Emergency Medicine Curriculum Utilizing the Flipped Classroom Method: Pulmonary Emergencies
This curriculum created and implemented at The Ohio State University Emergency Medicine Residency program was designed to educate our emergency medicine (EM) residents, PGY-1 to PGY-3, as well as medical students and attending physicians.
Shortness of breath is a very common presenting complaint for emergency department patients. This symptom can be caused by a multitude of conditions which require various treatments and interventions. Often, shortness of breath develops due to an underlying pulmonary problem. In 2014, shortness of breath made up about 3.4 million emergency department visits in the United States. This constitutes 2.4% of all emergency department visits.1Therefore, resident physicians must be proficient in the differential diagnosis and management of the wide variety of pulmonary emergencies.1 The American Board of Emergency Medicine (ABEM) EM Model curriculum lists “thoracic-respiratory disorders” as a key component of resident education.2 The flipped classroom curricular model emphasizes self-directed learning activities completed by learners, followed by 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 Studies have revealed that 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 Emergency Medicine Residency program didactic curriculum recently transitioned to a “flipped classroom” approach.8-11 Our curriculum utilizes an 18-month curricular cycle to cover the defined emergency medicine content. The flipped classroom curriculum maximizes didactic time and resident engagement, fosters intellectual curiosity and active learning, and meets the needs of today’s learners. 4,7,12
We aim to teach the presentation and management of pulmonary emergencies through the creation of a flipped classroom design. This is accomplished via the use of case-based learning. Residents are provided access to a list of learning objectives and several example cases at least one week prior to small group sessions. Each case is associated with question prompts, which residents are encouraged to be ready to answer and discuss during small group sessions. This 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 case-based modules authored by education faculty and content experts based on the core emergency medicine content outlined in the ABEM Model EM curriculum. The Socratic method, used during small group sessions, encourages active participation; small groups also focus on the synthesis and application of knowledge through the discussion of clinical experiences. The use of free open access medical education (FOAM) resources allows learners to work at their own pace and maximize autonomy. Learners are encouraged to use such resources for preparation prior to small group sessions, and also to review and help solidify important points after the conclusion of in-person discussions.
Emergency medicine, flipped classroom, medical education, pulmonary emergencies, pedagogy, teaching.