Promoting Student Success in the Flipped Online Classroom: Learning and Accountability Through Homework Strategies

As online and hybrid classes have become increasingly more prevalent in higher education, the flipped classroom structure has emerged as a viable, evidence-based, option for healthcare programs. In a flipped classroom, students view pre-recorded video lectures and complete reading assignments before class, and synchronous class time can then be used for active learning activities. Class sessions offer opportunities for group work, review of complex content, and access to instructor assistance with assignments. To effectively implement a flipped classroom approach, students must prepare prior to class time. One method for encouraging student accountability is to assign preparatory homework. This experimental study compared two types of accountability homework on measures of achievement, satisfaction, ease of use, and perceived learning from two types of assignments: concept maps or question-and-answer homework. Study participants included 46 first year occupational therapy students attending an online foundational occupational therapy course. Treatment included weekly completion of either a concept map or a set of three question-and-answer homework assignments over a period of three weeks. Findings suggested that accountability homework assignments of either type were helpful in promoting achievement. Results further revealed that satisfaction and perceived learning were greater in the concept map group as compared to the question-and-answer group. It is recommended that occupational therapy and other allied health instructors use accountability homework to reinforce student learning in the flipped classroom. The use of concept map assignments in particular has the potential to improve schema acquisition, critical thinking, and deep learning, which in turn can support educational success

Clinical and genetic characteristics of late-onset Huntington's disease

Background: The frequency of late-onset Huntington's disease (>59 years) is assumed to be low and the clinical course milder. However, previous literature on late-onset disease is scarce and inconclusive. Objective: Our aim is to study clinical characteristics of late-onset compared to common-onset HD patients in a large cohort of HD patients from the Registry database. Methods: Participants with late- and common-onset (30–50 years)were compared for first clinical symptoms, disease progression, CAG repeat size and family history. Participants with a missing CAG repeat size, a repeat size of ≤35 or a UHDRS motor score of ≤5 were excluded. Results: Of 6007 eligible participants, 687 had late-onset (11.4%) and 3216 (53.5%) common-onset HD. Late-onset (n = 577) had significantly more gait and balance problems as first symptom compared to common-onset (n = 2408) (P <.001). Overall motor and cognitive performance (P <.001) were worse, however only disease motor progression was slower (coefficient, −0.58; SE 0.16; P <.001) compared to the common-onset group. Repeat size was significantly lower in the late-onset (n = 40.8; SD 1.6) compared to common-onset (n = 44.4; SD 2.8) (P <.001). Fewer late-onset patients (n = 451) had a positive family history compared to common-onset (n = 2940) (P <.001). Conclusions: Late-onset patients present more frequently with gait and balance problems as first symptom, and disease progression is not milder compared to common-onset HD patients apart from motor progression. The family history is likely to be negative, which might make diagnosing HD more difficult in this population. However, the balance and gait problems might be helpful in diagnosing HD in elderly patients