Effects of a quasi-experimental study of using flipped classroom approach to teach evidence-based medicine to medical technology students

The effectiveness of the technology-enhanced flipped class on the learning and satisfaction of nursing students in the immunology course: A quasi-experimental study

BACKGROUND

Health professions graduates are expected to have core competencies and the ability to provide safe, high-quality, patient-centered care. To guarantee this, active learning and learner-oriented learning approaches should be employed.

OBJECTIVE

This research was conducted to determine the effect of the technology-enhanced flipped classroom on the learning and satisfaction of nursing students in the medical immunology course.

DESIGN

Quasi-experimental study.

SETTINGS AND PARTICIPANTS

The participants were 80 nursing students recruited through convenience sampling from the Faculty of Nursing and Midwifery, Tehran University of Medical Sciences who were taking the medical immunology course.

METHODS

In the odd sessions, teaching was traditional, and in the even sessions was flipped. The tools of this study included a satisfaction questionnaire and a class test. Data were analyzed using descriptive statistics, paired t-test, and One-sample t-test by SPSS21.

RESULTS

Longitudinal analysis showed that there was no change in the level of students' learning in the traditional method over time but in the flipped classroom method, there was a positive effect in increasing students' learning. The comparison of students' average learning scores showed the average learning scores in the traditional approach increased from 10.049 to 10.590 But this difference was not statistically significant (P = 0.247). In the flipped classroom, the average learning scores increased from 7.745 to 10.440 which was significant (P < 0.001). The average score of students' satisfaction with the flipped classroom teaching method was 7.56 ± 1.81 and higher than the average level.

CONCLUSION

Technology-enhanced flipped classroom was effective in improving learning and high satisfaction of nursing students which shows that this approach is successful for teaching medical immunology to nursing students. This approach has the potential to be expanded to other nursing courses according to its correct application and implementation.

Biomedical students' self-efficacy and academic performance by gender in a flipped learning haematology course

INTRODUCTION

This study investigated the impact of flipped learning versus traditional instruction on medical students' academic performance and self-efficacy in a haematology course, and examined gender differences. Flipped learning is an instructional approach where students review pre-recorded lecture content at home, and active learning occurs in the classroom. Self-efficacy refers to students' beliefs in their ability to succeed and accomplish learning goals.

METHODS

A quasi-experimental study was conducted with 86 third-year Saudi medical students (46 males, 40 females) in a 10-week haematology course. Students were assigned to flipped learning group (n = 41) or traditional lecture group (n = 45). Both groups completed pre- and post-intervention academic tests and self-efficacy surveys. Data were analyzed using descriptive statistics and t-tests.

RESULTS

The flipped learning group showed an increase in academic scores (p <.05) and self-efficacy scores (p <.05) compared to the traditional group, but between group differences were not statistically significant. Female students in the flipped learning group showed the greatest increase in academic scores and self-efficacy. Most students perceived flipped learning positively for enhancing learning and preparation for class.

CONCLUSION

Flipped learning promoted self-efficacy compared to traditional lectures in medical students. Gender-specific benefits were observed, highlighting the need to design instruction to meet diverse student needs.

The effects of flipped classrooms to improve learning outcomes in undergraduate health professional education: A systematic review

Background

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 reversed or 'flipped'.

Objectives

The primary objectives of this review were to assess the effectiveness of the flipped classroom intervention for undergraduate health professional students on their academic performance, and their course satisfaction.

Search Methods

We identified relevant studies by searching MEDLINE (Ovid), APA PsycINFO, Education Resources Information Center (ERIC) as well as several more electronic databases, registries, search engines, websites, and online directories. The last search update was performed in April 2022.

