A “Resident-as-Teacher” Curriculum Using a Flipped Classroom Approach: Can a Model Designed for Efficiency Also Be Effective?

Chokshi, Binny; Schumacher, Heidi; Reese, Kristen L.; Bhansali, Priti; Kern, Jeremy R.; Simmens, Samuel J.; Blatt, Benjamin; Greenberg, Larrie

doi:10.1097/acm.0000000000001534

Cited by 31 publications

(37 citation statements)

References 8 publications

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“…1 There is evidence to support the use of the flipped classroom in other settings, including graduate school and health professions education. [2][3][4][5] To date, there is a paucity of data in GME literature showing its effectiveness, [6][7][8][9] as most GME studies report only learner satisfaction. [10][11][12] To our knowledge, no published studies have attempted to enhance teaching on core subspecialty internal medicine (IM) rotations using a flipped classroom.…”

Section: Introductionmentioning

confidence: 99%

Effects of a Flipped Classroom Curriculum on Inpatient Cardiology Resident Education

Allenbaugh

Spagnoletti

Berlacher

2019

Journal of Graduate Medical Education

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Background The flipped classroom is designed to reinvigorate education and utilizes ''at-home'' time to learn concepts and ''inclass'' time for clinical application. While some studies have shown positive effects of the flipped classroom in undergraduate medical education, there is a paucity of data on its use in graduate medical education.Objective We hypothesized that a flipped classroom curriculum of Medical Knowledge Self-Assessment Program (MKSAP) content with group case discussions could improve resident knowledge and preparedness in cardiology.Methods Ninety-eight internal medicine residents who rotated on the inpatient cardiology service from March to October 2017 were quasi-randomized into control and intervention groups, with the intervention group assigned MKSAP readings and cases to review on their own, accompanied by weekly case discussion. Pre-post surveys evaluated for change in knowledge and preparedness, quantity of teaching received, and use of MKSAP.Results A total of 93 of 98 residents (95%) participated in the curriculum. There were 37 of 51 residents (73%) in the control group and 37 of 47 residents (79%) in the intervention group who responded to pre-post assessments. In paired analysis, knowledge score did not improve significantly between the groups, nor did self-reported preparedness, number of teaching sessions per week, or reported MKSAP use. However, all participants had positive perceptions of the curriculum, and the majority felt it should be continued.Conclusions This flipped classroom curriculum did not affect knowledge, preparedness, or number of teaching sessions for internal medicine residents on a cardiology rotation when compared to usual teaching, although residents experiencing the new model expressed high satisfaction.

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Section: Introductionmentioning

confidence: 99%

Effects of a Flipped Classroom Curriculum on Inpatient Cardiology Resident Education

Allenbaugh

Spagnoletti

Berlacher

2019

Journal of Graduate Medical Education

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“…Across all studies, approximately 985 learners were involved with a flipped classroom intervention. Thirteen medical specialties were represented, including anesthesiology, 46,49,50,57 emergency medicine, 8,38,44,52,58 internal medicine, 39 internal medicine-pediatrics, 43 neurology, 47 neurological surgery, 41 obstetrics and gynecology, 55,56 pathology, 42 pediatrics, 40,43,51 psychiatry, 45 radiology, 53 thoracic surgery, 48 and surgical intensive care. 54 All study designs were quantitative; however, a few gathered feedback through open-ended survey items.…”

