Abstract
Objective Effective flipped classroom (FC) education fosters learner engagement, promoting
higher-level cognitive skills. FC learning in graduate medical education (GME) has
increased, but few educators have significant experience with FC facilitation. There
are 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.
Study Design We conducted a mixed-methods, cross-sectional study of faculty educators who participated
in a randomized controlled trial (RCT) using FC for physiology education in neonatal–perinatal
medicine. Educators completed a 25-question survey about effective strategies for
FC facilitation. A subset of educators participated in interviews to share their FC
facilitation experiences and strategies to maximize learner engagement. Quantitative
survey data were analyzed with descriptive statistics. Qualitative survey and interview
data were coded and analyzed inductively to identify themes.
Results Seventy-five educators completed the survey (75/136, 55% response rate), and 11 participated
in semistructured interviews. While educators facilitated a median of two FC sessions
(interquartile range: 1, 5) during the RCT, 43 (57%) had not received prior training
in FC facilitation. Qualitative data analyses generated five themes that aligned with
quantitative survey results: (1) educator preferences, (2) unique FC facilitation
skills, (3) learning environment optimization, (4) subject matter expertise, and (5)
learner behavior management. Sixty-two educators (83%) felt they were well prepared
to lead FC sessions. Thirty-six educators (48%) reported that unprepared learners
disrupt the learning environment, and the provision of clear expectations and adequate
time to prepare for FCs improves learner preparation. Strategies to facilitate effective
FC sessions included creating a safe learning environment and engaging learners in
critical thinking.
Conclusion Educators highlighted faculty development needs, strategies, and actions to promote
effective FC facilitation. Further exploration through learner interviews will provide
additional evidence for the development of best practices and resources for FC facilitation.
Key Points
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Educators prefer the FC educational modality over traditional didactic lectures.
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Prior experiences in simulation debriefing provide foundational skills for new FC
facilitators.
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Setting learner expectations and ensuring safe space in the classroom encourage learner
engagement.
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Educator and learner preparation for FC is essential to optimize the learning experience.
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Unique approaches in facilitation are required to support all types of learners.
Keywords
neonatal–perinatal medicine - fellowship - educator - flipped classroom - facilitator
