learning outcomes and critical thinking

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Eight Instructional Strategies for Promoting Critical Thinking

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(This is the first post in a three-part series.)

The new question-of-the-week is:

What is critical thinking and how can we integrate it into the classroom?

This three-part series will explore what critical thinking is, if it can be specifically taught and, if so, how can teachers do so in their classrooms.

Today’s guests are Dara Laws Savage, Patrick Brown, Meg Riordan, Ph.D., and Dr. PJ Caposey. Dara, Patrick, and Meg were also guests on my 10-minute BAM! Radio Show . You can also find a list of, and links to, previous shows here.

You might also be interested in The Best Resources On Teaching & Learning Critical Thinking In The Classroom .

Current Events

Dara Laws Savage is an English teacher at the Early College High School at Delaware State University, where she serves as a teacher and instructional coach and lead mentor. Dara has been teaching for 25 years (career preparation, English, photography, yearbook, newspaper, and graphic design) and has presented nationally on project-based learning and technology integration:

There is so much going on right now and there is an overload of information for us to process. Did you ever stop to think how our students are processing current events? They see news feeds, hear news reports, and scan photos and posts, but are they truly thinking about what they are hearing and seeing?

I tell my students that my job is not to give them answers but to teach them how to think about what they read and hear. So what is critical thinking and how can we integrate it into the classroom? There are just as many definitions of critical thinking as there are people trying to define it. However, the Critical Think Consortium focuses on the tools to create a thinking-based classroom rather than a definition: “Shape the climate to support thinking, create opportunities for thinking, build capacity to think, provide guidance to inform thinking.” Using these four criteria and pairing them with current events, teachers easily create learning spaces that thrive on thinking and keep students engaged.

One successful technique I use is the FIRE Write. Students are given a quote, a paragraph, an excerpt, or a photo from the headlines. Students are asked to F ocus and respond to the selection for three minutes. Next, students are asked to I dentify a phrase or section of the photo and write for two minutes. Third, students are asked to R eframe their response around a specific word, phrase, or section within their previous selection. Finally, students E xchange their thoughts with a classmate. Within the exchange, students also talk about how the selection connects to what we are covering in class.

There was a controversial Pepsi ad in 2017 involving Kylie Jenner and a protest with a police presence. The imagery in the photo was strikingly similar to a photo that went viral with a young lady standing opposite a police line. Using that image from a current event engaged my students and gave them the opportunity to critically think about events of the time.

Here are the two photos and a student response:

F - Focus on both photos and respond for three minutes

In the first picture, you see a strong and courageous black female, bravely standing in front of two officers in protest. She is risking her life to do so. Iesha Evans is simply proving to the world she does NOT mean less because she is black … and yet officers are there to stop her. She did not step down. In the picture below, you see Kendall Jenner handing a police officer a Pepsi. Maybe this wouldn’t be a big deal, except this was Pepsi’s weak, pathetic, and outrageous excuse of a commercial that belittles the whole movement of people fighting for their lives.

I - Identify a word or phrase, underline it, then write about it for two minutes

A white, privileged female in place of a fighting black woman was asking for trouble. A struggle we are continuously fighting every day, and they make a mockery of it. “I know what will work! Here Mr. Police Officer! Drink some Pepsi!” As if. Pepsi made a fool of themselves, and now their already dwindling fan base continues to ever shrink smaller.

R - Reframe your thoughts by choosing a different word, then write about that for one minute

You don’t know privilege until it’s gone. You don’t know privilege while it’s there—but you can and will be made accountable and aware. Don’t use it for evil. You are not stupid. Use it to do something. Kendall could’ve NOT done the commercial. Kendall could’ve released another commercial standing behind a black woman. Anything!

Exchange - Remember to discuss how this connects to our school song project and our previous discussions?

This connects two ways - 1) We want to convey a strong message. Be powerful. Show who we are. And Pepsi definitely tried. … Which leads to the second connection. 2) Not mess up and offend anyone, as had the one alma mater had been linked to black minstrels. We want to be amazing, but we have to be smart and careful and make sure we include everyone who goes to our school and everyone who may go to our school.

As a final step, students read and annotate the full article and compare it to their initial response.

Using current events and critical-thinking strategies like FIRE writing helps create a learning space where thinking is the goal rather than a score on a multiple-choice assessment. Critical-thinking skills can cross over to any of students’ other courses and into life outside the classroom. After all, we as teachers want to help the whole student be successful, and critical thinking is an important part of navigating life after they leave our classrooms.

‘Before-Explore-Explain’

Patrick Brown is the executive director of STEM and CTE for the Fort Zumwalt school district in Missouri and an experienced educator and author :

Planning for critical thinking focuses on teaching the most crucial science concepts, practices, and logical-thinking skills as well as the best use of instructional time. One way to ensure that lessons maintain a focus on critical thinking is to focus on the instructional sequence used to teach.

Explore-before-explain teaching is all about promoting critical thinking for learners to better prepare students for the reality of their world. What having an explore-before-explain mindset means is that in our planning, we prioritize giving students firsthand experiences with data, allow students to construct evidence-based claims that focus on conceptual understanding, and challenge students to discuss and think about the why behind phenomena.

Just think of the critical thinking that has to occur for students to construct a scientific claim. 1) They need the opportunity to collect data, analyze it, and determine how to make sense of what the data may mean. 2) With data in hand, students can begin thinking about the validity and reliability of their experience and information collected. 3) They can consider what differences, if any, they might have if they completed the investigation again. 4) They can scrutinize outlying data points for they may be an artifact of a true difference that merits further exploration of a misstep in the procedure, measuring device, or measurement. All of these intellectual activities help them form more robust understanding and are evidence of their critical thinking.

In explore-before-explain teaching, all of these hard critical-thinking tasks come before teacher explanations of content. Whether we use discovery experiences, problem-based learning, and or inquiry-based activities, strategies that are geared toward helping students construct understanding promote critical thinking because students learn content by doing the practices valued in the field to generate knowledge.

An Issue of Equity

Meg Riordan, Ph.D., is the chief learning officer at The Possible Project, an out-of-school program that collaborates with youth to build entrepreneurial skills and mindsets and provides pathways to careers and long-term economic prosperity. She has been in the field of education for over 25 years as a middle and high school teacher, school coach, college professor, regional director of N.Y.C. Outward Bound Schools, and director of external research with EL Education:

Although critical thinking often defies straightforward definition, most in the education field agree it consists of several components: reasoning, problem-solving, and decisionmaking, plus analysis and evaluation of information, such that multiple sides of an issue can be explored. It also includes dispositions and “the willingness to apply critical-thinking principles, rather than fall back on existing unexamined beliefs, or simply believe what you’re told by authority figures.”

