Flipped classroom improves student learning in health professions education: a meta-analysis

Abstract

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.

The impact of flipped classrooms on student achievement in engineering education: A meta‐analysis of 10 years of research

“…Similarly, both the meta‐analyses for the health profession indicated statistically significant overall effect sizes in favor of the flipped classroom. The effect sizes were SMD = 0.468 in Chen et al () and Hedges' g = 0.33 in Hew and Lo (). As a side note, the difference in effect sizes in the two studies of the health profession was due to two reasons.…”

“…At the time of this article, only a few flipped classroom meta‐analyses papers had been published. For example, one was in mathematics education (Lo et al, ) and two were in the context of the health profession (Chen et al, ; Hew & Lo, ). The meta‐analysis of flipped mathematics education showed an overall positive significant effect of Hedges' g = 0.298 in favor of the flipped classroom over the traditional classroom.…”

Stimulating Intrinsic Motivation in Millennial Students: A New Generation, a New Approach

“…Evidence suggests that current health care students are becoming increasingly more conscious of the role of empathy in their training (Burgess et al, ; Deng et al, ; Palmen et al, ; Hulbert and Anderson, ), and want guidance to systematically inculcate these skills in client management (Hew and Lo, ; Hickman et al, ). Moreover, providing a warm and empathetic learning environment has been reported to encourage conceptualized help‐seeking (Karpicke and Bauernschmidt, ; Dassel et al, ; Hill et al, ) and reduce test anxiety in students (Ahrweiler et al, ; Jordan and Foster, ; Riley, ).…”

“…Furthermore, there is the growing consensus among educational and psychological researchers that the characteristics of millennial students in the health care profession have been excessively generalized (DiLullo et al, ; Kong et al, ; Cant and Cooper, ; Khalil et al, ). It needs to be recognized that students enrolled in different health care disciplines, such as medicine, pharmacy, veterinary medicine, and nursing, will conceivably have unique learning predispositions (Marks, ; Archer, ; DiLullo et al, ; Zielezinski and Karlowski, ; O'Mahony et al, ; Hew and Lo, ). Hence, progressive research designs that allow causal inferences to be derived from more dissimilar student populations would allow the results to be generalized to larger student populations.…”

“…These practices provide students with the opportunity to pursue unique individual goals (Woolley and Fishbach, 2018) and interests (Ezell et al, 2013;Agius et al, 2018), and satisfy their needs for autonomy (Woolley and Fishbach, 2018) and competence (Desy et al, 2018;Gauer and Jackson, 2018). It is significant that the practice of AST also benefits students with ingrained low levels of autonomy (Cohn and Lyons, 2003;Hew and Lo, 2018) and motivation (Spasenoska et al, 2016;Melin-Johansson et al, 2018;Rotenstein et al, 2016).…”