Effect of the Extended Inverted Classroom on clinical simulation for the resuscitation of trauma patients: Pilot study of student perceptions of learning
The inverted classroom is an interactive teaching model with promising results in surgery. Evidence of this model involving components of clinical simulation is scant.
To present a model of "Extended Inverted Classroom" (EIC), involving low and medium fidelity simulation, and to describe its effect on student perceptions of learning.
An EIC was designed for teaching medical students the clinical skills for the management and resuscitation of trauma patients. The pre- and post-interventional perceptions Wounds and injuries of learning were assessed using the "Flipped Classroom Perception Instrument" validated in the Spanish language. The Mann-Whitney test and the t-test (p < .05) were used for comparisons and Cohen's d was used for calculating the effect size of the intervention. Secondary outcomes were academic performance and student satisfaction.
A total of 75 students participated in the study. Global perception of learningwas 3.98 士0.58 (1.5-5.0) (pre-test) versus 4.24±0.64 (1.38-5.0) (post-test) (p <.05). The effect size was d = 0.42 (95% CI 0.094H0.75). High academic achievement and student satisfaction were identified.
The EIC model involving clinical simulation for the resuscitation of trauma patients has a positive effect on student perceptions of learning in the short term. Further studies are required to evaluate this model in other scenarios of resuscitation, critical care and emergencies, as well as to measure their effect on long-term learning.
2. Kesinger MR, Puyana JC, Rubiano AM. Improving trauma care in low- and middle-income countries by implementing a standardized trauma protocol. World J Surg. 2014;38:1869-74.
3. Ordóniez CA, Pino LF, Tejada JW, Badiel M, Loaiza JH, Mata LV, et al. Experience of two first level hospitals in the southwest region of Colombia on the implementation of the Panamerican Trauma Society International Trauma Registry. Rev Col Bras Cir. 2012;39:255-62.
4. Mohammad A, Branicki F, Abu-Zidan FM. Educational and clinical impact of Advanced Trauma Life Support (ATLS) courses: a systematic review. World J Surg. 2014;38:322-9.
5. Jayaraman S, Sethi D, Chinnock P, Wong R. Advanced trauma life support training for hospital staff. Cochrane Database Syst Rev. 2014;8. CD004173.
6. Villaveces A, Kammeyer JA, Bencevic H. Injury prevention education in medical schools: an international survey of medical students. Inj Prev. 2005;11:343-7.
7. Custers EJ. Long-term retention of basic science knowledge: a review study. Adv Health Sci Educ Theory Pract. 2010;15:109-28.
8. Vandewaetere M, Manhaeve D, Aertgeerts B, Clarebout G, Van Memenboer JJ, Roex A. 4C/ID in medical education: how to design an educational program based on whole-task learning: AMEE Guide No. 93. Me Teach. 2015;37:4-20.
9. Maestre JM, Manuel-Palazuelos JC, del Moral I, Simon R. La simulación clínica como herramienta para facilitar el cambio de cultura en las organizaciones de salud: aplicación práctica de la teoría avanzada del aprendizaje. Rev Colomb Anestesiol. 2014;42:124-8.
10. Liebert CA, Mazer L, Bereknyei Merrell S, Lin DT, Lau JN. Student perceptions of a simulation-based flipped classroom for the surgery clerkship: a mixed-methods study. Surgery. 2016;160:591-8.
11. Boysen-Osborn M, Anderson CL, Navarro R, Yanuck J, Strom S, McCoy CE, et al. Flipping the advanced cardiac life support classroom with team-based learning: comparison ofcognitive testing performance for medical students at the University of California, Irvine, United States. J Educ Eval Health Prof. 2016;18:11.
12. Morgan H, Marzano D, Lanham M, Stein T, Curran D, Hammoud M. Preparing medical students for obstetrics and gynecology milestone level one: a description of a pilot curriculum. Med Educ Online. 2014;6:25746.
13. Rose E, Claudius I, Tabatabai R, Kearl L, Behar S, Jhun P. The flipped classroom in emergency medicine using online videos with interpolated questions. J Emerg Med. 2016;51, 284-91.e1.
14. van Merrienboer JJG, Kirschner PA. Ten steps to complex learning: a systematic approach to four-component instructional design. 2nd ed. Routledge; 2012.
15. Advanced Trauma Life Support for Doctors. Student manual. 9th ed. Chicago: American College of Surgeons Committee on Trauma; 2012.
16. Bonnes SL, Ratelle JT, Halvorsen AJ, Carter KJ, Hafdahl LT, Wang AT, et al. Flipping the quality improvement classroom in residency education. Acad Med. 2017;92:101-7.
17. McLaughlin JE, Roth MT, Glatt DM, Davidson CA, Esserman DA. The Flipped classroom: a course redesign to foster learning and engagement in a health professions school. Acad Med. 2014;89:236-43.
18. Pierce R, Fox J. Vodcasts and active-learning exercises in a “flipped classroom” model of a renal pharmacotherapy module. Am J Pharm Edu?2012;76:196.
19. Lloret-Segura S, Ferreres-Traver A, Hernández-Baeza A, Tomás-Marco I. El Análisis Factorial Exploratorio de los Ítems: una guía práctica, revisada y actualizada. An Psicol. 2014;30:1151-69.
20. Hatcher L. Advanced statistics in research. USA: Shadow Finch Media; 2013.
21. Cronbach LJ, Warrington WG. Time-limit tests: estimating their reliability and degree of speeding. Psychometrika. 1951;16:167-88.
22. Cohen J. Statistical power analysis for the behavioural sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1998.
23. Maran NJ, Glavin RJ. Low- to high-fideltity simulation - a continuum of medical education? Med Educ. 2013;37 Suppl. 1:22-8.
24. Rotellar C, Cain J. Research, perspectives, and recommendations on implementing the flipped classroom. Am J Pharm Educ. 2016;80:34.
25. Liu Q, Peng W, Zhang F, Hu R, Li Y, Yan W. The effectiveness of blended learning in health professions: systematic review and meta-analysis. J Med Internet Res. 2016;18:e2.
26. Orsini C, Binnie VI, Wilson SL. Determinants and outcomes of motivation in health professions education: a systematic review based on self-determination theory. J Educ Eval Health Prof. 2016;2:19.