Despite variation in definitions, critical thinking is nonetheless promoted as an essential outcome of students’ learning—we want to see students and adults demonstrate it across all fields, professions, and in their personal lives. Yet there is simultaneously a rationing of opportunities in schools for students of color, students from under-resourced communities, and other historically marginalized groups to deeply learn and practice critical thinking.

For example, many of our most underserved students often spend class time filling out worksheets, promoting high compliance but low engagement, inquiry, critical thinking, or creation of new ideas. At a time in our world when college and careers are critical for participation in society and the global, knowledge-based economy, far too many students struggle within classrooms and schools that reinforce low-expectations and inequity.

If educators aim to prepare all students for an ever-evolving marketplace and develop skills that will be valued no matter what tomorrow’s jobs are, then we must move critical thinking to the forefront of classroom experiences. And educators must design learning to cultivate it.

So, what does that really look like?

Unpack and define critical thinking

To understand critical thinking, educators need to first unpack and define its components. What exactly are we looking for when we speak about reasoning or exploring multiple perspectives on an issue? How does problem-solving show up in English, math, science, art, or other disciplines—and how is it assessed? At Two Rivers, an EL Education school, the faculty identified five constructs of critical thinking, defined each, and created rubrics to generate a shared picture of quality for teachers and students. The rubrics were then adapted across grade levels to indicate students’ learning progressions.

At Avenues World School, critical thinking is one of the Avenues World Elements and is an enduring outcome embedded in students’ early experiences through 12th grade. For instance, a kindergarten student may be expected to “identify cause and effect in familiar contexts,” while an 8th grader should demonstrate the ability to “seek out sufficient evidence before accepting a claim as true,” “identify bias in claims and evidence,” and “reconsider strongly held points of view in light of new evidence.”

When faculty and students embrace a common vision of what critical thinking looks and sounds like and how it is assessed, educators can then explicitly design learning experiences that call for students to employ critical-thinking skills. This kind of work must occur across all schools and programs, especially those serving large numbers of students of color. As Linda Darling-Hammond asserts , “Schools that serve large numbers of students of color are least likely to offer the kind of curriculum needed to ... help students attain the [critical-thinking] skills needed in a knowledge work economy. ”

So, what can it look like to create those kinds of learning experiences?

Designing experiences for critical thinking

After defining a shared understanding of “what” critical thinking is and “how” it shows up across multiple disciplines and grade levels, it is essential to create learning experiences that impel students to cultivate, practice, and apply these skills. There are several levers that offer pathways for teachers to promote critical thinking in lessons:

1.Choose Compelling Topics: Keep it relevant

A key Common Core State Standard asks for students to “write arguments to support claims in an analysis of substantive topics or texts using valid reasoning and relevant and sufficient evidence.” That might not sound exciting or culturally relevant. But a learning experience designed for a 12th grade humanities class engaged learners in a compelling topic— policing in America —to analyze and evaluate multiple texts (including primary sources) and share the reasoning for their perspectives through discussion and writing. Students grappled with ideas and their beliefs and employed deep critical-thinking skills to develop arguments for their claims. Embedding critical-thinking skills in curriculum that students care about and connect with can ignite powerful learning experiences.

2. Make Local Connections: Keep it real

At The Possible Project , an out-of-school-time program designed to promote entrepreneurial skills and mindsets, students in a recent summer online program (modified from in-person due to COVID-19) explored the impact of COVID-19 on their communities and local BIPOC-owned businesses. They learned interviewing skills through a partnership with Everyday Boston , conducted virtual interviews with entrepreneurs, evaluated information from their interviews and local data, and examined their previously held beliefs. They created blog posts and videos to reflect on their learning and consider how their mindsets had changed as a result of the experience. In this way, we can design powerful community-based learning and invite students into productive struggle with multiple perspectives.

3. Create Authentic Projects: Keep it rigorous

At Big Picture Learning schools, students engage in internship-based learning experiences as a central part of their schooling. Their school-based adviser and internship-based mentor support them in developing real-world projects that promote deeper learning and critical-thinking skills. Such authentic experiences teach “young people to be thinkers, to be curious, to get from curiosity to creation … and it helps students design a learning experience that answers their questions, [providing an] opportunity to communicate it to a larger audience—a major indicator of postsecondary success.” Even in a remote environment, we can design projects that ask more of students than rote memorization and that spark critical thinking.

Our call to action is this: As educators, we need to make opportunities for critical thinking available not only to the affluent or those fortunate enough to be placed in advanced courses. The tools are available, let’s use them. Let’s interrogate our current curriculum and design learning experiences that engage all students in real, relevant, and rigorous experiences that require critical thinking and prepare them for promising postsecondary pathways.

Critical Thinking & Student Engagement

Dr. PJ Caposey is an award-winning educator, keynote speaker, consultant, and author of seven books who currently serves as the superintendent of schools for the award-winning Meridian CUSD 223 in northwest Illinois. You can find PJ on most social-media platforms as MCUSDSupe:

When I start my keynote on student engagement, I invite two people up on stage and give them each five paper balls to shoot at a garbage can also conveniently placed on stage. Contestant One shoots their shot, and the audience gives approval. Four out of 5 is a heckuva score. Then just before Contestant Two shoots, I blindfold them and start moving the garbage can back and forth. I usually try to ensure that they can at least make one of their shots. Nobody is successful in this unfair environment.

I thank them and send them back to their seats and then explain that this little activity was akin to student engagement. While we all know we want student engagement, we are shooting at different targets. More importantly, for teachers, it is near impossible for them to hit a target that is moving and that they cannot see.

Within the world of education and particularly as educational leaders, we have failed to simplify what student engagement looks like, and it is impossible to define or articulate what student engagement looks like if we cannot clearly articulate what critical thinking is and looks like in a classroom. Because, simply, without critical thought, there is no engagement.

The good news here is that critical thought has been defined and placed into taxonomies for decades already. This is not something new and not something that needs to be redefined. I am a Bloom’s person, but there is nothing wrong with DOK or some of the other taxonomies, either. To be precise, I am a huge fan of Daggett’s Rigor and Relevance Framework. I have used that as a core element of my practice for years, and it has shaped who I am as an instructional leader.

