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BMC Med Educ. 2018 Apr 2;18(1):63. doi: 10.1186/s12909-018-1150-1.

Evaluation of a flipped classroom approach to learning introductory epidemiology.

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Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 509, New York, NY, 10032, USA.
Department of Pediatrics, New York University School of Medicine, New York, NY, USA.
Center for Teaching and Learning, Columbia University, New York, NY, USA.
School of Professional Studies, Columbia University, New York, NY, USA.
Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 509, New York, NY, 10032, USA.



Although the flipped classroom model has been widely adopted in medical education, reports on its use in graduate-level public health programs are limited. This study describes the design, implementation, and evaluation of a flipped classroom redesign of an introductory epidemiology course and compares it to a traditional model.


One hundred fifty Masters-level students enrolled in an introductory epidemiology course with a traditional format (in-person lecture and discussion section, at-home assignment; 2015, N = 72) and a flipped classroom format (at-home lecture, in-person discussion section and assignment; 2016, N = 78). Using mixed methods, we compared student characteristics, examination scores, and end-of-course evaluations of the 2016 flipped classroom format and the 2015 traditional format. Data on the flipped classroom format, including pre- and post-course surveys, open-ended questions, self-reports of section leader teaching practices, and classroom observations, were evaluated.


There were no statistically significant differences in examination scores or students' assessment of the course between 2015 (traditional) and 2016 (flipped). In 2016, 57.1% (36) of respondents to the end-of-course evaluation found watching video lectures at home to have a positive impact on their time management. Open-ended survey responses indicated a number of strengths of the flipped classroom approach, including the freedom to watch pre-recorded lectures at any time and the ability of section leaders to clarify targeted concepts. Suggestions for improvement focused on ways to increase regular interaction with lecturers.


There was no significant difference in students' performance on quantitative assessments comparing the traditional format to the flipped classroom format. The flipped format did allow for greater flexibility and applied learning opportunities at home and during discussion sections.


Education; Epidemiology; Flipped classroom; Graduate level setting; Instructional tecnology; Public health

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