An Eight-year Retrospective Study in “Flipped” Pharmacokinetics Courses

Abstract

Objective. To assess the impact on student performance of increased active learning strategies in a foundational pharmacokinetics course and a clinical pharmacokinetics course over an 8-year period. Design. A foundational pharmacokinetics course with a lecture-with-active-learning (LAL) format was redesigned to a recitation-format (REC) using smaller groups of students (ie, the class divided into thirds) and eventually to a team-based learning (TBL) format. The lecture-based clinical pharmacokinetics course was redesigned to a case-based learning (CBL) format to encourage preclass preparation with class time used for application; this course format underwent minor redesigns over an 8-year period. An analysis of covariance (ANCOVA) was performed on examination scores in the clinical course based on foundational course format changes. End-of-semester student evaluations of the course were used as a secondary measure of impact. Assessment. The highest grades in the clinical course were associated with the TBL format within the foundational course compared to LAL format (effect size 0.78). The REC format in the foundational course compared to LAL was associated with higher performance in the clinical course (effect size 0.50). Examination performance in the clinical course had a small increase when the foundational course was transitioned from the REC format to the TBL format (effect size 0.27). There was a trend within the foundational course that overall student ratings of the course decreased with enhanced self-directed learning; there was no change in overall ratings of the clinical course. Conclusion. Increasing the amount of active learning within the foundational pharmacokinetics course increases performance in the clinical course but this increase in performance may be associated with decreases in student evaluations of the foundational course.

Students’ Attitudes, Academic Performance and Preferences for Content Delivery in a Very Large Self-Care Course Redesign

“…20 A growing body of literature on flipped classroom in medical, nursing, and pharmacy education reports that flipped courses improves attendance 21,22 and increases grades [21][22][23][24][25][26][27] and performance in follow-up courses. 28 Conversely, some reports discuss decreased student satisfaction, 25 significantly decreased examination scores resulting from a lack of accountability for out-of-class preparation, 29 and student satisfaction being influenced by the quality of content and activities. 27 Some negative aspects of TBL in the literature include increased preparation time by students and faculty members as well as student dissatisfaction (especially among introverted individuals and those who prefer the traditional faculty role of lecturing and storytelling).…”

Redesigning a Pharmacology Course to Promote Active Learning

“…While there was, and still remains, some student resistance to the active learning, the student evaluations improved with the active learning sessions compared to the class years before the recitations were started. This is not always the case 21 , but for those who pursue active learning, it is an increase in student knowledge, not satisfaction, that is the primary objective.…”

“…With the introduction of the A J P E A c c e p t e d D r a f t recitation sessions, students were challenged to evaluate, apply, and think critically about course content in comparison to the pre-recitation years. While we do not have a stand-alone advanced pharmacology course to directly compare to, Persky and Dupuis found that by forcing students to apply knowledge to different situations in a foundational course improved their performance in a clinical pharmacokinetics course 21 and it is our belief that a similar increase in performance in our integrated therapeutics courses may also occur, but believe too many other variable exist (different instructors, course assessment changes, etc…) to make a conclusion.…”

“…However, active content delivery methods in required pharmaceutical sciences courses are less common, and much of the work that is published in pharmacokinetics. Persky and colleagues, examined the impact of implementing games, multimedia modules and reflective writing 19 , by converting a large lecture pharmacokinetics course into smaller group courses 20 and then following that study up with an eight-year retrospective study in a "flipped" pharmacokinetics course that began first as a lecture with active learning course that was then redesigned to a recitation format before transitioning to a team-based-learning course 21 . Other examples include a process-oriented guided-inquiry learning (POGIL) 22 and a problem based learning based class in medicinal chemistry 23 and a POGIL introductory course in pharmaceutical sciences 24 .…”

Cost-benefit of Instructional Strategies

“…These outcomes can be challenging as they may decrease in active learning environments even as performance increases. 11 Confidence judgments are complex and may not represent actual knowledge. 12 Clinical performance is the most relevant measure but it is challenging to link a single curricular intervention (ie, course change, active learning strategy) to the outcome (ie, advanced pharmacy practice experience (APPE) grade).…”