King Andrew M, Gottlieb Michael, Mitzman Jennifer, Dulani Tina, Schulte Stephanie J, Way David P
J Grad Med Educ. 2019 Feb;11(1):18-29. doi: 10.4300/JGME-D-18-00350.2.
Flipped classroom (FC) instruction has become increasingly common in graduate medical education (GME).
The purpose of this study was to profile the use of FC in the GME setting and assess the current status of research quality.
We conducted a systematic literature search of major health and social science databases from July 2017 to July 2018. Articles were screened to ensure they described use of the FC method in an Accreditation Council for Graduate Medical Education-accredited residency program and included research outcomes. Resulting articles were analyzed, described, and evaluated for research quality using the Kirkpatrick framework and the Medical Education Research Study Quality Instrument (MERSQI).
Twenty-two articles were identified, all of which were recently published. Five were only indirectly related to FC methods. Most studies reported Kirkpatrick-level outcomes. Studies involving resident learner opinions were generally positive. Pre-posttest studies resulted in large positive improvements in knowledge or skills attainment. Control group study results ranged from large positive (1.56) to negative effects (-0.51). Average MERSQI scores of 12.1 (range, 8.5-15.5) were comparable to GME research norms.
Varying methods for implementing and studying the FC in GME has led to variable results. While residents expressed a positive attitude toward FC learning, shortcomings were reported. Approximately half of the studies comparing the flipped to the traditional classroom reported better achievement under the FC design. As indicated by the MERSQI score, studies captured by this review, on average, were as rigorous as typical research on residency education.
翻转课堂（FC）教学法在研究生医学教育（GME）中越来越普遍。
本研究旨在描述FC在GME环境中的使用情况，并评估研究质量的现状。
我们于2017年7月至2018年7月对主要健康和社会科学数据库进行了系统的文献检索。对文章进行筛选，以确保它们描述了在研究生医学教育认证委员会认可的住院医师培训项目中FC方法的使用情况，并包括研究结果。使用柯克帕特里克框架和医学教育研究质量工具（MERSQI）对所得文章进行分析、描述和研究质量评估。
共识别出22篇文章，均为近期发表。其中5篇仅与FC方法间接相关。大多数研究报告了柯克帕特里克级别的结果。涉及住院医师学习者意见的研究总体上是积极的。前后测试研究在知识或技能掌握方面取得了大幅积极改善。对照组研究结果从大幅积极影响（1.56）到负面影响（-0.51）不等。平均MERSQI评分为12.1（范围为8.5 - 15.5），与GME研究规范相当。
在GME中实施和研究FC的方法各不相同，导致了不同的结果。虽然住院医师对FC学习表达了积极态度，但也有缺点被报告。大约一半比较翻转课堂和传统课堂的研究报告称，在FC设计下取得了更好的成绩。正如MERSQI评分所示，本次综述所涵盖的研究平均而言与住院医师教育的典型研究一样严谨。
