Medical Education Clinical Trial
Official title:
Comparison of a "Flipped" Classroom Methodology to Traditional Instructional Techniques for Neonatal-perinatal Medicine Fellows: A National Prospective Study
This is an educational research study to compare knowledge retention of neonatal-perinatal medicine (NPM) fellowship trainees instructed on a subsection of the American Board of Pediatrics (ABP) NPM Content Outline using traditional didactic lectures (control group) versus a flipped classroom methodology (intervention group). The primary objectives are to assess whether the flipped classroom provides equivalent or superior outcomes for knowledge acquisition and retention compared to traditional lecture-based formats, based upon baseline and serial knowledge assessments (after the educational session, and at 3- and 6- month intervals). The secondary outcomes are learner and educator preference.
Sixty-three ACGME-accredited NPM fellowship training programs in the United States have
enrolled to participate in this study. Programs have been randomized to teach a subsection of
neonatal physiology using the traditional didactic approach or using the "flipped" classroom
methodology.
The ACGME requires that NPM fellowship programs provide formal instruction to teach trainees
about key concepts in the care of neonates and infants, and most programs have traditionally
utilized didactic presentations to relay this information. These sessions are typically
instructor-centered, with little requirement for involvement or engagement on the part of the
learner, and are not felt to optimize long-term knowledge acquisition and retention. A newer
educational model, the "flipped" classroom, increases the opportunities for learner
engagement and requires investment and preparation. Using this educational structure, fellows
receive learning materials that need to be reviewed prior to the in-person educational
session. The participants will then spend the in-person session actively engaged in applying
the knowledge to answer questions, participate in discussions, and solve problems. Adult
learning theory supports this active involvement as a way to increase learner engagement,
improve recognition of meaning of the material, and improve knowledge acquisition and
long-term retention.
Fellowship Program Directors involved in the Organization of Neonatal Training Program
Directors (ONTPD) have been contacted about the opportunity to participate in this
prospective multi-center study. After enrollment, program directors will complete a brief
survey of their program's baseline educational methods and demographics. Fellows will be
contacted directly by local site PIs for individual consent to data collection. Fellows will
be asked to provide demographic information, assessment of learning style/ practices, time
devoted to educational pursuits, and perceptions of current physiology education. The fellows
will be asked to complete 4 knowledge assessments (baseline, at the end of the educational
block, 3 months, 6 months) in REDCap over the course of 6 months. All data will be
de-identified, and individual and programmatic data will be anonymous. The assigned ABP
content will be taught within the same 3-month period any time between September 2018 and
March 2019 via the assigned method (traditional didactic or flipped classroom). All
educational materials will be provided to both arms of the study. Learning objectives will be
based on the ABP NPM Content Outline and materials with be authored by experts in neonatal
physiology. Materials will undergo rigorous peer-review by an editorial board.
Traditional/control fellows will be instructed using the provided educational materials in an
instructor-led didactic slide presentation. Intervention group fellows will be required to
view the same educational materials in online videos prior to their assigned classroom
session. During the "flipped" classroom session, the fellows will work through a series of
questions based on the assigned educational materials with a local facilitator using a
facilitation guide who has been trained in flipped classroom facilitation. This facilitator
guide will present discussion points based upon the pre-learning materials and requires
learners to apply acquired knowledge. The facilitator guides are also peer-reviewed for
content and quality.
In the present study, only the ABP Content Objectives for NPM on gastroenterology and
bilirubin will be included. Educational materials will be reviewed and revised by a 4-member
editorial board to ensure accuracy, completeness, and quality. For online viewing, these
materials are uploaded on MedEdOnTheGo.com, an online learning management platform. Fellows
will be provided with additional reading materials, such as seminal articles or textbook
chapters, that will allow them to develop a deep understanding of the topic.
Fellows will be surveyed regarding their learning experiences at 3 different time points;
before the educational intervention begins, at the completion of the educational
intervention, and 3 months after completion of the intervention. Fellows will complete
anonymous surveys in REDCap regarding their learning experiences, class preparation, the
quality of teaching, perceived effectiveness of teaching efforts, and preferences for
learning. Fellows will also participate in short 15-item multiple choice quizzes to measure
knowledge retention. There will be 4 quizzes in total; prior to the intervention (baseline),
at the completion of the intervention, 3 months post, and 6 months post-intervention. These
quizzes will be proctored and closed book. Fellows in either randomization arm will answer
the same questions. The quiz questions will cover the specific content addressed in the
educational sessions, be created by the study team, and piloted by attending neonatologists
for clarity, accuracy, and relevance.
Data will be tabulated on baseline information for both program level and fellow level with
testing to determine if pre-intervention testing data is different between groups
(equivalence variance 2-tailed T-tests for continuous data and likert scores, and chi square
for categorical data). Knowledge retention curves will be developed by performing T-tests of
mean scores for each time point. Post-education surveys for program directors and fellows
will be evaluated to assess effect of interventions using equal variance 2-tailed T-tests for
continuous data and likert scores.
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