The effects of flipped classrooms to improve learning outcomes in undergraduate health professional education: A systematic review.
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ABSTRACT:
SUBMITTER: Naing C
PROVIDER: S-EPMC10326838 | biostudies-literature | 2023 Sep
REPOSITORIES: biostudies-literature
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The effects of flipped classrooms to improve learning outcomes in undergraduate health professional education: A systematic review.
Naing Cho C Whittaker Maxine A MA Aung Htar Htar HH Chellappan Dinesh Kumar DK Riegelman Amy A
Campbell systematic reviews 20230707 3
<h4>Background</h4>The 'flipped classroom' approach is an innovative approach in educational delivery systems. In a typical flipped class model, work that is typically done as homework in the didactic model is interactively undertaken in the class with the guidance of the teacher, whereas listening to a lecture or watching course-related videos is undertaken at home. The essence of a flipped classroom is that the activities carried out during traditional class time and self-study time are revers ...[more]
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Project description:BackgroundIn recent years, flipped classrooms (FCs) have gained popularity in higher education, particularly among healthcare students. The FC model is a blended learning approach that combines online learning with in-class activity. This has prompted many instructors to assess how they teach and prepare successful graduate students for today's society. Additionally, colleges and universities have been challenged to deliver curricula that are relevant to the needs of students and to provide the rising skills and knowledge that are expected to be acquired by students.ObjectiveThis systematic review aims to evaluate the flipped classroom teaching approach in pharmacy education and to provide a summary of the guidance for the introduction and implementation of the flipped classroom model in pharmacy educational programs.MethodThis systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Eight databases were cross-screened by four reviewers, following key terms and predefined inclusion and exclusion criteria. A form was developed to extract relevant data from the reviewers. Qualitative data within the studies reporting students' and educators' perceptions and views on the FC model were also analyzed using a thematic analysis. Studies were appraised using the Medical Education Research Quality Instrument (MERSQI) and the Joanna Briggs Institute (JBI) checklist for qualitative research.ResultsThe reviewers screened 330 articles, of which 35 were included in the review. The themes identified were implementation, academic performance outcomes, student satisfaction with the flipped classroom model, and long-term knowledge retention. Most studies (68%) have found that flipped learning enhances students' success and exam performance. Six (27%) studies reported no statistically significant difference in academic performance. However, two studies reported lower long-term knowledge retention in FC learning than in lecture-based learning. The students' perceptions of the FC approach were assessed in 26 studies, and the majority reported positive feedback. However, some students found the pre-class homework difficult to complete before class, and some expressed dissatisfaction with the inconsistent grading and unclear assessment questions in the FC model. Overall, the FC model was found to enhance the students' critical thinking and communication skills, self-confidence, and time management.ConclusionsThe findings of this review indicate that pharmacy students generally found the flipped classroom model preferable to traditional lectures. However, this preference is conditional on the effective implementation of this approach and alignment within the core instructional elements. The issue of increased workload for students associated with self-directed pre-class learning may present a challenge.
| S-EPMC10685032 | biostudies-literature
Project description:IntroductionOral histopathology is a bridge course connecting oral basic medicine and clinical dentistry. However, the application of outcomes-based education via flipped classroom (FC) in oral histopathology has not been well explored. This study has assessed the efficacy of outcomes-based education via FC in undergraduate oral histopathology module learning in Nanjing Medical University of China.Materials and methodsA total of 214 third-year students were enrolled and assigned to the FC group of the batch 2022-23 (n = 110) and the traditional classroom (TC) group of the batch 2021-22 (n = 104) to participate the oral histopathology sessions respectively in the study. The FC group were required to preview the online course materials pre-class, followed by in-class quizz, in-class interactive group discussion, and slides microscopic observation. The outcomes-based formative and summative assessments for FC were designed. The TC group attended traditional laboratory class for the same glass slides microscopic observation. In addition, a questionnaire was performed to investigate the satisfaction of learning. Along with this, the performances of FC group in written theory tests and oral histopathology slide tests were compared with TC group.ResultsStudents in the FC group gained significantly final higher scores of the course than those in the TC group (score: 83.79 ± 11 vs. 76.73 ± 10.93, P<0.0001). Data from the student questionnaires indicated a preference for outcomes-based module education via FC. In the questionnaires, most students considered outcomes-based module education via FC to be beneficial to learning motivation, knowledge comprehension, critical thinking and teamwork. FC group had a higher level of satisfaction with oral histopathology teaching than TC group (satisfaction score: 4.599 ± 0.1027 vs. 4.423 ± 0.01366, P<0.01).ConclusionAn outcomes-based module education via FC has a promising effect on undergraduate oral histopathology education.
