Flipping the Classroom in Graduate Medical Education: A Systematic Review.

Area of Science:

• Medical Education Research
• Instructional Design
• Graduate Medical Education

Background:

• Flipped classroom (FC) instructional methods are increasingly adopted in graduate medical education (GME).
• Understanding the current landscape and research quality of FC in GME is crucial for effective implementation.

Purpose of the Study:

• To systematically profile the utilization of the flipped classroom (FC) model within graduate medical education (GME).
• To critically assess the quality of research evaluating FC methods in GME settings.

Main Methods:

• Conducted a systematic literature search (July 2017-July 2018) of health and social science databases.
• Screened articles for FC use in Accreditation Council for Graduate Medical Education-accredited residency programs with outcome data.
• Evaluated research quality using Kirkpatrick framework and Medical Education Research Study Quality Instrument (MERSQI).

Main Results:

• Identified 22 recent articles, with 5 indirectly related to FC.
• Most studies reported Kirkpatrick-level outcomes; resident opinions were generally positive.
• Pre-posttest designs showed large knowledge/skill gains; control group results varied significantly (effect sizes -0.51 to 1.56).
• Average MERSQI scores (12.1) were comparable to GME research standards.

Conclusions:

• Implementation and study variations in FC within GME yield inconsistent findings.
• Residents generally hold positive attitudes towards FC, despite reported challenges.
• Approximately 50% of comparative studies indicated superior resident achievement with FC compared to traditional methods.
• Research rigor, as measured by MERSQI, aligns with typical standards in residency education research.