A 2010 study by the Carnegie Foundation for the Advancement of Teaching (Benner, Sutphen, Leonard, & Day) found that while nursing schools do an outstanding job of teaching students at the bedside, classroom teaching often fails to engage them. In particular, nursing education has been doing poorly in helping students connect abstract scientific concepts to the clinical realm. The authors recommend that coursework be “tied to what actually happens in patient care rather than in the abstract, helping students make the connection between acquiring and using knowledge, integrating the classroom with clinical practice” (p. 4). This higher order processing can be difficult to incorporate into a traditional classroom where valuable time is spent exposing students to information and ideas for the first time.
In his 2012 text, Teaching Naked, author Jose Antonio Bowen observes that college classrooms have typically focused on first exposure with the assumption that analysis, reflection and synthesis would occur when students are alone and away from the professor. Many educators and researchers argue that this system needs to be ‘flipped’, with first exposure to material occurring outside of the classroom, effectively preparing students for active learning opportunities when interacting face-to-face with instructors and classmates. Many studies comparing a flipped classroom with standard lecture delivery have found improved test scores as well as significantly better results with applied clinical skills, clinical judgement and reasoning (Messaro & Wolf, 2013). If we consider the recommendations of the Carnegie study, this strategy could effectively facilitate required growth and learning in nursing students.
Learning about the pedagogical model of a flipped classroom challenges the way in which I’ve long viewed education delivery. This is uncomfortable, not because I believe the value of this new model is lacking, but simply because any challenge to a deeply rooted belief system is uncomfortable. However, questioning one’s own beliefs and having the ability to change a belief based on evidence is necessary to be effective in the world. I am challenged but excited by the potential I see in radically changing the way I teach.
Through nearly 40 years of personal education experience, 5 years of teaching experience, and two years working on my Provincial Instructors’ Diploma I had never been exposed to the concept of a flipped classroom. Even though I have been learning about and working hard to integrate active learning opportunities into my own classroom, I have still followed a traditional model in which first exposure to material is in the classroom. I want to engage students in their learning and increase their motivation by “constantly demonstrating relevance, making connections to interesting ideas and information, and inspiring study ” (Bowen, 2012, p. 130). However, it just isn’t working. I give students a list of required pre-readings and they don’t do them. I fill most of the class with first exposure to material, albeit in a creative and interactive manner, but am left with little or no time for facilitating higher order processing. I have long felt frustrated with this lack in my current methods but, aside from adding hours to my courses, could see no way to change what was happening. As a student myself once again I am even more aware of the value of students’ time. If I am taking two weekends out of my full life to attend classes they had better include something that I cannot get at home from the internet or from books. I want to show my students that I respect their time and to provide them with opportunities in the classroom that will prepare them well for the challenges of a multifaceted and ever-changing nursing career.
Flipping a classroom requires a substantial investment of work by both faculty and students. Not only does a pedagogical change have to occur, as Critz & Knight remarked, it takes time to “develop and narrate concise, meaningful online lectures and acquire relevant, evidence-based articles from which questions [are] posed” (2013, para 7). I will not likely record all of my own lectures, but follow Bowen’s suggestion to “do what you do best & link the rest” (2012, p. 125). There are many valuable resources already available on the internet but it will take time, not only to find, evaluate, and incorporate them, but to ensure that links remain active and that the most current material is addressed.
My program currently uses a Learning Management System, Desire to Learn (D2L), as the platform for all of our courses. However, we do not use it to its full capability. Although I do not see myself changing all of my courses to an entirely flipped model, I think that I can begin in the fall flipping some of my classes. I have the ability on D2L to post articles, videos and podcasts as well as to set up group discussions about presented material. Not only will this change create more opportunity to work with students face-to-face in a meaningful way, it will help to develop essential informational and digital literacy in students. As Bowen remarked, “We need to focus on helping students build the skills that will be essential to navigate access to unlimited sources of data” (2012, p. 130). I need to do all that I can to ensure that the students I work with are prepared for the profound changes in science, technology and the nature and settings of nursing practice. I believe that a flipped classroom can facilitate that learning.