INVESTIGATING THE INTERPLAY BETWEEN SELF-REGULATED LEARNING AND INSTRUCTIONAL DESIGN IN A FLIPPED CLASSROOM SETTING

Abstract

Purpose: Self-regulated learning (SRL) skills have been identified as modifier for flipped classroom success. The Foundations course at Harvard Medical School is 13-week long, integrated basic science course for first year medical students taught via Case-based Collaborative Learning (CBCL). CBCL was specifically developed for medical students and incorporates a flipped classroom framework. The aim of this study was to learn what study strategies students deploy in interacting with the CBCL instructional design, which strategies are most effective for learning, and whether SRL skills play a role in this. Methods: This work is a mixed methods quality improvement study. A validated SRL assessment tool was combined with newly developed CBCL-specific items into one survey. Students (n=169) were asked to complete the survey as part of professional skills development activities in week 1 and 10 of the course. Performance on course assessments (4 non-cumulative exams) was used as an outcome measure of learning. Results: Students widely adapted their SRL skills and study strategies across the 10 weeks. Students shifted from rehearsal to prioritizing elaboration, and were found to have increased organization and metacognitive awareness over time. Specific study habits like test taking strategies related to low-stakes readiness assessments were associated with significantly increased exam performance, while other study habits like preferring videos over readings did not affect outcomes. About 10% of the class struggled to adapt to the flipped classroom setting throughout the course and performed significantly lower on exams than their peers. This group of students used less active study strategies and found it challenging to identify key concepts. Conclusions: This study provides a detailed window into how first year medical students adapted study habits to a flipped classroom environment. Successful adaptation required students to exhibit adaptive SRL expertise and prioritizing elaboration over rehearsal practice consistent with the goals of active learning. Students that struggled with the transition to an active learning curriculum may benefit from targeted coaching on how to engage with specific instructional design elements like formative quizzes as well as more general coaching on SRL domains like time and effort management.