Selection Criteria

Included studies had to meet the following criteria: Participants: Undergraduate health professional students, regardless of the type of healthcare streams (e.g., medicine, pharmacy), duration of the learning activity, or the country of study. Intervention: We included any educational intervention that included the flipped classroom as a teaching and learning tool in undergraduate programs, regardless of the type of healthcare streams (e.g., medicine, pharmacy). We also included studies that aimed to improve student learning and/or student satisfaction if they included the flipped classroom for undergraduate students. We excluded studies on standard lectures and subsequent tutorial formats. We also excluded studies on flipped classroom methods, which did not belong to the health professional education(HPE) sector (e.g., engineering, economics). Outcomes: The included studies used primary outcomes such as academic performance as judged by final examination grades/scores or other formal assessment methods at the immediate post-test, as well as student satisfaction with the method of learning. Study design: We included randomised controlled trials (RCTs), quasi-experimental studies (QES), and two-group comparison designs. Although we had planned to include cluster-level RCTs, natural experiments, and regression discontinuity designs, these were not available. We did not include qualitative research.

Data Collection and Analysis

Two members of the review team independently screened the search results to assess articles for their eligibility for inclusion. The screening involved an initial screening of the title and abstracts, and subsequently, the full text of selected articles. Discrepancies between the two investigators were settled through discussion or consultation with a third author. Two members of the review team then extracted the descriptions and data from the included studies.

Main Results

We found 5873 potentially relevant records, of which we screened 118 of them in full text, and included 45 studies (11 RCTs, 19 QES, and 15 two-group observational studies) that met the inclusion criteria. Some studies assessed more than one outcome. We included 44 studies on academic performance and eight studies on students' satisfaction outcomes in the meta-analysis. The main reasons for excluding studies were that they had not implemented a flipped class approach or the participants were not undergraduate students in health professional education. A total of 8426 undergraduate students were included in 45 studies that were identified for this analysis. The majority of the studies were conducted by students from medical schools (53.3%, 24/45), nursing schools (17.8%, 8/45), pharmacy schools (15.6%, 7/45). medical, nursing, and dentistry schools (2.2%, 1/45), and other health professional education programs (11.1%, 5/45). Among these 45 studies identified, 16 (35.6%) were conducted in the United States, six studies in China, four studies in Taiwan, three in India, two studies each in Australia and Canada, followed by nine single studies from Brazil, German, Iran, Norway, South Korea, Spain, the United Kingdom, Saudi Arabia, and Turkey. Based on overall average effect sizes, there was better academic performance in the flipped class method of learning compared to traditional class learning (standardised mean difference [SMD] = 0.57, 95% confidence interval [CI] = 0.25 to 0.90, τ 2: 1.16; I 2: 98%; p < 0.00001, 44 studies, n = 7813). In a sensitivity analysis that excluded eleven studies with imputed data from the original analysis of 44 studies, academic performance in the flipped class method of learning was better than traditional class learning (SMD = 0.54, 95% CI = 0.24 to 0.85, τ 2: 0.76; I 2: 97%; p < 0.00001, 33 studies, n = 5924); all being low certainty of evidence. Overall, student satisfaction with flipped class learning was positive compared to traditional class learning (SMD = 0.48, 95% CI = 0.15 to 0.82, τ 2: 0.19, I 2:89%, p < 0.00001, 8 studies n = 1696); all being low certainty of evidence.

Authors' Conclusions

In this review, we aimed to find evidence of the flipped classroom intervention's effectiveness for undergraduate health professional students. We found only a few RCTs, and the risk of bias in the included non-randomised studies was high. Overall, implementing flipped classes may improve academic performance, and may support student satisfaction in undergraduate health professional programs. However, the certainty of evidence was low for both academic performance and students' satisfaction with the flipped method of learning compared to the traditional class learning. Future well-designed sufficiently powered RCTs with low risk of bias that report according to the CONSORT guidelines are needed.

Effectiveness of the flipped classroom methodology on the learning of evidence-based practice of nursing students: Quasi-experimental design

BACKGROUND

International organizations recognize the importance of evidence-based practice (EBP) for nurses. The objective of teaching EBP in the Nursing degree is to train future nurses on this subject. Different teaching models exist for this, from less active traditional models to more active ones such as the flipped classroom.

OBJECTIVE

To compare the degree of EBP competence of undergraduate nursing students after an EBP course, through the application of a traditional methodology versus a flipped classroom methodology.

DESIGN

Quasi-experimental study of non-equivalent groups.

