Interviewer: Today I am sitting with Greg DeBourgh, a faculty member in the School of Nursing. Actually, before we get started, Greg, could you tell us a little bit about yourself? Mainly not so much the research side, but who you are, what kind of courses you teach.
Greg DeBourgh: I've taught at the university since 1993. I started as an adjunct faculty, and in 1998, I became full-time, and I teach in the School of Nursing and Health Professions. I teach a course at the junior level of our four-year program. It's a course that really emphasizes synthesis and application of knowledge. We refer to it as the meat and potatoes course. The students actually have to do things as opposed to just memorize things for a test. I've been teaching the same course for quite some time. I found that using technology in a purposeful way has really benefited the learning outcomes as well as helped me gain some insights about how to help them learn.
I try to be very student-centric, and the challenge is in my discipline and for registered nursing is that we have a lot of dense information that we have to pack in over these four years, and it's a parallel course of both helping them learn content and process, but also the professionalization piece. There's a lot of stuff about the role. That was a huge challenge is how to get these principles and concepts and embedded psychomotor skills into some sort of package that's doable because the cognitive overload feature is huge in this particular course.
Interviewer: If we think about that course, and you may flip all your classes or only some, that part I don't know, but why did you decide to start flipping? What are the problems that you were seeing that you were hoping to solve by flipping?
Greg: Because of this dense content, cognitive overload was number one. The class is scheduled for 3 hours and 40 minutes once a week. The rest of the week, the students are in other core courses, theory courses, and they're 8 to 12-hour clinicals. It's an exhausting curriculum. For 3 hours and 40 minutes to be in a room where I am transmitting information to students, I'm going to have a roadkill in this classroom. I'm going to run over somebody, I'm going to leave someone behind. I was looking for a way to make it digestible if you will. I wanted to really role model how nurses think, so the metacognition piece.
I wanted enough time when I'm with the students when we're all together. By the way, I have 50 students in a room for 3 hours and 40 minutes. That's one huge challenge. Cognitive overload, 50 students in a section, 3 hours and 40 minutes long, how can I through interaction- not only with the content and the process but with each other, how can I package that so that the students are not overwhelmed? They really come to an understanding of what they do and do not know. I wanted to build their confidence. I have found over the years, the only way to do that is to let them explore the content. In other words, apply it.
I had to find a way to repackage this course so that I wasn't being teacher-centric coming in and talking at them for 3 hours and 40 minutes. I had to find a way to buy back some time. That's what drove me to consider flipping. This particular course, the entire course is flipped. By that, I mean that every week there are pre-class activities. There are in-class activities, and there are after-class activities. I do that for the 14 weeks of instruction.
Interviewer: Got it. Now, if I think about this, I'm going to divide it up into little bits. You're out of class, your pre-class activities, what do they look like typically? I know it may vary.
Greg: It does vary based on the content because some content is more skill-oriented and some is more principles and concepts. For me, the focus of the pre-class is prerequisite knowledge focus. That's where I'll narrate some PowerPoints, I'll insert some video. I try to keep them in little packages of a 20-minute theory burst with some sort of application. Sometimes it's responding to a video clip. Sometimes I've inserted a template that's heavily scaffolded in the process of how a nurse thinks, asking them to do something with the information. The pre-class is where they compile the principles and concepts, the textbook learning stuff. That's the pre-class. I have found that it's important to have some deliverables for the pre-class. Otherwise, I can't do what I need to do in class.
Interviewer: I'm assuming that what you're really saying under the surface is if I don't have some sort of deliverable, I may have a noticeable percentage of my students who came in who aren't ready.
Greg: Exactly right.
Interviewer: They didn't do the study.
Greg: Exactly right.
Interviewer: This is a question that I know comes up a lot with faculty in terms of, especially people who have not flipped yet, they're worried about that portion that students just are going to not do anything. What kinds of things do you do in terms of a pre-class deliverable that seems to work?
Greg: Two strategies. One is that I have unannounced quizzes in the first 12 minutes of class, and that unannounced quiz, 12 minutes to do 10 questions. They respond on their clicker system. We do it right upfront, and we use that as a springboard then to clarify any misperceived knowledge or misunderstandings. There's one motivation right there. Those quizzes are based on the work they should have done. In terms of the deliverables for the homework, sometimes the reflection pieces about, "Highlight your-- Based on this article about team process, provide your reflections about your role as a nurse on the team."
