Benefits and Limitations of Flipped Classroom

Abstract

In the digital age of learning, new learning ecologies provide students with new web-based learning opportunities and resources. Medical education is reaching a new trend in teaching–learning methods by providing student-centered teaching. Flipped classroom is one among the teaching–learning methods. The contribution of the flipped classroom to education is discussed in relation to the changes in students’ and instructors’ roles. Subsequently, flipped classroom advantages and drawbacks are illustrated. For the current article literature was searched in databases PubMed and Scopus and only articles related to medical teaching were included. Studies on non-academic or informal settings without relevance to flipped classrooms were excluded. The study’s findings suggest that creating successful flipped classroom environments may be aided by carefully considering the cautions and suggestions given in the literature and also this article attempts to inform those who are thinking of using new technologies and approaches to deliver courses.

INTRODUCTION

In the digital age of learning, new learning ecologies provide students with new web-based learning opportunities and resources. The quick adoption of cutting-edge strategies in higher education that support cooperative learning, exploration, and research in online networked learning environments has been made possible by the rapid proliferation of interactive technologies. Alternative methods of teacher-centered instruction have emerged in this setting and achieved success in tertiary education.

In this regard, the emergence of creative student-centered teaching strategies has compelled educators to reconsider how they carry out their roles in the classroom in order to put students first, stimulate their engagement, foster the growth of practical thinking, and advance their digital literacy.

Even with technological improvements, lectures are still recognized as a crucial method of adult education. Medical schools and universities throughout the world have had difficulties in recent years as a result of their continuing failure to offer students a high-quality medical education.[1,2] Flipped classroom, a new teaching–learning method has been emerging to provide student-centered medical education.

METHODOLOGY

The PubMed and Scopus databases were used to conduct a thorough literature search for the current article. These platforms were selected because they provide thorough coverage of excellent medical and academic research. The purpose of the search technique was to find papers that particularly addressed the implementation of the flipped classroom concept in medical education settings. Combinations of keywords and search phrases, such as “flipped classroom,” “medical education,” “active learning,” and “teaching strategies in medicine,” were carefully chosen to guarantee a focused and pertinent retrieval of research.

Only publications specifically about medical education were chosen, with a focus on research that examined the use, advantages, drawbacks, and results of the flipped classroom model in medical education. Studies that addressed non-academic or informal settings, or those that lacked direct relevance to flipped classroom practices, were excluded from the review. This exclusion criterion ensured that the analysis remained focused on formal educational contexts and avoided diluting the findings with unrelated or less applicable data. The inclusion and exclusion process was carefully applied to maintain the integrity and specificity of the review’s scope. Priority was given to articles that offered insights into the use of this methodology for improving learning in medical students, residents, or healthcare professionals.

BENEFITS OF FLIPPED CLASSROOM IN MEDICAL EDUCATION

Student satisfaction

Increased student satisfaction is one of the flipped classroom strategy’s most well-researched advantages. When compared to traditional lecture formats, students in flipped classrooms express more satisfaction with the flexibility to access preclass assignments and learn at their own pace, as well as with a greater emphasis on discussions and hands-on activities during class.[3,4,5]

According to psychologists, self-pacing and modifying the content to the needs of the learners are essential strategies for assisting students in managing the cognitive load associated with learning new material. Essentially, flipped classroom models have been shown to let students tailor their learning experiences to lessen cognitive load based on their level of understanding (tailoring to expertise); high achievers can skip the parts they understand, and lower achievers can review material they are having trouble with (self-pacing).[4,5,6]

MOTIVATION OF LEARNER

Prioritizing learner motivation is essential when choosing a flipped classroom format. For the flipped classroom to be successful, students must either have their own intrinsic motivation or feeling competent (from performing well on quizzes or tasks linked to the assignments), or a sense of autonomy to accomplish assignments. A superb flipped classroom approach, according to psychologists, combines elements that foster learners’ intrinsic and extrinsic motivation.[5,6]

As part of the flipped classroom paradigm, the usage of quizzes or other metrics not only aids in measuring student learning for instructional purposes but also fosters a sense of competence and serves to prime the learner through knowledge recall.

Additionally, students claim that quizzes given before in-class activities improve their incentive to review the material before class. According to JD Karpicke, regular retrieval practice after the first learning phase is followed by spaced repetition testing over time improves long-term memory.[7]

BENEFITS IN LEARNING PROCEDURES AND HIGHER PROCESSING

There is conflicting evidence regarding how flipped classrooms affect knowledge retention over time and changes in practice behaviors relevant to the clinical setting. However, current research indicates that while some studies in particular healthcare settings have found better retention in flipped classroom settings, students are performing at least as well as those who attended regular lectures.[5,7]

According to Morton et al.,[8] the flipped classroom is most effective when used to teach higher order skills or processing, such as knowledge analysis or application, as opposed to basic memorizing.

Instead of increasing students’ unnecessary cognitive load, the flipped classroom idea maximizes students’ relevant cognitive load, or their deep processing of new material and assists in integrating it with past knowledge.[8]

Lehmann et al.,[9] for instance, showed that pediatric residents who used a blended learning classroom with virtual or video content had better procedural knowledge than a control group who received education through conventional lecture and skills station teaching.

