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A4505 - Creation, Implementation and Evaluation of a Novel “Flipped Classroom” Approach to ICU Intern Bootcamp
Author Block: L. Santhosh1, A. D. Gomez2; 1Pulmonary/Critical Care, UCSF Medical Center, San Francisco, CA, United States, 2San Francisco General, San Francisco, CA, United States.
Introduction Internal medicine interns arrive to their first ICU rotation with various levels of prior experience. The “flipped classroom” is a pedagogical model where ‘lecture’ occurs asynchronously via video before the live, interactive session. Over two years, we created, implemented, and evaluated an introductory MICU “Bootcamp” experience to teach the foundations of critical care medicine using a flipped classroom approach. Methods In June 2014, we created a 2-hour interactive lecture targeting pain/sedation management, mechanical ventilation, and septic shock using a case-based approach. In collaboration with campus technology services, we created, recorded, edited, and piloted unique video-based modules on core critical care topics from 2016-2017. In July 2017, we completely converted to a ‘flipped classroom’ approach with required video modules for review prior to the in-person session. Interns completed a knowledge-based baseline assessment and then independently reviewed five video modules on sedation/pain management, ventilator modes, weaning from the ventilator, ARDS, and septic shock. They then attended an in-person case-based interactive session focused on these topics. Three months later, a medical knowledge based post-assessment was administered. Results 65 internal medicine interns completed the MICU flipped classroom Bootcamp. On the pre-test, 47% chose the appropriate analgesia for an intubated patient and 57% chose the correct sedative. 89% correctly identified indications for intubation, 55% chose proper initial ventilator settings, 83% identified criteria for extubation, and 92% chose the correct initial vasopressor. 11 interns completed the post-test - 100% of them agreed or strongly agreed that the Bootcamp improved the ability to understand core ICU topics and 90% agreed or strongly agreed that the flipped classroom format was the preferred format. 100% now chose correct sedative, 82% chose correct analgesia, 91% chose correct ventilator settings, 91% chose correct pressor choice and indications for extubation. Discussion This project highlights the creation, implementation, and evaluation of a novel flipped classroom approach to education of internal medicine interns rotating through the MICU. Limitations include the lack of sufficient post-test respondents as this was not a requirement for ‘passing’ the rotation. Improvements were seen in the delayed recall post-test questions, however, it is unclear whether this correlates with the new curriculum versus greater clinical exposure to MICU patients throughout intern year. Further directions would include dissemination to other institutions and structured interviews with Bootcamp participants to refine the in-classroom component.