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West J Emerg Med. 2019 May;20(3):527-536. doi: 10.5811/westjem.2019.2.40979. Epub 2019 Apr 16.

The Flipped Classroom: A Critical Appraisal.

Author information

University of Wisconsin School of Medicine and Public Health, Berbee Walsh Department of Emergency Medicine, Madison, Wisconsin.
Johns Hopkins School of Medicine, Department of Emergency Medicine, Baltimore, Maryland.
Stanford University School of Medicine, Department of Emergency Medicine, Palo Alto, California.
David Geffen School of Medicine at UCLA, Department of Emergency Medicine, Los Angeles, California.
Wake Forest School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina.
Denver Health Medical Center, Department of Emergency Medicine, Denver, Colorado.
Oregon Health and & Science University, Department of Emergency Medicine, Portland, Oregon.
University of Wisconsin School of Medicine and Public Health, Library Services, Madison, Wisconsin.



The objective of this study was to review and critically appraise the medical education literature pertaining to a flipped-classroom (FC) education model, and to highlight influential papers that inform our current understanding of the role of the FC in medical education.


A search of the English-language literature querying Education Resources Information Center (ERIC), PsychINFO, PubMed, and Scopus identified 296 papers related to the FC using either quantitative, qualitative, or review methods. Two reviewers independently screened each category of publications using previously established exclusion criteria. Eight reviewers then independently scored the remaining 54 publications using either a qualitative, quantitative, or review-paper scoring system. Each scoring system consisted of nine criteria and used parallel metrics that have been previously used in critical appraisals of education research.


A total of 54 papers (33 quantitative, four qualitative, and 17 review) on FC met a priori criteria for inclusion and were critically appraised and reviewed. The top 10 highest scoring articles (five quantitative studies, two qualitative studies, and three review papers) are summarized in this article.


This installment of the Council of Emergency Medicine Residency Directors (CORD) Academy Critical Appraisal series highlights 10 papers that describe the current state of literature on the flipped classroom, including an analysis of the benefits and drawbacks of an FC approach, practical implications for emergency medicine educators, and next steps for future research.

Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.

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