With changes in learner perception (Kirkpatrick level 1), change in learner opinion (Kirkpatrick level 2a), change in knowledge or skills (Kirkpatrick level 2b), or change in behaviors (Kirkpatrick level 3),[10] investigated whether flipped classroom learning was utilizing higher processing.

Further research is required to evaluate long-term behavior modification and practice patterns in medical settings (Kirkpatrick levels 3 and 4) as a result of flipped classrooms. Internal medicine residents did, however, gain knowledge and self-reported changes in prescription behaviors (Kirkpatrick levels 2 and 3) after a flipped classroom session that examined pharmacotherapy in type 2 diabetes mellitus, according to data from small studies.[11] Many of these studies are preliminary, and more investigation is necessary to see whether they have broad relevance, but many are encouraging, particularly in the procedural or skill areas. The flipped classroom may be beneficial in situations when more extensive processing is required.

FACULTY INTEREST

The desire of teachers to change their teaching strategies and their interest in picking up new skills is another advantage of using flipped classrooms. When it was used in a study by Martinelli et al.,[12] of the 244 faculty members who responded to the survey on flipped classroom teaching, 57% said they understood how it worked and 32% had used it in the previous year. However, 89% said they wanted more information on the subject.

If using new teaching techniques and flipping medical classes will result in better use of class time, professors are interested in doing so.[4,12] According to Moffett, if teachers are unsure about how to best use the time they spend in front of students, switching to a flipped classroom or incorporating some of its characteristics could help breathe new life into a classroom that has grown stale.[13]

FLIPPED CLASSROOM LIMITATIONS IN MEDICAL EDUCATION

Lack of extensive knowledge retention studies

There are a few arguments against flipping the classroom, as with any novel strategy. One is the amount of time it takes to create flipped classroom teaching resources. Another would be the absence of proof that knowledge retention is better in flipped classrooms than in traditional classrooms. Large research comparing the long-term knowledge retention of students in flipped classrooms and traditional classrooms is scarce. We do know that students frequently perform as well in flipped classrooms as in traditional lectures, that they are frequently more motivated, and that they frequently perform better in specific settings in smaller studies but is that evidence sufficient to suggest that flipping the curriculum is what educators would consider worthwhile.[14]

Because some procedural abilities and higher order processing may not always be accurately assessed using conventional (multiple choice) or modern testing methodologies, more research must be done to ensure we are properly measuring knowledge retention.

The fact that many of the earlier studies, like that by Riddell et al.[15] in Graduate Medical Education, introduce a flipped classroom strategy over a brief period of time which is an issue.[16] True differences cannot be assessed by flipping the classroom through recorded lectures distributed over several days, without a period for students to acclimatize to the prework necessary in flipping the classroom.[15] Flipping the classroom requires adjustment. For the majority of students, the flipped classroom is a novel experience that is different from how they have ever before learned or studied.

Time investment

It is not small in terms of the amount of time educators spend flipping medical curriculum. According to McLaughlin et al.,[16] a teacher must devote 127% more effort to course development and 57% more time to course maintenance in order to successfully flip a classroom. However, Wagner et al.[17] contend, in line with the author’s own observations, that once preclass material has been recorded or prepared, online courses and learning resources can be used with numerous, succeeding cohorts of students, freeing up teachers’ time to devote to practical matters like bedside teaching, cases, and discussions. Shimamoto and Snowden assert that the effectiveness of a flipped classroom course depends significantly on the preparation of the teachers.

Applicability to graduate medical education

It is uncertain whether flipped classroom learning would be generally applicable to graduate medical education given that learner preparation time is a concern. However, according to a study, despite the fact that the specific methods used differed from program to program, they discovered that flipped classroom learning had been adopted in over 13 different residency program types.[10] It appears that several programs became inventive with the prework given because of the concern over residents’ limited time to prepare for class.[10] According to Blair et al.,[11] planning preparation time into the didactic timetable for flipping medical classrooms in graduate medical education may be necessary.

Utilize materials that already exist

Institutions can start by incorporating existing video content and other prework into their class discussions and case studies. Drawing material from either paid or open-source platforms may help educators start quickly and efficiently.[13,18] A teacher’s innovative ideas for incorporating particular teaching methods into their own curriculum may also be inspired by looking at what other educators have done.

CONCLUSION

Any new teaching or learning technique necessitates a mental shift in both educators and students. Through active learning, they should understand it. Students may enhance higher order thinking abilities and creativity using technology-enabled flipped classroom practices. Many educational institutions employ the flipped classroom as an instructional strategy. The sage on the stage and the guide on the side are combined in the flipped classroom, which allows all learning styles to be catered to during the entire course. The flipped classroom method is being used by instructors in different health professions to encourage active, student-centered learning and to provide students the power to build higher order cognitive skills. The flipped classroom: a dynamic approach to teaching and learning that makes classes more engaging and challenging and to partake in worthwhile learning that would ultimately enhance the way healthcare is delivered.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.