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Christopher Schaberg’s recent piece, “HyFlex Is Not the Future of Learning,” is getting shared across the higher ed interwebs. Schaberg, a professor of English at Loyola University New Orleans, memorably calls HyFlex the “black mirror” of higher ed.

In a response piece called “How Not to Write About HyFlex or Online Learning,” Bryan Alexander takes Schaberg to task for failing to engage the literature on this subject, for generalizing across higher ed from a single example and for conflating HyFlex with online learning.

In our book The Low-Density University: 15 Scenarios for Higher Education, Eddie Maloney and I cover HyFlex as one of the potential strategies (scenario No. 13) for universities to ensure resiliency during the pandemic, giving consideration to the many challenges involved in this approach.

With all this talk about HyFlex, I was interested to hear from a colleague about an example where HyFlex actually worked well. That example came from my backyard, and it occurred during the January 2022 residential component of Dartmouth’s master of health care delivery science (MHCDS) program. To learn more about this particular example of HyFlex, I reached out to my longtime friend and colleague Katy Milligan, MHCDS’s founding program director. Katy graciously agreed to answer my questions about her program’s positive HyFlex experience.

Q: Can you tell us about the MHCDS program, its structure and its students—and why it was necessary for your team to adopt a HyFlex model during the January 2022 residential session?

A: MHCDS is a 12-month, hybrid degree program for midcareer health-care leaders, jointly offered by the faculties of the Geisel School of Medicine and the Tuck School of Business at Dartmouth. Our students are clinician leaders and executives from hospitals and health systems, private practices, safety-net institutions, health insurance, state and national government, and the U.S. military. They are highly committed to the education we offer as a way to transform health-care delivery for the better within their home organizations.

Because our students have demanding jobs and important personal commitments, they need predictability and flexibility in their educational requirements and a high service level from faculty and staff. In addition, because they are already so accomplished, students have a great deal to learn from each other, as well as from faculty. The MHCDS program is designed with these student qualities in mind. The academic calendar includes three short residential periods of five to eight days each with the explicit goal of building trust and creating a sense of community. The rest of the education is delivered online, with courses built on a standard weekly structure of classes and assignments. The program is cohort-based, with lots of small group work.

During the first year of COVID, our residential sessions had to move online. We produced two “unresidentials” that were scaled back in total contact hours, but nonetheless created a lot of Zoom fatigue. In August of 2021, after vaccinations but before Delta or Omicron, we had a cautious but relatively normal on-campus residential. With the unresidentials, our students expressed great regret and a sense of loss. They missed the social interaction, the informal water-cooler type extension of classroom conversations and the sense of support they got from each other. When we were able to bring the students back to campus last August, they expressed a mix of trepidation, relief and even joy. We have heard a lot in the last couple of years about the mental health needs of undergraduates who crave social interaction; this was also true of our midcareer graduate students in their 40s and 50s. It was a source of solace for them to be together.

In January 2022, then, it was clear that we needed to support those students who could travel to campus. However, with Omicron surging nationally and regionally, we also needed to support those who could not. In the end, about 25 percent of the student were remote, for a variety of reasons: childcare (schools and day cares closed unpredictably), demands of work (between workforce shortages and COVID “my hospital is in a state of chaos”), travel (flights canceled due to COVID-related staffing issues), and personal or family illness. In addition, three MHCDS faculty members who do not live locally opted to teach remotely rather than travel to campus.

Q: Describe the people and technology resources that your team was able to utilize to simultaneously teach in-person and remote students. What was the learning experience like for the students in both the physical and virtual classroom, and what was the teaching experience like for the professors?

A: Residential periods for MHCDS are intended to build trust and cultivate community. Academically, some classes are introductory sessions for upcoming online courses and some are part of residential-only courses. For instance, the Operations course, which takes place primarily online, had an introductory class during the January 2022 residential; the Strategy course had nine of its 18 total classes. All in all, the residential involved 55 classes with 19 different professors over eight days.

