Problem {#sec0001}
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The COVID-19 pandemic has created difficulties with execution of traditional didactic curricula. Programs have restricted in-person gatherings and increased use of work-from-home models. Essential staff involved in execution of didactics have also been subject to furlough. The pandemic has directly affected facilitator health and time for preparing and delivering didactics; this impact has been highly variable across regions and institutions.

Despite these challenges, it is imperative that programs continue to deliver quality didactic education. The Accreditation Council for Graduate Medical Education (ACGME) has issued statements indicating that "programs should continue to provide education to residents/fellows, when feasible, utilizing remote conferencing technology, web-based resources, and other innovative tools.[@bib0001]" Program directors need innovative approaches to ensure that didactics are held regularly, are high quality, and engaging to learners at a time of significant stress.

"Megaflip" is a novel form of open-access national didactics. These sessions are multicenter educational experiences using materials from The Organization of Neonatal-Perinatal Medicine Training Program Directors National Neonatology Curriculum, a standardized, peer-reviewed curriculum utilizing flipped classrooms.[@bib0002] In the National Neonatology Curriculum flipped classrooms model, learners are assigned prework, consisting of short videos and reading materials in preparation for the "classroom" session. The classroom session focuses on case-based knowledge application rather than knowledge acquisition.

"Megaflip" sessions are delivered via the Zoom (San Jose, Calif) platform. A small group of facilitators (2--3) hosts the Megaflip and interested programs request a link to participate. The participating programs provide a local facilitator to lead their own fellows in large group and breakout discussions. This facet of "Megaflip" allows the faculty team to highlight important interinstitutional practice differences and expands the peer-learning opportunity across programs. The Zoom platform overcomes many of the challenges of a large group interactive session by allowing learners to virtually raise their hand, answer yes/no questions with the click of a button, utilize the chat feature, and participate in smaller group discussions via the breakout room feature.

Outcomes to Date {#sec0002}
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There have been 2 pilot sessions with 131 fellows from 16 neonatology and pulmonary fellowship programs across the United States. We have thus far received 22 survey responses regarding the utility of Megaflips and the impact of COVID-19 on fellow education.

Prior to their Megaflip experience, only 4.5% of respondents had previously participated in didactics with fellows from other programs. Seventy-three percent felt the amount of active discussion was better than a typical educational session and 91% of respondents felt this model had good or great effectiveness for learning. No fellows reported technical difficulties with the online platform.

Next Steps {#sec0003}
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As expertise and comfort with the online format grows, we anticipate that more programs will host and facilitate Megaflip sessions. Expanding the use of Megaflips on a national level will allow increased education across medical disciplines and content areas. We plan to continue this model beyond the pandemic given the opportunity for multicenter collaboration, reduced burden on faculty facilitators, and expanding fellow exposure to center-specific innovations and practice patterns.

The authors have no conflicts of interest to disclose.
