Flipping, Engaging, and Teaming, Oh My! Lessons Learned from a Large Scale Curriculum Reform at a US Medical School

This paper describes the development and implementation of the "Next Generation" Cells to Society Pre-Clerkship Curriculum at the University of Virginia School of Medicine through the lens of Design-Based Implementation Research. Since the launch of this curriculum reform in 2008, more than 100 members of the faculty and staff have collaborated to design and deliver novel instructional activities for first and second year medical students. To date, five iterative processes of analysis, development, evaluation, and revision have been completed with large classes of medical students, with each class enrolling over 150 students. The 18-month Pre-Clerkship curriculum is supported by newly created system and technological infrastructure, and is continuously evaluated to assess the impact on students' learning. Lessons learned from each iteration inform revisions to curricular practices and infrastructure for subsequent iterations of the curriculum. As implementation of this innovative curriculum has progressed over several years, emergent issues have also stimulated medical education research projects that explore the implementation of Flipped Classroom Model and Team-Based Learning. In summary, the curriculum reform described in this paper provides valuable lessons for educators interested in implementing large-scale curricular innovations.