SETTING

The study was composed by a group of students who received training on EBP with the traditional model (face-to-face), and another intervention group with whom the flipped classroom model was utilized, using the online teaching platform EBP-eToolkit.

PARTICIPANTS

The study was conducted with 4th-year Nursing degree students enrolled in the course evidence-based practice, in academic years 2019/20 and 2021/2022.

METHODS

Before and after the course, the students completed a questionnaire about EBP competence (EBP-COQ), and an objective test was given at the end of the year.

RESULTS

A sample of 152 students in the face-to-face group (control), and 143 students in the flipped classroom group (intervention) participated. The intervention group significantly improved its competence on attitude (p = 0.01, η² = 0.022), skills (p = 0.019, η² = 0.018), and global competence in EBP (p = 0.003, η² = 0.030), with respect to those who were taught using the traditional method. However, there were no significant differences in the impact on knowledge, neither through the self-report dimension of the EBP-COQ (p = 0.188) nor the final test score, control group 6.89 (SD: 1.35) and flipped classroom group 7.12 (SD: 1.53) (p = 0.206).

CONCLUSIONS

The flipped classroom model is adequate for the teaching of EBP to undergraduate nursing students. It produced a slight increase in attitude, as well as in skills and global competence in EBP. Nevertheless, this increase was not significantly different from face-to-face learning in terms of impact on EBP knowledge.

Implementation of a Web-Based Educational Intervention for Promoting Flipped Classroom Pedagogy: A Mixed-Methods Study

Introduction

Flipped classroom pedagogy (FCP) is recognised as an effective and efficient teaching-learning method. However, nursing students and teachers may be hesitant to adopt FCP due to technophobia and time constraints linked to academic and clinical responsibilities. This necessitates the provision of promotional training for adopting FCP. However, there is a dearth of research regarding how the practice of FCP could be promoted and in demonstrating its efficacy in developing countries. Thus, this study aimed to examine the educational impact of a web-based education intervention, branded as the Flipped Classroom Navigator (FCN), for promoting FCP in nursing education in Sri Lanka.

Methods

This mixed-methods study employed pre- and post-training knowledge tests, the Instructional Materials Motivation Survey (IMMS), the Perceived Transfer of Learning Questionnaire survey, and collected students' and teachers' open-ended responses to evaluate the impact of the FCN. Fifty-five undergraduate nursing students and 15 university teachers participated in the study from two state universities in Sri Lanka. Repeated-measures ANOVA, t-tests, Levene's test of homogeneity, Cohen's d, and an inductive thematic approach were employed in the data analysis.

Results

Post-training knowledge test scores were significantly higher than the pre-training knowledge test scores indicating improved understanding of FCP. Participants were also highly motivated to learn in the FCN instructional materials. Participants exhibited positive attitudes towards FCN training with transfer of learning to their teaching-learning practice. The inductive thematic analysis identified the following themes: user experiences, FCN learning content, behaviour changes, and suggested improvements.

Conclusion

Overall, the FCN enhanced both students' and teachers' knowledge and understanding of FCP in undergraduate nursing education.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-022-01706-7.

Semi-flipped classroom-based learning interventions in a traditional curriculum of oral medicine: students' perceptions and teaching achievements

BACKGROUND

In recent years, flipped classes have emerged and become popular in college medical education. However, due to the huge medical learning system and the limited pre-class study time of students, it is difficult to implement in all courses. And then we adopted the semi-flipped classes (SFCs) to evaluate its teaching effect. This study analysed three educational methods that can be used in oral medicine courses: online education, offline education, and semi-flipped classes.

METHODS

We used two surveys to evaluate the three educational methods. In the first survey 46 teachers and 238 undergraduates shared their experience of the live-streaming and traditional offline courses offered in the different oral medicine curricula; we used anonymous questionnaires to evaluate their class experience. In the second survey 94 students shared their experience of the semi-flipped and traditional classrooms. Students who attended the SFCs in the experimental group learned about the oral mucosa disease by themselves using an online video course and then participated in offline interaction with teachers. The evaluation of the above educational methods was conducted using the anonymous questionnaires and final exam assessment.

