The “Flipped Classroom” in Neurotology Resident Education: A Pilot Study

Objective The flipped classroom (FC) model blends online learning at home with more interactive in-class sessions that focus on case-based discussions. It has been proposed as a more efficient model for resident education. The purpose of this pilot study was to investigate the efficacy of a novel FC model at improving knowledge retention rates of otolaryngology residents undergoing a neurotology curriculum, as well as to assess the perceived advantages and disadvantages with the web-based FC by otolaryngology residents.

Study Design We performed a single-institution, randomized prospective trial of 12 otolaryngology residents using a counterbalanced alternating treatment design.

Methods Both FC and traditional content delivery modules were created on two topics: otosclerosis and facial nerve disorders. FC modules included watching web-based media prior to attending case-based discussions. Traditional modules included completing a reading assignment prior to attending a 30-minute PowerPoint lecture. Residents were randomized to the FC (intervention) or traditional (control) module for each topic. A 35-question multiple choice test was administered 2 weeks prior, immediately after, and 15 weeks after sessions. Mean test scores were compared between the groups. A 10-question Likert-scale survey was used to assess resident satisfaction.

Results Pretest scores were similar between intervention and control groups (69.9 vs. 67.0%, p = ns). For both groups, immediate test scores were significantly increased from baseline (88.5 and 86.7%, p < 0.01); however, 15-week scores did not differ from pretest scores (72.1 vs. 71.5%, p = ns). Scores were not significantly affected by intervention, level of training, or the modules experienced. Subgroup analysis showed similar knowledge retention between residents with high versus low pretest scores. Survey responses indicated that residents were more likely to complete preparation for FC modules. Residents felt the FC model provided more interaction with faculty and better prepared them for clinical work.

Conclusion Among otolaryngology residents, traditional and FC didactics lead to a significant increase in immediate knowledge comprehension. Knowledge retention rates, however, were minimal for both teaching styles at 15 weeks, with no difference between them. Residents were more likely to complete online learning tasks compared with reading book chapters for class preparation. Residents also preferred flipped learning, and felt it better prepared them for clinical work. Further studies are warranted to investigate the efficacy of the FC model in improving residents’ clinical performance.