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Academic physicians must teach elements in an Accreditation Council for Graduate Medical Education (ACGME)-mandated curriculum while balancing career development and clinical workload. Exploring educator perceptions on the learning environment and comparing two instructional methods (traditional didactics [TD] vs. flipped classroom [FC]) in one pediatric subspecialty may elucidate current challenges, barriers, and strategies to optimize learning and educator satisfaction. A randomized trial comparing effectiveness and learner preference for FC versus TD physiology teaching was conducted in ACGME-accredited neonatal-perinatal medicine (NPM) fellowship programs in 2018 to 2019. Educator preferences were elicited through online surveys pre- and postintervention. Free-text comments were provided for questions exploring strengths, challenges, and opportunities in fellowship education. Statistical analysis included comparisons of demographics and pre-post-intervention educator responses between groups. Thematic analysis of text responses was conducted to identify common subthemes. From 61 participating programs, 114 FC educators and 130 TD educators completed surveys. At baseline, all educators experienced professional satisfaction from teaching fellows, but noted challenges with time available to create and/or deliver educational content, limited content expertise amongst faculty, colleagues' limited enthusiasm toward educating fellows, and lack of perceived value of education by institutions given limited protected time or credit toward promotion. Postintervention, educators in both groups noted a preference to teach physiology using FC due to interactivity, learner enthusiasm, and learner-centeredness. FC educators had a 17% increase in preference to teach using FC ( Overall, NPM educators in a trial evaluating a standardized, peer-reviewed curriculum report professional satisfaction from teaching, but described logistical challenges with developing/delivering content. Educators preferred instruction using FC, but identified challenges with learner preparedness and ensuring adequate educator time and skill. Future efforts should be dedicated to addressing these barriers.· Many challenges exist for educators teaching neonatal-perinatal medicine fellows, including time, support, and recognition.. · Many educators preferred using flipped classroom methodology with a standardized curriculum due to interactivity and learner-centeredness.. · Benefits of a standardized, peer-reviewed curriculum include reduced preparation time, adaptability of content, and learning environment enhancement..

OBJECTIVEDespite longstanding and recurrent calls for effective implicit bias (IB) education in health professions education as one mechanism to reduce ongoing racism and health disparities, evidence-based IB curricula for neonatal-perinatal medicine (NPM) are limited. We aim to determine the key IB curricular elements for teaching NPM fellows, advanced practice providers, and attending physicians. STUDY DESIGNA modified Delphi study was performed with content experts in IB and health disparities who had educational relationships to those working and training in the neonatal intensive care unit. RESULTThree Delphi rounds were conducted. Experts reached consensus on a variety of items for inclusion in an IB curriculum, including educational goals, learning objectives, teaching strategies, and educator principles.CONCLUSIONEssential IB curricular components for the field of neonatal medicine were defined using rigorous consensus building methodology.

Due to the changing complex healthcare environment, educational innovation is essential to meet the needs of current and future neonatal-perinatal medicine (NPM) leaders. Greater clinical demands, decreased academic funding, and expanded graduate medical education program requirements have negatively impacted time for teaching and educational scholarship potentially limiting innovation in the field. By focusing on adult learning principles, embracing technology, and promoting collaboration, today's educators are preparing the next generation of neonatologists. Current innovations include regionalizing simulation boot camps, leveraging virtual learning to increase accessibility, developing niche training opportunities, and incorporating population health principles within existing quality initiatives. Areas in need of additional innovation include faculty and fellow development for teaching skills, expansion of educational networks, and dissemination and financial support of educational scholarship. These efforts and future innovations will require medical institutions and national NPM organizations to further invest in the medical educator as part of their missions.

This is the second article in a seven-part series in the Journal of Perinatology that aims to critically examine the current state of Neonatal-Perinatal Medicine (NPM) fellowship training from the structure and administration of a program, to the clinical and scholarly requirements, and finally to the innovations and future careers awaiting successful graduates. This article focuses on the current clinical requirements; recent changes to the clinical environment and their effect on learning; and additional challenges and opportunities in clinical education.

Despite longstanding and recurrent calls for effective implicit bias (IB) education in health professions education as one mechanism to reduce ongoing racism and health disparities, such curricula for neonatal-perinatal medicine (NPM) are limited. We aim to determine the key curricular elements for educating NPM fellows, advanced practice providers, and attending physicians in the critical topics of IB and health disparities.A modified Delphi study was performed with content experts in IB and health disparities who had educational relationships to those working and training in the neonatal intensive care unit.Three Delphi rounds were conducted from May to November 2021. Experts reached consensus on a variety of items for inclusion in the curriculum, including educational goals, learning objectives, teaching strategies, and educator principles.Essential curricular components of an IB and health disparities curriculum for neonatal medicine were defined using rigorous consensus building methodology.

