The Effectiveness of Flipped Classroom Models in Undergraduate Medical Education: A Systematic Review
Flipped Classroom Models in Undergraduate Medical Education
DOI:
https://doi.org/10.54393/pjhs.v6i8.3404Keywords:
Flipped Classroom, Medical Education, Undergraduate Students, Academic Performance, Self-Directed Learning, Student Satisfaction, Knowledge RetentionAbstract
The flipped classroom has emerged as a progressive pedagogical model in undergraduate medical education, aiming to improve learning outcomes by combining self-directed pre-class learning with interactive in-class activities. Unlike traditional lectures, this method fosters active engagement, critical thinking, and practical skill development. Objectives: To evaluate the effectiveness of flipped classroom models in improving academic outcomes, student satisfaction, and skill acquisition among undergraduate medical students. Methods: A comprehensive literature search was conducted across PubMed, Springer Link, Science Direct, BMC, Wiley Online Library, and Taylor & Francis for studies published between January 2019 and August 2024. Eligible studies included undergraduate medical or allied health students exposed to flipped classroom models, with outcomes compared against traditional teaching methods. Data extraction and quality appraisal were performed using standardized tools, and results were synthesized narratively due to heterogeneity. Results: Most included studies reported improvements in academic performance, student satisfaction, and engagement. The flipped classroom was particularly effective in enhancing clinical reasoning and knowledge retention. However, some studies demonstrated variable outcomes depending on the quality of implementation and learner readiness. Conclusions: The flipped classroom approach shows considerable potential to strengthen undergraduate medical education. Its effectiveness is maximized when supported by structured implementation, faculty training, and strategies that foster self-regulated learning among students.
References
Ge L, Chen Y, Yan C, Chen Z, Liu J. Effectiveness of Flipped Classroom Vs Traditional Lectures in Radiology Education: A Meta-Analysis. Medicine. 2020 Oct; 99(40): e22430. doi: 10.1097/MD.0000000000022430. DOI: https://doi.org/10.1097/MD.0000000000022430
Oudbier J, Spaai G, Timmermans K, Boerboom T. Enhancing the Effectiveness of Flipped Classroom in Health Science Education: A State-of-the-Art Review. BioMed Central Medical Education. 2022 Jan; 22(1): 34. doi: 10.1186/s12909-021-03052-5. DOI: https://doi.org/10.1186/s12909-021-03052-5
Al-Samarraie H, Shamsuddin A, Alzahrani AI. A Flipped Classroom Model in Higher Education: A Review of the Evidence Across Disciplines. Educational Technology Research and Development. 2020 Jun; 68(3): 1017-51. doi: 10.1007/s11423-019-09718-8. DOI: https://doi.org/10.1007/s11423-019-09718-8
Yang FC and Chen HM. Examining Flipped Classroom and Project-Based Learning Integration in Older Adult Health Education: A Mixed-Methods Study. Nursing Reports. 2025 Jul; 15(8): 267. doi: 10.3390/nursrep15080267. DOI: https://doi.org/10.3390/nursrep15080267
Zheng B, Ward A, Stanulis R. Self-Regulated Learning in A Competency-Based and Flipped Learning Environment: Learning Strategies Across Achievement Levels and Years. Medical Education Online. 2020 Jan; 25(1): 1686949. doi: 10.1080/10872981.2019.1686949. DOI: https://doi.org/10.1080/10872981.2019.1686949
Park JH, Han WS, Kim J, Lee H. Strategies for Flipped Learning in the Health Professions Education in South Korea and Their Effects: A Systematic Review. Education sciences. 2020 Dec; 11(1): 9. doi: 10.3390/educsci11010009. DOI: https://doi.org/10.3390/educsci11010009
Shi Y, Ma Y, MacLeod J, Yang HH. College Students’ Cognitive Learning Outcomes in Flipped Classroom Instruction: A Meta-Analysis of the Empirical Literature. Journal of Computers in Education. 2020 Mar; 7(1): 79-103. doi: 10.1007/s40692-019-00142-8. DOI: https://doi.org/10.1007/s40692-019-00142-8
Sultan AS, Ali R, Zahid N, Akbar R, Ali M, Fatima S et al. Experiences of Undergraduate Medical, Nursing Students and Faculty Regarding Flipped Classroom: A Mixed Method Study at Private Medical University in Pakistan. British Medical Journal Open. 2023 Apr; 13(4): e070276. doi: 10.1136/bmjopen-2022-070276. DOI: https://doi.org/10.1136/bmjopen-2022-070276
Shaikh KR, Soomro UA, Ata MA, Abbasi P, Kazi SA, Ali S et al. The Impact of Flipped Classroom on Enhancing Pharmacology Education among 3rd-Year MBBS Students. Journal of Peoples University of Medical & Health Sciences. 2024; 14(4): 171-175.
