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Cited by 1,207Innovative Teaching MethodsInnovations in Medical EducationUndergraduate Neuroscience Education and Research

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

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HEW, Khe Foon, LO, Chung Kwan·2018·BMC Medical Education
DOI 10.1186/s12909-018-1144-zPMC PMC5855972
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Abstract

BACKGROUND: The 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). METHOD: Using 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. RESULTS: A 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. CONCLUSIONS: Current evidence suggests that the flipped classroom approach in health professions education yields a significant improvement in student learning compared with traditional teaching methods.

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  • This finding is in line with previous meta-analyses showing that formative assessments between pre-class and in-class activities can greatly enhance learning.

    “This finding is in line with previous meta-analyses (Hew & Lo, 2018b;Låg & Sæle, 2019;Lo & Hew, 2019;van Alten et al., 2019) showing that formative assessments (e.g., quizzes or reviews) used between pre-class activities and in-class activities can greatly enhance students' learning.”

    From Exploring the Effectiveness of Flipped Classroom on STEM Student Achievement: A Meta-analysis (2024) · cites this paper as Hew & Lo, 2018b

    The Discussion and Conclusions report that quizzes assessing pre-class material at the start of an in-class session made flipped classrooms more effective in health professions education. They do not establish the same result for formative assessments such as reviews generally, or quantify the added benefit as a great enhancement. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Only peer-reviewed journal studies were included, as their results are believed to be of sufficient quality.

    “Only peer-reviewed journal studies were included, as their results are believed to be of sufficient quality (Cheng et al., 2019a;Hew & Lo, 2018a;Korpershoek et al., 2016;Lo et al., 2017).”

    From Exploring the Effectiveness of Flipped Classroom on STEM Student Achievement: A Meta-analysis (2024) · cites this paper as Hew & Lo, 2018a

  • Previous reviews found small effect sizes under a random effects model across engineering, mathematics, and health profession education.

    “According to some previous reviews (Chen et al., 2018;Hew & Lo, 2018a;Lo et al., 2017), the effect sizes were small under a random effect sizes model across three disciplines (engineering, mathematics, and health profession education).”

    From Exploring the Effectiveness of Flipped Classroom on STEM Student Achievement: A Meta-analysis (2024) · cites this paper as Hew & Lo, 2018a

  • Hew & Lo (2018a) found that using quizzes at the start of face-to-face courses can help students recall knowledge, identify misconceptions, and improve learning outcomes.

    “(Hew & Lo, 2018a) found in their meta-analysis that using quizzes at the start of face-to-face courses can help students recall knowledge and identify possible misconceptions and so improve learning outcomes.”

    From Exploring the Effectiveness of Flipped Classroom on STEM Student Achievement: A Meta-analysis (2024) · cites this paper as Hew & Lo, 2018a

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Cited by

Sorted by citations

Authors
HEW, K. F., & LO, C. K.
Affiliations
University of Hong Kong (HK)
Corresponding author
HEW, Khe Foon
ORCID
Venue
BMC Medical Education
Publisher
Springer Science and Business Media LLC
Published
2018-03-15
Volume
18
Issue
1
Pages
38-38
ISSN
1472-6920 (ISSN-L)
DOI
10.1186/s12909-018-1144-z
PMC
PMC5855972
OpenAlex
W2795129397
Cited by
1,207
References
8
Citations by year
2026: 104 · 2025: 134 · 2024: 158 · 2023: 210 · 2022: 220 · 2021: 189 · 2020: 118 · 2019: 58 · 2018: 15
FWCI
37.17
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Medical Education (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics
  • Social Sciences › Education › Innovative Teaching Methods
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Undergraduate Neuroscience Education and Research
Keywords
flipped classroom, health professions education, student learning, traditional classroom comparison, in-class quizzes, medical students, nursing education, dental education, pharmacy education, learner preferences
MeSH terms
Health Occupations, Humans, Teaching, Problem-Based Learning, Quality Improvement

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