Online flipped classroom with team-based learning promoted learning activity in a clinical laboratory immunology class: response to the COVID-19 pandemic

Abstract

Background Given the rapid development of clinical immunology technologies, students majoring in laboratory medicine should master the technological principles and application of clinical laboratory immunology. However, many are required to take online courses due to COVID-19 restrictions, which highlights the need to revisit teaching strategies. Recently, various medical education courses (such as Biochemistry, Physiology, etc.) have implemented the flipped classroom (FC) and team-based learning (TBL) methods, resulting in more positive teaching evaluations. To promote the students' mastery of the difficult knowledge effectively during the online teaching work, we evaluated the performance of online FC-TBL in a clinical laboratory immunology course. Methods Sixty-two third-year students from two classes majoring in Laboratory Medicine were recruited and divided into two groups, including one group with traditional lecture-based learning teaching strategy (LBL group) and the other group with LBL or online FC combined with TBL teaching strategy (FC-TBL group). We selected three chapters to conduct FC-TBL teaching in class. All participants took in-class quizzes and final examinations that targeted the same knowledge points. Finally, all participants completed anonymous questionnaires asking for their perceptions of the respective teaching models. In addition, we conducted a survey of teaching suggestions by a FC-TBL class of students majoring in Laboratory Medicine. Results The FC-TBL group (vs LBL group) had significantly higher scores on the in-class quizzes and final examinations, and also reported high satisfaction with the FC-TBL model. These findings indicate that FC-TBL is suitable for clinical laboratory immunology, as the participants quickly gained essential knowledge. Specifically, FC-TBL helped to “increase learning motivation,” “promote self-directed learning skills,” “extend more related knowledge,” “enhance problem-solving abilities,” “enhance clinical reasoning abilities,” and “enhance communication skills.” For participants’ suggestions, 48.38% (15/31) students held positive attitude to FC-TBL teaching strategy compared to 25.81% (8/31) students who considered FC-TBL teaching strategy still needs continuous improvement, and 25.81% (8/31) students reported that they believed FC-TBL teaching strategy was perfect and no further suggestions. Conclusions Online FC-TBL effectively enhanced learning activity among students of a clinical laboratory immunology course. This is particularly useful in the COVID-19 context.

Use of the Community of Inquiry Framework to Measure Student and Facilitator Perceptions of Online Flipped Classroom Compared with Online Lecture Learning in Undergraduate Medical Education

“…The favorable scores within the cognitive presence domain for the online FC tutorial are consistent with findings from other FC-oriented studies, both for in-person and online FC compared to traditional learning formats. 3,6,[9][10][11] Students reported feeling more engaged in discussing ideas, more able to identify relevant points from the thyroid case vignettes, and more ready to apply learning concepts than after online lectures. This is perhaps not too surprising given the inherent nature of the FC model in which students have already reviewed resources and video recordings before class and are primed to dive into extended discussion on class arrival.…”

“…In general, exam performance has been observed to be stronger after online FC modalities compared with online lectures. 10,11,13 On the other hand, a recent study examining online FC versus in-person FC formats in a physical therapy course demonstrated that exam performance and total course grade were similar between the two formats. 29 Thus, in-person and online FC formats for our thyroid pathophysiology tutorial might have resulted in similar test performance as well.…”

“…Since the pandemic, some studies have also shown online FC to be a feasible learning model with similar benefits of higher student engagement and test performance compared with traditional online learning formats. [10][11][12][13] Still, lecturebased learning remains a common instructional method in undergraduate medical education. It requires fewer resources and less organization and is easier to implement online.…”

“…16,17 Social interaction may also feel less natural in online class settings, even with active or FC learning models. 11,18 Though most medical schools did not exclusively use online instruction prior to the COVID-19 pandemic, online learning formats have been utilized and studied since the 1990s as the Internet became more widely available. 19 In 2000, Garrison and colleagues established the Community of Inquiry (CoI) model to inform the development of online and blended learning environments.…”

“… 16 , 17 Social interaction may also feel less natural in online class settings, even with active or FC learning models. 11 , 18 …”