RESULTS

According to the first survey, teachers and students both agreed that the overall teaching experience and learning effectiveness in offline education are superior to those in online education. According to the second survey, students who participated in the SFCs performed better in the final exam than those who participated in the simple offline classes. Additionally, the survey showed that the new teaching method helped students gain more knowledge and positively influenced their clinical practice.

CONCLUSIONS

Compared with the online and offline educational methods, the SFC showed better results in both the questionnaire and final exam assessment. Hence, the effectiveness of medical education can be improved by adopting a teaching mode that combines online and offline teaching methods. Scientific and logical SFCs designs, along with their effective implementation, would eventually make SFCs an important tool for medical education.

Maintaining informatics training learning outcomes with a COVID-19 era shift to a fully online flipped course

The emergence of the coronavirus disease 2019 pandemic forced us to adapt our recently developed informatics training serving a variety of students as well as faculty and staff. The successful flipped classroom course series (a hybrid-format with both asynchronous online learning and in-person synchronous components) was shifted to a fully online format with the synchronous portion now held via web-based video conference. We repeated our participant survey at the end of each of the 3 one-credit courses to compare student satisfaction and learning outcomes achievement to the original offering. The responses were overall very positive again and while there were no differences in satisfaction levels for 2 of the courses, overall satisfaction was higher for the new, fully online Python Programming course. Likewise, students reported similar achievement of the learning outcomes across all courses with 1 of the 12 objectives receiving higher competency agreement in the new, fully online version. Overall, the fully online version of the course series was equally successful, if not more so, than the original version with a physical classroom session each week. Given that participants also had strong agreement with a new question that they would prefer online class meetings instead of in a classroom, even if there wasn’t a global pandemic (citing a variety of logistical reasons such as “convenience of screen sharing,” parking issues, and job-related time constraints), the fully online version of the informatics training will be retained.

Effect of flipped classroom approach in the teaching of a hematology course

The flipped classroom is a teaching strategy used to enhance the engagement of students in the learning process. Replacing didactic lectures with active learning strategies through flipped classroom sessions fosters independence and the opportunity for students to engage in different passive learning styles. Although many studies of the flipped classroom approach have been conducted with medical students, few have focused on the effect of flipped classroom sessions on students in other medical professional fields. The aim of this study was to assess the effect of the flipped classroom approach on the performance of medical laboratory science students in a hematology course and their perception of the flipped classroom as an active learning strategy. In addition, students' perceptions regarding the flipped classroom as an active learning strategy were assessed. Of two cohorts in hematology courses, cohort 2 attended flipped classroom sessions, whereas cohort 1 underwent traditional class sessions. Students' learning outcomes, achievements and performance on examinations in hematology courses were assessed. In addition, a satisfaction survey was distributed to the students to evaluate their perception of the flipped classroom as a student-centred learning strategy. Students in cohort 2 performed significantly better in the knowledge and cognitive domains than did those in cohort 1 (p < 0.001). Cohort 2 students completed the course successfully with an average grade of 81%, and few students received low grades; in comparison, cohort 1 students completed the course with an average grade of 73%, and 7 students received a grade of F. Of students in cohort 2, 83% believed that the flipped classroom provided a better understanding of the subject matter and appropriate knowledge and skills. The results indicate the effectiveness of flipped classrooms as an active learning style in enabling students to obtain desirable knowledge and improve their academic performance. Moreover, students zrecognized that the flipped classroom as an active learning style was more beneficial than the traditional teaching approach.

Promoting Pre-service Teacher Students' Learning Engagement: Design-Based Research in a Flipped Classroom

Students' learning engagement is recognized as one of the main components of effective instruction and a necessary prerequisite for learning, but students' learning engagement in flipped classroom poses some pedagogical challenges. This study aimed to promote students' learning engagement via the flipped classroom approach. Design-based research (DBR) was adopted in this study to conduct an experiment involving three iterations in a Modern Educational Technology (MET) course in a Chinese university. The participants included 36 third-year pre-service teacher undergraduates. Classroom observations and a learning engagement questionnaire were used to measure the effectiveness of the flipped instruction in terms of students' learning engagement. Data analysis applied descriptive statistics, ANOVA, and paired samples t tests. The results showed that after three rounds of iterative experiments, students' learning engagement (behavioral, cognitive, and emotional) significantly improved. Several principles are provided as guidelines for instructors to implement flipped classroom approach to promote students' learning engagement.

