Curriculum Structure

At the University of Iowa, the introductory clinical ophthalmology clerkship comprises a 2-week selective rotation. Each session accommodates a maximum of 8 medical students who have completed their 3rd semester of medical school. Over 100 medical students participate each year.

The flipped classroom curriculum, implemented in 2017, is a chief-complaint-based model with a primary care focus. Ten pre-recorded online video lectures, ranging in length from 24 to 35 minutes, were prepared in advance by the clerkship director. Each video corresponded to a chapter of the American Academy of Ophthalmology Basic Ophthalmology textbook.6 At the start of the rotation, students were given access to the video lectures, lecture slide sets, and a course textbook. All content, including the modules and videos used can be found on EyeRounds.org (https://eyerounds.org/article/online-ophthalmology-curriculum/index.htm). Prior to daily learning sessions, students were asked to watch the lecture, view the slide set, or read the textbook chapter corresponding to that day’s topic. The in-class session was then dedicated to interactive case-based discussions led by faculty, fellows, or residents. The flipped classroom model stands in contrast to the traditional classroom, in which class time is used to deliver a didactic lecture with limited time for in-class discussion.

In addition to daily classroom time, the rotation included an eye examination skills session led by an ophthalmology resident, mid-clerkship feedback discussion with the clerkship director, and evaluation of clinical notes by residents and faculty. On the last day of the clerkship, students took a computerized multiple-choice examination. These parameters remain an integral part of the clerkship and were not factored into our analysis.