Chokshi Binny D, Schumacher Heidi K, Reese Kristen, Bhansali Priti, Kern Jeremy R, Simmens Samuel J, Blatt Benjamin, Greenberg Larrie W
B.D. Chokshi is assistant professor, George Washington School of Medicine and Health Sciences, Department of Pediatrics, Children's National Health System, Washington, DC. H.K. Schumacher is clinical associate, Goldberg Center for Community Pediatric Health, Children's National Health System, Washington, DC. K. Reese is clinical associate, Children's Pediatricians and Associates, Children's National Health System, Washington, DC. P. Bhansali is associate professor of pediatrics, George Washington University School of Medicine and Health Sciences, Department of Pediatrics, Children's National Health System, Washington, DC. J.R. Kern is assistant professor of pediatrics, George Washington School of Medicine and Health Sciences, Department of Pediatrics, Children's National Health System, Washington, DC. S.J. Simmens is research professor, Department of Epidemiology and Biostatistics, Milken Institute of Public Health, George Washington University, Washington, DC. B. Blatt is professor, Department of Medicine, and medical director, Clinical Learning and Simulation Skills Center, George Washington University School of Medicine and Health Sciences, Washington, DC. L.W. Greenberg is clinical professor, Department of Pediatrics, and senior consultant, Office of Faculty Affairs, George Washington University School of Medicine and Health Sciences, Washington, DC.
Acad Med. 2017 Apr;92(4):511-514. doi: 10.1097/ACM.0000000000001534.
The Accreditation Council for Graduate Medical Education requires training that enhances resident teaching skills. Despite this requirement, many residency training programs struggle to implement effective resident-as-teacher (RAT) curricula, particularly within the context of the 80-hour resident workweek.
In 2013, the authors developed and evaluated an intensive one-day RAT curriculum using a flipped classroom approach. Twenty-nine second-year residents participated in daylong RAT sessions. The curriculum included four 1-hour workshops focusing on adult learning principles, giving feedback, teaching a skill, and orienting a learner. Each workshop, preceded by independent reading, featured peer co-teaching, application, and feedback. The authors evaluated the curriculum using pre- and postworkshop objective structured teaching examinations (OSTEs) and attitudinal and self-efficacy teaching questionnaires.
Residents demonstrated statistically significant improvements in performance between pre- and postworkshop OSTEs on each of three core skills: giving feedback (P = .005), orienting a learner (P < .001), and teaching a skill (P < .001). Residents expressed positive attitudes surrounding teaching on the retrospective pre-post attitudinal instrument (P < .001) and rated themselves as more effective teachers (P < .001) after the training.
The authors have demonstrated that the flipped classroom approach is an efficient and effective method for training residents to improve teaching skills, especially in an era of work hour restrictions. They have committed to the continuation of this curriculum and are planning to include assessment of its long-term effects on resident behavior change and educational outcomes.
毕业后医学教育认证委员会要求开展能提高住院医师教学技能的培训。尽管有此要求，但许多住院医师培训项目仍难以实施有效的住院医师即教师（RAT）课程，尤其是在80小时住院医师工作周的背景下。
2013年，作者采用翻转课堂方法开发并评估了一门为期一天的强化RAT课程。29名二年级住院医师参加了为期一天的RAT课程。该课程包括四个1小时的工作坊，重点关注成人学习原则、提供反馈、教授一项技能以及指导学习者。每个工作坊在独立阅读之前进行，以同伴共同教学、应用和反馈为特色。作者使用工作坊前和工作坊后的客观结构化教学考试（OSTE）以及态度和自我效能教学问卷对课程进行评估。
住院医师在工作坊前和工作坊后的OSTE中，在三项核心技能上的表现均有统计学意义的显著提高：提供反馈（P = 0.005）、指导学习者（P < 0.001）和教授一项技能（P < 0.001）。住院医师在回顾性的工作坊前 - 工作坊后态度量表上对教学表达了积极态度（P < 0.001），并且在培训后将自己评为更有效的教师（P < 0.001）。
作者已证明翻转课堂方法是培训住院医师提高教学技能的一种高效方法，尤其是在工作时间受限的时代。他们致力于继续开展这一课程，并计划评估其对住院医师行为改变和教育成果的长期影响。