Clinical Learning in Medical and Health Professions Education amid COVID-19 Pandemic: A Literature Review of Various Methods and Innovations

BACKGROUND: COVID-19 has caused disruption to medical education and health care systems around the world. The highly contagious nature of the virus makes it difficult for educational institutions to continue their studies as usual, thus affecting the medical and health professions education which is based on face-to-face lectures, practicum, skills laboratories, and clinical practice in health facilities. AIM: This paper discovers clinical learning initiatives across the globe and highlights the contribution toward educational processes. METHODOLOGY: This study utilized an integrated literature review method. A systematic search for articles published was performed in Springer, ScienceDirect, PubMed, and EBSCOHost. Primary search monetary terms were e-learning (all synonyms) and health sciences education (all synonyms), including COVID-19. Articles published within the period of COVID-19 pandemic included in this study. For the synthesis, the 20 included studies selected were coded. In this study, data were synthesized through narrative synthesis using thematic analysis (TA). To identify the recurrent themes author followed six steps when synthesizing data using TA, for example, familiarizing with the data, developing initial (sub) codes, searching for (sub) themes, reviewing (sub) themes, compiling ideas or issues, and producing final data in line with the study aims and objectives. RESULTS: Out of records identified, a total of citations was screened, of which 20 were found to be of relevance to this study most were quantitative (14.70%) in design. Studies were published in 2020 since the beginning of COVID-19 pandemic. The geographical range of papers covered mostly the moderate-income regions. On conducting TA of the included studies, it was possible to obtain two broad descriptive themes/categories: enablers or drivers of, and barriers or challenges to, under which important themes have emerged. CONCLUSION: Study suggests that developing e-learning in effective clinical learning is needed, not only limited to moving the learning process but also needing to follow the instructional design, so that learning outcomes can be achieved by students. In addition, a learning process that promotes self-directed-learning is needed so that students have flexibility, use relevant learning styles and are able to integrate knowledge, skills and attitudes as a meaningful learning process.

A study on how using an interactive multimedia e-book improves teachers' ability to teach evidence-based medicine depending on their seniority

BACKGROUND

Teaching evidence-based medicine (EBM) is not an easy task. The role of the electronic book (e-book) is a useful supplement to traditional methods for improving skills. Our aim is to use an interactive e-book or PowerPoint to evaluate instructors' teaching effects on EBM.

METHODS

Our study group was introduced to learning EBM using an interactive e-book available on the Internet, while the control group used a PowerPoint presentation. We adopted the Modified Fresno test to assess EBM skills both before and after their learning. EBM teaching sessions via e-book or PowerPoint were 20-30 min long, followed by students' feedback. We adopted Student's t-test to compare teachers' evaluation of their EBM skills prior to the class and the students' assessment of the teachers' instruction. We also adopted repeated measures ANCOVA to compare teachers' evaluation of their EBM skills using the Fresno test both before and after the class.

RESULTS

We observed no difference regarding EBM skills between the two groups prior to their experimental learning, which was assessed by the Modified Fresno test. After learning, physicians in the study group ranked higher in choosing a case to explain which kind of research design was used for the study type of the question and explaining their choice (P = 0.024) as assessed by the post-test to pre-test Fresno test. Teaching effect was better in the e-book group than in the control group for the items, "I am satisfied with this lesson," "The teaching was of high quality," "This was a good teaching method," and "It aroused my interest in EBM." However, no differences were observed between the two groups in physicians who had more than 10 years' experience.

CONCLUSIONS

The use of interactive e-books in clinical teaching can enhance a teacher's EBM skills, though not in more senior physicians. This may suggest that teaching methodology and activities differ for teachers' varying years of experience.

