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Effect of a Flipped Classroom on Knowledge Acquisition and Retention in an Internal Medicine Residency Program.

ABSTRACT: Background:The flipped classroom is a teaching approach with strong evidence for effectiveness in undergraduate medical education. Objective data for its implementation in graduate medical education are limited. Objective:We assessed the efficacy of the flipped classroom compared with standard approaches on knowledge acquisition and retention in residency education. Methods:During academic year 2016-2017, 63 medical interns in a large academic internal medical residency program on their ambulatory block were randomized to a flipped classroom or standard classroom during a 6-hour cardiovascular prevention curriculum. The primary outcome was performance on a 51-question knowledge test at preintervention, immediate postintervention, and 3- to 6-month postintervention (delayed postintervention). Secondary outcomes included satisfaction with the instructional method and preparation time for the flipped classroom versus standard approach. We also examined feasibility and barriers to the flipped classroom experience. Results:All 63 interns (100%) responded during the preintervention period, 59 of 63 (94%) responded during the postintervention period, and 36 of 63 (57%) responded during the delayed postintervention. The flipped classroom approach significantly improved knowledge acquisition immediately after the curriculum compared with the standard approach (knowledge test scores 77% versus 65%, P?

SUBMITTER: Graham KL

PROVIDER: S-EPMC6375314 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Effect of a Flipped Classroom on Knowledge Acquisition and Retention in an Internal Medicine Residency Program.

Graham Kelly L KL Cohen Amy A Reynolds Eileen E EE Huang Grace C GC

Journal of graduate medical education 20190201 1

<h4>Background</h4>The flipped classroom is a teaching approach with strong evidence for effectiveness in undergraduate medical education. Objective data for its implementation in graduate medical education are limited.<h4>Objective</h4>We assessed the efficacy of the flipped classroom compared with standard approaches on knowledge acquisition and retention in residency education.<h4>Methods</h4>During academic year 2016-2017, 63 medical interns in a large academic internal medical residency pro ...[more]

PMID: 30805104

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Project description:BackgroundPoor quality handoffs have been identified as a major patient safety issue. In residency programs, problematic handoffs may be an unintended consequence of duty-hour restrictions, and key data are frequently omitted from written handoffs because of the lack of standardization of content.ObjectiveDetermine whether an intervention that facilitates face-to-face communication supported by an electronic template improves the quality and safety of handoffs.DesignBefore-after trial.ParticipantsThirty-nine interns providing nighttime coverage over 132 intern shifts, representing ?9,200 handoffs.InterventionsTwo interventions were implemented serially-an alteration of the shift model to facilitate face-to-face verbal communication between the primary and nighttime covering physicians and an electronic template for the day-to-night handoff.MeasurementsOverall satisfaction and handoff quality were measured using a survey tool administered at the end of each intern shift. Written handoff quality, specifically the documentation of key components, was also assessed before and after the template intervention by study investigators. Interns used the survey tool to report patient safety events related to poor quality handoffs, which were validated by study investigators.ResultsIn adjusted analyses comparing intern cohorts with similar levels of training, overall satisfaction with the new handoff processes improved significantly (p?<?0.001) post intervention. Verbal handoff quality (4/10 measures) and written handoff quality (5/6 measures) also improved significantly. Study investigators also found significant improvement in documentation of key components in the written handoff. Interns reported significantly fewer reported data omissions (p?=?0.001) and a non-significant reduction in near misses (p?=?0.056), but no significant difference in adverse events (p?=?0.41) post intervention.ConclusionsRedesign of shift models common in residency programs to minimize the number of handoffs and facilitate face-to-face communication, along with implementation of electronic handoff templates, improves the quality of handoffs in a learning environment.

Project description:Background: Medical education is evolving to incorporate learner-centered strategies which encourage student engagement. Educators need to ensure that meaningful education occurs within limited interaction time between teachers and trainees. The Flipped Classroom (FC) model combines the use of both online and face-to-face interaction. Studies describing the process and resource utilization in anesthesia residency programs are limited. Methods: After Institutional Review Board (IRB) exemption, a qualitative study to assess the feasibility of introducing an FC model in the anesthesia residency didactic curriculum was conducted. The Post Graduate Year 2 (PGY2) anesthesia resident didactic sessions were modified to include one session a month using the FC format with the other three sessions presented using traditional PowerPoint lecture format at a tertiary academic medical center. Post-session surveys were administered to both learners and teachers. Survey data were analyzed using Qualtrics® software. Survey data included perceptions of both learners and teachers regarding quality of learning and engagement in the new format. Results: Nineteen residents and 10 faculty participated in 10 sessions over the span of 10 months. A total of 153 resident responses and 8 faculty responses were submitted voluntarily. In our study, a majority of residents indicated they preferred the FC format. They also indicated they enjoyed working in groups. All the participating faculty felt that student interaction and student learning were higher in these sessions. Conclusions: Residency programs need to adopt evidence-based solutions to problems arising in medical education. We present our experiences in finding a solution to make didactic sessions more engaging. Our initial assessment shows that it is feasible to introduce the FC model into an existing curriculum in an anesthesia residency program and both residents and faculty felt that the format enhanced learning and interaction in class.

Dataset Information

Effect of a Flipped Classroom on Knowledge Acquisition and Retention in an Internal Medicine Residency Program.

Publications

Effect of a Flipped Classroom on Knowledge Acquisition and Retention in an Internal Medicine Residency Program.

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