The Flipped Classroom in Medical Education: Systematic Review and Meta-Analysis
BackgroundThe concept of flipped classrooms (FCs) is gaining attention in medical education as it aligns with the digital age’s demand for more interactive and accessible learning experiences. By shifting the delivery of instructional content outside of the classroom, an FC a...
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JMIR Publications
2025-08-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2025/1/e60757 |
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| author | Dragan Spaic Zoran Bukumiric Nina Rajovic Ksenija Markovic Marko Savic Jelena Milin-Lazovic Nikola Grubor Nikola Milic Dejana Stanisavljevic Aleksa Despotovic Dejan Bokonjic Jelena Vladicic Masic Valerija Janicijevic Srdjan Masic Natasa Milic |
| author_facet | Dragan Spaic Zoran Bukumiric Nina Rajovic Ksenija Markovic Marko Savic Jelena Milin-Lazovic Nikola Grubor Nikola Milic Dejana Stanisavljevic Aleksa Despotovic Dejan Bokonjic Jelena Vladicic Masic Valerija Janicijevic Srdjan Masic Natasa Milic |
| author_sort | Dragan Spaic |
| collection | DOAJ |
| description |
BackgroundThe concept of flipped classrooms (FCs) is gaining attention in medical education as it aligns with the digital age’s demand for more interactive and accessible learning experiences. By shifting the delivery of instructional content outside of the classroom, an FC allows students to engage with materials at their own pace, thereby maximizing in-class time for discussions, problem-solving, and other active learning activities.
ObjectiveThis study aimed to conduct a comprehensive meta-analysis to appraise the comparative effectiveness of FC instruction in contrast to traditional pedagogical modalities, with a particular focus on postepidemic analyses within specific subfields of medical education.
MethodsThe PubMed, Web of Science, and Scopus databases were systematically searched for studies comparing academic outcomes between the FC and traditional learning approaches in medical education. The primary outcome measures were knowledge assessment and students’ satisfaction. The standardized mean difference (SMD) was used as a measure of the overall effect, and subgroup analysis was performed according to the study design (randomized controlled trial [RCT] vs observational). The Cochran Q test and Baujat plots were used to estimate heterogeneity, coupled with I2. Highly influential studies were identified; sensitivity analyses and metaregression were performed.
ResultsIn total, 141 studies were included in the systematic review; 127 (90.1%) studies with 21,171 participants were included in the meta-analysis of students’ knowledge assessment, of which 37 (29.1%) were RCTs. FCs had significantly better outcomes than the traditional method in knowledge test scores in both observational studies and RCTs (SMD 0.90, 95% CI 0.59-1.20, P<.001 and SMD 0.93, 95% CI 0.65-1.22, P<.001, respectively). There was substantial heterogeneity among included studies (I2=95.2%, τ2=1.614; P<.001). The funnel plot showed high asymmetry with significant small study effects (P<.001). However, the effect estimate remained robust to the exclusion of highly influential studies in the sensitivity analysis. In total, 27 (21.3%) studies with a total of 5842 participants reported students’ satisfaction. Higher student satisfaction scores for FCs were demonstrated in contrast to control groups (SMD 0.82, 95% CI 0.45-1.19; P<.001). There was substantial heterogeneity among the included studies (I2=97.8%, τ2=0.913; P<.001) but no evidence for publication bias, and no studies were found to be influential.
