Flipped online teaching of histology and embryology with design thinking: design, practice and reflection | BMC Medical Education

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Flipped online teaching of histology and embryology with design thinking: design, practice and reflection | BMC Medical Education

Histology is the study of the microstructure and related functions of the human body [1], while embryology studies the laws and mechanisms of ontogenesis and development; these two sciences are interrelated and self-contained [2]. As one of the important professional core programs of most medical specialties, Histology and Embryology (HE) has been an indispensable curriculum bridge between normal microstructure and pathological changes in tissue and organs.

The teaching targets of HE are mainly first-year undergraduate students in clinical medicine, psychiatry, stomatology, nursing, etc. The importance of fostering the development of empathy in undergraduate students is continuously emphasized in international recommendations for medical education [3]. Freshmen have a certain ability to think logically and analyse problems, but this ability is limited, and they have a yet to develop familiarity with scientific research hotspots. Moreover, they are often unaware of their creative potential, and this phenomenon often causes them to passively accept knowledge, and their autonomous learning ability and student participation in class are less than that of upperclassmen. These first year students face the need to develop scientific literacy and the ability to integrate theory with practice [4]. However, traditional teaching methods may have failed to fully meet students’ need for a profound understanding of these abstract concepts, leading to challenges such as low interest in learning and inadequate knowledge absorption. Consequently, educators urgently need to seek innovative teaching strategies to enhance students’ learning experience and academic performance.

In the information age, teacher teaching is no longer a simple superposition of knowledge and teaching methods but a fusion innovation of technology and teaching oriented to a more complex learning environment. The Teacher Standards issued by the American Educational Technology International Association note that the important role of future teachers is that of a “designer” [5]. DT combines a creative and innovative approach to dealing with complex problems, which serves as a valuable tool for those seeking to improve the challenging issues in medical education [6]. DT is a process of analysis that relies on the deconstruction of ideas and a creative process that relies on the construction of ideas. There are no judgements in DT. This eliminates the fear of failure and encourages maximum input and participation. Wild ideas are welcome since they often lead to the most creative solutions. Everyone is a designer, and DT is a way to apply design methodologies to any situation [5].

In the field of education, DT has been advocated as a means to promote the cultivation of innovative talent through innovative teaching methods. With the help of DT, and adhering learning as the concept in teaching, the transformation of teaching allows learners to explore real needs in real life scenes, to propose innovative solutions to meet those needs through teamwork, and to test the effectiveness of those solutions through prototype production. This process facilitates the further application of constructivism [7].

In the process of both conventional teaching and teaching innovation, the research team utilizes the “EDIPT” (Empathy, Define, Ideate, Prototype and TEST) DT theory [8] which originating in the Stanford University Design School to design teacher activities and student activities and select technical tools [9]. The basic process is shown in Fig. 1. The team is very accustomed to consciously applying DT methodology when facing difficulties and challenges to consistently obtain the desired results [10]. This study sets the teaching objectives and plans of a large cycle (one semester) to guide the teaching implementation of a small cycle (one section or one chapter); Then, small-cycle teaching feedback and achievement accumulation promote the progress of large-cycle teaching to ensure the coherence, effectiveness and improvement of teaching reform. For example, the difficult problem in the process of cardiovascular system embryogenesis is atrial separation; the team uses cardboard and plastic film to construct room partition “products” [11] to provide vivid explanations and body movements for clearer explication. In another example, they integrate scattered knowledge points including cleavage, blastocyst formation and implantation into a unified narrative called “the initial journey.” It solves the pain point that the dynamic abstraction of embryology knowledge is difficult to intuitively understand. The above are two examples of using EDIPT steps of design thinking to solve teaching pain points.

Fig. 1
figure 1

Problem solving steps incorporating DT

Research objectives and significance

In the 2021 Horizon Report: Teaching and Learning Edition, blended learning was once again selected as the key technology affecting the future development and practice of higher education [12], demonstrating great application potential. In this format, the teaching team adheres to the following practical principles to promote more blended learning courses to ensure high-quality outcomes [13]. In the recent period of epidemic prevention and control, effective online teaching combines asynchronous and synchronous delivery modes, addresses knowledge learning and ability development, and highlights interaction in teaching activities to improve the online teaching experience for both teachers and students and enhance the overall quality of online teaching. Online teaching is not simply an emergency measure taken during the epidemic but rather represents the future trend of education.

