The Flipped Patient

Many of us in the Program in Bedside Medicine are deeply involved in the medical students pre-clerkship curriculum. Each week the students interview hospitalized patients, perform physical exams, give presentations, followed by a written H&P note. These students enter the patient room with only pen and paper, as they have not yet gained access to the Electronic Health Record (EHR). By the end of the year, our students are able to obtain medical history from patients with complex medical problems on their own and able to communicate their findings concisely and effectively.

In the latest issue of JAMA, we describe our observations as these same students enter clerkships as 3rd year medical students the following year. Survival skills are developed as they learn how to adapt and function on the medical wards by unlearning much of what they have been taught the year before. Efficiency and the ability to multitask are rewarded. Like their supervising residents, they become accustomed to going to the computer first, confirm with the patient second, then reverse-engineering the patient presentation for rounds. This approach to information gathering is not dissimilar to the Flipped Classroom style of learning that has recently been introduced in classrooms. We dubbed this phenomenon on the wards the “Flipped Patient” to highlight its appeal to millennial learners and bring attention to this evolving workflow which had developed with the introduction of the EHR.

flipped

Click here to visit the JAMA website. Please note, there is a paywall for the full article. If you or your institution has access, please log-in first.