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3 reasons to flip the classroom back to lecture

What if we are wrong about the evils of lecture-based education and should be giving EMS students what they want?

Six EMS professionals ask ‘What if we are wrong?’ This article, like the others, explores the other side of impassioned debates on naloxone, endotracheal intubation, STEMI alerts, professionalism, and lecture-based education. Read all six articles.

For the last several years teachers of the teachers have been imploring us to ‘flip the classroom.’ The widely publicized and poorly defined educational revolution encourages teachers to make students responsible for their own learning. Instead of lecturing, the teacher facilitates learning by assigning videos, readings, and other self-paced activities before shared classroom time. During face-to-face time the teachers and students complete collaborative activities like case discussion, high-fidelity simulation, and other feel-good group activities.

The ‘flip the classroom’ movement is driven by the poor efficacy of lecture instruction - students don’t learn much and knowledge retention from a lecture is notoriously poor. Whether students are learning medical math, pit crew CPR, foam pit rescue, ECG intrpretation, or MCI response they are likely to learn better, learn more, and learn longer if they learn by doing rather than learn by hearing.

What if we are wrong? Here are three reasons to side step or swim out of the ‘flip the classroom’ tsunami.

1. Give the people what they want
Many years ago I delivered a conference session on principles of lifting, moving, and extrication, which was promoted and described as a hands-on training session. The ballroom set-up was simple: no chairs, no tables, no screen, no projector. Person after person, all EMTs and paramedics, walked through the door and were instantly befuddled by the lack of chairs, screen, and podium. Three-quarters of the people that walked two steps in the door turned around and left before we started. Several of the session evaluations complained about the lack of slides, handouts, and lecture. “Too much moving around for a CE session,” wrote one participant.

We expect and want EMS education, based on our years of initial and refresher education, to be delivered by lecture. More than half of respondents to an EMS1 poll call on continuing education (CE) prefer to receive their CE by classroom/lecture. Another 18 percent prefer earning CE at conference sessions, which are almost always lectures.

The outcome of CE is to meet recertification requirements. Hours of CE are awarded for completion in topic areas with regulatory indifference to the specific information learned, how that information is learned, and if that information is retained. For most EMS providers the only throttle on CE is the number of hours earned by distributive education - online videos.

2. Lectures are easy to prepare
A lecture, especially for an audience that is primarily driven to check an hours completed box, is easy to prepare. Use this recipe for baking a lecture:

  • Introduce heart failure
  • Describe the scope of heart failure
  • List the signs and symptoms of heart failure
  • Explain the assessment of heart failure
  • Review the treatment of heart failure

Substitute any medical problem or traumatic injury for ‘heart failure’ in the above recipe. As the lecture is delivered there is ample opportunity for war stories, once in a lifetime cases, and answering convoluted ‘this would probably never happen, but what if’ questions from students.

Once baked, the lecture can be delivered over and over with little or no modification. Many educators are able to prepare a lecture based on personal anecdotes, their recollection from EMT or paramedic school, and local response data.

For educators and training officers that don’t have time for lecture prep and cooking there are a lot of canned courses. These ready and simple to deliver card courses can be conveniently re-delivered every two years.

3. Slide decks are easily and widely available
Lecture delivery, unlike case-based learning or scenario-based discussion, does not require topic expertise. PowerPoint slide decks are available from book publishers, colleagues, and social sharing sites like SlideShare.

Slide decks that are text heavy, image light, and have lots of bullet points are designed to be presented by any educator. Avoid slide decks that are primarily images with minimal text. Those lectures are highly dependent on the knowledge and charisma of the presenter.

Finally, many of us, myself included, like being the sage on the stage. The crowd files in, listens (maybe), and applauses lightly. The experience is personally fulfilling for my ego - I love an audience - and professionally fulfilling for attendees - they earn an hour of CE.

Keep training engaging and effective without flipping the classroom
Fortunately many EMS educators, despite audience protestations or indifference, are delivering instruction with other methodologies. Check out these resources and consider how you might work them into your teaching skill set or training program.

Greg Friese, MS, NRP, is the Lexipol Editorial Director, leading the efforts of the editorial team on Police1, FireRescue1, Corrections1 and EMS1. Greg served as the EMS1 editor-in-chief for five years. He has a bachelor’s degree from the University of Wisconsin-Madison and a master’s degree from the University of Idaho. He is an educator, author, national registry paramedic since 2005, and a long-distance runner. Greg was a 2010 recipient of the EMS 10 Award for innovation. He is also a three-time Jesse H. Neal award winner, the most prestigious award in specialized journalism, and the 2018 and 2020 Eddie Award winner for best Column/Blog. Connect with Greg on LinkedIn.