College of Medicine
The CDC estimates more than 1.1 million people in the United States are living with HIV infection. Antiretroviral therapy has improved significantly over the last several years and most of the care of HIV-infected patients is now provided in the clinic, where there is less time for “bedside teaching” than in the inpatient setting. Moreover, follow-up of laboratory testing occurs after trainees have left the clinic, in settings that are not conducive to didactic discussions of management options.
Training programs have responded to this gap in ambulatory HIV training by providing dedicated didactic sessions to review the core topics regarding the clinical management of HIV infection. The physicians from the HIV program at UNMC train fellows in adult and pediatric infectious diseases (ID) from both UNMC and Creighton University Medical Center (eight fellows total). We meet with the fellows twice monthly to provide supplemental teaching and didactic workshops on important topics in HIV management. Although the sessions have been well-received, we have found ourselves competing with smartphones and pagers for the fellows’ attention. This is a common challenge faced by today’s medical educators. Many challenges to current models of medical education have been identified and the two that resonate most with our experience are distracted audiences and hit-or-miss clinical exposure during rotations leaving gaps in trainees’ experience.
One increasingly appreciated innovation to address these challenges is the “flipped-classroom” model in which students receive and master new knowledge outside the classroom, thereby allowing educators to use classroom time to reinforce learning and address students’ questions (Mehta et al. Acad Med 2013;88:00-00). This model is ideal for medical trainees with different degrees of knowledge and experience because it gives them the opportunity to review didactics on their own time and at their own pace while taking advantage of the group “classroom” setting to apply the knowledge learned.
Using the flipped-classroom model, we designed an electronic course on the clinical management of HIV and plan to pilot the course with the incoming group of UNMC and Creighton University Medical Center ID fellows in July 2014. The course is comprised of eight modules that will be administered over a period of four months. Interactive Webbased modules have been designed using Articulate Storyline and will be made available to course participants up to two weeks prior to the group session. We will spend group “class” time working through different case scenarios (e.g., counseling a newly diagnosed patient, design and initiation of a new ART regimen, genotype interpretation, etc.). Multiple instructional methods including role play, team-based learning and team problem-solving will be used during class time in order to create a learner-centered environment.
Knowledge gain/curriculum effectiveness will be assessed by a pretest/posttest design using a validated standardized assessment tool developed by the HIV Medical Association (HIVMA). Additionally, a brief survey designed to assess attitudes and perceptions about both the flipped class instructional model and the course content will be administered both at the beginning and end of the course. It is our hope that our flipped classroom HIV e-learning course will be well-received by the participants and serve to maximize individual learning.
Bares, Sara and Sandkovsky, Uriel, "Clinical Management of HIV Infection: A Flipped Classroom Model Incorporating Web-Based Modules and Active-Learning Case Exercises" (2014). Elearning Modules. Paper 4.