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Adv Med Educ Pract. 2017 Jun 28;8:419-426. doi: 10.2147/AMEP.S132266. eCollection 2017.

What factors facilitate the engagement with flipped classrooms used in the preparation for postgraduate medical membership examinations?

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School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, Sheffield, UK.



The "flipped classroom," a pedagogical model where typical lecture and homework elements are reversed, is being advocated in medical education to support the teaching of a large curriculum. However, research into the use of this model in postgraduate medical education, which requires the application of acquired knowledge, is limited. The aim of this study was to explore the barriers and facilitators to engagement with the flipped classroom model in preparation for the written element of postgraduate membership examinations.


Three focus groups (n=14) were held between February and June 2016. Participants were drawn from a membership examination preparation course, run by the University of Shef-field. Two of the groups (n=10) involved "students" (public health registrars) while the other focus group (n=4) was held with "tutors" (experienced registrars and consultants). The focus groups were audiorecorded and transcribed verbatim. Transcripts were thematically analyzed by using both predetermined and emergent themes.


Key themes that emerged from the data included variation in learning and teaching styles of individuals as well as the feasibility and flexibility of the overall course design. However, management of students' expectations was found to be the fundamental factor, which underpinned the engagement.


The complex interaction of factors affecting engagement in this study highlights the need to consider the appropriateness of the flipped classroom model. However, this must be balanced by the potential benefits of the approach for delivering a large curriculum. Recognizing the central importance of managing expectations at the outset would be useful when considering this model in postgraduate medical education.


flipped classroom; membership examination; postgraduate

Conflict of interest statement

Disclosure AJ has previously been both a student and a tutor on the Part A examination course; however, she was not involved in the most recent cohort, from which the participants for this study were drawn. HJ coordinates the organization of this course. AJ, KM, HJ, and ECG are all currently working at the School of Health and Related Research, University of Sheffield, where this course is run from. The authors report no other conflicts of interest in this work.

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