| S-EPMC10637004 | biostudies-literature
Project description:BackgroundRecently, flipped classrooms (FCs) have gradually been used in Chinese higher education settings. However, few studies have focused on the effects of FCs on interdisciplinary curricula. The purpose of this study was to examine the impact of an FC on the engagement, performance, and perceptions of students and on teacher-student interaction in a pharmaceutical marketing course.DesignA clustered randomized controlled study was conducted, with 137 junior-year pharmacy undergraduates using an FC serving as the intervention group, in contrast to students using lecture-based learning (LBL) as the control group. Flanders' interaction analysis system (FIAS) was used to measure teacher-student interaction, and questionnaires regarding attitudes toward and satisfaction with the teaching model were administered.ResultsThe students in the FC group scored significantly higher than those in the LBL group (88.21±5.95 vs. 80.05±5.59, t = -8.08, p = 0.000) on pharmaceutical marketing. The multiple linear regression results showed that the FC model had a significant impact on student performance (β = 8.16, p<0.0001). The percentages of teacher talk in the FC and LBL groups were 21% and 96%, respectively (χ2 = 2170.274, p = 0.000); however, the percentages of student talk in the FC and LBL groups were 75% and 2.6%, respectively (χ2 = 2012.483, p = 0.000). Compared with the LBL group, most students in the FC group held more positive attitudes toward the teaching model; the mean scores for the 8 attitude attributes in the FC group were significantly higher than those in the LBL group (p = 0.000). There were significant differences in the ratings of satisfaction with teacher-student interaction (p = 0.000), the students' learning attitude (p = 0.000), the teacher's preparatory work (p = 0.000), the teaching objective (p = 0.000), and the teaching effect (p = 0.000) between the two groups.ConclusionCompared with LBL methods, implementing the FC model improved student performance, increased teacher-student interaction and generated positive student attitudes toward the experience. As an effective pedagogical model, it can also stimulate pharmacy students' learning interest and improve their self-learning abilities.
| S-EPMC6457546 | biostudies-literature
Project description:Problem-based learning has been widely incorporated into pre-clinical medical education to increase the applicability of pre-clinical knowledge. However, studies have demonstrated increased learning burden and decreased confidence in learning when adapting to this didactic medium. To the authors' knowledge, limited interventions target these shortcomings in real time. Thus, we adapted and implemented a "Learning Assistants" (LA) program that can be deployed in pre-clinical didactic sessions. In this prospective pilot study, trained LAs were deployed in the classroom to assist students in their clinical case vignettes under instructor supervision. Learning assistants and students completed pre-session and post-session evaluation surveys to assess LA helpfulness, student confidence, and interest in study material. Paired observations were evaluated using Wilcoxon signed-ranks tests, ANCOVA, and paired t-tests. Unstructured responses were evaluated using thematic analysis. A significant improvement in both student interest (p < 0.001) and confidence (p < 0.001) in the course material was observed after each surveyed session. No significant difference was observed in student-perceived LA helpfulness across the sessions (p = 0.12). Thematic analysis revealed common themes in student knowledge gaps, including challenges with understanding drug mechanisms of action and drug interactions. The results suggest that this program may consistently positively impact student interest and confidence. However, further research is needed to evaluate the impacts of this intervention on learning outcomes and standardized assessments. This study highlights the potential for such a program to bolster pre-clinical didactic sessions that utilize the problem-based learning instructional modality.Supplementary informationThe online version contains supplementary material available at 10.1007/s40670-023-01958-x.