So, in order to explain critical thought, a teacher or a leader must familiarize themselves with these tried and true taxonomies. Easy, right? Yes, sort of. The issue is not understanding what critical thought is; it is the ability to integrate it into the classrooms. In order to do so, there are a four key steps every educator must take.

• Integrating critical thought/rigor into a lesson does not happen by chance, it happens by design. Planning for critical thought and engagement is much different from planning for a traditional lesson. In order to plan for kids to think critically, you have to provide a base of knowledge and excellent prompts to allow them to explore their own thinking in order to analyze, evaluate, or synthesize information.
• SIDE NOTE – Bloom’s verbs are a great way to start when writing objectives, but true planning will take you deeper than this.

QUESTIONING

• If the questions and prompts given in a classroom have correct answers or if the teacher ends up answering their own questions, the lesson will lack critical thought and rigor.
• Script five questions forcing higher-order thought prior to every lesson. Experienced teachers may not feel they need this, but it helps to create an effective habit.
• If lessons are rigorous and assessments are not, students will do well on their assessments, and that may not be an accurate representation of the knowledge and skills they have mastered. If lessons are easy and assessments are rigorous, the exact opposite will happen. When deciding to increase critical thought, it must happen in all three phases of the game: planning, instruction, and assessment.

TALK TIME / CONTROL

• To increase rigor, the teacher must DO LESS. This feels counterintuitive but is accurate. Rigorous lessons involving tons of critical thought must allow for students to work on their own, collaborate with peers, and connect their ideas. This cannot happen in a silent room except for the teacher talking. In order to increase rigor, decrease talk time and become comfortable with less control. Asking questions and giving prompts that lead to no true correct answer also means less control. This is a tough ask for some teachers. Explained differently, if you assign one assignment and get 30 very similar products, you have most likely assigned a low-rigor recipe. If you assign one assignment and get multiple varied products, then the students have had a chance to think deeply, and you have successfully integrated critical thought into your classroom.

Thanks to Dara, Patrick, Meg, and PJ for their contributions!

Please feel free to leave a comment with your reactions to the topic or directly to anything that has been said in this post.

Consider contributing a question to be answered in a future post. You can send one to me at [email protected] . When you send it in, let me know if I can use your real name if it’s selected or if you’d prefer remaining anonymous and have a pseudonym in mind.

You can also contact me on Twitter at @Larryferlazzo .

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Evidence-Based Teaching for the 21st Century Classroom and Beyond pp 77–120 Cite as

Learning Interventions: Collaborative Learning, Critical Thinking and Assessing Participation Real-Time

• Kumaran Rajaram 2  
• First Online: 17 March 2021

1186 Accesses

This chapter focuses on the authentic learning interventions for team-based and flipped classroom collaborative learning that assesses real-time class participation which develops competency and employability skills set. The discussions address the process in achieving the intended learning outcomes with the adoption of these learning interventions. It provides evidence-based results in terms of how these learning interventions facilitate effective learning in terms of higher-order critical thinking (refers to the process of thinking is made intensive through scaffolding approach that potentially enables learners to question and reflect deeply), deeper engagement amongst students (refers to the ability for students to be motivated and their involvement through listening and/or participation is much more spontaneous) and higher level of collaboration at inter- and intra-group levels (refers to much more interactivity, team-based involvement in engaging within the team members and/or across members of another group). Collaborative learning is generally defined as a situation in which two or more people learn or attempt to learn something together (Dillenbourg in Collaborative Learning: Cognitive and Computational Approaches 1:1–15, 1999), whereas in a cooperative learning context, individuals work together to optimize, maximize their own and each other’s learning to attain shared goals. Largely, there are three categories of cooperative learning namely informal cooperative learning groups, formal cooperative learning groups and cooperative base groups. In our context, informal cooperative learning was focused on. In accordance with research scholars (Johnson et al. in Change: The Magazine of Higher Learning 30(4):26–35, 1998a; Johnson et al. in Cooperation in the classroom , Interaction Book Company, Edina, MN, 1998b), informal cooperative learning entails students working together to achieve common learning goal in temporary, ad-hoc groups that last from a few minutes to one class period. In a meta-analysis performed by Johnson et al. (Johnson et al. in Change: The Magazine of Higher Learning 30(4):26–35, 1998a), studies since 1924 were reviewed and it was found that when students learn together, academic achievement is enhanced. Moreover, students were found to have higher self-esteem and better quality of relationships (Johnson et al. in Change: The Magazine of Higher Learning 30(4):26–35, 1998a). The functionalities offered within the learning interventions and support systems fundamentally promote collaboration. Student engagement is correlated with participation in public service, self-reported learning gains, increased student achievement (Carini et al. in Research in Higher Education 47:1–32, 2006) and job engagement (Busteed & Seymour in Gallup Business Journal 19, 2015). The goal of the learning interventions is to maximize student engagement in meaningful learning activities within classroom settings. When students engage in more meaningful learning activities, they are actively learning. DeLozier and Rhodes (DeLozier & Rhodes in Educational Psychology Review 29:141–151, 2017) believed that it is the active learning in class that is responsible for the enhancement in learning performances. The use of learning interventions also increases the number of students participating in meaningful learning activities through providing the quieter students in class an alternative avenue of input other than speaking up in front of the class. Cain and Klein ( Independent School 75(1):64–71, 2015) found in their study that quiet students indeed feel more comfortable sharing their ideas online. Moreover, shy and quiet students contribute more through synchronous online discussion than in regular classroom discussion (Warschauer in CALICO Journal , 7–26, 2015). Lastly, with the synchronous online discussion feature of the activity support system and the organized class activity sequences, it is expected that there will be a reduction in time used for transitions between activities, introductions to activities, and disruptions within activities. Both collaborative learning, through “discussion, clarification of ideas, and evaluation of others’ ideas” (Gokhale in Journal of Technology Education 7:22–30, 1995), and high student engagement (Carini et al. in Research in Higher Education 47:1–32, 2006) enhance the development of critical thinking. It was also argued that critical thinking can be learnt through every interaction (MacKnight in Educause Quarterly 23:38–41, 2000) provided the interaction is supported with specific critical thinking activities (Astleitner in Journal of Instructional Psychology 29:53, 2002; Kim in Interactive Learning Environments 22:467–484, 2014; Weltzer-Ward & Carmona in International Journal of Emerging Technologies in Learning 3:86–88, 2008). Therefore, our learning interventions and supports systems, which enhances students’ engagement and collaborative learning, would also lead to a desirable development of students’ critical thinking ability. The chapter will also describe the varying functionalities and the process of how the learning interventions enable the intended learning outcomes to be achieved. This chapter also furnishes the relevant video and training resources that are developed for the learning interventions. The findings from the surveys and interviews serve as evidence based to validate the discussions that emerge from the analysis.

