Flipped Classrooms in Graduate Medical Education: A National Survey of Residency Program Directors.

PURPOSE: To begin to quantify and understand the use of the flipped classroom (FC)-a progressive, effective, curricular model-in internal medicine (IM) education in relation to residency program and program director (PD) characteristics.

METHOD: The authors conducted a survey that included the Flipped Classroom Perception Instrument (FCPI) in 2015 regarding programs' use and PDs' perceptions of the FC model.

RESULTS: Among the 368 IM residency programs, PDs at 227 (61.7%) responded to the survey and 206 (56.0%) completed the FCPI. Regarding how often programs used the FC model, 34 of the 206 PDs (16.5%) reported "never"; 44 (21.4%) reported "very rarely"; another 44 (21.4%) reported "somewhat rarely"; 59 (28.6%) reported "sometimes"; 16 (7.8%) reported "somewhat often"; and 9 (4.4%) reported "very often." The mean FCPI score (standard deviation [SD]) for the in-class application factor (4.11 [0.68]) was higher (i.e., more favorable) than for the preclass activity factor (3.94 [0.65]) (P < .001). FC perceptions (mean [SD]) were higher among younger PDs (≤ 50 years, 4.12 [0.62]; > 50 years, 3.94 [0.61]; P = .04) and women compared with men (4.28 [0.56] vs. 3.91 [0.62]; P < .001). PDs with better perceptions of FCs had higher odds of using FCs (odds ratio, 4.768; P < .001).

CONCLUSIONS: Most IM programs use the FC model at least to some extent, and PDs prefer the interactive in-class components over the independent preclass activities. PDs who are women and younger perceived the model more favorably.