BackgroundThe use of flipped classroom approach has become increasingly popular in health professions education. However, no meta-analysis has been published that specifically examines the effect of flipped classroom versus traditional classroom on student learning. This study examined the findings of comparative articles through a meta-analysis in order to summarize the overall effects of teaching with the flipped classroom approach. We focused specifically on a set of flipped classroom studies in which pre-recorded videos were provided before face-to-face class meetings. These comparative articles focused on health care professionals including medical students, residents, doctors, nurses, or learners in other health care professions and disciplines (e.g., dental, pharmacy, environmental or occupational health).MethodUsing predefined study eligibility criteria, seven electronic databases were searched in mid-April 2017 for relevant articles. Methodological quality was graded using the Medical Education Research Study Quality Instrument (MERSQI). Effect sizes, heterogeneity estimates, analysis of possible moderators, and publication bias were computed using the Comprehensive Meta-Analysis software.ResultsA meta-analysis of 28 eligible comparative studies (between-subject design) showed an overall significant effect in favor of flipped classrooms over traditional classrooms for health professions education (standardized mean difference, SMD = 0.33, 95% confidence interval, CI = 0.21–0.46, p < 0.001), with no evidence of publication bias. In addition, the flipped classroom approach was more effective when instructors used quizzes at the start of each in-class session. More respondents reported they preferred flipped to traditional classrooms.ConclusionsCurrent evidence suggests that the flipped classroom approach in health professions education yields a significant improvement in student learning compared with traditional teaching methods.

An increasing number of teachers are using flipped classroom approach in their teaching. This instructional approach combines video-based learning outside the classroom and interactive group learning activities inside the classroom. The purpose of the present review is to provide an overview of flipped classroom studies in K-12 education. Particularly, we put emphasis on revealing and addressing the potential challenges of flipped classroom approach. Fifteen journal publications of K-12 flipped classrooms were analyzed in terms of their flipped learning activities, student achievement, student attitude, and challenges encountered. The results suggested that a variety of pre-class (e.g., online exercises) and in-class (e.g., brief review, individual practices) activities were provided in addition to instructional videos and small-group activities respectively. The use of flipped classroom approach in K-12 education yielded a neutral or positive impact on student achievement when compared to traditional classroom. Mixed results of student attitude toward flipped classroom approach were discovered. Challenges of implementing flipped classrooms were identified and categorized into student-related challenges, faculty challenges, and operational challenges. Based on the suggestions of previous studies together with relevant empirical supports, we propose a rudimentary flipped classroom model and a set of 10 guidelines to address these challenges. Finally, several recommendations of future research are provided. ReviewFlipped classroom approach has become a popular pedagogy in many education institutes around the world. The basic notion of flipped classroom approach is to deliver the teacher's lectures before class through online videos, in order to free-up the in-class time for active learning and problem solving activities.The use of flipped classroom approach has been extensively studied, especially in the contexts of higher education. Following the previous reviews (e.g., Bernard 2015; Betihavas et al.

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