Greenberg Garred S, Mansour Mayce
Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, USA.
Cureus. 2022 Jul 27;14(7):e27360. doi: 10.7759/cureus.27360. eCollection 2022 Jul.
Introduction Cardiology is a complex discipline that requires mastery of key principles and the ability to apply them in varied clinical scenarios, which may be challenging to teach in the traditional lecture-based format. The purpose of this educational intervention was to evaluate the effect of a flipped classroom model on knowledge base and attitudes towards high-yield cardiology concepts in third and fourth-year medical students at our institution. Methods An invitation to this optional course was sent to third and fourth-year medical students at the Icahn School of Medicine at Mount Sinai. Interested students were sent a document providing optional pre-course self-directed educational materials designed to take one hour to review. The materials included videos, graphics, and short sections of articles related to heart failure (HF), acute coronary syndrome (ACS), and tachyarrhythmias (TA). Students were then scheduled for a thirty-minute small-group session with a clinician, during which they reviewed the diagnosis and management of HF, ACS, and TA on an online video conference platform. Anonymous pre- and post-course assessments to measure knowledge and confidence were collected. Results Twenty-one students completed the pre-course assessment, and 19 students completed the post-course assessment. Seventy-nine percent of the students reported completion of at least half of the self-directed pre-work. The average score on the knowledge assessment rose from 42% to 71% after the course (p<0.001). After the course, 18 (95%) felt comfortable contributing to the management of a case of HF, 16 (84%) a case of ACS, and 13 (68%) a case of TA. Conclusion Knowledge assessment scores and learner self-confidence with the management of HF, ACS, and TA rose significantly after undergraduate medical education students completed this flipped classroom training. This exploratory study showed that the flipped classroom model with small group sessions can be a well-received model for medical student cardiology education among a self-motivated group of learners, though further analysis with a larger learner cohort is needed.
引言
心脏病学是一门复杂的学科，需要掌握关键原则并具备在各种临床场景中应用这些原则的能力，而这在传统的基于讲座的教学形式中可能具有挑战性。本教育干预的目的是评估翻转课堂模式对我校三、四年级医学生的知识库以及对高收益心脏病学概念的态度的影响。
方法
向西奈山伊坎医学院的三、四年级医学生发出了参加这门选修课程的邀请。感兴趣的学生收到了一份提供选修课前自主学习材料的文档，这些材料预计需要一小时来复习。材料包括视频、图表以及与心力衰竭（HF）、急性冠状动脉综合征（ACS）和快速性心律失常（TA）相关的文章片段。然后，学生们安排与一名临床医生进行30分钟的小组会议，期间他们在在线视频会议平台上复习HF、ACS和TA的诊断与管理。收集了用于衡量知识和信心的匿名课前和课后评估。
结果
21名学生完成了课前评估，19名学生完成了课后评估。79%的学生报告完成了至少一半的自主预习工作。课程结束后，知识评估的平均分数从42%提高到了71%（p<0.001）。课程结束后，18名（95%）学生觉得自己能够自如地参与HF病例的管理，16名（84%）学生觉得自己能够参与ACS病例的管理，13名（68%）学生觉得自己能够参与TA病例的管理。
结论
本科医学教育学生完成这种翻转课堂培训后，他们在HF、ACS和TA管理方面的知识评估分数和学习者自信心显著提高。这项探索性研究表明，对于一群有学习积极性的学习者来说，带有小组会议的翻转课堂模式可能是一种广受好评的医学生心脏病学教育模式，不过还需要对更大的学习者群体进行进一步分析。
