Implementation of a flipped classroom approach to promote active learning in the third-year surgery clerkship

Background: Constructivist student-centered instructional models such as the flipped classroom (FC) have been shown to improve learning. Methods: A FC approach was implemented for the surgery clerkship. Data was collected in phase 1 to evaluate student learning and attitudes. Based on these results, questions for the phase 2 open-ended survey were developed to improve understanding of learner attitudes, and ascertain how well the FC aligns with constructivist principles. Results: There was no significant difference in shelf exam performance between the control and intervention groups. A majority of students agreed that they preferred the FC over lectures, and that their learning improved. Open-ended survey analysis demonstrated that the FC fostered self-directed, active learning, and that the in-class sessions facilitated application of concepts and deeper learning. Areas identified for improvement included better alignment with learning preferences through greater variety of pre-class learning options, improvement of podcast technical quality, and utilization of smaller in-class discussion groups. Conclusions: Students had a positive perception of the FC. The FC supports self-directed and more active and deeper in-class learning. (c) 2017 Elsevier Inc. All rights reserved.