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. 2021 Jan 2;20:1. doi: 10.1186/s12912-020-00515-w

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© The Author(s) 2021

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 1 — The impact of flipping the classroom on the percentage of correct answers in anatomy and physiology. a A comparison of students’ pre-test and post-test scores for the five quizzes administered for the EG (N = 53). Results are expressed as mean ± standard error of the mean (SEM) and converted into a percent class average. Before any in-class explanation or activity, students obtained an accuracy of 64% on the quizzes, showing that they had watched the videos prior to class. The active learning in class increased students’ performance by almost 20%. b Anatomy and physiology final examination average (in percent) for the EG in a flipped classroom (N = 53) was significantly higher than the average of the CG in a traditional didactic lecture (N = 59). Results are expressed as percentage of correct responses mean ± SEM on the respiratory system items compared to the other items. Improvement in scores was 8% better with flipped classroom than with didactic lecturing. Bars graphs are plotted separately by group for CG and EG. Statistically significant differences are indicated by *** Wilcoxon signed-rank test p < 0.001 and ### Mann-Whitney U test p < 0.001. c Students in a flipped classroom course (EG) performed significantly better than the previous cohort (CG) on high-order analysis multiple-choice questions in the final examination. Statistically significant differences are indicated by ### Mann-Whitney U test, p < 0.001. d Difference in students’ semester average grades between respiratory items (flipped classroom) and other items (traditional lecture) in an anatomy and physiology course for EG (N = 53). Students were divided into quartiles based on their final score on the final examination with 38–68% (1st quartile, N = 12), 69–80% (2nd quartile, N = 13), 81–85% (3rd quartile, N = 13), and 86–100% (4th quartile, N = 15). Each stratified group scored higher on the respiratory system items compared to the other items. The Wilcoxon signed-rank test was used for comparisons and significant p values are indicated. Error bars represent SEM; * < 0.05; ** < 0.01