| S-EPMC10948711 | biostudies-literature
Project description:AimTo design and validate the Flipped-Learning Assessment Scale; a tool for assessing students' experience of flipped learning.BackgroundFrequently, university students are introduced to new content during lectures. In contrast, active learning activities, such as Flipped Learning, are designed as an instructional method to engages students in the learning process.DesignCross-sectional descriptive study.MethodsA cross-sectional study was carried out in three phases ((1) item selection, rephrasing and translation; (2) content analysis through expert panel and (3) confirmatory factor analysis). The final version of the scale was piloted on a sufficient sample of undergraduate student nurses from three Spanish universities.ResultsA total of 455 students completed the questionnaire; 373 women and 82 men. The total Cronbach's alpha value for the complete instrument was 0.893. Cronbach alpha for each separate dimension ranged between 0.660 and 0.897. Goodness-of-fit values were acceptable, implying that the model was validated.ConclusionThe flipped learning approach has become increasingly popular in academic settings. Evaluating the students' flipped learning experience is important to analyse aspects such as acceptability and effectiveness of this methodology. The Flipped-Learning Assessment Scale is a valid and reliable tool for analysing students' experience of flipped learning.ImpactFlipped learning has been a useful pedagogical model very for cultivating student skills in problem-solving, critical thinking, teamwork and self-active learning in nursing education. A key issues, such as student satisfaction, has been explored further before implementing this teaching and learning methodology.Patient or public contributionNone.
| S-EPMC11627244 | biostudies-literature
Project description:ObjectiveOpen science (OS) is a global movement focused on improving research equity, reproducibility, and transparency of research outputs in publicly funded research. While OS education in academia is becoming more common, examples of health sciences librarians providing OS training are not. This paper describes how a librarian collaborated with teaching faculty and a research program coordinator to integrate an OS curriculum into an undergraduate professional practice course and assess students' perceptions of OS after participating.MethodsA librarian developed an OS-specific curriculum for an undergraduate professional practice course in Nutrition. This course is part of the First Year Research Experience (FYRE) program, which is integrated into 13-week undergraduate courses to introduce students to core elements of the research process in their first year of study by carrying out a research project. The OS curriculum included an Introduction to OS class, a requirement that students share their research outputs in the Open Science Framework, and an assignment asking students to reflect on their experience learning about and practicing OS. Twenty-one of 30 students consented to having their reflection assignment undergo thematic analysis.ResultsStudents indicated transparency, accountability, accessibility to research outputs, and increased efficiency as positive attributes of OS. The time commitment, fear of being scooped, and concerns over having research be misinterpreted were considered negative attributes. 90% (n=19) of students indicated that they intend to practice OS in the future.ConclusionBased on strong engagement from the students, we believe that this OS curriculum could be adapted to other undergraduate or graduate student contexts where a research project is required.
| S-EPMC10124608 | biostudies-literature
Project description:PurposeEffective trauma resuscitation requires efficient and coordinated care from a team of providers; however, providers are rarely instructed on how to be effective members of trauma teams. Team-based learning using Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) has been shown to improve team dynamics among practicing professionals, including physicians and nurses. The impact of TeamSTEPPS on students being trained in trauma management in an undergraduate health professional program is currently unknown. We sought to determine the impact of TeamSTEPPS on team dynamics among undergraduate students being trained in trauma resuscitation.MethodsWe enrolled teams of undergraduate health professional students from four programs: nursing, physician assistant, radiologic science, and respiratory care. After completing an online training on trauma resuscitation principles, the participants completed a trauma resuscitation scenario. The participants then received teamwork training using TeamSTEPPS and completed a second trauma resuscitation scenario identical to the first. All resuscitations were recorded and scored offline by two blinded research assistants using both the Team Emergency Assessment Measure (TEAM) and Trauma Team Performance Observation Tool (TPOT) scoring systems. Pre-test and post-test TEAM and TPOT scores were compared.ResultsWe enrolled a total of 48 students in 12 teams. Team leadership, situational monitoring, and overall communication improved with TeamSTEPPS training (P=0.04, P=0.02, and P=0.03, respectively), as assessed by the TPOT scoring system. TeamSTEPPS also improved the team's ability to prioritize tasks and work together to complete tasks in a rapid manner (P<0.01 and P=0.02, respectively) as measured by TEAM.ConclusionsIncorporating TeamSTEPPS into trauma team education leads to improved TEAM and TPOT scores among undergraduate health professionals.
