Teaching In A Flipped Classroom Within An Established Medical And Graduate Curriculum: Evaluation Of Modalities

The Special Master's Program at Georgetown University Medical Center (GUMC SMP) is a one year MS in which students take medical and graduate courses to prepare for medical school, taught mainly through lecture with some small group sessions. We have reported on technological enhancements to our teaching (rich lecture capture (LC), audience response technology, interactive white board, and rich LMS course sites that include practice quizzes, short videos, learning exercises with feedback), and the rapid spread of these innovations within Georgetown. In August 2015, we opened a new branch of the SMP, delivering the same curriculum, but with an exclusively flipped classroom model. Students at the Georgetown Downtown (GTDT) SMP study LCs and other materials on their own, and on-site instructors provide flipped sessions to reinforce the material. In 2015, we reported that GTDT students were performing (often significantly) higher than GUMC SMP counterparts in all courses. Notably, incoming grades and standardized test scores were equivalent for two groups; students select which SMP section they wish to attend (GTDT enrollment is limited to 26). For the current, second cohort of GTDT, we expanded and regularized the types of flipped sessions and we have analyzed student perceptions regarding whether specific types of sessions enhance their learning, as well as whether they enjoyed participating in the various sessions: 1) clinical cases with discussion, 2) multiple choice questions and discussion, 3) student presentations and discussion, 4) team-based games and activities. 25 of 26 students in the GTDT SMP responded to the survey, which employed a Likert-type scale of 1 to 5 (strongly agree, somewhat agree, neutral, somewhat disagree, strongly disagree) to statements regarding learning enhancement and enjoyment. All four types of sessions were strongly rated in both areas. Team-based games and activities received the highest ratings for enhancing learning (average score 1.7; 80% responding strongly or somewhat agree); the other three modalities were similarly well regarded, with Likert scores of approximately 1.8. In terms of student enjoyment, team-based games and activities scored highest (1.6; 82% responding strongly or somewhat agree) and presentations and discussion scored lowest but were still well-received (2.0; 60% somewhat or strongly agree). Additional questions revealed that students generally agreed that the number of hours of flipped session per hour of self-directed study was appropriate (roughly 1: 2), and that they felt they had an equal or better opportunity to reach their potential in terms of learning and grades relative to the GUMC SMP students in the traditional program (76% strongly and somewhat agree, 20% neutral). Importantly, these results suggest that in the flipped-learning environment of the GTDT SMP, students appreciate the diversity of teaching paradigms and feel that the mix of modalities contributes to their learning of the difficult curriculum and enjoyment of time spent in class. These findings will be used to inform further innovations as we move forward with the GTDT SMP.