P0740 - Impact of Standardized Instructional Method on Learner Perceptions, Preferences, and Classroom Experience in a National GME Curriculum

Background:
Active, learner-centric educational methods in graduate medical education are infrequently used despite evidence suggesting they are more effective for adult learners. The Organization of Neonatal-Perinatal Medicine (NPM) Training Program Directors developed a National Neonatology Curriculum to teach neonatal physiology incorporating andragogic principles. Using American Board of Pediatrics content specifications, NPM faculty developed peer-reviewed online videos and discussion guides for flipped classroom (FC) sessions.


Objective:
To determine NPM fellow (learner) preferences for FC vs. TD modalities in a large, randomized controlled trial. We hypothesized that fellows would prefer FC compared to TD.


Methods:
NPM fellowships were prospectively cluster randomized to FC or TD education for gastroenterology/bilirubin physiology. Slide-based materials with identical visual content were presented as a series of 8 pre-class videos followed by educator-facilitated discussions (FC) or 8 lectures by local educators (TD). Learners were surveyed regarding their attitudes and preferences for educational methodologies and materials before, 1 week, and 3 months after the curriculum. Data were analyzed using the chi-squared or Fisher exact test.


Results:
Learners (n=457) from 63 NPM fellowships were enrolled. Baseline characteristics, year of fellowship, and time spent preparing for educational sessions were similar between FC and TD learners. After participating in their respective curriculum, all learners indicated an increased preference for group discussions with faculty facilitation (FC) over TD lectures as an educational modality (p=0.001, Figure 1). The preference for FC was significantly associated with differences between FC and TD learners regarding: learners’ impressions of quantity and quality of group discussion, learner-educator interaction, quality of teaching/facilitation, complexity of discussion, and ability to ask questions during group sessions.

FC participants reported higher scores for visual effectiveness (p<0.0001) and relevance (p<0.01) compared to TD. Educators who taught FC were perceived to have better subject matter knowledge (p<0.01) and higher quality teaching (p<0.01) compared to TD. Participants reported greater effectiveness of identical educational materials when presented via FC compared to TD (p<0.01). At 3 months’ post-intervention, differences in preferred modality persisted, with the largest difference in participants randomized to TD favoring independent study over classroom sessions.


Conclusion:
NPM learners reported an increased preference for FC as an educational modality. Factors that increased learner-educator engagement during in-class discussions were more prominent during FC vs. TD, supporting the development and use of a FC curriculum that incorporates adult learning principles in fellowship training. Higher quality teaching was reported in FCs, suggesting that the FC may benefit not only learners but educators looking to improve teaching quality. The addition of active group discussion, the hallmark of FCs, likely improves learner experience.