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Acknowledgements

The above two research studies were funded by Nanyang Technological University (NTU) through the NTU Educational Excellence Grants. The author would also like to thank the anonymous reviewers and editors for providing valuable feedback and guidance.

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Appendix A: Post-Survey (After the Intervention of the Learning Support System)

3.1.1 survey questions.

The experience of using “K^mAlive” in this class is ___________________.

Very Positive

Somewhat Positive

Very Negative

What are your thoughts and feelings about your contributions in class being captured?

____________________________________________________________

The use of “K^mAlive” in this class is a/an _________ way to encourage my participation in class.

Very Effective

Somewhat Effective

Ineffective

Very Ineffective

What are your thoughts in terms of the impact of class participation through the adoption of K^mAlive?

The use of “K^mAlive” in this class motivates me to listen more attentively to my classmates’ contributions in class.

Strongly Agree

Strongly Disagree

The use of “K^mAlive” in this class developed my critical thinking abilities.

If you have answered “Strongly Agree/Agree” to question 5, can you explain how the use of “K^mAlive” has enhanced your critical thinking skills?

I believe the use of “K^mAlive” in this course gives a fair assessment of my participation in class.

What are your thoughts and feelings regarding the grading of your participation in class using “K^mAlive”?

What do you like the best about the experience of using “K^mAlive” in class? Please explain why.

What would you like to change about the experience of the usage of “K^mAlive” in class? Please explain why.

Any other comments?

Appendix B: Interview Questions

What are your experiences of using this real-time learning support system—K^mAlive?

How does it explicitly enhance (a) higher levels of class participation; (b) make you think more critically; (c) better engagement with your peers in your group and others in the class

What are your overall perspectives of the features offered in this learning intervention—K^mAlive on how it supports your learning process and how do you learn?

Appendix C: Video Resources

Value Proposition of Learning Support System: K^mAlive (5 min)

https://www.youtube.com/watch?v=NZOpR4fWL0s

Value Proposition of Learning Support System: K^mAlive (20 min)

https://www.youtube.com/watch?v=fjDQcbq84V4

Operational Guide: K^mAlive

https://www.youtube.com/watch?v=O0Iv0q1IdiM

The video trailers with supporting illustrations could also be viewed in the furnished links:

K^mAlive Learning Blog Site: https://blogs.ntu.edu.sg/learning-innovations/kumalive/

Research Lab for Learning Innovation and Culture of Learning: https://learningintervention.wixsite.com/researchlab/klive

Appendix D: Screen Shot of K^mAlive Feature Embedded with NTULearn (Blackboard)

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Rajaram, K. (2021). Learning Interventions: Collaborative Learning, Critical Thinking and Assessing Participation Real-Time. In: Evidence-Based Teaching for the 21st Century Classroom and Beyond. Springer, Singapore. https://doi.org/10.1007/978-981-33-6804-0_3

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Essential Learning Outcomes: Critical/Creative Thinking

• Civic Responsibility
• Critical/Creative Thinking
• Cultural Sensitivity
• Information Literacy
• Oral Communication
• Quantitative Reasoning
• Written Communication
• Diversity, Equity & Inclusion

Description

Guide to Critical/Creative Thinking

Intended Learning Outcome:

Analyze, evaluate, and synthesize information in order to consider problems/ideas and transform them in innovative or imaginative ways (See below for definitions)

Assessment may include but is not limited to the following criteria and intended outcomes:

Analyze problems/ideas critically and/or creatively

• Formulates appropriate questions to consider problems/issues
• Evaluates costs and benefits of a solution
• Identifies possible solutions to problems or resolution to issues
• Applies innovative and imaginative approaches to problems/ideas

Synthesize information/ideas into a coherent whole

• Seeks and compares information that leads to informed decisions/opinions
• Applies fact and opinion appropriately
• Expands upon ideas to foster new lines of inquiry
• Synthesizes ideas into a coherent whole

Evaluate synthesized information in order to transform problems/ideas in innovative or imaginative ways

• Applies synthesized information to inform effective decisions
• Experiments with creating a novel idea, question, or product
• Uses new approaches and takes appropriate risks without going beyond the guidelines of the assignment
• Evaluates and reflects on the decision through a process that takes into account the complexities of an issue

From Association of American Colleges & Universities, LEAP outcomes and VALUE rubrics:   Critical thinking  is a habit of mind characterized by the comprehensive exploration of issues, ideas, artifacts, and events before accepting or formulating an opinion or conclusion.

Creative thinking  is both the capacity to combine or synthesize existing ideas, images, or expertise in original ways and the experience of thinking, reacting, and working in an imaginative way characterized by a high degree of innovation, divergent thinking, and risk taking.

Elements, excerpts, and ideas borrowed with permission form Assessing Outcomes and Improving Achievement: Tips and tools for Using Rubrics , edited by Terrel L. Rhodes. Copyright 2010 by the Association of American Colleges and Universities.

How to Align - Critical/Creative Thinking

• Critical/Creative Thinking ELO Tutorial

Critical/Creative Thinking Rubric

Analyze, evaluate, and synthesize information in order to consider problems/ideas and transform them into innovative or imaginative ways.

Elements, excerpts, and ideas borrowed with permission form  Assessing Outcomes and Improving Achievement: Tips and tools for Using Rubrics , edited by Terrel L. Rhodes. Copyright 2010 by the Association of American Colleges and Universities.

Sample Assignments

• Cleveland Museum of Art tour (Just Mercy) Assignment contributed by Chris Wolken, Matt Lafferty, Luke Schuleter and Sara Clark.
• Disaster Analysis This assignment was created by faculty at Durham College in Canada The purpose of this assignment is to evaluate students’ ability to think critically about how natural disasters are portrayed in the media.
• Laboratory Report-Critical Thinking Assignment contributed by Anne Distler.
• (Re)Imaginings assignment ENG 1020 Assignment contributed by Sara Fuller.
• Sustainability Project-Part 1 Waste Journal Assignment contributed by Anne Distler.
• Sustainability Project-Part 2 Research Assignment contributed by Anne Distler.
• Sustainability Project-Part 3 Waste Journal Continuation Assignment contributed by Anne Distler.
• Sustainability Project-Part 4 Reflection Assignment contributed by Anne Distler.
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Learning outcomes and critical thinking – good intentions in conflict

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... …materials such as those stored on a computer so that they can be accessed by teachers and students whenever and wherever, and the use of lesson schedules, curricula, learning outcomes, and other matters related to educational administration that can be viewed on computers (Erikson & Erikson, 2019). ...

