Results of a Flipped Classroom Teaching Approach in Anesthesiology Residents

By John Gilboy, MS4 Tufts- Maine Track

Given the competing responsibilities of residents to patient care and professional growth, program directors must critically contemplate the most effective means of providing formal learning opportunities. Sparked by Educating Physicians: A Call for Reform of Medical School and Residency1 and fanned by increased student motivation, task value, and engagement, the UGME curriculum has transitioned from the traditional passive transfer of content-centered knowledge to a flipped classroom model emphasizing self-paced asynchronous learning and learner-center activities.2 Despite this fundamental shift, passive lectures still dominate formal education opportunities in weekly resident conferences.

Aiming to optimize knowledge and skill transference to residents, modern researchers are applying flipped classroom principles to graduate medical education.  In a prospective controlled multicenter educational research study of anesthesiology residents, educational content was delivered by either flipped classroom or traditional lecture for a given topic. Residents were assed for knowledge transfer via 40 item multiple choice test, including benchmark (pretest), acquisition (posttest), and retention (4-month retention) tests. Residents’ attitudes towards the flipped classroom were measured with a survey before and after the intervention. Results indicated that the teaching style did not impact knowledge acquisition (posttest adjusted mean = 5%, P= .06; d= 0.48), but that the flipped classroom demonstrated improved retention compared to traditional lectures (retention adjusted mean =6%, P= .014, d= 0.56). In addition to knowledge retention, residents preferred the flipped classroom modality (pre= 46%; post =82%, P< .0001).3

Questions for Discussion

  • Does implementing a flipped classroom model for resident didactics present unique logistical barriers to the residents, teaching attending, and program directors?
  • What aspects of the flipped classroom correspond to increased resident preference? Could similar elements be introduced our current lecture-based of resident curriculum?
  • Does the flipped classroom model present additional opportunities for attending to assess and provide feedback on clinical reasoning, professionalism, and/or teamwork?
  • Does the pre-assignment present a barrier to implementation and resident engagement?


  1. Dooley-Hash S. Educating Physicians: A Call for Reform of Medical School and Residency. 2010;304(11):1240–1241. doi:10.1001/jama.2010.1351
  2. Chen, Fei, Angela M. Lui, and Susan M. Martinelli. “A systematic review of the effectiveness of flipped classrooms in medical education.” Medical Education 51.6 (2017): 585-597.
  3. Martinelli, Chen, Dilorenzo, Mayer, Fairbanks, Moran, . . . Schell. (2017). Results of a Flipped Classroom Teaching Approach in Anesthesiology Residents. Journal of Graduate Medical Education,9(4), 485-490.

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