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BMC Med Educ. 2020 Mar 17;20(1):75. doi: 10.1186/s12909-020-1991-2.

Existing contradictions and suggestions: flipped classroom in radiology courses of musculoskeletal disease under Chinese medical educational mode from medical imaging student perspective.

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Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.
Medical imaging, China Medical University, Shenyang, China.
Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.
Office of Educational Administration, Shengjing Hospital of China Medical University, Shenyang, China.



Flipped classrooms have already begun to be used in many universities aboard, and they now make up for some of the short comings of the traditional classroom. We introduced the concept of flipped classrooms into a radiology class in China and evaluated the students' performance to find out whether it was a better learning method. Furthermore, we have attempted to identify the problems of application of flipped classrooms (as practiced under the Chinese education system) and make suggestions.


Facilities made videos and prepared clinical cases and short lectures for the flipped classroom. A total of 55 undergraduate radiology students were asked to finish pre-class learning and pre-learning assessment, participate in a flipped classroom about bone malignant tumours, and complete questionnaires. Teachers were also need to finish the survey.


1) The students showed good performances in the pre-learning assessment. The mean scores for three pre-learning assessment were 89.77, 96.54, and 93.71, respectively; the median scores were 90, 97.5, and 94, respectively. 2) After they attended the flipped classroom, their mastery of knowledge (case-solving skills, basic feature command, comparison ability, and overall knowledge command) showed improvements; after flipped classroom, the scores for these knowledge factors improved to 81.25, 85.42, 85.42, and 85.42%, respectively, compared to the scores they obtained before taking the flipped classroom (1.25, 68.75, 64.58, and 72.92% respectively). 3) The students' discussion time and student-teacher-communication time increased, and the students' questions were solved satisfactorily. 4) CTDI-CV showed no improvement in critical thinking skills after taking the course. 5) The time spent in previewing (pre-class video watching, material reading, and pre-learning assessment) increased significantly.


Flipped classrooms, when tested in a radiology classroom setting, show many advantages, making up for some inadequacies of didactic classrooms. They provide students with better learning experiences. We can continue to practice flipped classroom methods under the curriculum, but we still need to make improvements to make it more suitable for the Chinese medical education mode.


CTDI-CV; Critical thinking; Flipped classroom; Radiology education; Undergraduate education

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