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... These dispositions include both the ability to distinguish situations that call for critical thinking and the motivation to actually think critically in those situations (e.g. Facione 2000; Giancarlo and Facione 2001; Halpern 1998). ...

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Improving Students’ Critical Thinking Outcomes: An Process-Learning Strategy in Eight Steps

Permissions : This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. Please contact [email protected] to use this work in a way not covered by the license.

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This article describes an eight-step strategy through which students learn to critically analyze situations that they have encountered in their clinical practice. The method was derived from Stephen Brookfield’s four components of critical thinking and his suggestions for themes that relate to nursing culturalization. The approach used to develop this model has implications for educators in all fields because it illustrates a method for integrating the learning of critical thinking processes with their real-world applications.

Although educators in all disciplines share a general interest in developing students’ ability to think critically, nurse educators are especially challenged because they must prepare their students to perform technical; interpersonal, and critical thinking skills simultaneously. They must learn to function as safe, competent, and skillful clinical nurse practitioners in a complex health care environment in which new information and new clinical situations continually emerge (del Bueno, 1990; Miller & Malcolm,1990).

In 1988, the U. S. Department of Education issued a mandate that required accrediting agencies to consider evidence of educational outcomes when conducting program reviews (U. S. Department of Education, 1988). As a result, nursing education’s accrediting agency, the National League for Nursing (NLN), changed its accreditation criteria to include five required outcomes, including critical thinking, in Baccalaureate and Higher Degree Programs (National League for Nursing, 1991). As defined by the NLN, critical thinking should reflect student skills in reasoning, analysis, research, or decision making relevant to the discipline of nursing (National League for Nursing, 1992). In addition to these developments, the U.S. Department of Health and Human Services published a list of national health promotion and disease prevention objectives that supported the need to balance nursing education’s program content and learning strategies (U.S. Department of Health and Human Services, 1992).

These factors provided the impetus for the authors’ development of a process-focused critical thinking strategy. The authors’ employment setting is a baccalaureate nursing program with over 500 nursing student majors, located in an urban area of the Southeastern region of the country. Students participating in the critical thinking activity selected acute cardiology nursing for their clinical learning setting in a nursing synthesis course. The cardiology nursing unit is located in a large urban regional medical center complex.

Conceptual Framework

In his 1987 book on developing critical thinkers, Stephen Brookfield posited four components of critical thinking: (1) identifying and challenging assumptions; (2) challenging the importance of context; (3) imagining and exploring alternatives; (4) reflective skepticism. More recently, Brookfield (1993) also suggested a “phenomenography of nurses as critical thinkers” to account for how nurses learn and experience critical thinking. Each of these culturalization themes has important implications for anyone who practices critical thinking in the field of nursing (and, potentially, many other professional fields): impostership, cultural suicide, lost innocence, roadrunning, and community. Because these themes are less widely known than Brookfield’s components of critical thinking, they require some elaboration. A complete exploration of these themes is beyond the scope of this article, but brief definitions, based on Brookfield (1993), follows.

“Impostorship,” common to many professionals, is a feeling of underlying incompetence that often does not diminish with years of practice. Imposters must always appear to know what they are doing and they live in fear that they will be “exposed” for the hopeless incompetents that really are. “Cultural suicide” refers to a kind of cultural alienation that can result when critically aware nurses question their colleagues who are less critically aware: … nurses who expect their efforts to ignite a fire of enthusiasm for critical reflection and democratic experimentation may be sorely disappointed when they find themselves regarded as uncooperative subversives (and) whistleblowers … (p. 201). The theme of “lost innocence” relates to the often sad discovery that there are no perfect, unchanging models of clinical practice, but only ‘‘the contextual ambiguity of practice” (p. 203). “Roadrunning” (inspired by the Warner Brothers cartoon) describes the state of limbo that occurs in the process of critical thinking when “we realize that the old ways of thinking and acting no longer make sense, but … new ones have not yet formed to take their place” (p. 204). Brookfield explores this theme in the context of the rhythm and pace of the epistimologic, transformational process of critical thinking. “Community” is a more positive and hopeful theme that relates to the development of “emotionally sustaining peer groups” that may consist of just four or five good friends who “know that experiencing dissonance, challenging assumptions, taking new perspectives, and falling foul of conservative administrators are generic aspects of the critical process, not idiosyncratic events” (p. 205).

Brookfield’s four components of critical thinking and his culturalization themes provided the conceptual framework for the authors’ eight-step learning strategy for critical thinking. The process is initiated in Step One by the examination of a critical incident (a real-life situation) in nursing care. Steps Three, Four, Five, and Six incorporate Brookfield’s four components of critical thinking, and his culturalization themes involve Steps Two and Seven. In Step Eight students explore the usefulness of critical incidents as a means of achieving their’ learning outcomes.

The Eight-Step Process: Critical Thinking in Clinical Practice

Step one: identify a critical incident.

In Step One students first identify critical incidents they encountered during clinical practice. As Brookfield (1993) advises, students are instructed to think about episodes in which they experienced “good” or ‘‘bad” forms of clinical practice. A critical incident cited by a student in the class is described below and used as an example in the remaining steps of the process:

The 40 year old cardiac patient was experiencing chest pain, nausea, vomiting, and headache. He was unable to take his oral medications for the heart condition and other problems. The student nurse notified the staff nurse assigned to the patient. The nurse told her not to “bother” the patient’s physician because they had talked with him earlier and he was aware of the patient’s present condition and had not given any additional orders to treat the patient. The nurse refused to call the physician for the student nurse.

Step Two: Note Personal Experience

An inability to relieve the patient of symptoms prompted the student to engage in critical thinking. The most helpful resource was the patient’s understanding of the students desire to care him and the faculty serving as a resource when the staff nurse differed in the student’s decision to call the physician. The helplessness experienced by the student nurse after the staff nurse refused to call the physician was the low point of the episode.

Step Three: Identify & Challenge Assumptions

Nurses rely on the medical doctor and or medications for relieving patient’s symptoms.

