title: "Flipping" the introductory clerkship in radiology: impact on medical student performance and perceptions.
abstract: OBJECTIVE
  Among methods of "blended learning" (ie, combining online modules with in-class instruction), the "flipped classroom" involves student preclass review of material while reserving class time for interactive knowledge application. We integrated blended learning methodology in a "flipped" introductory clerkship in radiology, and assessed the impact of this approach on the student educational experience (performance and perception).
  
  
  METHODS
  In preparation for the "flipped clerkship," radiology faculty and residents created e-learning modules that were uploaded to an open-source website. The clerkship's 101 rising third-year medical students were exposed to different teaching methods during the course, such as blended learning, traditional lecture learning, and independent learning. Students completed precourse and postcourse knowledge assessments and surveys.
  
  
  RESULTS
  Student knowledge improved overall as a result of taking the course. Blended learning achieved greater pretest to post-test improvement of high statistical significance (P value, .0060) compared to lecture learning alone. Blended learning also achieved greater pretest to post-test improvement of borderline statistical significance (P value, .0855) in comparison to independent learning alone. The difference in effectiveness of independent learning versus lecture learning was not statistically significant (P value, .2730). Student perceptions of the online modules used in blended learning portions of the course were very positive. They specifically enjoyed the self-paced interactivity and the ability to return to the modules in the future.
  
  
  CONCLUSIONS
  Blended learning can be successfully applied to the introductory clerkship in radiology. This teaching method offers educators an innovative and efficient approach to medical student education in radiology.
authors.affiliation: Department of Radiology, New York Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th Street, New York, NY 10065. Electronic address: lib9050@med.cornell.edu.
authors.forename: Lily M
authors.initials: LM
authors.lastname: Belfi
authors.affiliation: Department of Radiology, New York Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th Street, New York, NY 10065.
authors.forename: Roger J
authors.initials: RJ
authors.lastname: Bartolotta
authors.affiliation: Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY.
authors.forename: Ashley E
authors.initials: AE
authors.lastname: Giambrone
authors.affiliation: Office of Curriculum and Educational Development, Weill Cornell Medical College, New York, NY.
authors.forename: Caryn
authors.initials: C
authors.lastname: Davi
authors.affiliation: Department of Radiology, New York Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th Street, New York, NY 10065.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Min
mesh_terms: D001291:Attitude of Health Personnel; D002982:Clinical Clerkship / Q000706:statistics & numerical data*; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003194:Computer-Assisted Instruction / Q000706:statistics & numerical data; D003479:Curriculum; D004521:Educational Measurement; D006801:Humans; D011871:Radiology / Q000193:education*; D013337:Students, Medical / Q000706:statistics & numerical data*
keywords: Flipped classroom; blended learning; clerkship; e-learning; radiology education