Objective This study aimed to determine the value, strengths, and challenges of implementing an e-learning based flipped classroom (FC) educational modality as part of the standardized physiology National Neonatology Curriculum (NNC), created for neonatal-perinatal medicine (NPM) fellow learners and faculty educators. Study Design This is a cross-sectional study of NPM fellows and faculty educators who utilized at least one of the e-learning based NNC FC respiratory physiology programs between May and September 2018. Participants were surveyed anonymously regarding their experiences participating in the NNC, including measures of preparation time. A combination of descriptive statistics and proportion comparisons were used for data analysis. Results Among 172 respondents, the majority of fellow and faculty respondents reported positive attitudes toward the educational content and case discussions, and the majority supported national standardization of NPM physiology education (92%). Fellows reported greater preclass preparation for their FC compared with previous didactic lectures (30–60 vs. 0–15 minutes, p Conclusion Fellows and faculty educators supported the FC learning, reporting peer-to-peer learning, and the establishment of a learning community which promotes adult learning and critical thinking skills. A national physiology curriculum creates equitable and engaging educational experiences for all NPM fellows while reducing individual program burden of content creation. Our findings further supported the development of an NNC using a flipped classroom modality.

Measure the effectiveness of and preference for a standardized, national curriculum utilizing flipped classrooms (FC) in neonatal-perinatal medicine (NPM) fellowships.Multicentered equivalence, cluster randomized controlled trial of NPM fellowship programs randomized to receive standardized physiology education as in-class lectures (traditional didactic, TD arm) or as pre-class online videos followed by in-class discussions (FC arm). Four multiple-choice question quizzes and three surveys were administered to measure knowledge acquisition, retention, and educational preferences.530 fellows from 61 NPM fellowships participated. Quiz performance was comparable between groups at all time points (p = NS, TD vs FC at 4 time points). Post intervention, more fellows in both groups preferred group discussions (pre/post FC 42% vs. 58%, P = 0.002; pre/post TD 43% vs. 60%, P = 0.001). FC fellows were more likely to rate classroom effectiveness positively (FC/TD, 70% vs. 36%, P 0.001).FCs promote knowledge acquisition and retention equivalent to TD and FC modalities are preferred by fellows.

Background: Active, learner-centric educational methods in graduate medical education are infrequently used despite evidence suggesting they are more effective for adult learners. The Organization of Neonatal-Perinatal Medicine (NPM) Training Program Directors developed a National Neonatology Curriculum to teach neonatal physiology incorporating andragogic principles. Using American Board of Pediatrics content specifications, NPM faculty developed peer-reviewed online videos and discussion guides for flipped classroom (FC) sessions. Objective: To determine NPM fellow (learner) preferences for FC vs. TD modalities in a large, randomized controlled trial. We hypothesized that fellows would prefer FC compared to TD. Methods: NPM fellowships were prospectively cluster randomized to FC or TD …

Purpose: The learning environment encompasses the diverse physical locations, contexts, instructional methods, and cultures where learning occurs. Effective learning environments require preparation, promote collaboration, improve critical thinking, and increase learner engagement and knowledge retention. The Organization of Neonatal-Perinatal Medicine Training Program Directors (ONTPD) National Neonatology Curriculum (NNC) Randomized Controlled Trial (RCT) explored the impact of instructional methods on perceptions of the learning …

To explore interest, feasibility, perceived effectiveness, and acceptability of a standardized, national physiology curriculum for neonatal–perinatal medicine (NPM) fellows using online videos for knowledge acquisition paired with flipped classrooms (FCs) for knowledge application. Two educational programs pairing online videos with FCs were developed and peer-reviewed. These programs were piloted at five institutions. Fellows completed surveys, and fellows and educators participated in focus groups after their FC experiences. Thirty-five fellows responded to the survey. Forty-one fellows and six educators participated in focus groups. Fellows and educators preferred online videos paired with FCs over didactic teaching and perceived them to be effective for knowledge acquisition and application. Fellows and educators preferred FC learning over traditional didactics and reported that FCs facilitated creation of a learning community, fostering active learning. The favorable response toward this pilot project and the feasibility of its use supports further development of a standardized NPM physiology curriculum for fellowship training.

The development of an effective poster for presentation is a multistep process that requires careful planning. When executed successfully, the poster can visually draw interest from viewers and stimulate discussion with the presenter. This article provides guidance and illustrates tips on effective poster design based on research findings and recommendations from health care educators, abstract reviewers, and graphic designers.

