**7. Implementing the flipped classroom method**

Flipped classrooms is a method in which the learner, viewing the learning topics by means of virtual technologies and videos prior to the classroom lecture and makes preparations and then comes to the classroom, engages in face-to-face interaction with the instructor and peers with the instructor assuming the role of a guide and facilitator. There are two distinct components of the flipped classroom exercise. These are out-of-class and in-class activities. Out-ofclass activities is a platform involving technical equipment which aims to form a resource for learning where the learners will access the information they will acquire themselves. In-class activities are the part where interactive methods are used [4, 13, 40–42]. **Figure 4** demonstrates the planning of out-of-class and in-class activities in the flipped classroom exercise.

including lecture notes, research tasks, field work, papers, voiced-over PowerPoint presentations, reports, cases, websites, blog contents, educational games, videoconference record-

Organ Donation Course in Medical Education Program http://dx.doi.org/10.5772/intechopen.76657 197

• For suitable videos, web-sourced open resources may be used, but educators may also make their own videos. Bergmann and Sams [47] recommend that video lessons be prepared by the educator personally [47]. Video lessons prepared by the educator make it possible to initiate student-educator interaction during out-of-classroom activities, resulting in readier acceptance of the model among students [48]. The duration of video lessons is very important. Prolonged video lessons are hard to watch alone, which reduces the success of the exercise, and are also not welcomed by the students [45, 49, 50]. The recommendation

Step 4. In-class activities should be planned. Methods such as discussion sessions, group work, project development work, problem-solving, question-answer exercises, and case discussions can be used in in-class activities. The key is to prefer teaching methods in which knowledge can be used with the highest efficiency. The more in-class activities are supported

Step 5–6. Flipped class model should be delivered and information on how post-class link will

Step 7. Assessment and evaluation method should be decided at the very beginning and

• Flipped classrooms possess quite suitable conditions for both formative and summative evaluation [52]. Although studies do not indicate increased success versus the classical system in summative evaluation scales, there is compelling evidence that it improves analytical thinking skills of the learner [4, 6, 13, 32, 49, 50, 53–55]. The assessment and evaluation method should be changed when the model is not improving students' examination success [40]. Also

by the educator, the higher cognitive learning, and reasoning skills will develop [11].

ings, demonstration, and lecture videos can be made use of [43–46].

**Figure 5.** Structuring lectures in flipped classrooms. Source: Karanicolas and Snelling [42].

is mini video lessons of 20–30 mın in duration [50, 51].

be made should be provided.

should be appropriately structured.

The cyclical steps in **Figure 5** can be used in structuring lectures in flipped classrooms [42].

Step 1. The content and learning outcomes should be prepared.

• Students should be informed of the flipped classroom method and should be clearly explained what are being expected of them.

Step 2–3. Technical hardware to be used out of and in the class should be prepared, choosing systems that all students can use easily and uninterruptedly (**Table 1**) [40].

• Out-of-class teaching materials suitable for the content and learning outcomes of the chosen lecture should be prepared (**Table 1**). When preparing teaching materials, various resources

**Figure 4.** Out-of-class and in-class activities. Source: Lo and Hew [41].

**Figure 5.** Structuring lectures in flipped classrooms. Source: Karanicolas and Snelling [42].

to videos. Later on, Salman Khan, with the math videos he recorded without any commercial

The title of the book released by Bergmann and Sams in 2012 was "Flip your classroom; reach every student in every class every day" [4]. As the title suggests, the main objective of the "flipped classroom" method is to make classroom lessons available using technology and to reach all students with different types of learning by making in-class activities more active.

Flipped classrooms is a method in which the learner, viewing the learning topics by means of virtual technologies and videos prior to the classroom lecture and makes preparations and then comes to the classroom, engages in face-to-face interaction with the instructor and peers with the instructor assuming the role of a guide and facilitator. There are two distinct components of the flipped classroom exercise. These are out-of-class and in-class activities. Out-ofclass activities is a platform involving technical equipment which aims to form a resource for learning where the learners will access the information they will acquire themselves. In-class activities are the part where interactive methods are used [4, 13, 40–42]. **Figure 4** demonstrates

the planning of out-of-class and in-class activities in the flipped classroom exercise.

The cyclical steps in **Figure 5** can be used in structuring lectures in flipped classrooms [42].

• Students should be informed of the flipped classroom method and should be clearly ex-

Step 2–3. Technical hardware to be used out of and in the class should be prepared, choosing

• Out-of-class teaching materials suitable for the content and learning outcomes of the chosen lecture should be prepared (**Table 1**). When preparing teaching materials, various resources

purpose, helped the model spread wider and be known as "Flipped Classroom" [39].

