"Flipping" the Introductory Clerkship in Radiology: Impact on Medical Student Performance and Perceptions

Rationale and Objectives: Among methods of "blended learning" (le, combining online modules with in-class instruction), the "flipped classroom" involves student preclass review of material while reserving class time for interactive knowledge application. We integrated blended learning methodology in a "flipped" introductory clerkship in radiology, and assessed the impact of this approach on the student educational experience (performance and perception). Materials and Methods: In preparation for the "flipped clerkship," radiology faculty and residents created e-learning modules that were uploaded to an open-source website. The clerkship's 101 rising third-year medical students were exposed to different teaching methods during the course, such as blended learning, traditional lecture learning, and independent learning. Students completed precourse and postcourse knowledge assessments and surveys. Results: Student knowledge improved overall as a result of taking the course. Blended learning achieved greater pretest to post-test improvement of high statistical significance (P value,.0060) compared to lecture learning alone. Blended learning also achieved greater pretest to post-test improvement of borderline statistical significance (P value,.0855) in comparison to independent learning alone. The difference in effectiveness of independent learning versus lecture learning was not statistically significant (P value,.2730). Student perceptions of the online modules used in blended learning portions of the course were very positive. They specifically enjoyed the self-paced interactivity and the ability to return to the modules in the future. Conclusions: Blended learning can be successfully applied to the introductory clerkship in radiology. This teaching method offers educators an innovative and efficient approach to medical student education in radiology.