that learning is an active, integrated, and constructive
process influenced by social and contextual factors (Barrows, 1996)
� a student-centered learning with
� specific problems (ill-structured real-world clinical, community or scientific problems)
� in small groups with facilitating tutors
� whilst identifying and evaluating information sources, acquiring knowledge, and seeking solutions
� in an active, integrated, and constructive process
PBL is both a method and a philosophy.
FLPBL Future DirectionMix
Problem-based Learning:
Process
Describe Problem
Interpret Problem
Brainstorm Hypothesis/Ideas
Identify Learning Issues/Learning Needs
Research – Learn
Define what we know,
what we don’t know, and
what we don’t know that we don’t know it
Develop Diverse Perspectives
Identify Facts Provided
Devise Solutions
Evaluate Solutions and Reflect
FLPBL Future DirectionMix
Problem-based Learning:
(Fincham & Shuler, 2001)
Six core features of PBL (Barrows, 1969)
(1) Learning is student-centered;
(2) Learning occurs in small peer-groups;
(3) Teachers act as facilitators;
(4) Problems provide the organizing focus and stimulus for learning;
(5) Problems are the vehicle for the development of problem- solving skills;
(6) New information is acquired through self-directed learning.
FLPBL Future DirectionMix
Problem-based Learning:
� Problem solving skills
� Reasoning, Critical thinking skills
� Self-assessment skills
� Self-directed learning skills
� Intrinsic interest in the subject matter
� Communication, teamwork, leadership
� Increased retention of knowledge
� Enhanced integration of basic scientific concepts
Benefits of PBL
FLPBL Future DirectionMix
Problem-based Learning:
Classical cognitive theories supporting PBL
Tulving & Thomson, 1973
FLPBL Future DirectionMix
Problem-based Learning:
(Rich, Keim, & Shuler, 2005)
FLPBL Future DirectionMix
Problem-based Learning:
Classical cognitive theories supporting PBL
Conditionalized Knowledge
(Simon, 1980; Glaser, 1992)
FLPBL Future DirectionMix
Problem-based Learning:
Research Evidences on the PBL Effectiveness
Medical Education Literature
� Overall outcome: NSD
� Acquisition of factual knowledge: negative effect
� Self-directed learning: NSD
FLPBL Future DirectionMix
Problem-based Learning:
Research Evidences on the PBL Effectiveness
Dental Education LiteratureSystematic review on the effectiveness of PBL in Dental Education from 1997-2012
� Factual knowledge: Significantly superior performance
� Knowledge application to clinical situation: Significantly superior performance
� Clinical hand skills: NSD
� Perceived career preparedness: Significantly superior performance
FLPBL Future DirectionMix
Problem-based Learning:
Issues
Variability affects the effectiveness of PBL.
� Mode and degree of the implementation
� Role of faculty, faculty training, time-poor faculty
� Relevant students assessment
� Relevant problems
� Relevant timing
� Program evaluation
� Cost and effort – class size, group size, maintenance, staffs
Is PBL still worth the cost and effort?
FLPBL Future DirectionMix
Problem-based Learning:
Paradigm Continuum
both a method and a philosophy based on a certain paradigm
FLPBL Future DirectionMix
Problem-based Learning:
Paradigm Continuum
both a method and a philosophy based on a certain paradigm
Views on Objectivism Constructivism
Knowledge Absolute objective knowledge exists
independently of or experiences
The true meaning of knowledge is constructed by
individual learner’s mind
Learning Transmitting the absolute objective
knowledge into learners’ mind
Active construction of meaning based on
learner’s experiences
Conditions
of Learning
Absolute knowledge can be taught regardless
of context.
Rich real-world context should be provided
where knowledge can be interpreted and applied.
Outcome
of Learning
Same understanding and memory across
individual learners
Diverse meaning-making by individual
Teaching Delivery of knowledge Supporting learners to construct his/her own
meaning
Role of teacher Efficient and effective deliverer of knowledge Facilitator, mentor, supporter
Major method Lecture PBL, Discussion, Inquiry Learning
FLPBL Future DirectionMix
Problem-based Learning:
Paradigm Continuum
both a method and a philosophy based on a certain paradigm
Views on Objectivism Constructivism
Knowledge Absolute objective knowledge exists
independently of or experiences
The true meaning of knowledge is constructed by
individual learner’s mind
Learning Transmitting the absolute objective
knowledge into learners’ mind
Active construction of meaning based on
learner’s experiences
Conditions
of Learning
Absolute knowledge can be taught regardless
of context.