The aim of this study is to explore the application of design thinking in the teaching of histology and embryology courses. By investigating the impact of design thinking in the teaching process, we aim to gain a deeper understanding of the effects of this innovative teaching strategy on students’ learning experience and academic performance, as well as its potential applications in medical education.

The significance of this research lies in its contribution to medical education with novel teaching methods and strategies. By incorporating design thinking, educators can better cater to students’ learning needs and enhance their comprehension and mastery of the subject matter. Furthermore, this study contributes to the expansion of teaching research in the field of medical education, providing valuable insights for educational reform and improvements in teaching quality.

The analysis of the correlation between design thinking and this study

Design thinking plays a crucial role in formulating the educational reform. During the empathize phase, an in-depth understanding of teachers’ and students’ needs and challenges is achieved. This includes considering teachers’ expectations and pedagogical beliefs, as well as students’ learning styles and feedback, leading to a clear definition of the problem and setting specific objectives for the educational reform. In the define phase, the importance of improving teachers’ pedagogical approaches and methods, and cultivating students’ creative learning and competencies is underscored. This serves as the foundation for selecting appropriate teaching strategies and establishes the specific direction for incorporating design thinking in the flipped classroom model. During the ideate phase, innovative thinking is employed to explore diverse teaching strategies. For enhancing teachers’ pedagogical approaches, approaches such as case-based teaching and collaborative learning are recommended to stimulate students’ intrinsic motivation for active learning. For promoting students’ creative learning and overall competencies, methods like project-based learning and critical thinking cultivation are considered to facilitate holistic student development. In the prototype phase, the devised teaching strategies are implemented in the flipped classroom setting. Continuous prototyping and rapid experimentation facilitate the collection of valuable feedback and data from students and teachers, enabling further optimization of the teaching strategies to align with the original intent of design thinking. Finally, in the test phase, a comprehensive evaluation of the teaching implementation is conducted. By collecting and analyzing data, the study delves deep into the impact of the educational reform on teachers’ pedagogical beliefs and students’ creative learning and overall competencies. This process provides crucial feedback and evidence for the ongoing improvement of the educational reform.

In conclusion, the selection of flipped classroom as a pedagogical strategy is closely guided by design thinking principles. Through the application of design thinking, this observational study aims to enhance teachers’ pedagogical approaches and methods while fostering students’ creative learning and overall competencies, thus promoting the successful implementation of the educational reform.”

Flipped classroom sessions can also allow learners to gain competence through their educational endeavours [14]. As Bransford writes, “To develop competence in an area, students must: a) have a deep foundation of factual knowledge, b) understand facts and ideas in the context of a conceptual framework, and c) organize knowledge in ways that facilitate retrieval and application” [15]. Flipped classrooms can lead to competence in factual knowledge by fostering mastery of content through content understanding and application, as in traditional classrooms [16].

“O-PIRAS” Flipped classroom

The flipped classroom teaching model used in this study was formed and adjusted on the basis of Professor Jianpeng Guo’s “O-PIRTAS” model. The flipped teaching mode can enable both teachers and students to acquire further abilities through teaching activities [17].

The first step(O: Objective) in flipped classroom teaching design is to formulate two types of teaching objectives: low level and high level. The lower level teaching objectives include two cognitive objectives from Bloom’s classification of teaching objectives: the memory and understanding of knowledge, while the higher level teaching objectives include four cognitive objectives from Bloom’s classification: application, analysis, evaluation and creation, as well as objectives pertaining to movement skills and emotion [18]. The second step is to design a preparation activity (P: Preparation) for students to complete before class, which helps students form necessary prior knowledge and stimulates their learning motivation by exploring relevant issues prior to the class [19]. The third step is for teachers to send teaching materials (I: Instructional video) to their students for pre-class learning to facilitate their early acquisition of knowledge [19]. Fourth, teaching is transferred from online classes to offline classes. The teacher briefly reviews (R: Review) the video content before class to help students quickly focus on and prepare for the next stage of learning both cognitively and psychologically. Fifth, teachers should design classroom activities (A: Activity) appropriate to high-level teaching objectives to promote in-depth learning and successfully achieve high-level objectives. Sixth, teachers should conduct classroom summaries (S: Summary), reflection and improvement to help students form integrated structured knowledge. The six steps of flipping the classroom link form a closed loop, which can be summarized as in Fig. 2.

Fig. 2
figure 2

Process of “O-PIRAS” flipped teaching

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