**7. Implementing the flipped classroom method**

196 Organ Donation and Transplantation - Current Status and Future Challenges

Step 1. The content and learning outcomes should be prepared.

systems that all students can use easily and uninterruptedly (**Table 1**) [40].

plained what are being expected of them.

**Figure 4.** Out-of-class and in-class activities. Source: Lo and Hew [41].

including lecture notes, research tasks, field work, papers, voiced-over PowerPoint presentations, reports, cases, websites, blog contents, educational games, videoconference recordings, demonstration, and lecture videos can be made use of [43–46].

• For suitable videos, web-sourced open resources may be used, but educators may also make their own videos. Bergmann and Sams [47] recommend that video lessons be prepared by the educator personally [47]. Video lessons prepared by the educator make it possible to initiate student-educator interaction during out-of-classroom activities, resulting in readier acceptance of the model among students [48]. The duration of video lessons is very important. Prolonged video lessons are hard to watch alone, which reduces the success of the exercise, and are also not welcomed by the students [45, 49, 50]. The recommendation is mini video lessons of 20–30 mın in duration [50, 51].

Step 4. In-class activities should be planned. Methods such as discussion sessions, group work, project development work, problem-solving, question-answer exercises, and case discussions can be used in in-class activities. The key is to prefer teaching methods in which knowledge can be used with the highest efficiency. The more in-class activities are supported by the educator, the higher cognitive learning, and reasoning skills will develop [11].

Step 5–6. Flipped class model should be delivered and information on how post-class link will be made should be provided.

Step 7. Assessment and evaluation method should be decided at the very beginning and should be appropriately structured.

• Flipped classrooms possess quite suitable conditions for both formative and summative evaluation [52]. Although studies do not indicate increased success versus the classical system in summative evaluation scales, there is compelling evidence that it improves analytical thinking skills of the learner [4, 6, 13, 32, 49, 50, 53–55]. The assessment and evaluation method should be changed when the model is not improving students' examination success [40]. Also according to the constructivist theory, assessment and evaluation methods should be changed accordingly after teaching processes in which active teaching strategies are extensively used.

**8. What should be paid attention to in a flipped classroom?**

successful implementation of it.

maintained when the classrooms are flipped.

**9. The place of flipped classrooms in medical education**

It is possible to say that the flipped learning approach contributes to more active involvement of learners in the learning process and help them learn better by increasing their motivation. However, it also appears that very diligent and meticulous work is required in implementing it. There are many points to consider, especially by the educator, in implementing the flipped classroom concept. Foremost among these is the preparation of videos that are included in out-of-class activities. When preparing videos, having an extended video length causes students to get distracted and reduces the viewability of the video, decreasing the success of the practice. Therefore, the recommended duration for the videos was limited as 20–30 min [38, 50, 51]. It may also be useful to add motivating elements to the videos and to add worksheets or questions at the end of the videos to be able to understand whether students have watched the video [45, 47, 51]. Videos prepared by the educator will improve acceptance of the model by the students. This is because flipped classroom exercise should be adopted not only by the educators but also by the students [37]. The practice should be clearly explained to the students for them to adopt the model. Studies report that students find it difficult to internalize the practice when they are not open to change and sometimes because of cultural habits, especially in Asian countries [46, 56]. Students and educators who are equipped with knowledge about their duties and responsibilities surrounding this practice will contribute to

Organ Donation Course in Medical Education Program http://dx.doi.org/10.5772/intechopen.76657 199

Another point to consider is to encourage students to come to the class prepared. For this, in- and out-of-classroom activities should be defined and planned very well and executed according to the plan. Effective use of time and material and the qualities of in- and out-ofclassroom activities are the factors that directly affect learning [49, 50]. For example, out-ofclassroom activities should be planned so as not to place excessive burden on the student and care should be taken to ensure that materials are comprehensible, especially for difficult subjects. In addition, out-of-classroom activities should be arranged to cover not more than 60 min a day. In in-class activities, on the other hand, approaches should be offered to learners, which allow them to ask questions to improve their deep learning skills, to make associations by following the flow of thoughts, and to make assessments and estimations. Learnings should be supported by proper feedback at proper times and opportunities should be offered for the learner to reflect so that they can comprehend their own learnings. This not only supports learning efficacy but may also be used to formatively evaluate student's knowledge [43–45]. Methods to be used in assessment and evaluation should also be structured to the content and targets of education. Quizzes measuring conventional knowledge should not be

The future of medical education lies in technology. The cost and efficiency technology allows represent a paradigm shift in how we teach and utilize faculty, space, finances, and other resources [57]. Today's physicians who completed their education in the previous century are

• Formative evaluations are important in monitoring the improvement of the learner and checking the efficiency of the in- and out-of-class activities.


**Table 1.** Learning resources that can be used in a flipped classroom [40].