Many times there're synthesis activities, where they have to compile what's the highest-risk medically or physiologically for a patient with this disease? Then what's your role? It's this idea of rapid recognition and response. I have many different templates that I use that tease out both the content process and their role. The course because of what needs to be done is heavily queued because of this thinking as a nurse. That might be a little different for my discipline than my peer faculty. I try to make the assignment a one-page kind of assignment.
Interviewer: Now that we've looked at briefly what you do before they come into the class, how have you taken advantage of that in the class setting? Again, I know that may be in a variety of ways, but in a generic way, what are you doing in the live class that's different that you couldn't have done 5 or 10 years ago or whenever pre-flipping occurred for Greg?
Greg: I understand that question because I get asked that a lot by students and other faculty. When you flip a class, you're just doubling the work, and you're making me work pre-class and in-class. There's a lot of truth to that inquiry. I think it's a responsibility, I take seriously that what happens in the classroom needs to be a real focus on the application of the new knowledge and sustained practice because that's what makes their knowledge usable is that they apply the knowledge, and I situate that into a context because that complex domain of situating-- Context for us is everything.
You make different decisions based on different contexts. I think about it a lot, that what I do in the class needs to be very learner-centered, lots of applications, for example, a lot of faculty use case studies. If they're well-designed and they're aligned with the outcomes you want and not just busywork, I break the students into collaborative communities. I let them pick two other people to work with, groups of three or four, again, remember I have 50 in the classroom. They break into these little collaborative communities. They work together on a timeframe and then we debrief each other, and I pick their names out of a hat.
They get practice talking. We do case studies. Because I've bought back some time, that I don't need to cover the grounding principles and theories, let's say, on heart failure, they've done that pre-class. I can begin where they've left off. I can do a simulation in the classroom sometimes with mannequins, sometimes with role-play. I can use the live interaction to help them discover what they do and they don't know. I always say to myself, "Am I just adding on more or am I truly-- Have I designed this to pick up to left off?" It only takes them about three weeks or so to figure out they really do need to do the pre-class work.
Interviewer: I can believe that about the students, but for you, or as an instructor, any instructor, that's a great guiding question, in terms of a gut check of whether they're developing their flipped class in a way that makes sense. Is it really making the class better or is it doubling up work?
Greg: Yes, it shouldn't be more. It should be different. It's kind of a little mantra, I've been doing this now for about two years and it works. It works because I ask myself that question every time. Don't add more just because you have more time, I have to do this differently, not more, but the students tell me that they don't use the word cognitive overload, but from their feedback and course evals, they tell me that it's more understandable and they know what to do with their new knowledge.
That was a hallelujah moment for me because it's not about just memorizing for the exam only, the activities we do in the classroom, help them get in touch with what they do and don't know. Sometimes they'll ask questions in a way that just stops me. Like, "Oh, well, I've never been asked the question in quite that way before. Let me think about that," it gives me the opportunity to do a lot of think-aloud protocol. If I were in a clinical and this situation came up, here's what I'd be thinking about. I involve them in that process. Very interactional.
I ask myself every week when I'm preparing the class, "Am I being professor-centric or student-centric?" That guides me on the activities, and then I try to reduce whatever I had planned by 30%.
Interviewer: It also sounds like a great guideline. You're reminding me of something in all of this. I think I noticed this, especially the first or second time that I flipped, was the kinds of questions students would ask and the quality of questions students were asked. All of a sudden, I could tell where at a much higher and much deeper and much more provocative-- They're a much greater percentage of more I couldn't just, "Oh, here's the response," I had to think it through too. That was really enjoyable that I was having these richer questions from students. It seems like that was your experience too, or am I hearing you wrong?
Greg: You are hearing me correct. I've had the same experience. I'm glad you used the word enjoyable. My experience, how the courses changed over the last two years, and I'm continuing to refine it, is I enjoy the course even more, because of what you just touched on there that the students overall are better prepared. They do ask more high-level questions. I have my prompts and my plans to get them all involved. I draw their names, as I mentioned before from a hat. I tell them right up front the semester, "We're going to be doing a lot of talking out loud to each other, a lot of mental processing because that's one of your professional skills to learn to speak in front of people."