Rich real-world context should be provided
where knowledge can be interpreted and applied.
Outcome
of Learning
Same understanding and memory across
individual learners
Diverse meaning-making by individual
Teaching Delivery of knowledge Supporting learners to construct his/her own
meaning
Role of teacher Efficient and effective deliverer of knowledge Facilitator, mentor, supporter
Major method Lecture PBL, Discussion, Inquiry Learning
FLPBL Future DirectionMix
Problem-based Learning:
Paradigm Continuum
both a method and a philosophy based on a certain paradigm
Views on Objectivism Constructivism
Knowledge Absolute objective knowledge exists
independently of or experiences
The true meaning of knowledge is constructed by
individual learner’s mind
Learning Transmitting the absolute objective
knowledge into learners’ mind
Active construction of meaning based on
learner’s experiences
Conditions
of Learning
Absolute knowledge can be taught regardless
of context.
Rich real-world context should be provided
where knowledge can be interpreted and applied.
Outcome
of Learning
Same understanding and memory across
individual learners
Diverse meaning-making by individual
Teaching Delivery of knowledge Supporting learners to construct his/her own
meaning
Role of teacher Efficient and effective deliverer of knowledge Facilitator, mentor, supporter
Major method Lecture PBL, Discussion, Inquiry Learning
FLPBL Future DirectionMix
Problem-based Learning:
Paradigm Continuum
both a method and a philosophy based on a certain paradigm
Views on Objectivism Constructivism
Knowledge Absolute objective knowledge exists
independently of or experiences
The true meaning of knowledge is constructed by
individual learner’s mind
Learning Transmitting the absolute objective
knowledge into learners’ mind
Active construction of meaning based on
learner’s experiences
Conditions
of Learning
Absolute knowledge can be taught regardless
of context.
Rich real-world context should be provided
where knowledge can be interpreted and applied.
Outcome
of Learning
Same understanding and memory across
individual learners
Diverse meaning-making by individual
Teaching Delivery of knowledge Supporting learners to construct his/her own
meaning
Role of teacher Efficient and effective deliverer of knowledge Facilitator, mentor, supporter
Major method Lecture PBL, Discussion, Inquiry Learning
FLPBL Future DirectionMix
Problem-based Learning:
Paradigm Continuum
both a method and a philosophy based on a certain paradigm
Views on Objectivism Constructivism
Knowledge Absolute objective knowledge exists
independently of or experiences
The true meaning of knowledge is constructed by
individual learner’s mind
Learning Transmitting the absolute objective
knowledge into learners’ mind
Active construction of meaning based on
learner’s experiences
Conditions
of Learning
Absolute knowledge can be taught regardless
of context.
Rich real-world context should be provided
where knowledge can be interpreted and applied.
Outcome
of Learning
Same understanding and memory across
individual learners
Diverse meaning-making by individual
Teaching Delivery of knowledge Supporting learners to construct his/her own
meaning
Role of teacher Efficient and effective deliverer of knowledge Facilitator, mentor, supporter
Major method Lecture PBL, Discussion, Inquiry Learning
FLPBL Future DirectionMix
Problem-based Learning:
Paradigm Continuum
both a method and a philosophy based on a certain paradigm
Views on Objectivism Constructivism
Knowledge Absolute objective knowledge exists
independently of or experiences
The true meaning of knowledge is constructed by
individual learner’s mind
Learning Transmitting the absolute objective
knowledge into learners’ mind
Active construction of meaning based on
learner’s experiences
Conditions
of Learning
Absolute knowledge can be taught regardless
of context.
Rich real-world context should be provided
where knowledge can be interpreted and applied.
Outcome
of Learning
Same understanding and memory across
individual learners
Diverse meaning-making by individual
Teaching Delivery of knowledge Supporting learners to construct his/her own
meaning
Role of teacher Efficient and effective deliverer of knowledge Facilitator, mentor, supporter
Major method Lecture PBL, Discussion, Inquiry Learning
FLPBL Future DirectionMix
Problem-based Learning:
Paradigm Continuum
both a method and a philosophy based on a certain paradigm
Views on Objectivism Constructivism
Knowledge Absolute objective knowledge exists
independently of or experiences
The true meaning of knowledge is constructed by
individual learner’s mind
Learning Transmitting the absolute objective
knowledge into learners’ mind
Active construction of meaning based on
learner’s experiences
Conditions
of Learning
Absolute knowledge can be taught regardless
of context.
