A flipped classroom in graduate medical education

The role of the flipped classroom model in graduate medical education (GME) is not yet defined. We set out to evaluate the feasibility, acceptability and outcomes of a flipped classroom instructional model in an internal medicine curriculum.

This pilot study was carried out in an academic medical centre in the USA with 43 second-year internal medicine postgraduate trainees. Trainees watched videos on the pharmacological treatment of type 2 diabetes outside of the classroom, followed by an in-class session in which they engaged in case-based discussions. The intervention was evaluated using surveys and a knowledge test before, immediately after and 6 months after the intervention.

The mean number of correct answers for a 10-question knowledge test was 5.25 before the intervention, 8.00 in the immediate post-intervention test, and 7.10 in the 6-month follow-up test (p < 0.001). Six months after the intervention, 57.1% of participants reported prescribing an antidiabetic medication discussed at the session. In a focus group, trainees reported their preference for interactive, case-based learning, concern about the time required for preparation and interest in incorporating real patient cases.

Trainees preferred the flipped classroom, which also resulted in increased knowledge and self-reported prescribing changes; however, the required preparatory time may limit its feasibility in GME.