Flipping the Traditional Classroom With Technology

Stuart D. Inglis, PhD, instructor of pathology and anatomical sciences, has long been using a flipped classroom approach for his teaching of gross anatomy. His in-class video sessions are active learning, where students are challenged with clinical questions that they work in groups to solve.

He says he had an epiphany of sorts years ago while looking at the history of art in anatomy and in looking at images from hundreds of years ago, noting they had not really changed much over the course of time.

It got him to thinking about the earliest traditional universities that began to originate, with all of them predating the printing press by hundreds of years.

“Textbooks were scarce back then, but people wanted copies of information, so the most effective way of disseminating that would be to have large groups of individuals sitting in lecture halls and instructors standing at the front of the room, essentially reading from a textbook so that everyone could transcribe what was in there,” he notes.

By the time textbooks became widespread and were something that people could afford, several hundred years of university practice had ingrained a strong tradition, so there wasn’t any reason to change anything, Inglis says.

“It’s only very recently with all of the massive changes in technology — within the last 20 to 30 years — that we have a lot more options available. So this is really a prime time to be rethinking the best approaches,” he says. “And you are seeing it right now with the pandemic.”

“Empirical evidence suggests that sitting in a lecture hall for 50 minutes at a time, listening to an individual and trying frantically to write down what they are saying is not an effective means of learning material,” Inglis adds.

“That got me looking more at the educational paradigms and what the educational research was showing, and to think with the technology that we currently have, what would be the best way of being able to educate today’s students.”

The use of videos and video conferencing have become critical components in today’s teaching environment.

While it is a time-consuming effort to develop high-quality videos that can be put online, Inglis notes that the benefits for instructors and students are plentiful.

“If you take the time and effort when it is initially done, you can keep the video up for several years,” he says. “You do want to update them every so often, but because I can go back and do a lot of editing and take out mistakes and make sure everything flows correctly, I now have a recorded copy of the best possible way that I could present the information with no mistakes because they have been edited out.”

“That is something that students can listen to year after year and I don’t have to be concerned that I forgot to mention something a particular year or forgot to stress a certain point, because it is the same record that students are consistently getting.”

There are a number of advantages from a student’s perspective, Inglis points out.

“When you think about the traditional lecture in a classroom, the student would have to do it at the exact same time as everyone else because there was a set time. They would have to make sure they were on time,” he says.

“They would not be able to take any breaks or leave to use the washroom. If they did, they would just have to accept they were missing that portion of the lecture,” Inglis adds. “Educational research shows that attention span lasts less than 15 minutes, so invariably, everyone is going to tune the instructor out part way through.”

With the new approach, students can access the videos whenever it is convenient for them. They can pause the recordings if they need to take a break.

With the speed function, students who feel they already understand the material can watch it at double speed — or slow it down if there is a point being made that they just weren’t familiar with before.

“The students who are really struggling can pause it multiple times and they can go back and rewatch,” Inglis notes. “In a lecture setting, you’ll occasionally get students who will say ‘can you repeat that point?’ but you can’t consistently do that or you will never get through a 50-minute lecture.”

Inglis says whether he is leading in-person sessions or on a Zoom video conference, he is having students work through clinical cases that he wants them to be able to solve.

“These are things that would traditionally be worked on outside of class time, but the students have me in the room with them or on the Zoom call while they are working through it so they have direct access to me,” he says. “So it is more of an interaction back and forth, and I can get a sense as to whether the students are understanding the material.”

Inglis has more than 100 videos uploaded to his YouTube channel. One trait they all have in common is they are brief.

“It goes back to the philosophy of attention span lasting 15 minutes. When I first started the YouTube videos, I would take my entire lecture and recorded it en masse. Reviews I got back from students were that they liked the concept, but they found the lengths overwhelming,” Inglis says.

“It occurred to me it didn’t need to be like that. There are certain break points, where I was able to make the videos around 15 minutes,” he says. “Students are sometimes required to watch several a night so they are strongly encouraged to take mental breaks, to get up and walk away from their computer and process what they have just learned.”

Inglis has a long-term goal of creating videos lasting five minutes or less featuring a number of clinical experts who will discuss specific topics that tend to be high yield for board examinations.

“The idea is they can just create a script, come in and lay down the audio, and I do all the post-production,” he says.

Inglis notes that the production studio — located on the sixth floor of the Jacobs School of Medicine and Biomedical Sciences building on the downtown campus — is open to anyone affiliated with the University at Buffalo.

“It is particularly useful for the medical community that works or is located close to the downtown campus — to anyone on the medical campus who thinks they might be able to make use of a recording space,” he says. “It’s small, but I have put in some bells and whistles that can create some pretty impressive effects.”

