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A "Resident-as-Teacher" Curriculum Using a Flipped Classroom Approach: Can a Model Designed for Efficiency Also Be
Binny D Chokshi1, Heidi K Schumacher, Kristen Reese
1B.D. Chokshi is assistant professor, George Washington School of Medicine and Health Sciences, Department of Pediatrics, Children's National Health System, Washington, DC. H.K. Schumacher is clinical associate, Goldberg Center for Community Pediatric Health, Children's National Health System, Washington, DC. K. Reese is clinical associate, Children's Pediatricians and Associates, Children's National Health System, Washington, DC. P. Bhansali is associate professor of pediatrics, George Washington University School of Medicine and Health Sciences, Department of Pediatrics, Children's National Health System, Washington, DC. J.R. Kern is assistant professor of pediatrics, George Washington School of Medicine and Health Sciences, Department of Pediatrics, Children's National Health System, Washington, DC. S.J. Simmens is research professor, Department of Epidemiology and Biostatistics, Milken Institute of Public Health, George Washington University, Washington, DC. B. Blatt is professor, Department of Medicine, and medical director, Clinical Learning and Simulation Skills Center, George Washington University School of Medicine and Health Sciences, Washington, DC. L.W. Greenberg is clinical professor, Department of Pediatrics, and senior consultant, Office of Faculty Affairs, George Washington University School of Medicine and Health Sciences, Washington, DC.
Problem:
The Accreditation Council for Graduate Medical Education requires training that enhances resident teaching skills. Despite this requirement, many residency training programs struggle to implement effective resident-as-teacher (RAT) curricula, particularly within the context of the 80-hour resident workweek.
Approach:
In 2013, the authors developed and evaluated an intensive one-day RAT curriculum using a flipped classroom approach. Twenty-nine second-year residents participated in daylong RAT sessions. The curriculum included four 1-hour workshops focusing on adult learning principles, giving feedback, teaching a skill, and orienting a learner. Each workshop, preceded by independent reading, featured peer co-teaching, application, and feedback. The authors evaluated the curriculum using pre- and postworkshop objective structured teaching examinations (OSTEs) and attitudinal and self-efficacy teaching questionnaires.
Outcomes:
Residents demonstrated statistically significant improvements in performance between pre- and postworkshop OSTEs on each of three core skills: giving feedback (P = .005), orienting a learner (P < .001), and teaching a skill (P < .001). Residents expressed positive attitudes surrounding teaching on the retrospective pre-post attitudinal instrument (P < .001) and rated themselves as more effective teachers (P < .001) after the training.
Next Steps:
The authors have demonstrated that the flipped classroom approach is an efficient and effective method for training residents to improve teaching skills, especially in an era of work hour restrictions. They have committed to the continuation of this curriculum and are planning to include assessment of its long-term effects on resident behavior change and educational outcomes.
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