Integrating Basic Tissue Histology into a Medical Gross Anatomy Course using a Flipped Classroom Team‐Based Design in a Remote Learning Environment

Abstract

Introduction and Objective During the COVID-19 pandemic, we were tasked with integrating basic tissue histology into a dissection-based medical gross anatomy course. In response, we created and implemented a series of flipped classroom exercises consisting of pre-recorded lectures supplemented with novel and live but remote virtual team-based exercises related to cytology and the histology of the basic tissues. These problem-solving exercises demonstrated the practical application of histology and clinical relevance of the basic tissues to medicine while simultaneously preparing our students for their study of microscopic anatomy and organ pathology in subsequent systems-based modules. Here, we outline a method for teaching histology in a team-based virtual learning environment that may serve as a useful model for histological teaching at other institutions. Materials and Methods Overall, six histology topics were integrated into a medical gross anatomy course and were timed to complement the regional anatomy: Back the six quizzes contributed 10% to the overall final grade in gross anatomy. Histology questions were also incorporated into the three theory and practical examinations. The students were engaged remotely in problem solving sessions by using an on-line active learning platform (TopHat.com) broadcasted through video conferencing (Zoom Video Communications). The problems were modeled after USMLE step 1 questions. The students submitted two responses for each question: (1) an independent response when the question was initially presented;and (2) a group response after discussion with a learning team of approximately six students (Breakout Room). The histology questions included multiple choice and ?Tap-On-Target?-type questions using screen shots of histological slides. Results With the exception of cytology and hematology, the basic tissues were easily integrated to complement the gross anatomy presented the course. The students freely discussed solutions to problems in small groups and readily shared their answers with the class. The inclusion of scores from the quizzes in final grading of the gross anatomy course accentuated the importance of histology, kept students on task and encouraged integration between disciplines and cooperative learning. Positioning the quiz at the end of the active learning sessions gave students an opportunity to solidify and clarify concepts with the histology faculty. Conclusion The flipped classroom approach to histology in a remote learning environment promoted participation, contextualized the value of histology and its clinical relevance to the practice of medicine. Future plans include to formally survey and evaluate medical student perceptions of the flipped classroom histology exercises.