One of the things I learned that was helpful to make the connection between pre-class and in-class is, I always begin with what kind of foggy facts do you have? What questions came up for you? Anything at all related to the content, the process, or your role? We always start with a little debriefing. It's very interesting what questions come up. Sometimes the questions are beyond the scope of what we're here to do this semester. It helps me get even more artful with, "How do you take on a question and not have a derail what you had planned timewise, but still respond to the students in an appropriate way?"
Many times, again, one of the benefits from buying back some freedom of time and content is we can stop the action, get on our electronic devices and find the answer together, which I feel I'm contributing to them learning how to learn. Again, in my field, it's not static knowledge. Of course, it's not static knowledge in anyone's field, but it can be very overwhelming. We always start with a debriefing. That seems to address whatever uncertainty the students had because when they do the pre-class, they're either doing it in groups, which is okay. They have to generate their own deliverable, but they can certainly work in groups.
Some prefer to work solitarily and if they do that, they come in the class and they have this need to say, "I have this unfinished business from the pre-class," so I found if you don't start that way, it gets frustrating for them.
Interviewer: That makes sense. That's great. If you can remember, I know it wasn't that long ago, but sometimes memories vanish. What was your personal experience like the first time that you flipped? Was there a third or halfway through the course you kind of went, "Oh, my God, did I make a huge mistake?" Can you guide me through what that first experience was like? Because when anybody is going to try something new, it can be attractive if it seems the right thing, but it can also be a lot of scary especially with a big investment of time, which flipping initially looks like a big investment of time. Can you tell me a little bit about your experience, whether you had any doubts as you started the process or not, and just what happened?
Greg: I think the most challenging aspect is giving up control of what's going on in that 3 hours and 40 minutes. I can manage it, but it's not the same level of control as it is when you're more professor-centric about it, more teacher-centric. I can cover a whole lot of ground very efficiently and effectively, I think, in 3 hours and 40 minutes. In other words, I can get to the finish line. Every faculty has this challenge of- "Am I going to get through the content? What's going to be leftover that I now have to take part of the next class?"
That is always a concern, "Are the students going to experience and gain the knowledge that they need to gain this session before we move on?" That's always on my mind. So I have to have now plan A, plan B and plan C. I've worked out some strategies.
Interviewer: You have to have those plans because it's more unpredictable how time will get used in the light of-
Greg: Exactly, and that's unsettling to a faculty who's at the top of their game. They're very experienced in both teaching and their content area. You want to go with the story because the students are interested, but in the back of your mind, you're going, "Oh, now I wonder if we're going to be able to have time to get to that and such," that's where flipping can actually address that concern and challenge of covering the content because it forces you to think of the entire semester. You got to begin with the end in mind and start, "Okay, where's the finish line? How am I going to package this up?"
That's the metaphor that works best for me is I'm a producer now. I'm not the talent. I'm the producer. I got to think, "How can I package this so that the students get where they need to go knowing that there'll be a little difference among students?" Of course, variation, but by thinking ahead this way, what's realistic, what is better suited for the pre-class that they don't need me for? Because I've designed the learning package.
As I said earlier, most of the time, it's things like narrated PowerPoints, it's pieces of videotape, with some scaffolding around it and some seek-and-find kind of exercises, "I need you to identify the four top priorities when you're managing a patient with heart failure," so, at the conclusion of the pre-class, that's what I'm going to have you bring in as a scored assignment, that sort of thing. Thinking ahead like that, about how you're going to package it and being a producer rather than the talent, shifts your mind. It's a whole new paradigm. It actually helps me feel that I have been effective, because they do get the knowledge they need, but the process is really different.
Through some design features, you can package essential content on maybe some PowerPoint slides that are at the end of your presentation. If you don't get to them, I design them to be self-explanatory. That's one little out technique that I use. I know I have maybe 10 slides at the end that are important but don't necessarily require a lot of interaction. I restage even how I present the order of presentation during that session.