ConclusionsThe FC method is associated with better knowledge achievement and greater student satisfaction than the traditional approach in medical education, paving the way for its broader integration into medical school curricula. However, it is essential to consider various factors, such as the availability of resources, faculty readiness, and student preferences when implementing any new educational approach. This study holds promise for advancing medical education by exploring innovative teaching methodologies that leverage technology to enhance learning outcomes. |
| format | Article |
| id | doaj-art-b62f8c2bbfbf41d6a514cd69f972f731 |
| institution | Kabale University |
| issn | 1438-8871 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj-art-b62f8c2bbfbf41d6a514cd69f972f7312025-08-20T03:36:34ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-08-0127e6075710.2196/60757The Flipped Classroom in Medical Education: Systematic Review and Meta-AnalysisDragan Spaichttps://orcid.org/0000-0003-0892-3283Zoran Bukumirichttps://orcid.org/0000-0002-7609-4504Nina Rajovichttps://orcid.org/0000-0002-8509-0329Ksenija Markovichttps://orcid.org/0009-0002-6244-7775Marko Savichttps://orcid.org/0000-0002-0487-8043Jelena Milin-Lazovichttps://orcid.org/0000-0002-4655-2383Nikola Gruborhttps://orcid.org/0009-0007-7876-1554Nikola Milichttps://orcid.org/0009-0000-3246-2283Dejana Stanisavljevichttps://orcid.org/0000-0001-8899-2929Aleksa Despotovichttps://orcid.org/0000-0001-8137-911XDejan Bokonjichttps://orcid.org/0000-0002-7749-5326Jelena Vladicic Masichttps://orcid.org/0009-0000-4960-2959Valerija Janicijevichttps://orcid.org/0000-0001-7252-7731Srdjan Masichttps://orcid.org/0000-0001-8852-2054Natasa Milichttps://orcid.org/0000-0001-7074-1187 BackgroundThe concept of flipped classrooms (FCs) is gaining attention in medical education as it aligns with the digital age’s demand for more interactive and accessible learning experiences. By shifting the delivery of instructional content outside of the classroom, an FC allows students to engage with materials at their own pace, thereby maximizing in-class time for discussions, problem-solving, and other active learning activities. ObjectiveThis study aimed to conduct a comprehensive meta-analysis to appraise the comparative effectiveness of FC instruction in contrast to traditional pedagogical modalities, with a particular focus on postepidemic analyses within specific subfields of medical education. MethodsThe PubMed, Web of Science, and Scopus databases were systematically searched for studies comparing academic outcomes between the FC and traditional learning approaches in medical education. The primary outcome measures were knowledge assessment and students’ satisfaction. The standardized mean difference (SMD) was used as a measure of the overall effect, and subgroup analysis was performed according to the study design (randomized controlled trial [RCT] vs observational). The Cochran Q test and Baujat plots were used to estimate heterogeneity, coupled with I2. Highly influential studies were identified; sensitivity analyses and metaregression were performed. ResultsIn total, 141 studies were included in the systematic review; 127 (90.1%) studies with 21,171 participants were included in the meta-analysis of students’ knowledge assessment, of which 37 (29.1%) were RCTs. FCs had significantly better outcomes than the traditional method in knowledge test scores in both observational studies and RCTs (SMD 0.90, 95% CI 0.59-1.20, P<.001 and SMD 0.93, 95% CI 0.65-1.22, P<.001, respectively). There was substantial heterogeneity among included studies (I2=95.2%, τ2=1.614; P<.001). The funnel plot showed high asymmetry with significant small study effects (P<.001). However, the effect estimate remained robust to the exclusion of highly influential studies in the sensitivity analysis. In total, 27 (21.3%) studies with a total of 5842 participants reported students’ satisfaction. Higher student satisfaction scores for FCs were demonstrated in contrast to control groups (SMD 0.82, 95% CI 0.45-1.19; P<.001). There was substantial heterogeneity among the included studies (I2=97.8%, τ2=0.913; P<.001) but no evidence for publication bias, and no studies were found to be influential. ConclusionsThe FC method is associated with better knowledge achievement and greater student satisfaction than the traditional approach in medical education, paving the way for its broader integration into medical school curricula. However, it is essential to consider various factors, such as the availability of resources, faculty readiness, and student preferences when implementing any new educational approach. This study holds promise for advancing medical education by exploring innovative teaching methodologies that leverage technology to enhance learning outcomes.https://www.jmir.org/2025/1/e60757 |
| spellingShingle | Dragan Spaic Zoran Bukumiric Nina Rajovic Ksenija Markovic Marko Savic Jelena Milin-Lazovic Nikola Grubor Nikola Milic Dejana Stanisavljevic Aleksa Despotovic Dejan Bokonjic Jelena Vladicic Masic Valerija Janicijevic Srdjan Masic Natasa Milic The Flipped Classroom in Medical Education: Systematic Review and Meta-Analysis Journal of Medical Internet Research |
| title | The Flipped Classroom in Medical Education: Systematic Review and Meta-Analysis |
| title_full | The Flipped Classroom in Medical Education: Systematic Review and Meta-Analysis |
| title_fullStr | The Flipped Classroom in Medical Education: Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Flipped Classroom in Medical Education: Systematic Review and Meta-Analysis |
| title_short | The Flipped Classroom in Medical Education: Systematic Review and Meta-Analysis |
| title_sort | flipped classroom in medical education systematic review and meta analysis |
| url | https://www.jmir.org/2025/1/e60757 |
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