title: A Flipped Classroom Approach to Improving the Quality of Delirium Care Using an Interprofessional Train-the-Trainer Program.
abstract: BACKGROUND
  Given the prevalence and morbidity associated with delirium, there is a need for effective and efficient institutional approaches to delirium training in health care settings. Novel education methods, specifically the "flipped classroom" (FC) and "train-the-trainer" (TTT), have the potential to address these delirium training gaps. This study evaluates the effect of a TTT FC interprofessional delirium training program on participants' perceived ability to manage delirium, delirium knowledge, and clinicians' delirium assessment behaviors.
  
  
  METHODS
  FC Delirium TTT sessions were implemented in a large four-hospital network and consisted of presession online work and a 3-hour in-session component. The 156 TTT interprofessional participants who attended the sessions (ie, trainers) were expected to then deliver delirium training to their patient care units. Delirium care self-efficacy and knowledge test scores were measured before, after, and 6 months after the training session. Clinician delirium assessment rates were measured by chart audits before and 3 months after trainer's implementation of delirium training sessions.
  
  
  RESULTS
  Delirium knowledge test scores (7.8 ± 1.6 versus 9.7 ± 1.2, P < .001) and delirium care self-efficacy were significantly higher immediately after the TTT session compared with those of presession and these differences remained significant at 6-month after the TTT session. Trainer sessions significantly improved clinician delirium assessment rates from 53% for pretraining to 66% for posttraining.
  
  
  CONCLUSIONS
  Our data suggest that a TTT FC delirium training approach can improve participants' perceived delirium care skills and confidence, and delirium knowledge up to 6 months after the session. This approach provides a model for implementing hospitalwide delirium education that can change delirium assessment behavior while minimizing time and personnel requirements.
authors.affiliation: Dr. Sockalingam: Centre for Mental Health, University Health Network, Toronto, ON, Canada and Department of Psychiatry, University of Toronto, Toronto, ON, Canada. Ms. James: University Health Network, Toronto, ON, Canada. Ms. Sinyi: University Health Network, Toronto, ON, Canada. Ms. Carroll: University Health Network, Toronto, ON, Canada. Dr. Laidlaw: Surrey Memorial Hospital, Surrey, BC, Canada. Dr. Yanofsky: Centre for Mental Health, University Health Network, Toronto, ON, Canada and Department of Psychiatry, University of Toronto, Toronto, ON, Canada. Dr. Sheehan: Centre for Mental Health, University Health Network, Toronto, ON, Canada and Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Sockalingam
authors.forename: Sandra-Li
authors.initials: SL
authors.lastname: James
authors.forename: Rebecca
authors.initials: R
authors.lastname: Sinyi
authors.forename: Aideen
authors.initials: A
authors.lastname: Carroll
authors.forename: Jennifer
authors.initials: J
authors.lastname: Laidlaw
authors.forename: Richard
authors.initials: R
authors.lastname: Yanofsky
authors.forename: Kathleen
authors.initials: K
authors.lastname: Sheehan
mesh_terms: D003693:Delirium / Q000150:complications / Q000628:therapy*; D004493:Education / Q000379:methods* / Q000592:standards; D006801:Humans; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D000070260:Teacher Training / Q000379:methods*; D013663:Teaching / Q000592:standards