Simulation and Classroom-Based Learning in Obstetrics and Gynaecology Residency Training To the Editor: We were very interested to read about the development of a Canadian simulation-based education (SBE) curriculum in obstetrics and gynaecology. 1 Dr. Craig and Dr. Posner used a modified Delphi technique to survey program directors and produce consensus lists of both common and high- acuity/low-frequency events in obstetrics and gynaecology believed to be relevant to SBE. Given the increasing role of simulation in surgical training, this document will be in- tegral to the implementation of Competence-Based Medical Education (CBME) nationally and internationally. The creation and implementation of a national SBE cur- riculum also raises the broader question of how residents best learn the competencies needed to transition to inde- pendent practice. While the foundation of resident learning is authentic par- ticipation in clinical activity, 2 classroom-based learning such as academic half days play a critical complementary role. 3 Simulation-based education takes place outside the sphere of direct patient care and can be framed as a type of classroom-based learning. Classroom-based learning, when done well, enhances knowledge acquisition through the con- solidation of clinical experiences with theoretical knowledge and by providing access to expert clinical reasoning. One of the key problems addressed by classroom learning in general, and SBE in particular, is that learners may not receive adequate exposure to rare critical events during their train- ing. Having an organized classroom-based curriculum, which includes simulation of rare critical events, helps to ensure systematic teaching of important topics. Active participation, whether through simulation, small groups, or case-based learning, is important to residents, but maintaining engagement in classroom learning can be a chal- lenge, particularly in larger programs. Integrating resident- led feedback on the role of AHD led to the University of British Columbia’s obstetrics and gynaecology program de- veloping a “flipped classroom” model, wherein a topic is covered by a clinical expert in a 1 to 2-hour didactic session followed by a resident-led case-based discussion. We foresee that further integration of simulation into resident educa- tion will also improve engagement and active learning. Riki Dayan, MD; 1 Jagdeep Ubhi, MD; 1 Luke Y.C. Chen, MD, MMEd 2 1 Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC 2 Centre for Health Education Scholarship and Division of Hematology, University of British Columbia, Vancouver, BC REFERENCES 1. Craig C, Posner GD. Developing a Canadian curriculum for simulation- based education in obstetrics and gynaecology: a Delphi study. J Obstet Gynaecol Can 2017;39:757–63. 2. Teunissen PW, Scheele F, Scherpbief AJ, et al. How residents learn: quali- tative evidence for the pivotal role of clinical activities. Med Educ 2007;41:763–70. 3. Chen LY, McDonald JA, Pratt DD, et al. Residents’ views of the role of classroom-based learning in graduate medical education through the lens of academic half days. Acad Med 2015;90:532–8. J Obstet Gynaecol Can 2018;■■(■■):■■–■■ https://doi.org/10.1016/j.jogc.2017.10.008 Copyright © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved. Competing interests: None declared. LETTER TO THE EDITOR ■■ JOGC ■■ 2018 • 1