Staff nurse showed more compassion and caring for the physician than for the patient.

Staff nurse feared physician actions more than patient as a consumer of health care.

Student nurse had more compassion and caring for the patient than did the primary nurse assigned to his care.

The patient was passive in his ability to treat himself and required the care of his admitting physician.

The staff nurse and student nurse were in conflict with the method of treatment.

Step Four: Challenge the Importance of Context

Developmental context issues identified by the student nurse included the patient’s loss of role functions: i.e. head of household, family provider, faced with serious debilitating heart disease at an early age.

Professional context issues included student nurse-staff nurse relationships, student nurse-physician relationships. Students were concerned with care of this patient only and their perspective on the situation concerned only the patient, as opposed to staff nurses who were concerned with a myriad of other issues such as the physician’s actions, the days unit staffing, and previous experiences in caring for the patient.

Step Five: Imagine and Explore Alternatives

Student nurse could state she was caring for the patient also and would call the physician without the staff nurse’s permission.

The student nurse could confer with a faculty member and request the faculty member call the physician.

The student nurse could present the situation to the nurse responsible for all patients care on the unit.

The student could explain to the patient the staff nurse’s decision to not call the physician and perhaps the patient could call the physician from his room telephone.

The staff nurse could reassess the patient’s chest pain and other symptoms, and call the physician to report the changes with additional orders to treat the patient’s current status.

The student could reevaluate the situation from a more holistic viewpoint of the patient.

The student could provide nursing comfort measures for the symptoms noted for the patient without relying totally on the medical regimen.

Step Six: Reflective Skepticism

Are the decisions made by the unit nurses regarding assigned patients made with an awareness that the decisions have an impact on all members of the health care team?

Are nurses a part of a collaborative effort to assure that quality care standards are maintained?

Are unit nurses accepting the accountability and responsibility for providing nursing care to all patients according to the hospitals established standards of care?

Is the patient allowed to participate in decisions related to his/her plan of care?

Are the patient’s rights a factor in this situation?

Step Seven: Consequences of Critical Thinking Experience

Calling the physician without the nurse’s permission would be cultural suicide for the student. The student with less experience and nursing knowledge has questioned the nursing care practices of a “real” nurse.

Impostership may be a consequence also. The student nurse may agree with the staff nurse’s decision to not call the physician but the “correct” decision is to be a patient advocate.

The situation is jolting to a student nurse who envisions nursing practice as nursing education has shaped the student’s image of nursing practice. The student’s way of interpreting nursing practice and the way nursing is practiced differs. This jolting, halting, and fluctuating rhythm is “roadrunning.”

The student nurse realizes that nursing care practices and decisions involving patient care are complex and there are no set rules to serve as a rigid guide. Hence, another consequence may be “lost innocence.’’

Step Eight: Impact of Thinking Critically on Learning Outcomes

Patient care decisions learned in education programs may differ in nursing practice since many variables are considered in actual nursing practice situations.

Nurses standards of care may differ from student nurses, from ones ascribed to, and from ones reflected in actual nursing practice.

Nurses practice nursing from a medical model of care more than from an interdisciplinary patient care framework.

Conclusions and Recommendations

Students were pleased with their critical thinking experience in this class, citing the use of real clinical situations as a basis for learning and how the process assisted them in clarifying course objectives, understanding the management theory of the course, and validating clinical outcome behaviors. The richness of the critical incidents they chose helped make the method a success. They explored situations relating to issues of management, patients and families, nurse-physician relationships, and clinical nursing practice. Students also participated freely in discussions and they differed widely in their individual responses during each step of the process.

The eight-step critical thinking process encourages students to engage in critical thinking, to view situations from broad perspectives, and to seek solutions to problems and situations experienced in clinical practice settings. This learning strategy incorporates the realities of nursing practice, merges nursing education with practice, and involves students in affective, cognitive, and psychomotor domains of learning. It provides students with enhanced skills in critical thinking and prepares them to function in a dynamic and complex health care system. Baccalaureate nursing education programs seeking accreditation could document their graduates’ critical thinking abilities using this strategy at all levels of the curriculum. Completing the eight-step critical thinking learning strategy could also serve as an alternative clinical learning method for Registered Nurse students and students absent from clinical practice.

Brookfield’s culturalization themes for nursing and their relationship to critical thinking clearly have parallels in other professional fields. Educators in these fields might find it useful to study the extent to which the themes apply in other fields and possibly identify additional themes that could be used to teach the application and consequences of critical thinking in the real world. Critical incidents for use in the program could be suggested by recent graduates or developed by teachers, based on their own real-life experiences. Using Brookfield’s model of the four components of critical thinking as a basis for analyizing these incidents, multi-step processes such as the one described in this article could be established in many other fields.

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• National League for Nursing, (1989). Curriculum revolution: Reconceptualizing nursing education. New York: National League for Nursing Press.
• National League for Nursing, (1991). National League for Nursing Accreditation Criteria: 1991. New York: National League for Nursing Press.
• National League for Nursing, (1992). Perspective in Nursing-1991-1993. New York: National League for Nursing Press.
• U. S. Department of Education (1988). Secretary’s procedures and criteria for recognition of accrediting agencies. Federal Register, 53 (127),25088-25099.
• U.S. Department of Health and Human Services Public Health Service. (1992). Healthy people 2000 national health promotion and disease prevention objectives. Boston:Jones and Bartlett Publishers.

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• v.15(11); 2023 Nov
• PMC10694389

Flipped Classrooms in Medical Education: Improving Learning Outcomes and Engaging Students in Critical Thinking Skills

Adwait nichat.

1 Medical Education, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Nagpur, IND

Ujwal Gajbe

2 Anatomy, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Nagpur, IND

Nandkishor J Bankar

3 Microbiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND

Brij Raj Singh

Ankit k badge.

4 Microbiology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Nagpur, IND

The flipped classroom (FC) model involves students independently acquiring knowledge before in-person class sessions, during which they engage in active discussions and problem-solving. Various methods to implement FC are quizzes, e-content, case-based learning, problem-based learning, and reading assignments. The advantages of the FC approach included improved student preparation, active participation, and the promotion of critical thinking skills. Some disadvantages identified are technical problems like internet connection, improper planning and preparation, which increases teacher workload, and lack of self-motivation. This review underscores the potential of the FC approach to improve medical education by promoting independent learning, active participation, and deeper understanding. Consideration of factors such as curriculum design, faculty development, technological infrastructure, and student readiness is vital for successfully implementing the FC model. Balancing self-directed study with meaningful face-to-face interactions remains crucial to harnessing the full benefits of this innovative approach. By leveraging technology and student-centered methods, medical educators can create an enriched learning experience that positively influences future healthcare professionals.