There's no doubt about it, though, that it's a little intimidating because it's so different from the way a lot of us have approached imparting this knowledge. If that's not a good match with your personality, then sometimes it's retraining for yourself as well, but I'll tell you that at the end when you look back, if you've packaged it correctly, and I've had some hits and some misses, and I constantly refine it mostly, by the way, I'll share with you scaling down. It's hard when you're an expert in your field to really tease out what's the critical must-know knowledge from the nice-to-know because everyone likes to tell and to hear stories. That's how I deal with that challenge. If anyone's feeling a challenge or intimidated about, "I don't think I want to flip this," we all have that experience. Talking with some folks who found some strategies to make flipping work to address things when the students say, "You're making us work double," or, "I thought we were paying you to teach, how come I'm teaching myself?" To think ahead and have your responses, prepared ahead of time on how you're going to respond to it. Always require deliverable, and although this is principle 101 probably, get some formative feedback from the students.
I have found that I need to provide them an opportunity about every three weeks to give me formative feedback. "How's this process working for you? What do you wish we were doing in class that we're not? What are some things that we're doing in class that you think could be done either before or after?" Then acting on at least some of their input. It brings them to the point they're going, "Okay, I guess he knows more than I do, and even though this isn't my preferred way of learning, I'm going to go with it."
Interviewer: When you do this every three weeks or more or less every three weeks, how much time is it taking? Are you doing it in the class? Are you doing it online? How much of your time is it taking?
Greg: It's like a 5 to 10-minute thing. I usually do it as part of the brief, the beginning brief at the beginning of the class. Again, we have 3 hours and 40 minutes, I take about 5 to 10 minutes to seek their questions, and then by the nature of their questions, sometimes it gives me a nice segue into, "It sounds like a lot of you are really unclear about managing chest drainage. It makes me think that the preclass learning didn't hit the sweet spot. Tell me more about what you wished you had known before we start." Those kinds of exploratory questions and they feel that I'm listening because I am and then I try to act on that in some way. I make modifications based on what they say. It doesn't have to take a long time, but it has to be deliberate.
Interviewer: Yes. It would sound like, usually when we make changes is when it's obvious that something's gone wrong, but it sounds like what you've done is you're much more proactive in terms of getting some feedback or exploring their experience when it may not have necessarily been the case that things went terribly wrong, but you're getting their voice and you're wanting to improve things.
Greg: Yes. It's that continuous quality improvement concept there--
Interviewer: It's quality improvements instead of desperation.
Greg: Exactly, and it's not the quality assurance after the fact thing. It's the formative thing. I've been teaching this course for a long time, and I teach pre-licensure students.
My comments are really coming from the context of undergraduates and in our school, the average age, by the time they get to me is like 21, 22. We certainly do have a lot of diversity, but I would say 80% of the students are in their early 20s. That balance between structure, when to back off from structure, that's the context for a lot of my approach.
I use a lot of scaffolding until the steepness of the learning curve smooths out a little bit and the command of knowledge catches up. That sweet spot is usually around week seven or eight in this course with this population. That's a big insight I got is my techniques of flipping and more in general of instruction are within the context of these pre-licensure fairly young learners who are facing a licensing exam. There's certain ground we got to cover. That is how I used flipping as a means to an end, and why I think it's particularly well-suited to this course that I teach.
Interviewer: Great. Well, I wanted to ask you a slightly different question too to fill this out. Another hesitancy that comes up for some faculty is, they don't think of themselves as being very technology-oriented to some level. How would you describe your background with technology and how challenging it was from a technological perspective to create your out-class flipped experiences?
Greg: Good question. I had the advantage of being an early adopter with technology. Very visually oriented, using dual coding and some of these principles that I learned about that are particularly well suited to this discipline. I did a lot of my learning about editing videos, using Camtasia, narrating PowerPoints, labeling graphics, and cleaning them up. I did a lot of that work up front. For me, the transition was pretty easy. My population, again, being in their early 20s, there are times when I have a tech question that I simply consult the students, and somebody in that group always knows the answer.
Interviewer: Fantastic.
