Novel Emergency Medicine Curriculum Utilizing Self-Directed Learning and the Flipped Classroom Method: Hematologic/Oncologic Emergencies Small Group Module
This curriculum, created and implemented at The Ohio State University Wexner Medical Center, was designed to educate our emergency medicine (EM) residents, intern to senior resident level, as well as medical students and attending physicians.
Disorders of the hematologic system represent a wide spectrum of disease, including bleeding disorders, coagulopathies, blood cell disorders, and oncology related disorders. Hematologic related problems often complicate other disease processes, including malignancy. The number of patients diagnosed with malignancy is increasing due to many factors, including, but not limited to, an aging population and the increased ability for early detection.1 Patients with oncologic conditions can present in a variety of ways with a variety of complications,2 and understanding the steps in diagnosis and management are important components of any emergency physician’s training.
To address this specific curricular need, we developed a flipped classroom, case-based, small group discussion series for emergency medicine learners. The flipped classroom curricular model emphasizes self-directed learning activities, followed by facilitated small group discussions pertaining to the topic reviewed. The active learning fostered by this curriculum increases faculty and learner engagement and interaction time typically absent in traditional lecture-based formats.3-5 The application of knowledge through case studies, personal interaction with content experts, and integrated questions are effective learning strategies for emergency medicine residents.5-7 The Ohio State University Wexner Medical Center EM residency didactic curriculum transitioned to a “flipped classroom” approach. We created this curriculum to improve our residency education program and to share educational resources with other EM residency programs. Our curriculum utilizes an 18-month curricular cycle to cover emergency medicine core content based on the American Board of Emergency Medicine (ABEM) EM model curriculum.8 The flipped classroom curriculum maximizes didactic time and resident engagement, fosters intellectual curiosity and active learning, and meets the needs of today’s learners.4,7,9
We aim to teach the presentation and management of psychiatric emergencies through the creation of a flipped classroom design. This unique, innovative curriculum utilizes resources chosen by education faculty and resident learners, study questions, real-life experiences, and small group discussions in place of traditional lectures. In doing so, a goal of the curriculum is to encourage self-directed learning, improve understanding and knowledge retention, and improve the educational experience of our residents.
The educational strategies used in this curriculum include small group modules authored by education faculty and content experts based on the core emergency medicine content as outlined in the ABEM model curriculum. Active participation is encouraged by the question and answer format of the Socratic Method, with an emphasis on an open and non-threatening learning environment, instead of negative “pimping” type questions which often humiliate and maintain hierarchy rather than promote learning.10,11 Small groups also focus on the synthesis and application of knowledge through the discussion of real-life experiences. The use of free open access medical education (FOAM) resources along with selected primary literature allows learners to work at their own pace and maximize autonomy.
Emergency medicine, flipped classroom, medical education, hematologic emergencies, oncologic emergencies, pedagogy, teaching.