Inglis says his interest in using YouTube videos came about due to an experience he had while teaching at the University of South Dakota.

“I gave the review for an examination on a Friday. The exam was on Monday. Everyone seemed fine,” he says. ”Saturday morning, I woke up and I already had two emails from students who had questions about a very particular topic.”

“It was something that was very difficult to explain over email, so here I am in my pajamas, maybe two sips into my coffee, I pull out my cellphone and do a very quick three-minute video where I explain this concept,” Inglis says. “I title it appropriately, upload it to YouTube and then send out the link to the entire class for anyone who has questions. It was about 150 students.”

He notes that several of his students sent emails thanking him for the explanation, but he never thought much more about it.

Then a year later, Inglis was looking for new lecture material and new sources.

“When I typed in that topic, I had a very surreal experience when I looked at the very first thing I saw on the Google page,” he says. “It took me a few seconds, but I said to myself ‘I think those are my hands.’ It was a hand topic. So I clicked on the link, and I had completely forgotten I had made this video. And it was up to 5,000 views. And last time I checked, I think it was over 80,000 views.”

The topic of the video Inglis made was about the “ulnar paradox.” It is covered on the board exams and is apparently incredibly confusing to many people.

“So here we have a bunch of medical students from around the United States and more globally, that were studying this and couldn’t quite understand it, so they did a Google search, came across my video, and it seemed to be beneficial,” Inglis says. “So the most pronounced, widespread educational thing I had ever done took me all of three minutes while I was half asleep in my pajamas.”

“But the thing that made that video work was it was less than five minutes and it was appealing. It was something that was high yield for board exams and something that students generally find confusing.”

“So if I can record a series of these topics and get the right clinicians to come in and do some audio, then we can start building this viral library up of these quick little explanations of some clinical puzzles,” Inglis says.

Inglis is also a huge proponent of using Open Educational Resources (OER), which is a way to deliver lessons to a wider population base without violating copyright restrictions.

“I was looking at these Wikipedia pages, and I was wondering how they are getting away with using these anatomical images. Then I found out that everything that was posted was more than 100 years old and was now part of the public domain,” he says. “That got me to thinking I could be doing the same thing.”

Initially, he used a lot of artwork from the original Gray’s Anatomy textbook by an artist named Henry Vandyke Carter and found that Wikipedia and Wikimedia had a large number of these images.

“The easiest thing to do is a Google image search, and under the tools there is a button called ‘usage rights,’ and you can select ‘labeled for reuse,’ and it will only give you material that is not protected by copyright.”

“It is the same with Wikipedia. Any images found on that page should be available to use as long as you cite the sources,” Inglis notes.

“And then that introduced to me a concept called Creative Commons, where people who want their work shared may put a Creative Commons license on it. It is a special type of copyright which says “this is mine, but anyone who comes across it can use it for their purposes as long as they cite it properly.’”

“There are a few different flavors to it, but ultimately it’s a collection of altruistic individuals who are interested in education and just want everyone to be able to benefit from it,” Inglis says.

Another advantage of OER is not having to worry about copyright issues when posting content.

“Even for our students, I can generally present all the information they need and not require an incredibly expensive textbook that they have to use,” Inglis notes.

“I still do have a textbook for the class that I do find beneficial, but there is a potential through Creative Commons and other groups, such as Open Stax, where you can develop online educational textbooks that wholly contain OER. So essentially anyone can go to Open Stax, put in a topic they are teaching, hopefully find a textbook that is there, and then send out a link to the students,” he adds. “The students have free access to it. No one has to pay a cent for the textbook.”

Open Stax content is also completely modifiable.

“Once you get the source, you can take it, and it’s not stealing it. It is written in there that once you get this textbook, you can change it anyway that you like,” Inglis says. “You can delete chapters, add chapters and personalize it for your specific class. Or take a combination of chapters from a variety of different textbooks. That is something that is loaded to Open Stax and that a person’s students can access completely for free.”

Inglis recalls that his experience of the ulnar paradox video going viral around the world — and people clicking away and leaving comments of gratitude and notes — had a significant impact on him.

“Although I am a UB professor, I like the notion that I am an educator, and I like the idea that people anywhere can learn something from me,” he says. “It can benefit people who may not necessarily have the advantage of being able to enroll in the university.”

Inglis says he was discouraged from pursuing use of OER at his previous position, but when he came to Buffalo he found that SUNY “has a huge push for OER.”

“I was finding my ideas were welcomed and encouraged. It’s just been a wonderful fit because UB has championed the idea.”

For more information on the downtown campus recording studio, or to schedule a recording session, please contact Inglis at stuartin@buffalo.edu.