Introduction and background

Medical education refers to teaching programs designed to serve the community in the near future. Good role models and learning environments which are examples of professional and organizational behaviors to be adopted, learning through practice, simulation programs, and educational tools such as electronic learning (e-learning) systems, good assessment and feedback systems, and portfolios that demonstrate and discuss professional progress are key elements of medical education programs [ 1 ]. Several advantages of traditional teaching involve face-to-face interactions between students and teachers. Face-to-face interactions provide a supportive learning environment with a positive psychological impact and motivate even less motivated students to participate [ 2 ]. Competency-based medical education (CBME) is a standardized framework for measuring student performance, focusing on the key learning components of good clinical practice. It also measures learning outcomes in training programs based on self-assessment, objective assessment, and multi-source assessment. It can be used for training in all medical fields [ 3 , 4 ]. One of the goals of CBME is self-directed learning, and flipped classroom (FC) is based on this concept, making FC an integral part of the CBME curriculum [ 5 , 6 ]. The main objective of CBME is to create competent Indian medical graduates (IMG) using a skill-based approach while also providing them with metacognition skills [ 3 , 7 ]. The objective of this review is to explore the effectiveness of FC in medical education.

Methods 

To conduct a comprehensive literature search, we used the PubMed and Google Scholar search. We searched for articles published between 2018 and 2023 using the following search terms: (Flipped classroom) OR (flipped classroom) AND (problem-based learning) AND (case-based learning) OR (virtual classroom) AND (traditional teaching). We applied the following inclusion criteria for the final review: (1) English language, (2) relevant to FC in medical education, (3) full text available, and (4) published in specified time frame.

Articles Screened

After conducting the initial search, we identified a total of (n=726) articles across the searched databases. We conducted an initial screening of titles and abstracts, which excluded (n=267) articles. After full-text screening of a total of (n=403) articles, we excluded (n=234) articles for not being retrieved. After screening (n=169) articles for eligibility, we excluded (n=150) articles that were not related to the topic and not in the English language leaving a total of (n=19) articles.

Duration and Number of Articles Included in the Final Review

The literature search was conducted in August 2023. The final review included a total of 19 articles from 2018 to 2023 (Figure ​ (Figure1 1 ).

n: number of studies; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analysis

The articles included in the review were each FC based on micro-video courses, self-learning-based online videos, texts, and traditional methods (Table ​ (Table1 1 ).

OSCE: objective structured clinical examination; FC: flipped classroom; NPE: near-peer education; NBME: National Board of Medical Examiners; ACLS: advanced cardiopulmonary life support

Nine studies [ 9 , 10 , 14 , 16 , 17 , 18 , 20 , 22 , 23 ] conducted pre tests and post tests. In each study [ 9 , 10 , 14 , 16 , 17 , 18 , 20 , 22 , 23 ], students were divided into two groups: one group was subjected to traditional teaching, while the other group was subjected to various methods to implement FC which were reading resources and video lectures [ 9 , 16 , 18 , 20 , 22 , 23 ], presentation [ 10 ], web-based learning [ 14 ], and e-content [ 17 ]. All studies [ 9 , 10 , 14 , 16 , 17 , 18 , 20 , 22 , 23 ] observed that FC is an effective tool. One study [ 25 ] divided students into two groups: one group was given micro-video lectures before class, while the other group was directly given theory lectures. Teacher-student interaction and questionnaires were used to assess the students, and it found that the FC model improved student performance. Six studies [ 7 , 8 , 13 , 15 , 19 , 21 ] assessed students based on final exam scores. In each study, students were divided into two groups: one group was subjected to traditional teaching, while for the other group, various methods were used including videos and resource materials [ 7 , 8 , 19 , 21 ], self-study [ 13 ], and PowerPoint [ 15 ]. Five studies [ 7 , 8 , 13 , 19 , 21 ] observed that FC is an effective tool for improving students' performance, while one study [ 15 ] did not observe any change in the students' performance. One study [ 11 ] conducted multilevel regression and observed that FC is an effective tool. In this study, the students were divided into two groups: one group was given videos and other resources via e-learning system, while lecture session was given to the other group. One study [ 12 ] observed the results based on OSCE (objective structured clinical examination) and NBME (National Board of Medical Examiners) scores and did not observe any change in students' performance. In this study, students were divided into two groups: one group was given only online instructions, while the other group was given both online and in-person instructions. One study [ 24 ] observed the result based on the composite learning score and found no significant difference. In this study, students were divided into two groups: one group was provided with theory notes beforehand, while the other group was directly subjected to training session.

Medical education

The systematic process of preparing interested and qualified people to become doctors is known as medical education. The Bachelor of Medicine, Bachelor of Surgery (MBBS) degree is considered capable of handling the responsibilities of a physician of first contact like patient care, medical practice, administrative duties, and ethical and legal duties [ 26 ]. The main objective of the National Medical Commission (NMC) project is to ensure that IMG are capable of serving as primary care physicians in their communities. The NMC project aims to improve the quality of medical education in India and enhance the practical skills of IMG. The NMC has taken an important initiative to introduce CBME to the undergraduate medical curriculum in India. The NMC clearly defined the competencies that an undergraduate medical student must have to become a globally competent IMG. The regulatory body has made significant efforts to design programs with the expert team and has also planned "training of trainers" from faculty at medical colleges throughout India, through the Curriculum Implementation Support Program (CISP) I and II, an implementation support program for schools across India [ 27 ]. Additionally, the project also seeks to bridge the gap between theoretical knowledge and hands-on experience, allowing IMG to confidently handle diverse medical cases and contribute to the overall development of the healthcare system [ 26 , 28 ]. The learning results and the competency of medical graduates are substantially impacted by the attitudes of both teachers and students. Medical educators' professionalism, management, and leadership abilities may be enhanced by well-crafted faculty development programs, which will help students become competent doctors [ 26 , 29 ]. Faculty members are primarily responsible for carrying out this significant duty. They are the most valuable resources and the foundation of any higher education institution. The role of the facilitator is to pay appropriate attention to the fields of competence, management, and leadership and to make accurate and comprehensive planning for students to become qualified future doctors in the role of therapists, managers, teachers, supporters, and researchers [ 30 ].