Development, Implementation, and Evaluation of an Open Access, Level-Specific, Core Content Curriculum for Emergency Medicine Residents

BACKGROUND

Leaders in graduate medical education must provide robust clinical and didactic experiences to prepare residents for independent practice. Programs traditionally create didactic experiences individually, requiring tremendous resources with variable content exposure and quality.

OBJECTIVE

We sought to create and implement a free, open access, learner-centric, level-specific, emergency medicine (EM) residency curriculum.

METHODS

We developed Foundations of Emergency Medicine (FoEM) Foundations I and II courses using Kern's model of curriculum development. Fundamental topics were identified through content guidelines from the American Board of Emergency Medicine. We incorporated learner-centric strategies into 2 flipped classroom, case-based courses targeting postgraduate year (PGY) 1 and PGY-2 residents. The curriculum was made freely available online in 2016. Faculty and resident users were surveyed annually for feedback, which informed iterative refinement of the curriculum.

RESULTS

Between 2016 and 2020, registration for FoEM expanded from 2 sites with 36 learners to 154 sites and 4453 learners. In 2019, 98 of 102 (96%) site leaders and 1618 of 2996 (54%) learners completed the evaluative survey. One hundred percent of responding leaders and 93% of learners were "satisfied" or "very satisfied" with FoEM content. Faculty and residents valued FoEM's usability, large volume of content, quality, adaptability, organization, resident-faculty interaction, and resident-as-teacher opportunities. Challenges to implementation included resident attendance, conference structure, technology limitations, and faculty engagement.

CONCLUSIONS

We developed and implemented a learner-centric, level-specific, national EM curriculum that has been widely adopted in the United States.

Influences of Flipped Teaching in Electronics Courses on Students' Learning Effectiveness and Strategies

The potential influence of the COVID-19 pandemic has changed the status of school education and further accelerated the revolution of regular teaching method. This study compared the learning effectiveness and learning strategies of vocational high school students in flipped teaching and traditional teaching modes. By adopting flipped teaching on an electronics course throughout the entire academic year, this study aimed to explore the effect of learning strategies of the students under flipped teaching. The subjects of this study were 85 sophomore students majoring in Electrical Engineering. This study randomly selected one class as the control group (n = 43), and adopted the regular teaching method while another class was selected as the experimental group (n = 42), and employed the flipped teaching method. This study used the "Learning strategy scale of students in vocational high schools" as the instrument. The students' scores of the Testing Center for Technological and Vocational Education Test were used to evaluate their learning effectiveness. The results of this study indicate that students under the flipped teaching model made remarkable progress in the electronics course and the learning outcomes remained significant after a long period of time. Moreover, they made notable changes in their learning strategies, including "learning motivation", "reading and exams", "self-testing", and "problem solving strategies".

Online training in evidence-based medicine and research methods for GP registrars: a mixed-methods evaluation of engagement and impact

BACKGROUND

Evidence-based medicine (EBM) is a core skillset for enhancing the quality and safety of patients' care. Online EBM education could improve clinicians' skills in EBM, particularly when it is conducted during vocational training. There are limited studies on the impact of online EBM training on clinical practice among general practitioner (GP) registrars (trainees in specialist general practice). We aimed to describe and evaluate the acceptability, utility, satisfaction and applicability of the GP registrars experience with the online course. The course was developed by content-matter experts with educational designers to encompass effective teaching methods (e.g. it was interactive and used multiple teaching methods).

METHODS

Mixed-method data collection was conducted after individual registrars' completion of the course. The course comprised six modules that aimed to increase knowledge of research methods and application of EBM skills to everyday practice. GP registrars who completed the online course during 2016-2020 were invited to complete an online survey about their experience and satisfaction with the course. Those who completed the course within the six months prior to data collection were invited to participate in semi-structured phone interviews about their experience with the course and the impact of the course on clinical practice. A thematic analysis approach was used to analyse the data from qualitative interviews.

