Hybrid Flexible (HyFlex) Learning in CPD: An Evolving CPD Modality

By Raynor Denitzio, CE News Reporter

On Tuesday, June 6, James W. Kim, MBBCh, PgDip, Clinical Assistant Professor at the University of Calgary, and Heather MacNeill, MD, BSc(PT), MScCH (HPTE), FRCPC Associate Professor, University of Toronto, offered a dynamic SACME sponsored workshop titled “Hybrid Flexible (HyFlex) Learning in CPD.” 

Georges Seurat,
A Sunday on La Grande Jatte, 1884-1886
Georges Seurat, A Sunday on La Grande Jatte, 1884-1886

Hybrid Flexible or “HyFlex” is an emerging modality that seeks to bridge the gap between traditional live in-person activities and the live streaming and asynchronous formats that have become increasingly popular post-pandemic.  Although the exact definition is still evolving, broadly HyFlex is defined as “technology-enhanced CPD learning environments that allow learners to choose between face-to-face or online attendance.” For example, the June 6 workshop featured a mix of learners and faculty on-site at the University of Toronto, as well as others joining virtually via Zoom.

According to the ACCME Annual Report, online live activities represented just over 3 percent of the activities offered by CME providers in 2019. By 2021, that figure had grown to nearly 17 percent.  As the continuing education community finds its equilibrium post-pandemic, CPD providers face a challenge – balancing the preferences of learners who prefer an in-person experience with the flexibility (and growing popularity) of live-streaming education.

“The big advantage of [HyFlex] is learner flexibility,” said Dr. McNeil “They get to choose, so they feel more engaged”.  Among the other advantages of the format, Dr. Kim noted the potential for programs to reach a larger audience with increased flexibility for scheduling faculty members while requiring a potentially decreased administrative and logistical burden.  “We even ran a program where I was in Calgary as an in-person speaker and we had one speaker in Vancouver and a lawyer as a speaker in Quebec City and it worked out very well,” said Dr. Kim. Given that the format is still very much in its infancy, Dr. Kim and Dr. McNeil acknowledged that more research was needed to formally demonstrate the value and impact of HyFlex models. Still, early research on learner experience has shown promise.

“What the HyFlex has shown, over and over and over, is that it is definitely non-inferior to all the other modes of delivery,” said Dr. Kim. Still, splitting formats does present challenges. Managing multiple “classrooms” can increase the level of effort required from faculty and administrative staff. “We want to make sure we are including [online learners] where you feel you are just as important a participant as everyone in the room,” said Dr. McNeil. Additionally, as always, dealing with learners and faculty with varying degrees of technological savvy remains an issue. “No matter how well you prepare, sometimes the hardware can just fail,” said Dr. Kim.

Dr. McNeil noted that in many ways employing a HyFlex format was similar to the “messiness” of the early days of Zoom learning during the pandemic. “Remember where we were on Zoom in 2020,” said Dr. McNeil. “That’s where we are again for HyFlex, and that’s okay, but we will get on that bicycle and start riding again.”

Raynor Denitzio is the Associate Director, Educational Development and Accreditation at Harvard Medical School.


The Englishman at the Moulin Rouge is a late-19th-century painting by French artist Henri de Toulouse-LautrecThe Englishman at the Moulin Rouge is a late-19th-century painting by French artist Henri de Toulouse-Lautrec
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