Medical education is undergoing significant change at all levels. Self-directed learning and reflection are becoming essential ingredients of both graduate medical training and postgraduate professional development. Recognition is growing for the need to incorporate the concepts of andragogy into physician education, concepts emphasizing that adult learners are self-directed and take responsibility for their own educational choices. The demonstration of competency for assessment of the individual and the educational program has received increased attention in the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project. (1) Assessment and documentation of self-directed learning, reflection, and competency are more difficult than traditional methods that have included standardized testing and conference attendance. The portfolio has been advocated as a tool for collecting and presenting these elements of learning at all levels of medical training. Butler (2) succinctly defines a portfolio as “a collection of evidence that is gathered together to show a person's learning journey over time and to demonstrate their abilities.” Missing from this definition is self-reflection, a component that several authors, including Rees, (3) believe is essential to a portfolio. A portfolio may be paper-based or electronic and serves as a coherent collection of documents chosen by the individual learner to fit the specific purpose of the portfolio. Several authors have attempted to describe different types of portfolios. Smith and Tillema (4) describe four different portfolio types that are defined according to purpose and setting of use. The purpose of a portfolio may be to assist with promotion or with learning. The background may be to fulfill external requirements or for self-learning. The dossier portfolio is a collection of mandated works that is required for entry into a profession, while a training portfolio is a set of mandatory works assembled for learning during training. The reflective portfolio is a personal selection of …

Over the past century, research involving the fruit fly Drosophila melanogaster has consistently yielded fundamental insights into the nature of complex organisms. The cardiovascular sciences have benefited from these discoveries. Examples include the discovery of the human ether-a-go-go inward rectifying potassium channel, a fly homologue of HERG that is implicated in inherited long-QT syndrome, and the tinman protein, a fly homologue of NKX2.5 that is responsible for certain congential atrial septal defects and conduction abnormalities. More recent results, such as those involving the insulin regulation of heart function in aging fruit flies, suggest that D melanogaster is an emerging model organism in cardiac disease. To date, functional studies of the adult D melanogaster heart have been difficult, and …

Real time in vivo optical coherence tomography (OCT) imaging of the adult fruit fly Drosophila melanogaster heart using a newly designed OCT microscope allows accurate assessment of cardiac anatomy and function. D. melanogaster has been used extensively in genetic research for over a century, but in vivo evaluation of the heart has been limited by available imaging technology. The ability to assess phenotypic changes with micrometer-scale resolution noninvasively in genetic models such as D. melanogaster is needed in the advancing fields of developmental biology and genetics. We have developed a dedicated small animal OCT imaging system incorporating a state-of-the-art, real time OCT scanner integrated into a standard stereo zoom microscope which allows for simultaneous OCT and video imaging. System capabilities include A-scan, B-scan, and M-scan imaging as well as automated 3D volumetric acquisition and visualization. Transverse and sagittal B-mode scans of the four chambered D. melanogaster heart have been obtained with the OCT microscope and are consistent with detailed anatomical studies from the literature. Further analysis by M-mode scanning is currently under way to assess cardiac function as a function of age and sex by determination of shortening fraction and ejection fraction. These studies create control cardiac data on the wild type D. melanogaster, allowing subsequent evaluation of phenotypic cardiac changes in this model after regulated genetic mutation.

This study sought to identify the content and source of information given to prospective breastfeeding mothers. The population included 111 mothers attempting to breastfeed at a community hospital during a 3-month period. Questionnaires were used to assess prenatal preparation and specific breastfeeding issues discussed by health care providers. During the prenatal period, 23% of mothers received counsel from their obstetrician, 47% from books, and 21% from classes. Postpartum, nurses provided breastfeeding information to 87% of mothers whereas obstetricians and pediatricians provided advice to 27% and 33% of mothers, respectively. Many women do not receive supportive breastfeeding counseling from physicians. Health care providers must develop better methods of prenatal and postpartum education to enhance breastfeeding initiation and continuation.

Optical Coherence Tomography (OCT): A Non-Invasive Method to Measure Neonatal Skin Thickness † 1028

To the Editor. The relative safety of fluoxetine chloride (Prozac) when used during pregnancy has been recently addressed.1,2 However, little attention has been paid to its potential neurologic and hematologic side effects in the newborn. Spencer3described an infant exposed to fluoxetine who demonstrated symptoms suggestive of toxicity. We would like to describe an additional infant with potential fluoxetine toxicity. A 3020-gram boy was delivered at term to a 34-year-old mother who had obsessive-compulsive disorder treated with fluoxetine, 60 mg daily. …