Open Access

Peer-reviewed

Research Article

Main Article Content

Sandeep Bansalcorresponding author
Minakshi Bansal
Kashif A Ahmad
Jyotsna Pandey

Abstract

Traditional lecture style instructional method is being replaced with innovative approaches that support active and self-directed learning in medical education. Despite increasing literature on novel pedagogies, educators are faced with mixed reviews on the impact of these approaches on the improvement of student learning. We explored student attitudes and measured learning outcomes using the flipped classroom approach within a single organ system module. Second year medical students received video-recorded lectures and handouts on selected pharmacology and pathology topics in the endocrine and reproductive module as learning resources. Students were required to study prior to attending the scheduled in-classroom knowledge application sessions focusing on critical thinking. Analysis of examination data (n = 235) of summative assessments showed 13% improvement in mean exam score of class on the selected topics compared to the previous class taught using traditional lecture approach. Lower 27% of class scored greater on the most difficult exam items compared to the traditional class. Performance of upper 27% students of both classes was found to be comparable on all selected exam items. In our study, the flipped classroom was perceived as a preferred instructional approach for student learning, and seemed to improve learning outcomes primarily of lower performing students on difficult concepts. The findings of this study can be useful in informing ongoing curriculum refinements in medical schools while selecting innovative active learning instructional methods and making best use of them.

Keywords
learning outcomes, application of knowledge, active learning, assessment, engagement

Article Details

How to Cite
Bansal, S., Bansal, M., Ahmad, K., & Pandey, J. (2020). Effects of a flipped classroom approach on learning outcomes of higher and lower performing medical students: A new insight. Advances in Educational Research and Evaluation, 1(1), 24-31. https://doi.org/10.25082/AERE.2020.01.005

References

  1. Heath C and Heath D. Made to stick: why some ideas survive and others die. 1st ed. New York: Random House, 2007.
  2. Prober CG and Heath C. Lectures halls without lectures- A proposal for medical education. New England Journal of Medicine, 2012, 366(18): 1657-59. https://doi.org/10.1056/NEJMp1202451
  3. Rhee EP, Scott JA and Dighe AS. Case records of the Massachusetts General Hospital. Case 4-2012. A 37-year-old man with muscle pain, weakness, and weight loss. New England Journal of Medicine, 2012, 366(6): 553-560. https://doi.org/10.1056/NEJMcpc1110051
  4. Shatto B, L’Ecuyer K and Quinn J. Retention of content utilizing a flipped classroom approach. Nursing Education Perspectives, 2017, 38(4): 206-208. https://doi.org/10.1097/01.NEP.0000000000000138
  5. Densen P. Challenges and opportunities facing medical education. Transactions of the American Clinical and Climatological Association, 2011, 122(122): 48-58.
  6. Berrett D. How “Flipping” the classroom can improve the traditional lecture. In: The Chronicle of higher education, 2012. https://www.chronicle.com/article/ How-Flipping-the-Classroom/130857
  7. Muller JH. Increasing the value of small-group learning. Acadamic Medicine, 2000, 75(5): 518. https://doi.org/10.1097/00001888-200005000-00038
  8. Goldberg HR, Haase E, Shoukas A, et al. Redefining classroom instruction. Advances in Physiology Education, 2006, 30(3): 124-127. https://doi.org/10.1152/advan.00017.2006
  9. Tune JD, SturekMand Basile DP. Flipped classroom model improves graduate student performance in cardiovascular, respiratory, and renal physiology. Advances in Physiology Education, 2013, 37(4): 316-20. https://doi.org/10.1152/adva
  10. Fatima SS, Arain FM and Enam SA. Flipped classroom instructional approach in undergraduate medical education. Pakistan Journal of Medical Sciences, 2017, 33(6): 1424- 1428. https://doi.org/10.12669/pjms.336.13699
  11. Lee RM and Kwan CY. The use of problem-based learning in medical education. Journal of Medical Education, 1997, 1(2): 149-158. https://pdfs.semanticscholar.org/fdd9/ 20b04c0eee39c89851ca0f5f032d17e
  12. Hartling L, Spooner C, Tjosvold L, et al. Problem-based learning in pre-clinical medical education: 22 years of outcome research. Medical Teacher, 2010, 32(1): 28-35. https://doi.org/10.3109/01421590903200789
  13. Veeramani R, Madhugiri VS and Chand P. Perception of MBBS students to “Flipped class room” approach in neuroanatomy module. Anatomy and Cell Biology, 2015, 48(2): 138-143. https://doi.org/10.5115/acb.2015.48.2.138
  14. Evans KH, Thompson AC, O’Brien C, et al. An innovative blended preclinical curriculum in clinical epidemiology and biostatistics: Impact on student satisfaction and performance. Academic Medicine, 2016, 91(5): 696-700. https://doi.org/10.1097/ACM.0000000000001085
  15. Street SE, Gilliland KO and McNeil C. The flipped classroom improved medical student performance and satisfaction in a pre-clinical physiology course. Medical Science Educator, 2014, 25(1): 35-43. https://doi.org/10.1007/s40670-014-0092-4
  16. Ramnanan C and Pound L. Advances in medical education and practice: student perceptions of the flipped classroom. Advances in Medical Education Practice, 2017, 8: 63-73. https://doi.org/10.2147/AMEP.S109037
  17. McLaughlin JE, Griffin LTM, Esserman DA, et al. Pharmacy Student Engagement, Performance, and Perception in a Flipped Satellite Classroom. American journal of Pharmaceutical Education, 2013, 77(9): 196. https://doi.org/10.5688/ajpe7
  18. Chen F, Lui AM and Martinelli SM. A systematic review of the effectiveness of flipped classrooms in medical education. Medical Education, 2017, 51: 585-597. https://doi.org/10.1111/medu.13272
  19. Wiersma W and Jurs S. Educational measurement and testing. Needham Heights, MA: Allyn and Bacon, 1990.
  20. Riddell J, Jhun P, Fung CC, et al. Does the Flipped classroom Improve Learning in Graduate Medical Education. Journal of Graduate Medical Education, 2017, 9(4): 491- 496. https://doi.org/10.4300/JGME-D-16-00817.1
  21. Kalantzis M and Cope B. New Learning: Elements of a Science of Education. 2nd ed. New York: Cambridge University Press, 2012.
  22. Stein RE, Colyer CJ and Manning J. Student Accountability in Team-Based Learning Classes. Teaching Sociology, 2016, 44(1): 28-38. https://doi.org/10.1177/0092055x15603429
  23. Koo CL, Demps EL, Farris C, et al. Impact of Flipped Classroom Design on Student Performance and Perceptions in a Pharmacotherapy Course. American Journal of Pharmaceutical Education, 2016, 80(2): 33. https://doi.org/10.5688/ajpe80233
  24. Munson A and Pierce R. Flipping Content to Improve Student Examination Performance in a Pharmacogenomics Course. American Journal of Pharmceutical Educucation, 2015, 79(7): 103. https://doi.org/10.5688/ajpe797103
  25. Missildine K, Fountain R, Summers L, et al. Flipping the classroom to improve student performance and satisfaction. Journal of Nursing Education, 2013, 52(10): 597-599. https://doi.org/10.3928/01484834-20130919-03
  26. Shukr I, Zainab R and Rana MH. Learning styles of postgraduate and undergraduate medical students. Journal of College and Physician Surgeon Pakistan, 2013, 23(1): 25- 30. https://doi.org/01.2013/JCPSP.2530