Implementing blended learning to improve practical science classes with large student groups

Background: Basic science courses are important in the education of health care students to develop their professional skills. These courses are often more theoretical than practical and hard to study. Practical classes connecting theory with practical applications can support students with their learning process. However, when student numbers arise, these practical classes often turn into theoretical explanations about the practice instead of practice itself.
Purpose: We aimed to redesign the practical classes of the course ‘Neurophysiology of pain and movement’ to improve teacher-student ratio, students’ active participation, and student-centered learning. Two different blended learning approaches where used. Firstly we used flipped classrooms and secondly knowledge clips by and for students.
Methods: Students were randomly divided in groups of four. These groups were the same for both assignments. Firstly, each group had to prepare the theoretical background and the execution of experiments at home with the help of textbooks, video tutorials and flowcharts. Then, during the supervised contact moments, the more elaborated experiments with specific equipment were carried out followed by a discussion between the groups on all experiments regarding result interpretation and experiment modalities. A total of eight experiments were carried out and/or discussed within four supervised contact moments. Secondly, each group chose a topic of preference from the theory that could be translated into daily practice. This part of the assignment runs parallel with part one and is focused on student-centered development of knowledge clips. In these, students explained the neurophysiology behind the chosen topic to fellow students. This process is supported by a feedback round within groups in which students are randomly assigned to give constructive feedback to other groups’ work. This enables the groups to further improve the quality of the knowledge clips.
Results: A total of 145 students in their second year of physiotherapy training followed the classes. Flipping the classes in which the theoretical part (knowledge and comprehension) moved out and application, analysis, synthesis and evaluation were trained within supervised hours reducing the supervised session time per student with 50%. This enables reducing the groups from 48 to 24 students with the same amount of teaching hours. This resulted in substantial increase in teacher-student ratio, students’ active participation (more equipment available pro student) and more useful interaction. In total 50 students (34%) provided feedback from which the most important: 1. In spite of the reduced duration of the classes students report that they had enough time to carry out the experiments. 2. The teachers’ availability for guidance and questions during the experiments was experienced as very good. 3. Evaluation of the knowledge clip assignment had polarized results with a subgroup stating that the assignment was very helpful and another subgroup stating that the assignment was not helpful at all to support understanding of the theoretical part of the course.
Conclusions: Introducing blended learning with flipped classroom principles has led to higher teacher-student ratio and improved the students’ active participation during supervised sessions. Knowledge clips as assignment have the potential to be useful tools but students need to be guided more strictly in their choice of topic. A library of ‘best-off’ knowledge clips can be valuable learning material over the years.