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      Randomized Controlled Study of a Remote Flipped Classroom Neuro-otology Curriculum

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          Abstract

          Context

          Medical Education can be delivered in the traditional classroom or via novel technology including an online classroom.

          Objective

          To test the hypothesis that learning in an online classroom would result in similar outcomes as learning in the traditional classroom when using a flipped classroom pedagogy.

          Design

          Randomized controlled trial. A total of 274 subjects enrolled in a Neuro-otology training program for non-Neuro-otologists of 25 h held over a 3-day period. Subjects were randomized into a “control” group attending a traditional classroom and a “trial” group of equal numbers participating in an online synchronous Internet streaming classroom using the Adobe Connect e-learning platform.

          Interventions

          Subjects were randomized into a “control” group attending a traditional classroom and a “treatment” group of equal numbers participating in an online synchronous Internet streaming classroom.

          Main outcome measures

          Pre- and post-multiple choice examinations of VOR, Movement, Head Turns, Head Tremor, Neurodegeneration, Inferior Olivary Complex, Collateral Projections, Eye Movement Training, Visual Saccades, Head Saccades, Visual Impairment, Walking Speed, Neuroprotection, Autophagy, Hyperkinetic Movement, Eye and Head Stability, Oscilllatory Head Movements, Gaze Stability, Leaky Neural Integrator, Cervical Dystonia, INC and Head Tilts, Visual Pursuits, Optokinetic Stimulation, and Vestibular Rehabilitation.

          Methods

          All candidates took a pretest examination of the subject material. The 2–9 h and 1–8 h sessions over three consecutive days were given live in the classroom and synchronously in the online classroom using the Adobe Connect e-learning platform. Subjects randomized to the online classroom attended the lectures in a location of their choice and viewed the sessions live on the Internet. A posttest examination was given to all candidates after completion of the course. Two sample unpaired t tests with equal variances were calculated for all pretests and posttests for all groups including gender differences.

          Results

          All 274 subjects demonstrated statistically significant learning by comparison of their pre- and posttest scores. There were no statistically significant differences in the test scores between the two groups of 137 subjects each (0.8%, 95% CI 85.45917–86.67952; P = 0.9195). A total of 101 males in the traditional classroom arm had statistically significant lower scores than 72 females (0.8%, 95% CI 84.65716–86.53096; P = 0.0377) but not in the online arm (0.8%, 95% CI 85.46172–87.23135; P = 0.2176) with a moderate effect size (Cohen’s d = −0.407).

          Conclusion

          The use of a synchronous online classroom in neuro-otology clinical training has demonstrated similar outcomes to the traditional classroom. The online classroom is a low cost and effective complement to medical specialty training in Neuro-Otology. The significant difference in outcomes between males and females who attended the traditional classroom suggests that women may do better than males in this learning environment, although the effect size is moderate.

          Clinical Trial Registration

          Clinicaltrials.gov, identifier NCT03079349.

          Related collections

          Most cited references 26

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          The flipped classroom for medical students.

          The objectives of this curricular innovation project were to implement a flipped classroom curriculum for the gynaecologic oncology topics of the obstetrics and gynaecology medical student clerkship, and to evaluate student satisfaction with the change.
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            Twelve tips for "flipping" the classroom.

            The flipped classroom is a pedagogical model in which the typical lecture and homework elements of a course are reversed. The following tips outline the steps involved in making a successful transition to a flipped classroom approach. The tips are based on the available literature alongside the author's experience of using the approach in a medical education setting. Flipping a classroom has a number of potential benefits, for example increased educator-student interaction, but must be planned and implemented carefully to support effective learning.
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              Acceptability of the flipped classroom approach for in-house teaching in emergency medicine.

              To evaluate the relative acceptability of the flipped classroom approach compared with traditional didactics for in-house teaching in emergency medicine.
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                Author and article information

                Contributors
                URI : http://frontiersin.org/people/u/96141
                URI : http://frontiersin.org/people/u/433984
                Journal
                Front Neurol
                Front Neurol
                Front. Neurol.
                Frontiers in Neurology
                Frontiers Media S.A.
                1664-2295
                24 July 2017
                2017
                : 8
                Affiliations
                1Neurology, Bedfordshire Centre for Mental Health Research, in association with University of Cambridge , Cambridge, United Kingdom
                2Neurology, Carrick Institute , Cape Canaveral, FL, United States
                3Medical Education, Harvard Macy and MGH Institutes , Boston, MA, United States
                4Department of Medical Education, Dubai Health Authority , Dubai, United Arab Emirates
                5Psychiatry, Bedfordshire Centre for Mental Health Research, in association with University of Cambridge , Cambridge, United Kingdom
                6Psychiatry, Carrick Institute , Cape Canaveral, FL, United States
                7Anesthesiology, University of Massachusetts Medical School , Worcester, MA, United States
                8Neuro-Ophthalmology, University of Montreal Medical School , Montreal, QC, Canada
                9Emergency Department, Bumrungrad International Hospital , Bangkok, Thailand
                10Health Professions Education, MGH Institute of Health Professions , Boston, MA, United States
                Author notes

                Edited by: Gregory Gruener, Loyola University Medical Center, United States

                Reviewed by: Andrés Soto-Varela, Complejo Hospitalario Universitario de Santiago, Spain; Alexandre Bisdorff, Centre Hospitalier Emile Mayrisch, Luxembourg

                *Correspondence: Frederick Robert Carrick, drfrcarrick@ 123456post.harvard.edu

                Specialty section: This article was submitted to Neurology Education, a section of the journal Frontiers in Neurology

                Article
                10.3389/fneur.2017.00349
                5523077
                Copyright © 2017 Carrick, Abdulrahman, Hankir, Zayaruzny, Najem, Lungchukiet and Edwards.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                Page count
                Figures: 3, Tables: 2, Equations: 0, References: 28, Pages: 10, Words: 7480
                Categories
                Neuroscience
                Original Research

                Neurology

                flipped classroom, neuro-otology, classroom learning, online learning, medical education

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