**10. Using flipped classrooms in organ donation courses**

Many organs should function in certain harmony for the human organism to work perfectly. Diseases occur when dysfunction appears in any of these organs. If the dysfunction is left untreated or becomes irreversible, this means that a threat to life has begun to shape, and life expectancy decreases as functional loss progresses. A person at this stage requires a new organ to sustain life. If that organ is the kidney, the person must be confined to dialysis machines for the rest of his/her life but if the organ with failure is the heart, lungs, or liver, death is inevitable. Unfortunately, all these patients could lose their lives if donation is not found in good time. One should bear in mind that organ transplantation is the only hope for these patients to survive. Excellent results can be achieved and lives can be saved with organ transplantation, but, unfortunately, people seem not to be sensitive enough regarding the topic of organ donation. When cadaveric organ donation falls short, the frequency of transplantations from living donors increases to prevent life losses. Under these circumstances, individuals with brain death are buried along with their organs, while healthy people are forced to give their organs to their significant other.

now face to face with new medical students with different ways of thinking and learning. Today's medical students' characteristics are their good command on digital technologies, easy access to information, and changing learning styles and needs, and they exhibit differences in thinking and processing information compared with the generations before them [4, 12]. This makes it imperative to develop alternative teaching-training methods in medical education.

200 Organ Donation and Transplantation - Current Status and Future Challenges

Looking at the medical education literature, examples of implementing the flipped classroom model are seen in the medical faculties in the USA and Central Asian countries. The most radical declaration for the method took place in the Medical Faculty of Stanford University. A model for medical education before graduation based on the flipped classroom philosophy was described by faculty members, Prober and Khan [58]. The two faculty members declared that the current systems were not flexible and did not support individual learning, and that they intended to make the method more common and increase its utilization [56]. There are also attempts to implement the model in Hawaii, as the joint major project of the Accreditation Council for Graduate Medical Education (ACGME) and local medical faculties [59]. Gillous et al. [60] reported that this method was used in the first year of educational programs in medical faculties in France since 2006 [60]. Interestingly, favorable results of the studies performed with the flipped classroom approach in medicine, nursing, and pharmacy domains have been

It can also be seen in the literature that flipped classrooms is a method, which can be used in medical education. Attention of students with intensive course load particularly during the preclinical education period can be grabbed and their motivation can be increased. Also, this method seems to be an opportunity in learning basic mechanisms and integrated pathophysiologic information in the preclinical phase. And in clinical education, flipped classroom can be used in acquiring higher-order cognitive skills such as critical thinking and evidence-based reasoning and application of clinical knowledge including deep learning strategies (approaching patients, initial diagnosis, differential diagnosis, treatment, complementary approach, etc.).

Current evidence suggests that the flipped classroom approach in health professions' education overall yields a statistically significant improvement in learner performance compared with traditional teaching methods. In addition, the flipped classroom would be more effective

In summary, flipped classrooms can be used in medical education in courses and applied training which require conveying the knowledge to a learning level of and above analysis in Bloom's taxonomy. This should therefore be taken into account when determining the con-

Many organs should function in certain harmony for the human organism to work perfectly. Diseases occur when dysfunction appears in any of these organs. If the dysfunction is left untreated or becomes irreversible, this means that a threat to life has begun to shape, and life expectancy decreases as functional loss progresses. A person at this stage requires a new organ to sustain life. If that organ is the kidney, the person must be confined to dialysis machines for

influential in regarding the flipped classroom concept as a pedagogical model.

when instructors use quizzes at the start of each in-class session [61].

**10. Using flipped classrooms in organ donation courses**

tent and targets of learning.

There is globally an increasing number of patients whose lives depend solely on organ or tissue transplantation. This increase also escalates the importance of organ and tissue transplantation. Many studies are being performed on this topic, particularly to raise awareness, but the effectiveness of these studies are disputable. People's awareness needs to be raised to increase cadaveric organ transplantations. The major role here belongs to physicians. Raising awareness is only possible by ensuring that physicians or candidate physicians understand the importance of topics such as cadaveric transplantation, donation, and brain death. By including organ donation as a topic in continuing professional development and undergraduation, medical education programs may emphasize the importance of the subject for physicians or candidate physicians. However, the effectiveness of these activities will still be disputable as long as they remain as didactic courses.

The flipped classroom model, which is an active teaching method, can be used in organ donation courses in medical education programs. Learners' participation/contributions in an education program are one of the key factors that maximize learning/teaching. With the use of the flipped classroom education method in organ donation courses offered in medical education programs, students' knowledge and skills that enable them to discuss the topic of donation with patients can be improved. Because when awareness develops, a number of new cognitive schemes occur in an individual's mind. The way individuals react to their experiences may be enriched by increasing the awareness on the thoughts and feelings that drive behaviors.

The objective and learning targets should be identified first when designing organ donation courses using the flipped classroom model in medical education programs. Students should then be informed of the model and be explained in detail what is expected of them. Technical equipment and educational materials that will be used out of the classroom and in the classroom should be prepared. It may be ensured that students understand the topic of organ donation by using voiced over PowerPoint presentations as educational materials. It may also be useful to add videos developed by the educator or presently available videos on organ donation as educational materials. In short, students may be asked to come to class prepared after learning about organ donation topic from videos and taking online quizzes before the actual lesson. During class time, students may be given the opportunity to practice what they have learned by the use of active learning methods as well as case scenarios, discussion sessions, question-answer exercises, project development work, and/or patient simulations. Studies emphasize the importance of in-class activities. Therefore, activities which allow students to practice their pre-class learnings and advance their professional competency should be planned for in-class activities, particularly in clinical case analyses. It should, however, be borne in mind that students not rehearsing their pre-class learnings in the class as part of the lesson (double course) and absence of a connection between pre-class learnings and in-class practices will result in failure. Testing of the students at the end of the class should aim to evaluate their higher-order cognitive learnings on organ transplantation topic such as practice, analysis, and assessment. Evaluation and assessment activities may utilize case analyses or simulated patient communications.

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