A Massive Open Online Course-Based Flipped Classroom Protocol For Pediatric Puncture Skills Training Among...

This protocol describes a reproducible teaching model designed to enhance the clinical competency of undergraduate medical interns in performing four essential pediatric puncture skills: thoracic, abdominal, lumbar, and tibial bone marrow punctures. The key procedural approach integrates self-paced, pre-class massive open online course (MOOC) learning with intensive, hands-on, in-class simulation practice. Prior to class, interns complete 10 to 20 min instructional videos covering operation principles, standard procedures, common mistakes, and clinical case analyses, while constructing mind maps to logically organize anatomical and procedural knowledge. During the in-class session, instructional time is completely reallocated from traditional lectures to personalized teacher guidance, peer discussion, and standardized scenario-based simulation practice using high-fidelity pediatric mannequins. The intended application of this protocol is to address the severe time and resource limitations inherent in traditional medical education by maximizing active hands-on practice opportunities. Validation studies indicate that this scalable flipped classroom framework significantly improves medical students' skill mastery, clinical thinking, and theory-practice integration without increasing their overall learning burden, making it highly adaptable for broader clinical skills training programs.