RESULTS

The data showed the registrars were generally positive towards the course and the concept of EBM. They stated that the course improved their confidence, knowledge, and skills and consequently impacted their practice. The students perceived the course increased their understanding of EBM with a Cohen's d of 1.6. Registrars identified factors that influenced the impact of the course. Of those, some were GP-related including their perception of EBM, and being comfortable with what they already learnt; some were work-place related such as time, the influence of supervisors, access to resources; and one was related to patient preferences.

CONCLUSIONS

This study showed that GP registrars who attended the online course reported that it improved their knowledge, confidence, skill and practice of EBM over the period of three months. The study highlights the supervisor's role on GP registrars' ability in translating the EBM skills learnt in to practice and suggests exploring the effect of EBM training for supervisors.

The Differentiate Effect of Self-Efficacy, Motivation, and Satisfaction on Pre-Service Teacher Students’ Learning Achievement in a Flipped Classroom: A Case of a Modern Educational Technology Course

To analyze how variability changes over time can enhance the understanding of how learners’ self-efficacy, motivation, and satisfaction is controlled and why differences might exist among groups of individuals. Therefore, this study compared the effect of variability on pre-service teacher students in the flipped classroom approach with a course named modern educational technology (MET). In total, 77 students in two groups participated in this study. Learners in the experimental group received the flipped classroom treatment. Learners in the control group received the traditional lecture-centered instructional approach. The learning outcomes were evaluated by practice assignment, transfer assignment, and student perception survey. The survey includes the evaluation of learning satisfaction, self-efficacy, and learning motivation. Pre-test and post-test were conducted by the two groups. The data analysis results applied analysis of variance (ANOVA) or analysis of covariance (ANCOVA) and revealed that the experimental group displayed a better learning achievement than the control group. The experimental group participants’ perception also showed variability (i.e., learning satisfaction, self-efficacy, and learning motivation) was better than the control group. Considering the overall study results, the flipped classroom model can be applied in the pre-service teacher students’ modern educational technology course.

An e-leadership training academy for practicing clinicians in primary care and public health settings

Leadership is an essential competency for clinicians; however, these skills are not a standard part of health professionals' education and training. Access to resources (time, money) is frequently cited as a barrier for clinicians to participate in leadership development programs. We aimed to tackle this barrier within postgraduate health professions education and training through establishing an online e-Leadership Academy. The e-Leadership Academy was developed as a community-academic partnership between Clinical Directors Network, Inc. (CDN) and the Harvard Medical School Center for Primary Care to train clinicians and healthcare staff in the fundamental concepts and skills for leading within a clinical practice. For this article, the primary outcome analysis examined participants' responses to both formative and summative evaluations that took place throughout and at the end of the course. Results were used to assess course quality, participant satisfaction, participant engagement, and provide recommendations about future course offerings for a similar audience. The authors propose that future training programs could measure the changes in team behavior and clinical outcomes using expanded evaluations. Proposed plans for expansion of the e-Leadership Academy include developing additional modules, virtual coaching and mentoring, and the potential integration of an in-person component.

Flipped classroom versus traditional lecture in training undergraduates in pediatric epilepsy

Introduction:

Pedagogical constructs such as flipped classroom are used to engage students in the learning process by their active participation. The aim of the present study was to compare the two models of flipped classroom and traditional lecture in training undergraduates in pediatric epilepsy.

Methods:

The study was conducted among the 3^rd-year undergraduate medical students. They were divided to either of Group I or II. Pediatric epilepsy was taught in two parts (clinical diagnosis and management). Group I received Part A as traditional lecture and Part B as the flipped classroom and the reverse for Group II. The difference in posttest and pretest scores was compared between two groups for each part.

Results:

There was a significant increase in posttest scores when compared to pretest scores in both the groups. Mean (standard deviation [SD]) difference in scores for epilepsy diagnosis was comparable in Group I (3.33 [2.3]) and Group II (2.46 [2.17]) (P = 0.16). Mean (SD) difference in scores for epilepsy management was significantly higher in Group I (3.41 [2.09]) when compared to Group II (1.30 [1.84]) (P < 0.01).

Conclusion:

Flipped classroom model resulted in better scores than the traditional teaching method for training undergraduates in the management of epilepsy in children. This teaching–learning method could be adopted in training of primary care physicians.