Rich real-world context should be provided
where knowledge can be interpreted and applied.
Outcome
of Learning
Same understanding and memory across
individual learners
Diverse meaning-making by individual
Teaching Delivery of knowledge Supporting learners to construct his/her own
meaning
Role of teacher Efficient and effective deliverer of knowledge Facilitator, mentor, supporter
Major method Lecture PBL, Discussion, Inquiry Learning
FLPBL Future DirectionMix
Problem-based Learning:
Paradigm Continuum
both a method and a philosophy based on a certain paradigm
Views on Objectivism Constructivism
Knowledge Absolute objective knowledge exists
independently of or experiences
The true meaning of knowledge is constructed by
individual learner’s mind
Learning Transmitting the absolute objective
knowledge into learners’ mind
Active construction of meaning based on
learner’s experiences
Conditions
of Learning
Absolute knowledge can be taught regardless
of context.
Rich real-world context should be provided
where knowledge can be interpreted and applied.
Outcome
of Learning
Same understanding and memory across
individual learners
Diverse meaning-making by individual
Teaching Delivery of knowledge Supporting learners to construct his/her own
meaning
Role of teacher Efficient and effective deliverer of knowledge Facilitator, mentor, supporter
Major method Lecture PBL, Discussion, Inquiry Learning
FLPBL Future DirectionMix
Problem-based Learning:
Paradigm Continuum
both a method and a philosophy based on a certain paradigm
Objectivism Constructivism
Lecture PBLFlipped Learning
Flipped Classroom / Flipped Learning
“what is traditionally done in class
what is traditionally done as homework
is now done at home and
is now completed in class”
(Bergman & Sams, 2012, p.13)
PBL FL Future DirectionMix
Flipped Classroom / Flipped Learning
PBL FL Future DirectionMix
OnlineOffline +Existing way of Blended Learning
Flipped Classroom / Flipped Learning
PBL FL Future DirectionMix
Online Offline+New way of Blended Learning
PBL FL Future DirectionMix
Which one is better
for students’ learning?
PBL FL Future DirectionMix
Media Theories
Cost↑, Richness ↑, Synchronicity ↑
Media richness theory
Cost of communication theory
Media synchronicity theory
More significant task should be done using media with
Flipped Learning
PBL FL Future DirectionMix
Face to face class phase
Online learning phase
Knowledge transmission
Knowledge application, assimilation, practice
More significant task should be done using media with Cost↑, Richness ↑, Synchronicity ↑
Flipped Learning
PBL FL Future DirectionMix
PBL FL Future DirectionMix
Teacher’s role Learner’s roleActivities
Flipped Learning
1. Pre-class: Online lecture produced in studio, Voice-over ppt, publicly available resources, reading materials
PBL FL Future DirectionMix
OROR
OR
PBL Mix Future DirectionFL
Flipped Learning
Team-based Learning (Michaelson, Knight, & Fink, 2002)
PBL FL Future DirectionMix
PBL FL Future DirectionMix
OCW
Open Courseware
MOOCs
Massive Open Online Courses
PBL FL Future DirectionMix
PBL FL Future DirectionMix
PBL Future DirectionMixFL
PBL FL Future DirectionMix
PBL FL Future DirectionMix
PBL FL Future DirectionMix
PBL FL Future DirectionMix
PBL FL Future DirectionMix
PBL FL Future DirectionMix
PBL FL Future DirectionMix
PBL FL Future DirectionMix
PBL FL Future DirectionMix
PBL FL Future DirectionMix
PBL FL Future DirectionMix
PBL FL Future DirectionMix
PBL FL Future DirectionMix
PBL FL Future DirectionMix
Flipped Classroom / Flipped Learning
2. Quiz
PBL FL Future DirectionMix
To ensure that the students had learned the pre-class materials prior to class
To evaluate students’ readiness for classroom phase (To see if mini-lecture is necessary)
To facilitate classroom learning activities
Flipped Classroom / Flipped Learning
F2F Group Activities
PBL FL Future DirectionMix
- Educationally purposeful interactive classroom activities consisting of a variety of interesting group
projects, scenarios, cases, and games allowed the instructor to make synchronous formative assessments
and address misconceptions in student learning
- Much more demanding because it is the core element of FL.
