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      Flipped classroom instructional approach in undergraduate medical education

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          In this study we implemented the “flipped classroom” model to enhance active learning in medical students taking neurosciences module at Aga Khan University, Karachi.


          Ninety eight undergraduate medical students participated in this study. The study was conducted from January till March 2017. Study material was provided to students in form of video lecture and reading material for the non-face to face sitting, while face to face time was spent on activities such as case solving, group discussions, and quizzes to consolidate learning under the supervision of faculty. To ensure deeper learning, we used pre- and post-class quizzes, work sheets and blog posts for each session. Student feedback was recorded via a likert scale survey.


          Eighty four percent students gave positive responses towards utility of flipped classroom in terms of being highly interactive, thought provoking and activity lead learning. Seventy five percent of the class completed the pre-session preparation. Students reported that their queries and misconceptions were cleared in a much better way in the face-to-face session as compared to the traditional setting (4.09 ±1.04).


          Flipped classroom(FCR) teaching and learning pedagogy is an effective way of enhancing student engagement and active learning. Thus, this pedagogy can be used as an effective tool in medical schools.

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          Most cited references 21

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          Learning to Teach in Higher Education

           Paul Ramsden (2003)
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            Friend or Foe? Flipped Classroom for Undergraduate Electrocardiogram Learning: a Randomized Controlled Study

            Background Interpreting an electrocardiogram (ECG) is not only one of the most important parts of clinical diagnostics but also one of the most difficult topics to teach and learn. In order to enable medical students to master ECG interpretation skills in a limited teaching period, the flipped teaching method has been recommended by previous research to improve teaching effect on undergraduate ECG learning. Methods A randomized controlled trial for ECG learning was conducted, involving 181 junior-year medical undergraduates using a flipped classroom as an experimental intervention, compared with Lecture-Based Learning (LBL) as a control group. All participants took an examination one week after the intervention by analysing 20 ECGs from actual clinical cases and submitting their ECG reports. A self-administered questionnaire was also used to evaluate the students’ attitudes, total learning time, and conditions under each teaching method. Results The students in the experimental group scored significantly higher than the control group (8.72 ± 1.01 vs 8.03 ± 1.01, t = 4.549, P = 0.000) on ECG interpretation. The vast majority of the students in the flipped classroom group held positive attitudes toward the flipped classroom method and also supported LBL. There was no significant difference (4.07 ± 0.96 vs 4.16 ± 0.89, Z = − 0.948, P = 0.343) between the groups. Prior to class, the students in the flipped class group devoted significantly more time than those in the control group (42.33 ± 22.19 vs 30.55 ± 10.15, t = 4.586, P = 0.000), whereas after class, the time spent by the two groups were not significantly different (56.50 ± 46.80 vs 54.62 ± 31.77, t = 0.317, P = 0.752). Conclusion Flipped classroom teaching can improve medical students’ interest in learning and their self-learning abilities. It is an effective teaching model that needs to be further studied and promoted. Electronic supplementary material The online version of this article (doi:10.1186/s12909-017-0881-8) contains supplementary material, which is available to authorized users.
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              Implementation of a flipped classroom educational model in a predoctoral dental course.

              This article describes the development and implementation of a flipped classroom model to promote student-centered learning as part of a predoctoral dental course. This model redesigns the traditional lecture-style classroom into a blended learning model that combines active learning pedagogy with instructional technology and "flips" the sequence so that students use online resources to learn content ahead of class and then use class time for discussion. The dental anatomy portion of a second-year DMD course at Harvard School of Dental Medicine was redesigned using the flipped classroom model. The 36 students in the course viewed online materials before class; then, during class, small groups of students participated in peer teaching and team discussions based on learning objectives under the supervision of faculty. The utilization of pre- and post-class quizzes as well as peer assessments were critical motivating factors that likely contributed to the increase in student participation in class and helped place learning accountability on the students. Student feedback from a survey after the experience was generally positive with regard to the collaborative and interactive aspects of this form of blended learning.

                Author and article information

                Pak J Med Sci
                Pak J Med Sci
                Pakistan Journal of Medical Sciences
                Professional Medical Publications (Pakistan )
                Nov-Dec 2017
                : 33
                : 6
                : 1424-1428
                [1 ]Syeda Sadia Fatima, MBBS, M.Phil, PhD. Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi, Pakistan
                [2 ]Fazal Manzoor Arain, MBBS, PhD. Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi, Pakistan
                [3 ]Syed Ather Enam, MD, PhD, FRCS, FRCS, FACS. Department of Surgery, The Aga Khan University, Karachi, Pakistan
                Author notes
                Correspondence: Dr. Syeda Sadia Fatima, Department of Biological and Biomedical Sciences, Aga Khan University, 74800, Karachi, Pakistan. Email: sadia.fatima@
                Copyright: © Pakistan Journal of Medical Sciences

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Original Article


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