PC3110: Educator Best Practices for Flipped Classroom Facilitation in Graduate Medical Education

Background: Effective flipped classroom (FC) education fosters learner engagement, promoting high-level cognitive skills. The use of FC learning in graduate medical education (GME) has increased recently, but many educators have limited-to-no experience with FC facilitation. There are currently no evidence-based practices to support professional development of FC facilitation skills in GME. The objective of this study is to identify best practices for effective FC facilitation in GME.

Methods: Neonatology faculty educators who recently participated in a national randomized controlled trial using FC for neonatal fellowship education were recruited to participate via email. Study participants were asked to complete an anonymous 20-question survey via REDCap about effective strategies for FC facilitation, using Likert scale ratings, multiple-choice options, and free-text responses. In addition, 13 educators participated in a phone interview to elicit strategies for effective FC facilitation. Survey responses were reported as percentages. Free-text survey responses and interviews were coded and analyzed for themes using principles of grounded theory. Interviews were conducted until thematic saturation was obtained.

Results: Of the 75/136 educators who responded to the survey, 68% lead at least 3 fellow educational sessions per year, but 89% had little or no experience with facilitating FCs prior to participating in the national RCT. In addition, 57% reported no prior training in FC facilitation, though 55% completed some training to facilitate debriefings, practice-based learning sessions or other non-lecture educational modalities. During interviews, educators expressed that facilitating FC sessions is a unique skill that would be enhanced by additional training and in-class experiences. Faculty development educators participated in included the training webinar provided by the RCT; self-directed methods, including literature review or tutorial videos; co-facilitation with experienced facilitators as role models; and experience with debriefing in simulation or delivery room resuscitation. Just over half (51%) experienced unprepared learners in their FC sessions and felt that these unprepared learners disrupted the learning environment. In the survey, educators suggested improving learner preparation by sending reminders, providing adequate time to complete pre-classwork, and reviewing professionalism expectations for preparation; these themes were also noted and expanded upon in the interviews (Table 1). Survey respondents noted strategies to facilitate effective FC sessions, including the creation of a nonthreatening learning environment; encouragement of critical thinking, engagement and participation by all learners; and topic expertise by the facilitator. The same themes were found in the interviews (Table 2).

Conclusion: Educators highlight strategies and actions to promote effective FC facilitation. Further exploration through learner interviews will provide additional information towards the development of best practices and evaluation tools for FC facilitation.