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Flipped Classrooms in Graduate Medical Education: A National Survey of Residency Program Directors
Christopher M Wittich1, Anoop Agrawal, Amy T Wang
1C.M. Wittich is consultant, Division of General Internal Medicine, Mayo Clinic, and associate professor of medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota. A. Agrawal is attending physician, Department of Medicine and Department of Pediatrics, Baylor College of Medicine, and assistant professor, Baylor College of Medicine, Houston, Texas. A.T. Wang is attending physician, Department of Medicine, Harbor-University of California, Los Angeles, and assistant professor of medicine, David Geffen School of Medicine, University of California, Los Angeles, Torrance, California. A.J. Halvorsen is statistician, Division of General Internal Medicine, Mayo Clinic, and assistant professor of medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota. J.N. Mandrekar is consultant, Division of Biomedical Statistics and Informatics, Mayo Clinic, and professor of biostatistics and neurology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota. S. Chaudhry is vice president of academic affairs, Department of Medicine, Memorial Healthcare System, Fort Lauderdale, Florida. D.M. Dupras is consultant, Division of Primary Care Internal Medicine, Mayo Clinic, and associate professor of medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota. A.S. Oxentenko is consultant, Division of Gastroenterology and Hepatology, Mayo Clinic, and associate professor of medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota. T.J. Beckman is consultant, Division of General Internal Medicine, Mayo Clinic, and professor of medical education and medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
Purpose:
To begin to quantify and understand the use of the flipped classroom (FC)-a progressive, effective, curricular model-in internal medicine (IM) education in relation to residency program and program director (PD) characteristics.
Method:
The authors conducted a survey that included the Flipped Classroom Perception Instrument (FCPI) in 2015 regarding programs' use and PDs' perceptions of the FC model.
Results:
Among the 368 IM residency programs, PDs at 227 (61.7%) responded to the survey and 206 (56.0%) completed the FCPI. Regarding how often programs used the FC model, 34 of the 206 PDs (16.5%) reported "never"; 44 (21.4%) reported "very rarely"; another 44 (21.4%) reported "somewhat rarely"; 59 (28.6%) reported "sometimes"; 16 (7.8%) reported "somewhat often"; and 9 (4.4%) reported "very often." The mean FCPI score (standard deviation [SD]) for the in-class application factor (4.11 [0.68]) was higher (i.e., more favorable) than for the preclass activity factor (3.94 [0.65]) (P < .001). FC perceptions (mean [SD]) were higher among younger PDs (≤ 50 years, 4.12 [0.62]; > 50 years, 3.94 [0.61]; P = .04) and women compared with men (4.28 [0.56] vs. 3.91 [0.62]; P < .001). PDs with better perceptions of FCs had higher odds of using FCs (odds ratio, 4.768; P < .001).
Conclusions:
Most IM programs use the FC model at least to some extent, and PDs prefer the interactive in-class components over the independent preclass activities. PDs who are women and younger perceived the model more favorably.
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