Impact of a Flipped Classroom on Evidence-Based Medicine Skills Among Pharmacy Students

In 2020, the lecture series for a written clinical inquiry (CI) assignment (ie, drug information papers) transitioned to a flipped model using asynchronous presentations with preclass assignments, followed by synchronous discussions with active learning. The objective of this evaluation was to determine the impact of a flipped instructional model on pharmacy students' evidence-based medicine (EBM) skills using CI scores.

A report of CI scores was generated for the 2019 third-year (P3) class (lecture) and the 2020 and 2021 P3 classes (flipped) as well as for Block 1 Advanced Pharmacy Practice Experience (APPE) CI scores. Clinical questions were assigned by faculty to P3 students, while preceptors assigned questions on APPEs. The CI rubric includes 3 major subscores: appropriate literature, evidence summary, and evidence-based answer, each contributing 25% of the total score.

There were 139 and 259 students in the lecture and flipped cohorts, respectively. In the flipped cohort, the mean overall CI scores improved in both the P3 and APPE years compared to the lecture cohort (mean change: 4.2% and 6.7%, respectively). The major subscores statistically significantly increased in the flipped model for both P3 and APPE assignments, except for a nonsignificant increase in the P3 evidence-based answer subscore. Improvements were primarily observed in the skills emphasized during in-class active learning.

Meaningful increases in CI scores were observed using a flipped model compared to a lecture-based model, especially in skills reinforced by in-class active learning. A flipped model can improve skills with translation to practice-based settings.