Implementing a Virtual Flipped Classroom in a Rheumatology Fellowship Program.

Wade, Stefanie D; Freed, Jason A; Kyttaris, Vasileios C; Saunders, Staci; Hausmann, Jonathan S

OBJECTIVE Active learning opportunities within graduate medical education may be underused. We aimed to assess whether active learning strategies increase after implementing a faculty development workshop and transitioning rheumatology fellowship didactics to a virtual flipped classroom. METHODS We measured baseline faculty use of active learning strategies during lectures within the Introductory Rheumatology Curriculum by calculating an "active learning score" from a cognitive learning theory assessment tool. We held a faculty development workshop demonstrating active teaching strategies and encouraged using a flipped classroom for fellowship didactics. Due to the COVID-19 pandemic, the strategies were discussed in a virtual classroom setting, where the intervention phase would occur. We compared active learning scores before and after the intervention for lectures within the Introductory Rheumatology Curriculum. The primary outcome was the change in active teaching scores pre- versus post-intervention. RESULTS Active learning scores increased in 14 out of the 16 lectures, with a mean score increase of 4.7 out of 24 points (95% CI 2.3-7.2). Paired T-test analyses comparing active learning scores pre-and post-intervention for each lecture confirmed that results were highly statistically significant (p < 0.001). Despite faculty hesitancy to teach within a virtual environment, faculty satisfaction remained high post-intervention. CONCLUSION A virtual flipped classroom increased the use of active learning strategies within the Introductory Rheumatology Curriculum. Faculty satisfaction remained high despite modest increases in time spent updating their presentations. Fellows and faculty reported a largely positive experience within the virtual classroom.