Council on Medical Student Education in Pediatrics


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COMSEP Meeting in Ottawa, ON

Poster Presentation:

Flipped for Fluids

Hosanna . Au,University of Toronto,Toronto,ON,Seetha . Radhakrishnan,University of Toronto,Toronto,ON,Furqan . Shaikh,University of Toronto,Toronto,ON,Mary . Antonopoulos,University of Toronto,Toronto,ON,Angela . Punnett,University of Toronto,Toronto,ON


Teaching students fluid replacement calculations in pediatric dehydration can be difficult using a traditional lecture format.  At our centre, students struggled with understanding the concepts and calculations as shown by low scores for the fluids question on the end of rotation exam compared to scores for the exam as a whole.   A new teaching format using “flipped classroom” techniques was designed. 


To measure the effectiveness of a new “flipped classroom” workshop on fluid management by analyzing exam scores.


We analyzed scores on the fluids question of the exam from 424 students who learned the material in the lecture format and 412 students in the flipped format.  There was minimal question variability across the exams.  There was a significant improvement in mean scores for the fluids exam question from 69.9% (lecture) to 80.9% (flipped) (p < 0.001).  There was a significant decrease in the number of students who failed the fluids question from 13.4% students (lecture) to 3.6% students (flipped) (p < 0.001).  The in-class workshop took 20 minutes whereas the lecture took one hour.


In the flipped classroom, knowledge transfer occurs at home, at the student’s own pace, and knowledge application to the real-world is the focus of the classroom setting (2). When we “flipped for fluids”, our students demonstrated improved understanding as evidenced by higher scores on the fluids question and fewer failures.  This time-saving teaching technique can be easily applied to other sessions for our students in clerkship and across clerkships at other medical schools.