You Flipped What?

Advanced neurological physical assessment is a fundamental skill taught in in the nurse practitioner curriculum. It is a subject that many students find difficult to master. Traditional methods of teaching this material include: assigned student reading assignments, classroom didactic lecture with PowerPoint and other multi-media resources. The students then participate in practicing advanced neurological physical assessment skills in the clinical laboratory.What is observed during the class and clinical lab pass-off are students who have not thoroughly studied nor mastered the material. The students have expectations of learning the required skills in didactic and clinical laboratory with minimal participation on their part. The students are then followed into the clinical setting where they continue to struggle with advanced neurological physical assessment skills.

The classroom was flipped and students were given a detailed outline of the four basic topics to be covered in advanced neurological assessment. A detailed explanation and summary of the assignment was given to students who were divided into four groups. Pre-class assignments included review of neurological anatomy and group development of a topic handout. Each group then had 30 minutes to present their topic, discuss the rationale for neurological physical assessment tests and abnormal findings, and demonstrate each test. The students then supervised their peers in the clinical lab and performed skills check-off. The faculty participated and served as part of the team.

In summary, flipping the classroom allowed the students to actively participate in their own learning and to assist each other in the learning process. The students demonstrated an understanding of the material and rationale for why they would perform the neurological physical assessment and what the findings meant in terms of pathology and impact to their patients.Evaluation showed that the students had better mastery of the material and were able to demonstrate advanced cognitive reasoning related to neurological exam.