Greg: What I hear implicit in that question is using technology in a meaningful way, not just because you can be, because it serves the purpose. I post streaming videos to deal with the bandwidth issue using Ensemble, which is a fabulous streaming server that we have here at the university that the folks in CIT can create an account free and teach you how to use it. There's definitely a learning curve for using some of the technology that enables you to package things, but we have a lot of rich resources here at our university to teach you how to use that.
The technology does not need to be really advanced. If you honor trying to keep these old theory bursts at about no more than 20 minutes, they get the immediacy through the voice, and most of the time I'm not on camera, I'm narrating it, but the key is to stop, have a pause point, and the streaming media, the reason I brought that up is that it lets the student be in control. The students love the fact that for the entire semester, they can go back and rewatch, relisten to anything they want. They can stop videos-
Interviewer: They can pause, you go get a snack.
Greg: They can pause, and when they've had enough, unlike in the classroom, when they've had enough, they can simply pause. I would say that the technology that'll help you flip a class, you don't have to have a degree in technology. There are resources and those were the experience right here on campus. It's one step at a time. My experience is that my course does get more sophisticated in terms of how I use the technology as time has gone on, but I wouldn't wait to not start flipping. The way I began is out of 14 weeks of instruction, which two or three weeks were the most dense, the most complicated, that's where I started because I had less flexibility in those weeks that were a challenge even for me with my experiences. How am I going to get them to the finish line on these weeks? That's where I started.
Interviewer: You started small.
Greg: I did.
Interviewer: You didn't do everything at once.
Greg: No, I did not flip the entire course. I started with three weeks out of the 14 that were the most complex, the most challenging for myself and students and that's where I started by repackaging it and made it more doable. Then when I found out the students were better prepared for class, I could do that idea of application of new knowledge and then give them an opportunity to practice applying the knowledge and they liked it better, I liked it better. We all felt the in-class time together was more enjoyable, and they told me this on the course evals.
Interviewer: Just fantastic.
Greg: It works.
Interviewer: This is a course-- How often do you teach it?
Greg: It's taught once a semester. I teach two sections of it, I'm the only instructor who teaches this course.
Interviewer: Does this mean you're teaching it four times a year?
Greg: I teach it in the fall and in the spring, which is when the course is scheduled.
Interviewer: Both times, it's one section?
Greg: There are two sections. Our dean lets us split it up. We have a cohort of a hundred students. We break it up into two sections with 50 in each section. I teach two sections of the course.
Interviewer: I think I may be asking this wrong. You have a hundred in the fall and a hundred in the spring.
Greg: Correct.
Interviewer: Four sections total?
Greg: Correct.
Interviewer: One of the benefits there is that you can really focus your attention on that class rather than teaching four or five different preps.
Greg: I hear what you're saying. Yes. My workload is this class.
Interviewer: There's a number of people who are in the same or similar position as you, and there's people who are in fairly different situations. I don't think it really changes your story very much, but my guess is since you were teaching that one content, it allowed you to speed up from two or three weeks to 14 in a shorter amount of time in terms of academic semesters, kind of improving things, and somebody who's- it's one out of three different courses they're teaching every year, might have to take longer to layer up.
Greg: You're referring to the developmental process-
Interviewer: Exactly. 
Greg: -of converting. Very astute of you to point that out. That is absolutely true. The other caveat I would offer is if I were teaching one section of this course, and then I were teaching a seminar course, or a different type of course, I would make different decisions.
Interviewer: Sure.
Greg: I would use aspects of the flipping design. If I were teaching upper-division seminar course, I doubt if I would flip every single week. Again, it's all driven by your learning outcomes. For me, it's knowledge outcomes, but it's also process outcomes, and it's also role outcomes. That's why it was a good match for me, but if I were teaching two other courses, then yes, I would pick one course, that I thought the flipping design would meet my educational outcomes.
As enjoyable as it is, once you get in the modality of this and you let go of some of the control and realize, "Okay, I'm just going to manage the in-class, pre-class, and after class, but I really can't control it anyway." Once you let go a little bit, then you can grow into it, but you're absolutely right. The strongest recommendation is "Grow into it". Pick the class sessions that are most challenging for you and students, start there, and then make purposeful decisions as you go.