Section: Education Contentmentioning

confidence: 99%

Flipping the Classroom in Graduate Medical Education: A Systematic Review

King

Gottlieb

Mitzman

et al. 2019

Journal of Graduate Medical Education

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Background Flipped classroom (FC) instruction has become increasingly common in graduate medical education (GME).Objective The purpose of this study was to profile the use of FC in the GME setting and assess the current status of research quality. MethodsWe conducted a systematic literature search of major health and social science databases from July 2017 to July 2018. Articles were screened to ensure they described use of the FC method in an Accreditation Council for Graduate Medical Education-accredited residency program and included research outcomes. Resulting articles were analyzed, described, and evaluated for research quality using the Kirkpatrick framework and the Medical Education Research Study Quality Instrument (MERSQI).Results Twenty-two articles were identified, all of which were recently published. Five were only indirectly related to FC methods. Most studies reported Kirkpatrick-level outcomes. Studies involving resident learner opinions were generally positive. Pre-posttest studies resulted in large positive improvements in knowledge or skills attainment. Control group study results ranged from large positive (1.56) to negative effects (-0.51). Average MERSQI scores of 12.1 (range, 8.5-15.5) were comparable to GME research norms.Conclusions Varying methods for implementing and studying the FC in GME has led to variable results. While residents expressed a positive attitude toward FC learning, shortcomings were reported. Approximately half of the studies comparing the flipped to the traditional classroom reported better achievement under the FC design. As indicated by the MERSQI score, studies captured by this review, on average, were as rigorous as typical research on residency education.

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“…In one example, after recognizing the deficit abroad, emergency medicine residents in Iran completed an 8-hour RAT workshop and resident attitudes towards their teaching ability was significantly improved (Nejad, 2017). In addition, Children's National Health System developed an intensive one-day RAT curriculum which included four 1-hour workshops focusing on adult learning principles using a flipped classroom approach (Chokshi, 2017). Their results showed statistically significant improvements in three core skills: giving feedback, orienting a learner, and teaching a skill.…”

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confidence: 99%

See one, do one...teach one? Learning to be doctors, teachers, or both?

Habermehl¹,

Habermehl²,

Kim³

2018

MedEdPublish

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Most residents have a desire to teach, but no unified curriculum exists to help residents be the best teachers they can be. Further investigation reveals this to be a global problem and a pedagogic curriculum should be a well-defined expectation. While there are multiple requirements during residency, a well-implemented Resident-As-Teachers (RAT) curriculum should be incorporated into every program.Keywords: Resident; Teacher; Pedagogy; Education. Perspective"Excuse me, doctor, I need you to speak to the patient's parents in room 500 and explain how to use a spacer and albuterol," the nurse states as she comes into the workroom. Immediately, the intern looks at me and asks, "How do I order this blood test, and can you help me with a venipuncture?" As I gather the supplies to obtain blood, the attending reminds me about my lecture on the basic management of anaphylaxis to the 3 rd year medical students at the end of the week. It is the first day of my final year of residency, and I can't believe that these teaching expectations have all accumulated within 10 minutes of each other.The Latin root of doctor, docere, means "to teach" and one of the core reasons that residents pursue a career in medicine is to educate others. It is known that effective patient education can improve healthcare outcomes, and we as residents are at the forefront of this endeavor. Residents spend up to one quarter of their time teaching during residency and report that they enjoy it, consider it important, and believe that it improves clinical knowledge (Busari, 2002). Clearly, the role of the resident educator is extremely important but often underrecognized.We must understand complex disease processes, teach it to junior peers, and educate patients who often do not have a medical background. The most apparent barrier is finding time to teach amidst substantial clinical responsibilities. A second barrier is educating others when we are still learning the intricacies of the disease processes that we are meant to be teaching. However, most significant is that residents are generally expected to become teachers with no Some have recognized that there is a need to train residents in pedagogy before expecting them to educate effectively. A literature review from 2004 found the need for improved supervision and curriculum in pedagogy specific to residents (Busari, Scherpbier, 2004). However, effective action to incorporate this specific curriculum during medical training remains a rarity. 87% of pediatric residency program directors in the United States reported having a resident-as-teachers (RAT) curriculum, but only 17% considered the program to be very or extremely effective (Fromme, 2011). In family medicine, one study concluded that 85% of residencies offered a RAT program in 2014, though effectiveness was not measured (Al Achkar, 2017). Clearly, attempts have been made to implement RAT curriculums, at least in some residencies, but as a profession, we should consider making serious improvements.This issue not only affects residen...

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A “Resident-as-Teacher” Curriculum Using a Flipped Classroom Approach: Can a Model Designed for Efficiency Also Be Effective?

Cited by 31 publications

References 8 publications

Effects of a Flipped Classroom Curriculum on Inpatient Cardiology Resident Education

Effects of a Flipped Classroom Curriculum on Inpatient Cardiology Resident Education

Flipping the Classroom in Graduate Medical Education: A Systematic Review

See one, do one...teach one? Learning to be doctors, teachers, or both?

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