Cai L, Li YL, Hu XY, Li R. Implementation of Flipped Classroom Combined with Case-Based Learning: A Promising and Effective Teaching Modality in Undergraduate Pathology Education. Medicine. 2022 Feb; 101(5): e28782. doi: 10.1097/MD.0000000000028782. DOI: https://doi.org/10.1097/MD.0000000000028782
Bhai SA and Poustinchian B. The Flipped Classroom: A Novel Approach to Physical Examination Skills for Osteopathic Medical Students. Journal of Osteopathic Medicine. 2021 May; 121(5): 475-81. doi: 10.1515/jom-2020-0198. DOI: https://doi.org/10.1515/jom-2020-0198
Khayat M, Hafezi F, Asgari P, Shoushtari MT. Comparison of the Effectiveness of Flipped Classroom and Traditional Teaching Method on the Components of Self-Determination and Class Perception Among University Students. Journal of Advances in Medical Education & Professionalism. 2021 Oct; 9(4): 230.
Rehman R and Fatima SS. An Innovation in Flipped Class Room: A Teaching Model to Facilitate Synchronous and Asynchronous Learning During a Pandemic. Pakistan Journal of Medical Sciences. 2021 Jan; 37(1): 131. doi: 10.12669/pjms.37.1.3096. DOI: https://doi.org/10.12669/pjms.37.1.3096
Huang HL, Chou CP, Leu S, You HL, Tiao MM, Chen CH. Effects of a Quasi-Experimental Study of Using Flipped Classroom Approach to Teach Evidence-Based Medicine to Medical Technology Students. BioMed Central Medical Education. 2020 Jan; 20(1): 31. doi: 10.1186/s12909-020-1946-7. DOI: https://doi.org/10.1186/s12909-020-1946-7
Zheng B and Zhang Y. Self-Regulated Learning: The Effect on Medical Student Learning Outcomes in A Flipped Classroom Environment. BioMed Central Medical Education. 2020 Mar; 20(1): 100. doi: 10.1186/s12909-020-02023-6. DOI: https://doi.org/10.1186/s12909-020-02023-6
Kang HY and Kim HR. Impact of Blended Learning on Learning Outcomes in the Public Healthcare Education Course: A Review of Flipped Classroom with Team-Based Learning. BioMed Central Medical Education. 2021 Jan; 21(1): 78. doi: 10.1186/s12909-021-02508-y. DOI: https://doi.org/10.1186/s12909-021-02508-y
Sourg HA, Satti S, Ahmed N, Ahmed AB. Impact of Flipped Classroom Model in Increasing the Achievement for Medical Students. BioMed Central Medical Education. 2023 Apr; 23(1): 287. doi: 10.1186/s12909-023-04276-3. DOI: https://doi.org/10.1186/s12909-023-04276-3
Bordes SJ, Walker D, Modica LJ, Buckland J, Sobering AK. Towards the Optimal Use of Video Recordings to Support the Flipped Classroom in Medical School Basic Sciences Education. Medical Education Online. 2021 Jan; 26(1): 1841406. doi: 10.1080/10872981.2020.1841406. DOI: https://doi.org/10.1080/10872981.2020.1841406
Hanafy SM, Arafa MA, Jumaa MI, Farhat KH, Refai AA, Elkordy EA et al. Neuroanatomy Teaching in the Flipped Classroom: Attitudes and Effect on Medical Students' Performance. Clinical Anatomy. 2025 Jan; 38(1): 105-12. doi: 10.1002/ca.24232. DOI: https://doi.org/10.1002/ca.24232
Wu S, Pan S, Ren Y, Yu H, Chen Q, Liu Z et al. Existing Contradictions and Suggestions: Flipped Classroom in Radiology Courses of Musculoskeletal Disease Under Chinese Medical Educational Mode from Medical Imaging Student Perspective. BioMed Central Medical Education. 2020 Mar; 20(1): 75. doi: 10.1186/s12909-020-1991-2. DOI: https://doi.org/10.1186/s12909-020-1991-2
Tahir F, Hafiz B, Alnajjar T, Almehmadi B, Besharah B, Gari A et al. Comparison of Performance of Medical Students Between Two Teaching Modalities “Flip the Classroom” and Traditional Lectures: A Single Center Educational Interventional Study. Pakistan Journal of Medical Sciences. 2020 Jul; 36(5): 958. doi: 10.12669/pjms.36.5.2730. DOI: https://doi.org/10.12669/pjms.36.5.2730
Kumar S and Usmani A. The Effectiveness of Flipped Classroom On 3rd Year Students of Oral Medicine Subject to Achieve the Learning Outcome: Flipped Classroom on 3rd Year Students of Oral Medicine. Pakistan Journal of Health Sciences. 2022 Dec: 103-7. doi: 10.54393/pjhs.v3i07.397. DOI: https://doi.org/10.54393/pjhs.v3i07.397
Jitha S and Thomas SP. A Comparative Mixed-Method Study of Flipped Classroom and Traditional Lecture for Teaching Rational Drug Prescription Among Undergraduates in Pharmacology. Indian Journal of Physiology and Pharmacology. 2024 Jul: 1-6.