For my course, the entire course is flipped because it's well suited. If I were teaching a leadership course or seminar course, I would pick out those weeks where the principles and concepts were complicated, challenging, and then I would use the in-class time to apply those, whereas other content, it might be, "I'd like you to read this article, and we're going to talk about this when we come to class."
Interviewer: Sure.
Greg: I don't really need to orchestrate the pre-class part, as significantly. Does that respond to- [crosstalk]
Interviewer: No, this is fantastic. Absolutely. Well, thank you so much for all of this. I'm asking the best questions I know how, but there's always stuff that I could be missing in the process. I'm wondering, from your perspective, if there are any key issues, confusions, misunderstandings, et cetera, about flipping that you think would be important to convey to other faculty that we haven't touched upon.
Greg: That would be to make your process transparent.
Interviewer: What does that mean in this context?
Greg: With flipping to explain to the students why you've designed the course as you have, to explain and embed the design in your course syllabus, or your course materials, in other words, call it out. This is pre-class learning. This is about you focusing on prerequisite knowledge before you come into the class. In-class is about engagement and interaction. I'm going to be using classroom assessment techniques. We're going to be doing activities that are going to help you know and me if you're getting it or not. Then the after-class is about reinforcing transfer and enriching your knowledge. I make that explicit, very transparent the first week of class as well as in the materials. So embed it in the design of your syllabus. Call it out. This is pre-class, here's our focus.
That's a big, preemptive approach so that students understand, "He has a reason for how he's defined the course." I think it just obviates some of that initial resistance, and I still invite students to give me feedback, but I think they understand that this course may be done a little differently than other courses, but here's why. I've had really good experience when I share why, either in response to a question, but my piece of advice would be to do that proactively. Tell them why you've designed it this way, what the outcomes you're looking for, and how they're going to be able to have input.
Interviewer: That's a great idea. I would imagine it's especially true now because flipping is a relatively rare phenomenon for students who have experienced before, but even in 10 years, when more of the students have been through a flipped class of some sort before they come to you, what you're talking about is still going to be important because it gets at not the mechanics of what you're doing, it gets a little bit, but you're really making clear is I'm not just doing stuff to do stuff, there's a reason behind it. Whether you're flipping or not, why am I doing things the way I am.
Greg: You really want to maintain all the good principles of instructional design. If there's anything about flipping that conflicts with that, well, then don't do it. Maintain your instructional design. The bottom line is that flipping does play into what students enjoy and that they want to control things and manage their learning. With the generation that makes up my population of learners, that's a natural fit for them. This is how they receive interact and digest information is this whole multimedia, and again, I don't have to be an expert in multimedia, I can specify the outcome and let them manage the process. "Okay, I need to see some visual manifestation that you understand this principle." I have them do peer teaching during the in-class sessions.
I give them a scaffold up front, but I let them go with and I say, "Your mission is to impart in a meaningful way this information, and you're going to manage these seven minutes of our class time." I think the flipping thing does let them be more in charge. They can do the pre-class at 2 AM on a Saturday morning if they want, and they do. That transparency, and explain your methods and educationally why you're doing it, what the meaning is, and the potential benefit for them. Then they'll at least hang with you and try it out.
Interviewer: That's all you need, that first two to four weeks.
Greg: Exactly.
Interviewer: Any other things?
Greg: I think that I would just remind all of us is that you don't have to reinvent the wheel. There definitely are people on campus, certainly at the Center for Teaching Excellence, but there's a fabulous model by Jackie Gerstein that was out on the web. She calls it a full picture model of flipping the class. It stimulated ideas that I hadn't thought about before about what kind of learning modalities might be appropriate for pre-class versus after-class.
There's a lot of information out there in the domain of flipping class. It's pretty rich right now, and I would strongly suggest if you're just getting started to peruse that a bit, and that can really get you started reproducing, if you will, for your context. Maybe as I suggested, only two or three weeks out of the entire semester.
Interviewer: Greg, thank you so much. I appreciate how generous you've been with your time. Your experiences with flipping and how you approach it, it's going to be really useful for faculty in terms of making informed decisions about whether to flip or not and then, if they do, how to strategically change their own classes. Thank you very much.
Greg: You're welcome.
[00:38:08] [END OF AUDIO]


File name: Greg DeBourgh on Flipped Classrooms.mp3
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