Flipped Learning at SNU
PBL FL Future DirectionMix
Topics Assignment Learning Activities
Week
1
Significance of dental infection control
Learning with clips (2 documentaries, 1 news clipon the Oklahoma incident)
Quiz─ Mini lecture─ Small group activities(Difference between the case of 2006 and 2006, USand Korea)
Week
2
The routes of cross-infection(Various pathogens): Immunological understanding
Learning with lecture clips (week 1 clip, week 2clip)
Quiz─ Mini lecture─ Small group activities(Analyzing routes of cross infection Hepatitis B andC Virus)
Week
3
Scientific understanding of standard precautions
Learning with reading material (CDC Summaryup to p.18) and with lecture clips (week 3 clip)
Quiz─ Mini lecture─ Small group activities(Discussing the clip “If saliva were red”)
Week
4Cross-infection cases in dental clinics Learning with reading material (Rha, 2015) Quiz─ Lecture
Week
5
Diverse possibilities of dental infection control
Devise an infection control solution regardingissues provided and send your ideas by email.
Idea presentation, Q & A on infection control indental clinics
Week
6
Current status of infection control in dental hospitals
Prepare your questions on infection control indental hospitals.
Special invited lecture by nurse and dental hygienistin SNUDH
Week
7
Levels of infection control, Related issues, Protocol development
Learning with a news report provided.Submit your own protocol by email.
Discussion on recent issues on the news report.Protocol presentation
Flipped Learning (SNU Case)
PBL FL Future DirectionMix
Flipped Learning at SNU
PBL FL Future DirectionMix
Course Evaluation Items (N=76)Strongly
AgreeAgree Neutral Disagree
Strongly
Disagree
This course gave me opportunities to participate during class. 21.1% 34.2% 25.0% 15.8% 3.9%
I can discuss my ideas with my peers and professor in this course. 21.1% 48.7% 15.8% 7.9% 6.6%
My professor responded to my questions immediately in this
course.36.8% 42.1% 13.2% 5.3% 2.6%
I got to know how basic bio-dental science learned in this course
can be applied to clinical situations.10.5 % 39.5% 32.9% 10.5% 6.6%
I think that what I learned in this course will be helpful in clinical
situations.26.3% 47.4% 19.7% 5.3% 1.3%
I am overall satisfied with this course. 5.3% 26.3% 35.5% 26.3% 6.6%
Flipped Classroom / Flipped Learning
PBL FL Future DirectionMix
• the possibility for students to appropriate content at their own learning pace;
• the possibility of self-assessment for students and lecturers, through the introduction of small
tasks and quizzes into the process;
• the possibility to receive direct feedback;
• the possibility to interact with the lecturer;
• the possibility to work on, answer and discuss questions that arise.
Advantages
Flipped Classroom / Flipped Learning
PBL FL Future DirectionMix
Disadvantages
• inadequate acquisition of knowledge in the online or self-directed learning phase
(It may be lack of time, lack of motivation, or highly complex content )
• The significance of a careful selection of preparatory material is correspondingly great.
• there is a danger that the online material and classroom instruction will not be congruent
• instructors must initially expend more effort
(selection of teaching material; content- and format-related planning of the classroom phase)
• Valid Students’ assessment is challenging.
PBL Mix Future DirectionFL
PBL FL Lecture
PBL Mix Future DirectionFL
PBL Flipped Learning
Start 1969 in medical education
1990 in dental education
2012 in high school chemistry
Process • Problem – Content – Problem
• Each students learn different content, and
share their learning.
• Content – Problem – Content
• Each students learn same content, and help each other
apply those content.
Strength • Students can develop self-directed learning,
life-long learning all through the learning
process.
• Students should evaluate and identify
learning materials by themselves.
• Credible learning materials are provided. Students search
further learning materials by their own.
• Knowledge can be efficiently structured.
• Online lecture can repeatedly learned on individual pace.
Weakness • Cognitive load to stay self-directed from the
beginning
• Insufficient “cognitive scaffolding” in the
basic sciences
• Faculty loads in the starting semester (developing online
lectures, designing learning activities)
• Online lecture is suitable for lower order cognitive skills .
• Students should have access to online learning resources.
PBL vs. Flipped Learning
PBL Mix Future DirectionFL
PBL Flipped Learning
Start 1969 in medical education
1990 in dental education
2012 in high school chemistry
Process • Problem – Content – Problem
• Each students learn different content, and
share their learning.
