Does the Flipped Classroom improve exam performance in medical education? A systematic review

This article was migrated. The article was marked as recommended. The 'flipped classroom' (FC) is a blended learning model in which educational material is delivered on-line prior to class, students then apply this knowledge through discussion and problem solving activities in class. Its effectiveness in medical education is debated. The aim of this systematic review is to assess the outcomes of studies which have compared the exam performance of traditional didactic teaching (DT) to the FC in medical education. A broad based literature search was performed in accordance with PRISMA protocol. MESH terms were 'flipped classroom', 'flipped teaching', 'blended learning' and 'medical education'. The outcomes of interest were test score results following FC compared to DT methods. Eleven studies with a total of 2052 study participants were included in the review. Four studies demonstrated a significant improvement in test scores using FC compared to DT; four showed no significant difference and three demonstrated mixed results. The results of this review are equivocal. Study heterogeneity in design, participants and subject covered may account for some of this disparity. Two studies provide evidence that the FC results in improved performance on higher cognitive tasks however further robust, in depth studies are required to demonstrate this conclusively.