Synergism of team-based learning and flipped classroom for comprehending posterior palatal seal

Abstract

Posterior palatal seal (PPS) is an area located posteriorly in the maxillary edentulous jaw that plays an important role in the retention of maxillary complete denture. Accurate visualization, demarcation and recording of PPS require pronunciation of specific sounds by patients and are quite challenging for dental students as it lies on soft tissue and varies from patient to patient. Errors in recording PPS abate denture retention, affecting the overall outcome of the prosthesis and negatively impacting student's and patient's confidence. The classical approach in teaching PPS in dental education encompasses didactic lectures and skill teaching through demonstration on real patients. Didactic lectures often lead to passive learning, limited interaction and difficulty in applying theoretical knowledge clinically, while clinical demonstrations restrict student participation and hands-on practice. Both methods may not address individual learning needs or provide sufficient personalized instruction and immediate feedback. Therefore, we felt a need to address this problem through an active learning approach and decided to synergize team-based learning (TBL) with student-led flipped classroom, aiming to make learning a student-driven process. These methods will provide an opportunity to apply conceptual knowledge, foster peer learning and facilitate development of communication, interpersonal and collaboration skills.

TBL along with flipped classroom was undertaken for undergraduate dental students (n = 10). Two teams comprising of five students each were formed for TBL through random assignment, based on the guidelines of Michaelson and Richards 2005.¹ Preparatory materials comprising of scholarly articles, PowerPoint presentation and a video demonstrating the marking of PPS were uploaded for individual pre-class preparation, 1 week prior to the in-class activity. The resources covered the anatomy, function and clinical importance of PPS. Individual Readiness Assurance Test (IRAT) that comprised of 10 MCQs was administered just before the start of the in-class activity. Conventionally in TBL, IRAT is followed by Team Readiness Assurance Test (TRAT) but to facilitate skill learning, clinical demonstration on marking of PPS was given by a faculty to the students as in-class activity. Subsequently, as a part of the clinical problem-solving activity, one student from each team was selected to mark the PPS area on a patient. While the student marked the area, other members of the team offered assistance and made a video recording. The same procedure was repeated by the second team. The video recordings were later projected on screen for group discussion and peer assessment. The faculty provided clarifications during the discussion. Lastly, IRAT was re-administered as TRAT followed by immediate feedback from the faculty.

Student-led flipped classroom worked as a useful tool for teaching PPS. Students might use the theoretical understanding practically by being able to find and delineate PPS in patients. Through active learning, TBL fostered critical thinking and collaborative learning among the chosen group of students. The synergistic usage of flipped classroom with TBL leads to active student participation, increased collaboration skills and deeper learning, eventually producing a more dynamic and productive learning experience. This strategy encouraged student buy-in, but there is a need to further study its advantages and problems via its administration on numerous batches of students.

Abhishek Kumar Gupta: Conceptualization; validation; writing—original draft; project administration; resources; methodology. Bhawana Tiwari: Conceptualization; visualization; project administration; resources. Komal Maheshwari: Conceptualization; methodology; project administration; resources; data curation. Sakshi Verma: Project administration; data curation; resources; methodology.