• Content – Problem – Content
• Each students learn same content, and help each other
apply those content.
Strength • Students can develop self-directed learning,
life-long learning all through the learning
process.
• Students should evaluate and identify
learning materials by themselves.
• Credible learning materials are provided. Students search
further learning materials by their own.
• Knowledge can be efficiently structured.
• Online lecture can repeatedly learned on individual pace.
Weakness • Cognitive load to stay self-directed from the
beginning
• Insufficient “cognitive scaffolding” in the
basic sciences
• Faculty loads in the starting semester (developing online
lectures, designing learning activities)
• Online lecture is suitable for lower order cognitive skills .
• Students should have access to online learning resources.
PBL vs. Flipped Learning
PBL Mix Future DirectionFL
PBL Flipped Learning
Start 1969 in medical education
1990 in dental education
2012 in high school chemistry
Process • Problem – Content – Problem
• Each students learn different content, and
share their learning.
• Content – Problem – Content
• Each students learn same content, and help each other
apply those content.
Strength • Students can develop self-directed learning,
life-long learning all through the learning
process.
• Students should evaluate and identify
learning materials by themselves.
• Credible learning materials are provided. Students search
further learning materials by their own.
• Knowledge can be efficiently structured.
• Online lecture can repeatedly learned on individual pace.
Weakness • Cognitive load to stay self-directed from the
beginning
• Insufficient “cognitive scaffolding” in the
basic sciences
• Faculty loads in the starting semester (developing online
lectures, designing learning activities)
• Online lecture is suitable for lower order cognitive skills .
• Students should have access to online learning resources.
PBL vs. Flipped Learning
PBL Mix Future DirectionFL
PBL Flipped Learning
Start 1969 in medical education
1990 in dental education
2012 in high school chemistry
Process • Problem – Content – Problem
• Each students learn different content, and
share their learning.
• Content – Problem – Content
• Each students learn same content, and help each other
apply those content.
Strength • Students can develop self-directed learning,
life-long learning all through the learning
process.
• Students should evaluate and identify
learning materials by themselves.
• Credible learning materials are provided. Students search
further learning materials by their own.
• Knowledge can be efficiently structured.
• Online lecture can repeatedly learned on individual pace.
Weakness • Cognitive load to stay self-directed from the
beginning
• Insufficient “cognitive scaffolding” in the
basic sciences
• Faculty loads in the starting semester (developing online
lectures, designing learning activities)
• Online lecture is suitable for lower order cognitive skills .
• Students should have access to online learning resources.
PBL vs. Flipped Learning
PBL Mix Future DirectionFL
Medical Education vs. Dental Education
• Clinical problem-solving in ME: focus on diagnosis
• Clinical skills in DE: focus on mechanical hand activities, psychomotor skills for treatment
• Outcome variables of PBL in DE (Bassir et al., 2013)
- knowledge acquisition,
- knowledge application,
- clinical hand skills,
- perceived preparedness, and
- a wide range of behavioral characteristics
PBL Mix Future DirectionFL
Learning Psychomotor Skills
• Cognitive phase – learning the
vocabulary and procedural rules
• Associative phase – learning how to
physically perform the skill
• Autonomous phase – practice and
feedback guide learner to smooth,
precise movements.
Bloom (1956)
Moore (1998)
When do we need self-directed learning?
When do we need guidance?
Shall we implement PBL or FL?
Smith & Ragan (2005)
PBL Mix Future DirectionFL
Paradigm Continuum
Objectivism Constructivism
Lecture PBLFlipped Learning
knowledge
acquisition
knowledge
application
clinical hand
skills
perceived
preparedness
a wide range of
behavioral
characteristics
FL O O O O
PBL O O O O
Psychomotor Skill Learning
O
PBL Future DirectionMixFL
• a growing commitment to competency-based curricula that focus on
learner acquisition of specific competencies while a more growing
concern for diverse teaching method to nurture self-directed lifelong
learner to think critically and independently
• move beyond individual competence to a collective competency or team
competency
• advances in digital media that enhance the delivery of content outside of
the lecture hall and free up resources for synthesis and application of
content
• evidence-based decision making in education based on educational
theory and research
Future Directions to Dental Education
Changes in healthcare and society
• Movement toward total wellness
and prevention-focused model
rather than treatment-focused
• Team-based care
• Advances in digital media
• Education as a significant agent
of social and scientific change
Thank you!감사합니다