| S-EPMC4536358 | biostudies-literature
Project description:PurposeThe goal of this systematic review was to examine self-directed learning (SDL) assessment practices in undergraduate health professions education.MethodsSeven electronic databases were searched (PubMed, Embase, PsycINFO, ERIC, CINAHL, Scopus, and Web of Science) to retrieve English-language articles published between 2015 and July of 2022, investigating assessment of SDL learning outcomes. Extracted data included the sample size, field of study, study design, SDL activity type, SDL assessment method, number of SDL assessments used, study quality, number of SDL components present utilising the framework the authors developed, and SDL activity outcomes. We also assessed relationships between SDL assessment method and number of SDL components, study quality, field of study, and study outcomes.ResultsOf the 141 studies included, the majority of study participants were medical (51.8%) or nursing (34.8%) students. The most common SDL assessment method used was internally-developed perception surveys (49.6%). When evaluating outcomes for SDL activities, most studies reported a positive or mixed/neutral outcome (58.2% and 34.8%, respectively). There was a statistically significant relationship between both number and type of assessments used, and study quality, with knowledge assessments (median-IQR 11.5) being associated with higher study quality (p < 0.001). Less than half (48.9%) of the studies used more than one assessment method to evaluate the effectiveness of SDL activities. Having more than one assessment (mean 9.49) was associated with higher quality study (p < 0.001).ConclusionsThe results of our systematic review suggest that SDL assessment practices within undergraduate health professions education vary greatly, as different aspects of SDL were leveraged and implemented by diverse groups of learners to meet different learning needs and professional accreditation requirements. Evidence-based best practices for the assessment of SDL across undergraduate healthcare professions education should include the use of multiple assessments, with direct and indirect measures, to more accurately assess student performance.
| S-EPMC10026772 | biostudies-literature
Project description:PurposeThe effects of class structure (i.e., lecture vs. flipped) and repeated review on: 1) exam scores and 2) student perceptions of learning were compared in a prospective randomized controlled trial (Study 1) and a retrospective cohort study (Study 2).MethodsIn Study 1, 42 second year students in a Doctor of Physical Therapy program were randomized to either a lecture or flipped section of a neurobiology class. Both sections incorporated repeated review. In Study 2, exam scores were retrospectively compared between two cohorts: a lecture cohort without repeated review (n = 42) and a flipped cohort with repeated review (n = 46). In both studies, outcomes of interest were exam scores and student surveys.ResultsIn Study 1, students in the lecture and flipped sections had similar exam averages (lecture = 76.7 ± 17%, flipped = 77.5 ± 17%, p = 0.73). Repeated review significantly improved exam scores by 12.0 percentage points (95% CI: 8.0 to 16.0 percentage points) in the lecture section and 10.8 percentage points (95% CI: 6.9 to 14.8 percentage points) in the flipped section. The flipped section reported higher levels of satisfaction and perceived learning. In Study 2, the flipped cohort had significantly higher exam scores than the lecture cohort (lecture = 70.2 ± 6.9%, flipped = 83.4 ± 7.7%, p < 0.0001). Student satisfaction and perceived learning were similar in both cohorts.ConclusionExam scores improve with review questions and quizzes provided in a class, both in a lecture or flipped classroom.
| S-EPMC9762591 | biostudies-literature
Project description:BackgroundSoft skills and flipped classrooms are important in the fields of education, nursing, and health techniques.AimThis study determined nursing teachers' knowledge of soft skills and flipped classrooms.DesignThis was a descriptive cross-sectional study with an analytical focus involving 100 teachers.SettingsThe study was conducted at the Higher Institute of Nursing Professions and Health Techniques (ISPITS) at Agadir and its annex in Tiznit.ParticipantsOne hundred permanent and temporary teachers (with an equal distribution of male and female teachers) participated in the survey.MethodsA five-part questionnaire was used to collect data. The independent variable was the use of a flipped classroom and dependent variable was the development of soft skills. SPSS version 25 software was used to process the data. Chi-square test, Ficher's test, binary logistic regression test, and multivariate logistic regression model were employed for data analysis.ResultsIn total, 80 % participants had knowledge of soft skills, and 75 % knew about flipped classrooms. The most important soft skills were considered to be communication, stress management, teamwork, conflict management, problem-solving, time management, critical thinking, autonomy, adaptability, and decision-making. The five soft skills considered most likely to be developed by flipped classrooms were autonomy, analysis, teamwork, communication, and time management. Furthermore, the development of soft skills through the flipped classrooms was independently associated with soft skills training (p = 0.008) and use of flipped classrooms (p = 0.042).ConclusionsTeachers have knowledge of soft skills and flipped classrooms despite a lack of training, and flipped classrooms contribute to the development of soft skills.
| S-EPMC11365298 | biostudies-literature