Academic Outcome and Moderator of Flipped Classroom Learning Program "teaching on the Run".

Background: Flipped classroom (FC) style Australian faculty development program Teaching on the Run (TOTR) was introduced into Chang Gung Memorial Hospital since 2014. However, its effectiveness in Taiwan has not been formally assessed. This work intended to examine the learning gain of TOTR and identify the moderators of FC outcome by using TOTR as a representative model of FC. Methods: A non-controlled before-after study was undertaken by retrospective analysis of learning data collected during TOTR workshop. Multiple choice questions were tested at baseline (pre-test), after pre-class learning (mid-test) and after classroom activity (post-test) to assess the learning gain. All available demographic and learning variables were included in the moderator analysis. Results: Stepwise and significant improvement in exam scores was noted from pre-test to mid-test and post-test (p < 0.001 for both). Univariate analysis showed pre-test scores, mid-test scores, class participation and session of TOTR were significantly associated with post-test scores. However, multivariate analysis by general linear model showed only mid-test scores and session of TOTR were significant predictor of post-test score. Generalized estimating equations analysis showed that class participation is a significant moderator that influence the scores change from mid-test to post-test. Conclusion: TOTR is effective in improving knowledge of teaching skills for clinical teachers in Taiwan. Achievement in pre-class learning, class participation and learner factor are potential moderators of the FC outcome. Thus, facilitators should try their best to promote a good achievement in pre-class learning and engagement in classroom activity in FC style learning.