Flipping early embryogenesis promotes short‐term knowledge retention in a condensed medical gross anatomy and embryology course
Authors: Askew Emily B. , Harrell Kelly M. 
Published: April 2020

A foundational knowledge of human embryology is essential for understanding the spatial and functional complexities of post‐natal anatomy as they relate to the practice of medicine. However, medical students often report difficulty conceptualizing early embryologic events, which can significantly affect the ability to understand downstream systems development. At the Brody School of Medicine (BSOM) human developmental anatomy content is incorporated into the curriculum of a condensed, first‐year medical gross anatomy and embryology course (GAE). Early embryogenesis topics have traditionally been delivered in two, 50‐minute, large‐group lectures within the first two weeks of the basic science curriculum. In 2019, these lectures were combined into one, 50‐minute flipped classroom (FC) session. This change was designed to provide students with a more active approach to understanding key concepts of early human embryology with the goal being to promote deeper thinking through focused small‐group discussion. This pilot study sought to evaluate the effectiveness of this change through two specific aims: 1. Evaluation of student performance on early embryogenesis questions across lecture‐only (2017–2018) and FC (2019) cohorts; 2. Assessment of student perception of the embryology FC session in 2019. Significant improvements in learner performance, as indicated by question performance following the implementation of the FC session, and highly favorable (>80% agree/strongly agree) learner perception were predicted. To investigate Aim 1, deidentified cohort performance data (%) on early embryology questions was analyzed. Lecture‐only (2017–2018, n=172) and FC (2019, n=92) cohorts averaged 85.36% and 89.89% on quiz questions, respectively. However, lecture‐only and FC cohorts averaged 76.73% and 69.84%, respectively, on examination questions. These data suggest that the FC session was more effective for short‐term retention of content, but that lecture‐based delivery may promote long‐term retention. BSOM students have unlimited access to recorded lectures, which allows for spaced, self‐guided repetition and review of content coupled with faculty explanation—features that are not currently available following a FC session. To assess Aim 2, a voluntary survey was sent to the FC cohort (92.4% response rate) to assess overall session perception. Survey data revealed 71.8% and 70.6% of respondents agreed/strongly agreed that the FC was engaging and promoted active learning in the small group setting, respectively. However, only 60% and 52.9% agreed/strongly agreed the FC enhanced understanding of early embryogenesis and improved assessment performance, respectively. While the majority of respondents indicated a preference for small‐group learning, data indicated that 37.7% of respondents prefer solely didactic and/or independent learning methods for comprehension of human embryology. Collectively, the results of this study suggest a need to reassess FC logistics, including session length, learning objectives and recordability, to more effectively produce long‐term knowledge retention of early human embryology content among BSOM medical students.