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 , .0001). This effect was sustained several months later (70% versus 62%, P ¼ .0007). Participants were equally satisfied with the flipped classroom and standard classroom. Conclusions A flipped classroom showed greater effectiveness in knowledge gain compared with a standard approach in an ambulatory residency environment.

Perspectives: The Flipped Classroom in Graduate Medical Education

“…The metric often evaluated for improved knowledge and performance is immediate posttest scores. Residents in emergency medicine (13) and internal medicine (14) had improved immediate posttest scores with the FC approach. Though promising, the next question posed by educators was whether these effects were sustained.…”

“…Though promising, the next question posed by educators was whether these effects were sustained. Studies involving residents in internal medicine (14) and anesthesiology (15) demonstrated that improved knowledge acquisition was sustained after several months. Furthermore, one study demonstrated that application of the FC approach to an anatomy course resulted in higher performance both in anatomy and in a subsequent kinesiology course, demonstrating long-term retention and transfer of critical thinking skills to subsequent courses.…”

Value, Strengths, and Challenges of e-Learning Modules Paired with the Flipped Classroom for Graduate Medical Education: A Survey from the National Neonatology Curriculum

“…The use of the FC in GME is relatively new, but existing studies suggest potential benefits in learner satisfaction, increased engagement, and improved knowledge acquisition with FC teaching methods when compared with traditional didactic education. [7][8][9] Neonatal-perinatal medicine (NPM) fellowship programs have traditionally employed didactic educational sessions to teach physiology. A traditional pedagogical model that promotes knowledge acquisition through passive, teacher-centered learning such as slide presentations, is generally used.…”

Coronavirus Disease 2019 Knowledge Acquisition and Retention: a Flipped Classroom Based on Micro-learning Combined with Case-based Learning in Interns

“…Findings from a meta-analysis including six studies with only one prospective randomized study [11], suggest that ipped classroom may be associated with minimal gains in student knowledge compared to lecture [12]. There are several practical problems associated with ipped classroom, particularly prominent of which is more faculty time, faculty development, or resources to ensure to be effectively delivered [13,14,15]. We nished the video recording in the lecture preparation stage, and according to the knowledge units decomposed into micro-lesson videos.…”