Flipping the switch: The feasibility of a think aloud flipped classroom approach to clinical reasoning instruction
Background: Clinical reasoning is a fundamental skill in medical and allied health professions. Implementation of the evidence based "think aloud" method (i.e. describing cognitive processes through verbalization) for teaching clinical reasoning has been variable due to time and resource constraints in healthcare education. Materials Methods: To explore the feasibility of implementing the think aloud method for teaching clinical reasoning, we piloted a flipped classroom model of instruction to free live synchronous educational time in a medical school clerkship. Two asynchronous web based videos were implemented prior to synchronous case based discussion applying the think aloud method. Performance was assessed by baseline and end of clerkship examination and NBME shelf exam; clinical skills by clinical evaluation; satisfaction and student learning styles by survey. Results: The flipped curriculum was piloted in 38 students; mean age 25+2.2 years; 63% male. Baseline knowledge was low (mean baseline score 43+21% and improved significantly (mean final score 70+23% increase 29% 95%CI 20 37% p