Tami Remington (College of Pharmacy), course director for the Self-Care Therapeutics course in the College of Pharmacy, and her colleagues wanted to provide more opportunities for their students to practice the skills they would need as practitioners.  In order to create these opportunities, the course instructors, as a group, decided to flip the course sequence using the team-based learning (TBL) pedagogy.  TBL challenges small, permanent student teams to apply foundational concepts to new problems.  Details about the TBL philosophy and pedagogy can be found at www.teambasedlearning.org.  Flipping a team-taught course has unique challenges, but the entire Therapeutics five-semester sequence now uses TBL.

Students’ First Exposure to Course Content

The College of Pharmacy faculty using TBL assign pre-work delivered in an array of media: “study guides” that they write themselves, parts of chapters from pharmaceutical textbooks, journal articles, previously recorded lectures and screencasts.  As a group, the faculty realized they had to strictly limit the amount of pre-work that they assigned, given that it takes novice pharmacists significantly longer to process and organize the information than it does an expert.

Student Accountability for the Pre-Work

Team-based learning is a highly structured. Each unit begins with a readiness assurance process that includes an individual quiz on the pre-work.  Once the individual quizzes are complete, the readiness assurance process concludes with students working in their teams to answer the same quiz questions.  Students receive instant feedback on whether their team has chosen the correct answer or not using special scratch-off answer cards.  Both the individual quiz scores and team quiz scores count toward a student’s final grade.

Face-to-Face Class Time

During the face-to-face class time, students work on cases related to the topic of the day.  The cases are structured as multiple choice questions, and each group of students is working on the same case to come to consensus on the one best course of action.  Each group simultaneously reports out their answer using large index cards with the letter corresponding to their choice.  Instructors can quickly survey the choices made in the room and call on groups that made different decisions to explain their choice.  This large group conversation largely replaces the lecture the instructor would historically have given.  The instructor designates one of the cases in class to be written up by each of the student teams before the large class discussion.  This case is graded by the faculty.

Assessment of Student Learning

The instructors in the Therapeutics course sequence use multiple mechanisms of assessing an individual student’s learning.  Both the individual quiz taken at the beginning of a unit and the same quiz, taken as a group, contribute to a student’s grade, as does the case write-up each group does in-class.  Additionally, the students take multiple choice and short answer tests similar to what was given when the class was largely lecture based.

Perceived Outcomes of the Flipped Classroom

Because the College of Pharmacy faculty converted the Therapeutics course sequence at the same time that the Pharm.D. curriculum was revised, they had a unique opportunity to compare student performance on exams after being taught with TBL or with traditional lecture. For five content areas, third year (P3) students were taught through traditional lecture and second year (P2) students were taught using Team-Based Learning during the same academic year.  The P2 students, who had fewer clinical experiences and basic science course, performed as well as the P3 students on a three-part essay question and on multiple-choice questions testing application and synthesis of information.  On questions testing recall of factual information, P3 students did perform statistically better than the P2 students.