Flipped classroom instruction is associated with higher final knowledge scores than traditional instruction in medical education (SMD 0.90).¶

Claim · All claims
Evidence · 1 study · quant-synthesis r3 · q3 · i3 large
Currency · newest study 2025 · checked against its sources 2026-10-31 (automated, 1 of 1 entry) · not reviewed by a person

Subclaims¶

q3 i3 Across 127 studies with 21,171 participants (90 observational, 37 RCTs), flipped classroom groups had significantly higher final knowledge scores than traditional-instruction groups (SMD 0.90, 95% CI 0.68-1.13, P<.001), a large difference, with substantial heterogeneity (I²=95.2%) and small-study effects; trim-and-fill attenuated it to SMD 0.30. → de Azevedo Cardoso T 2025

Evidence¶

de Azevedo Cardoso T 2025¶

de Azevedo Cardoso T, Aung H H, Yeh W-Y, Ozdamli F, Ignjatovic A, Spaic D, Bukumiric Z, Rajovic N, Markovic K, Savic M, Milin-Lazovic J, Grubor N, Milic N, Stanisavljevic D, Despotovic A, Bokonjic D, Vladicic Masic J, Janicijevic V, Masic S, Milic N. (2025). The Flipped Classroom in Medical Education: Systematic Review and Meta-Analysis. Journal of Medical Internet Research. https://doi.org/10.2196/60757

q3 · i3 · quant-synthesis · r3

Meta-analysis of 127 studies (21,171 participants; 90 observational studies and 37 RCTs) comparing flipped classroom to traditional instruction in medical education, using random-effects models. The pooled SMD of 0.90 (95% CI 0.68-1.13) is a "large" difference favoring the flipped classroom, with the FC group outperforming approximately 74% of control individuals; the RCT subgroup gave SMD 0.93 (95% CI 0.65-1.22). Heterogeneity was substantial (I²=95.2%), the funnel plot showed significant small-study effects, and trim-and-fill attenuated the estimate to SMD 0.30 (95% CI 0.002-0.59). Because most studies were observational, the pooled figure is a difference in scores, not by itself evidence that the flipped format caused it.

"The meta-analysis results identified significant differences in final knowledge scores between the FC and control groups (SMD 0.90, 95% CI 0.68-1.13; P<.001), thus favoring an FC"

Discussion¶

Related Claims¶

• Flipped classroom instruction is associated with higher student satisfaction than traditional instruction in medical education (SMD 0.82). — related
• Flipped classrooms are associated with higher learner satisfaction in medical education (pooled SMD = 0.69), with residents showing larger improvement than undergraduates (SMD 1.69 vs 0.37) — related
• Publication bias inflates flipped classroom effect estimates for knowledge outcomes but not for baseline knowledge. — related
• Flipped classrooms yield higher theoretical knowledge scores than traditional lectures in Chinese clinical practice students (pooled SMD = 8.33) — related
• Flipped classroom significantly improves practical exam scores over lecture-based learning (pooled SMD 0.50) — related
• Flipped classrooms are associated with improved procedural/technical skills in medical education (pooled SMD = 1.80), with larger effects among residents and in theoretical-course settings — related
• Flipped classrooms are associated with higher theoretical knowledge scores than lecture-based teaching in medical education (pooled SMD = 1.26), with very high heterogeneity — related
• The flipped classroom effect on knowledge scores does not differ significantly between RCT and observational study designs. — related
• Flipped classroom teaching improves medical students' multiple-choice question scores compared to traditional teaching — a narrower finding that bears on this claim
• Baseline knowledge differences between flipped classroom and control groups are small and may inflate final knowledge effect estimates. — related
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