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

• Published in: Journal of graduate medical education 2019-02, Vol.11 (1), p.92-97
• Main Authors: Graham, Kelly L, Cohen, Amy, Reynolds, Eileen E, Huang, Grace C
• Format: Article
• Language: English
• Subjects: Adult; Brief Report; Education, Medical, Graduate - methods; Educational Measurement - methods; Female; Humans; Internal Medicine - education; Internship and Residency; Male; Problem-Based Learning - methods; Surveys and Questionnaires
• ISSN: 1949-8349; 1949-8357
• DOI: 10.4300/JGME-D-18-00536.1

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. We assessed the efficacy of the flipped classroom compared with standard approaches on knowledge acquisition and retention in residency education. 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. 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%,