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Modes of learning

Blended & flipped learning


The term ‘blended’ learning is used to describe the combination and alignment of traditional and e-learning practices (Joint Information Systems Committee, 2004). This approach has been adopted to utilise the benefits afforded by each practice. A study by Kiviniemi (2014) found that a blended approach significantly increased students’ performance on a health science course. Face-to-face time can be used more effectively and because digital resources can be made available for anytime anywhere access, learners are given more flexibility, which is particularly important when learners are balancing work and study commitments.


‘Flipped learning’ or the ‘flipped classroom’ is a blended learning approach whereby the traditional instructional approach is ‘flipped’ so that short video-lectures, narrated presentations or podcasts are viewed by the learner at home before the classroom-based activities. This means that the classroom element is repurposed into much more of a workshop style approach, focused around applying learning, questioning and clarifying concepts and engaging in interactive activities (Tucker 2012, p.82).


This approach needs as much preparation (if not more) than the traditional lecture but is particularly helpful for complex concepts. Learners are able to learn at their own pace, rerun lectures, skip over sections they know and read around the topic in their own time. The online resources are also available afterwards for revision and consolidation. This overcomes some of the disadvantages of the traditional lecture in which learners have to take notes, gain understanding from handouts and pay attention throughout. Class time can be used more effectively to ensure learners have understood and mastered the topic. Lecturers’ classroom role changes to one of facilitator rather than didactic teacher. Rooms and equipment need to support the flipped approach and it involves a culture shift amongst the student and staff body.

Open Pedagogy


The term ‘open content’ was devised by David Wiley (Grossman, 1998) to define resources and artefacts that are openly licensed (e.g.  creative commons license: and freely available for use or modification depending on the license conditions. This can include photographs, images, videos and documentation. Since the emergence of Web 2.0 tools and user-generated content there has been an exponential growth in open content and open educational resources (OER).


In 2008, Siemens and Downes (University of Manitoba, Canada) delivered a course in Connectivism and Connected Knowledge. More than 2000 learners participated online, and 24 students attended the course in face-to-face sessions for academic credits (Mackness et al., 2010). Course materials were freely published and open platforms such as social networking sites were used to facilitate learning activities. Cormier (2008b) coined the phrase MOOC, to describe these Massive Open Online Courses. Since 2012 a number of MOOC platforms have been launched such as FutureLearn (, Coursera ( and edX ( A number of free online MOOCs are available throughout the year, lasting from 4–10 weeks, on a variety of subjects including health, medicine and education. MOOCs and other open content could be incorporated into learning activities, or promoted to learners to encourage them to develop or extend their learning beyond the formal curriculum.


A list of open educational resource repositories is provided in the references section.

Clinical Learning Environments


Many clinical teachers are busy delivering healthcare and may teach diverse groups of students and trainees. Applying good practice principles for student-centred learning into practice may be more difficult in clinical settings than in a university setting where teaching sessions for groups of learners are clearly timetabled. Here, e-learning might be helpful to ‘scaffold’ the learning through providing a common set of learning materials, links to library resources or by enabling group discussion or collaboration to occur without the need for teacher and learners to be in the same room, or even working at the same time. One advantage of e-learning is that learners and teachers can work independently and communicate asynchronously (not in real time) through discussion boards or email. Teachers and/or learners may communicate in real time (from their own homes or other workplaces) through chat rooms, instant messaging or Skype. Such ‘classrooms without walls’ can provide useful learning spaces for trainees and students who might find it difficult to meet in real time. Some challenges and barriers need to be addressed in clinical settings, such as lack of internet access or system firewalls, in order to access some of these systems and tools.


The Higher Education Academy report ‘Flexible pedagogies: employer engagement and work-based learning’ (Kettle, 2013) provides a comprehensive overview of how flexible pedagogies may be developed and promoted in the context of work-based learning.

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