1. References Methods Background Results Conclusions Click headings to further view content Implementation of Learner Centered Teaching in an Emergency Medicine Residency ●Active learning formats such as Flipped Classroom or Team Based Learning are increasingly popular in medical education as they are more engaging and preferred by learners. ●Previous studies have shown increased learner engagement and satisfaction with active learning formats, though some decrease in test scores has been observed. ●Lectures are a passive learning technique with limited knowledge transference and retention. ●The effect of implementing an active learning curriculum in an Emergency Medicine (EM) residency on objective measures of knowledge is unknown. ●23 residents were enrolled ●Mean change in Percentile Rank: ○-1.2 (95%CI -9.5-7.2, p=0.77) for all subjects ○+7.4 (95%CI 3.5-18.2, p=0.13) for residents Below Target in 2014 ●Mean change in Distance from their Target Score: ○0.7 (95%CI -1.1-2.5, p=0.44) for all subjects ○2.2 (95%CI -0.5-4.9, p=0.09) for residents Below Target in 2014 ●Single center, single group, pre-post study of the effect of changing to a Learner Centered Teaching (LCT) curriculum in an EM residency training program. ●All residents with both 2014 (pre-) and 2015 (post-) ITE scores were eligible for inclusion. ○Starting in July 2014 the LCT curriculum was implemented with approximately half of the core content lectures replaced with small group discussions that included pre- discussion homework submitted in advance. ●Performance on the ITE was evaluated for all residents completing both 2014 and 2015 exams. ○The mean change in Percentile Rank on the ITE and the mean Distance from Target score, how far the subject was from their year specific goal, were evaluated with a paired t test. ○A secondary outcome evaluated was change in Percentile Rank and Distance from Target for the residents Below Target in 2014 (PG1 = 65, PG2 = 70, PG3 = 75). ●Implementation of an LCT curriculum did not show a statistically significant improvement or worsening of ITE performance. ●There was a trend toward greater improvement in both Percentile Rank and Distance from Target score for residents who were below target in 2014. ●Areas for future study include: ○Evaluation of the individual components of the LCT ○Change in clinical performance ○Impact on ITE scores for those Below Target ●Interventions in a single center study may not be generalizable to a broader population. ●This study was not adequately powered to show a significant difference in ITE performance among the sub-set of residents below their target score in 2014. ●Other unrecognized confounders may have impacted ITE scores. Shivani Mody, DO, Jade Malcho, MD, Adam Kellogg, MD Baystate Medical Center, Tufts School of Medicine Objective ●We hypothesize that implementing an active learning curriculum within an EM Residency will increase In Training Exam (ITE) Scores. Limitations

2. Background Implementation of Learner Centered Teaching in an Emergency Medicine Residency Shivani Mody, DO, Jade Malcho, MD, Adam Kellogg, MD Baystate Medical Center, Tufts School of Medicine ●Active learning formats such as Flipped Classroom or Team Based Learning are increasingly popular in medical education as they are more engaging and preferred by learners. ●Previous studies have shown increased learner engagement and satisfaction with active learning formats, though some decrease in test scores has been observed. ●Lectures are a passive learning technique with limited knowledge transference and retention. ●The effect of implementing an active learning curriculum in an Emergency Medicine (EM) residency on objective measures of knowledge is unknown.

3. Objective Implementation of Learner Centered Teaching in an Emergency Medicine Residency Shivani Mody, DO, Jade Malcho, MD, Adam Kellogg, MD Baystate Medical Center, Tufts School of Medicine ●We hypothesize that implementing an active learning curriculum within an EM Residency will increase In Training Exam (ITE) Scores.

4. Methods Implementation of Learner Centered Teaching in an Emergency Medicine Residency Shivani Mody, DO, Jade Malcho, MD, Adam Kellogg, MD Baystate Medical Center, Tufts School of Medicine ●Single center, single group, pre-post study of the effect of changing to a Learner Centered Teaching (LCT) curriculum in an EM residency training program. ●All residents with both 2014 (pre-) and 2015 (post-) ITE scores were eligible for inclusion. ○Starting in July 2014 the LCT curriculum was implemented with approximately half of the core content lectures replaced with small group discussions that included pre-discussion homework submitted in advance. ●Performance on the ITE was evaluated for all residents completing both 2014 and 2015 exams. ○The mean change in Percentile Rank on the ITE and the mean Distance from Target score, how far the subject was from their year specific goal, were evaluated with a paired t test. ○A secondary outcome evaluated was change in Percentile Rank and Distance from Target for the residents Below Target in 2014 (PG1 = 65, PG2 = 70, PG3 = 75).

5. Graphs Implementation of Learner Centered Teaching in an Emergency Medicine Residency Shivani Mody, DO, Jade Malcho, MD, Adam Kellogg, MD Baystate Medical Center, Tufts School of Medicine

6. Results Implementation of Learner Centered Teaching in an Emergency Medicine Residency Shivani Mody, DO, Jade Malcho, MD, Adam Kellogg, MD Baystate Medical Center, Tufts School of Medicine ●23 residents were enrolled ●Mean change in Percentile Rank: ○-1.2 (95%CI -9.5-7.2, p=0.77) for all subjects ○+7.4 (95%CI 3.5-18.2, p=0.13) for residents Below Target in 2014 ●Mean change in Distance from their Target Score: ○0.7 (95%CI -1.1-2.5, p=0.44) for all subjects ○2.2 (95%CI -0.5-4.9, p=0.09) for residents Below Target in 2014

7. Conclusions Implementation of Learner Centered Teaching in an Emergency Medicine Residency Shivani Mody, DO, Jade Malcho, MD, Adam Kellogg, MD Baystate Medical Center, Tufts School of Medicine ●Implementation of an LCT curriculum did not show a statistically significant improvement or worsening of ITE performance. ●There was a trend toward greater improvement in both Percentile Rank and Distance from Target score for residents who were below target in 2014. ●Areas for future study include: ○Evaluation of the individual components of the LCT ○Change in clinical performance ○Impact on ITE scores for those Below Target

8. Limitations Implementation of Learner Centered Teaching in an Emergency Medicine Residency Shivani Mody, DO, Jade Malcho, MD, Adam Kellogg, MD Baystate Medical Center, Tufts School of Medicine ●Interventions in a single center study may not be generalizable to a broader population. ●This study was not adequately powered to show a significant difference in ITE performance among the sub-set of residents below their target score in 2014. ●Other unrecognized confounders may have impacted ITE scores.

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