Randomized Controlled Study of a Remote Flipped Classroom Neuro-otology Curriculum

Abstract

ContextMedical Education can be delivered in the traditional classroom or via novel technology including an online classroom.ObjectiveTo test the hypothesis that learning in an online classroom would result in similar outcomes as learning in the traditional classroom when using a flipped classroom pedagogy.DesignRandomized controlled trial. A total of 274 subjects enrolled in a Neuro-otology training program for non-Neuro-otologists of 25 h held over a 3-day period. Subjects were randomized into a “control” group attending a traditional classroom and a “trial” group of equal numbers participating in an online synchronous Internet streaming classroom using the Adobe Connect e-learning platform.InterventionsSubjects were randomized into a “control” group attending a traditional classroom and a “treatment” group of equal numbers participating in an online synchronous Internet streaming classroom.Main outcome measuresPre- and post-multiple choice examinations of VOR, Movement, Head Turns, Head Tremor, Neurodegeneration, Inferior Olivary Complex, Collateral Projections, Eye Movement Training, Visual Saccades, Head Saccades, Visual Impairment, Walking Speed, Neuroprotection, Autophagy, Hyperkinetic Movement, Eye and Head Stability, Oscilllatory Head Movements, Gaze Stability, Leaky Neural Integrator, Cervical Dystonia, INC and Head Tilts, Visual Pursuits, Optokinetic Stimulation, and Vestibular Rehabilitation.MethodsAll candidates took a pretest examination of the subject material. The 2–9 h and 1–8 h sessions over three consecutive days were given live in the classroom and synchronously in the online classroom using the Adobe Connect e-learning platform. Subjects randomized to the online classroom attended the lectures in a location of their choice and viewed the sessions live on the Internet. A posttest examination was given to all candidates after completion of the course. Two sample unpaired t tests with equal variances were calculated for all pretests and posttests for all groups including gender differences.ResultsAll 274 subjects demonstrated statistically significant learning by comparison of their pre- and posttest scores. There were no statistically significant differences in the test scores between the two groups of 137 subjects each (0.8%, 95% CI 85.45917–86.67952; P = 0.9195). A total of 101 males in the traditional classroom arm had statistically significant lower scores than 72 females (0.8%, 95% CI 84.65716–86.53096; P = 0.0377) but not in the online arm (0.8%, 95% CI 85.46172–87.23135; P = 0.2176) with a moderate effect size (Cohen’s d = −0.407).ConclusionThe use of a synchronous online classroom in neuro-otology clinical training has demonstrated similar outcomes to the traditional classroom. The online classroom is a low cost and effective complement to medical specialty training in Neuro-Otology. The significant difference in outcomes between males and females who attended the traditional classroom suggests that women may do better than males in this learning environment, although the effect size is...

Flipped classroom improves the results in Pathophysiology learning: results of a non-randomized controlled study

“…The results contrast with other authors' findings (15), who found a more evident improvement in female students. On the other hand, Carrick et al (14) found that women scored higher than men in a traditional classroom environment, but the differences disappeared in the online classroom. Differences between genders have also been found with the use of other teaching methods, like the writing of multiple-choice questions by the students (16).…”

“…The FC method of teaching increases active learning (1) and stimulate students to deep understanding (2). Despite all these results, other authors have not found such positive effect on learning (12)(13)(14) and a recent meta-analysis in Pharmacy education concluded that flipped classroom is associated with minimal gains in student knowledge compared to lecture (4). This may be due to different methods of flipped teaching used by different authors.…”

Strategic Considerations for Applying the Flipped Classroom to Neurology Education

“…Only one study has, to date, flipped the whole curriculum for non–neuro‐otologists enrolled in a neuro‐otology training program over a 3‐day course; however, this again emphasizes that flipped classrooms may provide a tool best suited to subspecialty modules rather than whole curricula. No statistically significant difference in the pre‐ to post‐test score gains was noted between the flipped classroom model and traditional classroom teaching . However, this design was not entirely comparable to a standard flipped classroom model, as the follow‐up exercises could be attended virtually.…”

“…No statistically significant difference in the pre-to post-test score gains was noted between the flipped classroom model and traditional classroom teaching. 32 However, this design was not entirely comparable to a standard flipped classroom model, as the follow-up exercises could be attended virtually. Nonetheless, learners reported enjoying the preparatory material, the improvements in the quality of the discussions, the ease of access to the material from any location, and the standardization of examinations.…”

“…Nonetheless, learners reported enjoying the preparatory material, the improvements in the quality of the discussions, the ease of access to the material from any location, and the standardization of examinations. 32 To capture the evolving scenario of flipped classroom in US neurology education, we have surveyed the A. B. Baker Section on Neurological Education of the AAN.…”