Algarni A. Biomedical Students’ Self-Efficacy and Academic Performance by Gender in A Flipped Learning Haematology Course. BioMed Central Medical Education. 2024 Apr; 24(1): 443. doi: 10.1186/s12909-024-05421-2. DOI: https://doi.org/10.1186/s12909-024-05421-2
Alnahdi M, Agha S, Khan MA, Almansour M. The Flipped Classroom Model: Exploring the Effect on the Knowledge Retention of Medical Students. Journal of Ayub Medical College Abbottabad. 2022 Sep; 34(4): 759-65. doi: 10.55519/JAMC-04-10957. DOI: https://doi.org/10.55519/JAMC-04-10957
Shi XY, Yin Q, Wang QW, Lu BR, Li GX, Huang SH et al. Is the Flipped Classroom More Effective Than the Traditional Classroom in Clinical Medical Education: A Systematic Review and Meta-Analysis? In Frontiers in Education. 2025 Jan; 9: 1485540. doi: 10.3389/feduc.2024.1485540. DOI: https://doi.org/10.3389/feduc.2024.1485540
Islam MS, Alam KK, Talukder MH, Rahman I, Noman MU, Nahar S et al. Effectiveness of Traditional Lecture-Based Learning and Flipped Classroom Learning in Teaching Dermatology among Undergraduate Medical Students of Bangladesh. Bangladesh Journal of Medical Education. 2025 Jul; 16(2): 10-23. doi: 10.3329/bjme.v16i2.83093. DOI: https://doi.org/10.3329/bjme.v16i2.83093
Gautam N, Dhungana R, Gyawali S, Dhakal S, Pradhan PM. Perception of Medical Students Regarding TU-IOM MBBS Curriculum and Teaching Learning methods in Nepal. Kathmandu University Medical Journal. 2022 Jun; 20(2): 219-24. doi: 10.3126/kumj.v20i2.51404. DOI: https://doi.org/10.3126/kumj.v20i2.51404
Aristotle S, Subramanian S, Jayakumar S. Effectiveness of Flipped Classroom Model in Teaching Histology for First-Year MBBS Students Based on Competency-Based Blended Learning: An Interventional Study. Journal of Education and Health Promotion. 2021 Jan; 10(1): 152. doi: 10.4103/jehp.jehp_467_20. DOI: https://doi.org/10.4103/jehp.jehp_467_20
Patriota RD, Frias LG, Silton GA, Silva MA, Duque TB, Lorena SB. Flipped Classroom for Learning Clinical Examination. Revista Brasileira de Educação Médica. 2022; 46(1). doi: 10.1590/1981-5271v46.1-20210364.ing. DOI: https://doi.org/10.1590/1981-5271v46.1-20210364.ing
Amorim MB, de Moraes AR, de Souza DK, Coêlho EC, Vieira GB, de Oliveira GP et al. Benefits of the Flipped Classroom in Health Education-A Systematic Review. Brazilian Journal of Health Review. 2020 Dec; 3(6): 17428-37. doi: 10.34119/bjhrv3n6-160. DOI: https://doi.org/10.34119/bjhrv3n6-160
Weimer JM, Recker F, Horn L, Kuenzel J, Dirks K, Ille C et al. Insights into Modern Undergraduate Ultrasound Education: Prospective Comparison of Digital and Analog Teaching Resources in A Flipped Classroom Concept–the DIvAN Study. Ultrasound International Open. 2024; 10(continuous publication). doi: 10.1055/a-2389-9410. DOI: https://doi.org/10.1055/a-2389-9410
Wang A, Xiao R, Zhang C, Yuan L, Lin N, Yan L et al. Effectiveness of a Combined Problem-Based Learning and Flipped Classroom Teaching Method in Ophthalmic Clinical Skill Training. BioMed Central Medical Education. 2022 Jun; 22(1): 487. doi: 10.1186/s12909-022-03538-w. DOI: https://doi.org/10.1186/s12909-022-03538-w
Chan PP, Lee VW, Yam JC, Brelén ME, Chu WK, Wan KH et al. Flipped Classroom Case Learning Vs Traditional Lecture-Based Learning in Medical School Ophthalmology Education: A Randomized Trial. Academic Medicine. 2023 Sep; 98(9): 1053-61. doi: 10.1097/ACM.0000000000005238. DOI: https://doi.org/10.1097/ACM.0000000000005238
Ding C, Li S, Chen B. Effectiveness of Flipped Classroom Combined with Team-, Case-, Lecture-and Evidence-Based Learning on Ophthalmology Teaching for Eight-Year Program Students. BioMed Central Medical Education. 2019 Nov; 19(1): 419. doi: 10.1186/s12909-019-1861-y. DOI: https://doi.org/10.1186/s12909-019-1861-y
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