Facing the challenges in ophthalmology clerkship teaching: Is flipped classroom the answer?

Abstract

Recent reform of medical education highlights the growing concerns about the capability of the current educational model to equip medical school students with essential skills for future career development. In the field of ophthalmology, although many attempts have been made to address the problem of the decreasing teaching time and the increasing load of course content, a growing body of literature indicates the need to reform the current ophthalmology teaching strategies. Flipped classroom is a new pedagogical model in which students develop a basic understanding of the course materials before class, and use in-class time for learner-centered activities, such as group discussion and presentation. However, few studies have evaluated the effectiveness of the flipped classroom in ophthalmology education. This study, for the first time, assesses the use of flipped classroom in ophthalmology, specifically glaucoma and ocular trauma clerkship teaching. A total number of 44 international medical school students from diverse background were enrolled in this study, and randomly divided into two groups. One group took the flipped glaucoma classroom and lecture-based ocular trauma classroom, while the other group took the flipped ocular trauma classroom and lecture-based glaucoma classroom. In the traditional lecture-based classroom, students attended the didactic lecture and did the homework after class. In the flipped classroom, students were asked to watch the prerecorded lectures before the class, and use the class time for homework discussion. Both the teachers and students were asked to complete feedback questionnaires after the classroom. We found that the two groups did not show differences in the final exam scores. However, the flipped classroom helped students to develop skills in problem solving, creative thinking and team working. Also, compared to the lecture-based classroom, both teachers and students were more satisfied with the flipped classroom. Interestingly, students had a more positive attitude towards the flipped ocular trauma classroom than the flipped glaucoma classroom regarding the teaching process, the course materials, and the value of the classroom. Therefore, the flipped classroom model in ophthalmology teaching showed promise as an effective approach to promote active learning.

Comparison between flipped classroom and lecture-based classroom in ophthalmology clerkship

“…This study was a further investigation into the effectiveness and suitability of the flipped classroom model in an ophthalmology clinical clerkship, which was developed based on our previous pilot study [34]. This study was an improvement over the pilot in that: (1) we optimized the flipped classroom approach in ocular trauma teaching due to our previous finding that both students and teachers considered the ocular trauma subject more suitable for flipped classroom [34]; (2) this study compared the students’ perspectives between flipped classroom and a traditional lecture-based classroom in ophthalmology clerkship; and (3) this study had a larger sample size.…”

“…According to the feedback from our previous study, teachers in ZOC agreed that ocular trauma is a more suitable topic for the implementation of the flipped classroom approach compared to other topics. Consistently, students had evaluated the flipped ocular trauma classroom more positively than the flipped glaucoma classroom [34]. Ocular trauma cases usually cover multiple eyeball injuries, which requires students to have a comprehensive grasp of knowledge about ophthalmic diseases, including endophthalmitis, glaucoma, cataract, iris concussion, vitreous hemorrhage, and retinal detachment.…”

“…The traditional lecture-based classroom followed the same procedure as we described in our previous study [34]. Briefly, the students attended a two-hour didactic lecture followed by a 30-minute question-and-answer session.…”

“…However, the application of the flipped classroom in ophthalmology education is less well studied. Previous studies from our group took the first step in applying the flipped classroom approach to clerkship teaching of glaucoma and ocular trauma, and showed that the flipped classroom was welcomed by both students and teachers [34,35]. More importantly, the flipped classroom helped students to develop skills in problem-solving, creative and critical thinking, and team work [34].…”

“…Previous studies from our group took the first step in applying the flipped classroom approach to clerkship teaching of glaucoma and ocular trauma, and showed that the flipped classroom was welcomed by both students and teachers [34,35]. More importantly, the flipped classroom helped students to develop skills in problem-solving, creative and critical thinking, and team work [34]. However, this pilot study had a relatively small sample size, and was not designed to compare students’ perspectives of both flipped and traditional lecture-based classrooms.…”