We were fortunate to be able to use classrooms at the Tuck School of Business that have been upgraded during the pandemic with HyFlex learning in mind. Most importantly from my point of view, the audio capabilities of the classrooms were terrific. Without additional microphones, words spoken at a normal volume in the classroom (even with mandatory masking) were crystal clear to those on Zoom, and vice versa.

Remote students’ video images were projected for the in-person class members on one screen and the professor’s slides on the other; the same was true for confidence monitors, so that the faculty, too, could see both. For remote students, we always had a camera on the instructor, and some of the larger classrooms had automated camera systems capable of showing both the instructor and students speaking in the classroom. Remote students raised their hands to speak. Remote students could also chat with each other, and staff monitored the chat in case troubleshooting was necessary, but the chat was not projected in the classroom.

Importantly, for each class, the faculty had two staff partners: one to run the technology and the other to assist with teaching needs (e.g., handouts, note taking) and monitor the Zoom room. This level of staffing was an extraordinary luxury, enabled on all sides by the recognition that the situation offered a unique opportunity to implement best practices for HyFlex and to learn from the experience.

The learning experience was seamless for residential students, and they were deeply grateful that we made the effort to have them on campus rather than moving the entire residential online as we had the year before. In our postresidential evaluation, one student wrote:

“I think, in retrospect, the Summer 2021 and Winter 2021 residentials should not have moved to full remote, and going forward, the option should be HyFlex until we reach the endemic phase. I got so much fulfillment from the in-person residentials; I feel like the full-remote residentials deprived us of an experience that many of the students had enrolled in this specific program for.”

Remote students were tired because of time-zone issues (some were on the West Coast) and general Zoom fatigue but participated actively in class throughout and also expressed gratitude that we made such efforts to include them. Comments from remote students included:

“Thank you for ensuring those of us attending virtually had everything we needed prior to and during residential. I enjoyed the courses, breakout sessions, and guest speakers.”

“Great job offering a virtual experience that was fairly immersive.”

Teaching was most successful for the faculty members who gave some thought to the HyFlex mode ahead of time and actively engaged with the staff who are experts in HyFlex learning. Many professors used breakout rooms for in-class small-group discussion, and some used polls to generate a variety of opinions and spur discussion. For everyone involved, the level of staff and technology resources—as well as everyone’s increasing comfort with teaching and learning remotely—made it a very smooth experience.

Q: The classroom, technology and people resources that the MHCDS program was able to access for this example of HyFlex instruction seem to be extremely robust. How would you respond to readers who might be thinking that these sorts of resources are too expensive for the vast majority of all schools to even consider deploying to support HyFlex instruction? Are there less resource-intensive alternatives, or do you think that this level of instructional investment is nonnegotiable for successful HyFlex instruction?

A: The investment in staff and technology resources certainly made the January 2022 experience an excellent one. We were also producing HyFlex education for a limited period of time and for only two classes of students at once, both of which allowed us to go all out and really focus on quality.

If I think of doing HyFlex instruction at scale—across a whole school for entire semesters at a time—I think there might be a middle ground. Do you need more staff and technology resources than you would if you were teaching exclusively online or exclusively in residence? Yes. But do you need the level of resources that we had for our recent experience? Probably not.

Having attended HyFlex classes (ours and others) both in person and online, I believe the investment in technology is nonnegotiable. Certainly, the Tuck School has found it invaluable as they have operated in HyFlex mode throughout the pandemic. In particular, it has been my experience that without good audio, classroom learning grinds to a halt. Workarounds like passing a mike or repeating comments and questions add enough of a barrier that they seem unsustainable over more than a class or two. (The HyFlex mode can also give schools additional flexibility to accommodate students with hearing impairment using remote resources.) The good news is that technology becomes less expensive over time, so outfitting classrooms should be less of a financial burden in the future.

With regard to staff, I think it would be possible over time to develop systems that would allow HyFlex instruction with fewer staff than we used. With simplified processes, user-friendly technology interfaces and good help staff on call, professors could learn to start up and use a HyFlex classroom in the same way that many of us over the last few years have become adept at starting up and using a Zoom room. Then the same number of staff could support more HyFlex instruction, or staff could take on the more forward-looking work of helping faculty plan for excellent HyFlex learning experiences.

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