Development of an elearning module on headache for mastery learning and the flipped classroom


  1. Paul D. Larsen


4AA eLearning courses


University of Nebraska College of Medicine - United States of America


According to the WHO Global Burden of Disease 2012, tension and migraine headache are 2nd and 3rd on the list of most common worldwide diseases. In spite of the burden of headache, medical students have limited time to gain mastery of the basic concepts of headache pathophysiology in order to apply those concepts for patient care. An elearning module was developed aimed at mastery learning and to be used in conjunction with a flipped classroom focused on headache.

Summary of Results

Module used in 2nd year medical school Neurology course.

Students were instructed to view the module prior to a lecture on Headache. Classroom time was designed for application and building upon the concepts learned using videotaped patient cases and interactive discussion of the cases and patient management.

Students asked to evaluate the use of the module.   59/125 students completed the evaluation which consisted of 5 questions using a 0-4 Likert scale and a comments and suggestion section. Student comments were analyzed for common themes.  




Summary of student comments

They felt like it could be used as a model for developing elearning modules for other flipped classrooms.

The brevity, animation and mastery quizzes were recurrent positive themes.

Suggestions for improvement included more user navigation control, feedback on quiz questions and improve the ease of finding concepts for review.

Summary of Work

The design of the module was based on the following:

Brief- 15 minutes long

Focus- Principal concepts

Engaging- Animation to illustrate concepts


Organization- Sequencing of concepts to enhance memory and retention

Testing- Quiz after each section which the student must achieve 100% in order to advance to the next section. Test questions designed to assess comprehension and competency of key concepts and to reinforce those concepts to aid retention.




Principal concepts can be taught through a brief focused and engaging elearning format.

Emodules with mastery testing allows the student to repeat the learning experience until they have mastered the content.

Student perception of this type of learning activity is overall positive.

Having the students come to the classroom with mastery of important basic concepts sets the stage for knowledge application through interactive case presentations and activities designed for participation.  

Take-home Messages

Elearning modules designed for mastery and the flipped classroom enhance student learning. The module can be viewed at


Mastery learning- all learners are required to demonstrate mastery of all the required knowledge or skills without limiting learning time.

Flipped classroom- students are expected to master basic concepts prior to coming to the classroom and then they are to come prepared to use those concepts in an interactive learning session.

Summary of Results
Summary of Work

The module was developed using FLASH animation and the agile process.

The target learners for the module are second year medical students in the Neurology core but this module can be used as a free standing tutorial by learners at any level of training or practice.

There are 10 concept sections and 3 quizzes throughout the module. Sequential progression is the intended use mode but there is a menu bar that allows the learner to select and review any section.


Each quiz contains 6-8 multiple choice questions with immediate scoring.

Technical features of the module include the options for part and full screen viewing, close caption and a pause and start button. The module is designed to be an open access internet site.


The module is designed for individual learning but sections of the module can also be used in the classroom to focus on important concepts and demonstrate anatomical pathways and the pathophysiology of migraine.

Take-home Messages
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