FC is a technique where knowledge is acquired independently by a student prior to a classroom encounter. This knowledge is then applied during in-person interactions taken by a teacher, often in the form of case-based discussions, helping to achieve higher-level problem-solving. FC is an effective way to promote active learning and critical thinking skills among students. Having students acquire knowledge independently before class makes them better prepared to engage in meaningful discussions and analyze real-life scenarios. This approach enhances problem-solving abilities and encourages independent learning and self-motivation. FC provides a valuable framework for bridging the gap between theory and practice in classrooms [ 31 - 33 ]. In a traditional face-to-face learning environment, fundamental concepts can be supplemented with online or asynchronous activities [ 31 , 34 ]. By using various forms of technology to share lecture materials outside of the classroom and with greater student-teacher interactions inside the classroom, FC focuses on student-centered learning rather than teacher-centered learning [ 9 , 35 ]. It is an inverted method of instruction that disseminates lecture materials outside of the classroom using videos, podcasts, or slides [ 36 , 37 ]. It can improve student learning efficiency and deepen student understanding, but teachers may lose the constraints on students [ 36 , 38 ]. In the field of medical education, FC serves as an excellent resource and is suitable for students so that they can participate more actively and focus on class interaction while using the pre-class time to acquire a lot of knowledge in their leisure time. The FC model allows students to watch pre-recorded lectures or read assigned materials before class. This way, students can grasp the foundational concepts at their own pace and have more time for critical thinking and problem-solving during in-person sessions. Additionally, FC promotes self-directed learning and encourages students to take ownership of their education, resulting in a deeper understanding and retention of the material [ 9 , 39 , 40 ]. Figure ​ Figure2 2 shows the concept of FC.

PPT: PowerPoint presentation

References: [ 9 , 31 - 40 ]

Various methods used for implementing FC

Video is the most common type of e-content which can be viewed anytime and at a desired pace [ 41 ]. Video-based learning provides an avenue to tackle a lot of educational issues. As most of the people have mobile phones and access to the internet, video lectures can help deliver lectures more easily [ 42 ]. Virtual reality helps in improving students' understanding of the topic [ 43 ] and is emerging as a new technique for presenting simulation [ 44 ].

Medical quizzes often follow one of the two formats: case-based or image-based. This method aids in bridging the knowledge gap between standard classroom instruction and clinical application. The quiz is a simple tool that enhances didactic lectures by helping students learn and understand more. Being an interactive tool centered on students, it promotes regular feedback mechanisms and encourages active student participation. Web-based quiz games can also be used to summarize the key content [ 45 ].

Team-Based Learning (TBL) and Case-Based Learning (CBL)

The pedagogies of CBL and TBL share characteristics such as the use of a real clinical case, active small group learning, activation of prior knowledge, and application of newly learned knowledge. In CBL, teachers guide students as they apply new knowledge to these real-world clinical issues and engage in peer learning. Unlike problem-based learning (PBL), which is intended to allow teachers to criticize and guide students, CBL promotes an organized and critical approach to clinical problem-solving. CBL also encourages students to work collaboratively, fostering teamwork and communication skills essential in the medical field. The emphasis on real-world cases in CBL helps students develop a deeper understanding of how theoretical concepts apply to practical situations [ 46 , 47 ]. TBL provides active and structured small group learning methods and can be applied to large-scale classes. Students' responsibility is achieved through specific TBL steps, including preparatory preparation, preparation assurance tests, problem-solving activities, and immediate feedback [ 48 ].

Reading Assignments

Students should be provided with pre-class reading materials such as handouts or worksheets, instructor-developed texts, or other reading materials. They can also be assigned to read specific chapters or sections from textbooks or articles related to the topic. Research papers and scholarly articles help in promoting critical thinking among students. This approach allows students to engage with the material before coming to class, promoting a deeper understanding of the content. It also encourages independent research and analysis, as students must locate and read additional sources beyond the assigned readings. By incorporating research papers and scholarly articles, students are exposed to expert perspectives and encouraged to evaluate the information presented critically. This enhances their critical thinking skills and fosters a deeper appreciation for the subject matter [ 49 - 51 ].

Advantages and disadvantages of FC

FC helps to improve student engagement and encourages students in developing a deeper understanding of the topic. It helps in learning through projects, activities, and discussion which not only increases peer-peer interaction but also helps students to think out of the box. Knowing that each student has a different pace to acquire knowledge, FC helps students to learn at their own pace and do multiple revisions of the topic. As videos and class notes are provided beforehand to students, in-class time can be utilized for teacher-student interaction and to address students' doubts. FC gives flexibility to students by allowing them to learn anytime and anywhere and also helps to teach students time management and self-discipline [ 52 - 54 ].

Some students may not complete the pre-class assignments, and use of e-content which is not validated, internet issues, and the requirement of special software may cause problems. For the proper implementation of FC, thorough planning and preparation of both teachers and students is required which also increases the workload of teachers. Students may lack the motivation to self-study a topic beforehand or may not understand the topic on their own. Not all topics may be suitable to be taught using FC. Studying alone at home may lead to students feeling isolated or disconnected with the teacher [ 52 - 54 ]. The advantages and disadvantages of FC are listed below (Table ​ (Table2 2 ).

References: [ 52 - 54 ]

Conclusions

The emergence of the FC as a cutting-edge educational strategy holds promise for improving medical students' learning outcomes and experiences. The FC paradigm can benefit medical students' learning outcomes, learner engagement, and critical thinking skills. Careful consideration of variables such as curriculum design, technological infrastructure, faculty development, and student preparation is necessary for its successful adoption. The success of the FC approach depends on striking a balance between independent study and significant face-to-face contact, maximizing the advantages of both elements. Medical educators can continue to create a revolutionary educational experience that benefits both students and the future of healthcare by using technology, active learning, and student-centered techniques.

The authors have declared that no competing interests exist.

Author Contributions

Concept and design:   Adwait Nichat, Ankit K. Badge

Drafting of the manuscript:   Adwait Nichat, Ujwal Gajbe, Ankit K. Badge

Acquisition, analysis, or interpretation of data:   Nandkishor J. Bankar, Brij Raj Singh, Ujwal Gajbe, Ankit K. Badge

Critical review of the manuscript for important intellectual content:   Nandkishor J. Bankar, Brij Raj Singh

Supervision:   Nandkishor J. Bankar, Brij Raj Singh