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Anat Sci Educ. 2017 Jul;10(4):317-327. doi: 10.1002/ase.1664. Epub 2016 Nov 4.

The "flipped classroom" approach: Stimulating positive learning attitudes and improving mastery of histology among medical students.

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Division of Histology and Embryology, Jinan University School of Medicine, Guangzhou, People's Republic of China.
Ministry of Education Key Laboratory for Regenerative Medicine, School of Biomedical Sciences, Chinese University of Hong Kong, Shatin, Hong Kong.
Department of Radiology, VA San Diego Healthcare System, San Diego, California.
Department of Radiology, University of California San Diego, San Diego Medical Center, San Diego, California.


Traditional medical education methodologies have been dramatically impacted by the introduction of new teaching approaches over the past few decades. In particular, the "flipped classroom" format has drawn a great deal of attention. However, evidence regarding the effectiveness of the flipped model remains limited due to a lack of outcome-based studies. In the present study, a pilot histology curriculum of the organ systems was implemented among 24 Traditional Chinese Medicine (TCM) students in a flipped classroom format at Jinan University. As a control, another 87 TCM students followed a conventional histology curriculum. The academic performance of the two groups was compared. In addition, a questionnaire was administered to the flipped classroom group. The test scores for the flipped classroom participants were found to be significantly higher compared to non-participants in the control group. These results suggest that students may benefit from using the flipped classroom format. Follow-up questionnaires also revealed that most of the flipped classroom participants undertook relatively more earnest preparations before class and were actively involved in classroom learning activities. The teachers were also found to have more class time for leading discussions and delivering quizzes rather than repeating rote didactics. Consequently, the increased teaching and learning activities contributed to a better performance among the flipped classroom group. This pilot study suggests that a flipped classroom approach can be used to improve histology education among medical students. However, future studies employing randomization, larger numbers of students, and more precise tracking methods are needed before definitive conclusions can be drawn. Anat Sci Educ 10: 317-327.


flipped classroom; histology education; medical education; microscopic anatomy education; students’ perceptions; undergraduate education

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