Why The Flipped Lecture Is Not A ‘One Size Fits All’ Solution To Undergraduate Medical Education.





flipped lecture, medical education, student engagement, student learning, active learning


Lectures underpin most medical school curricula; however, due to their frequently didactic nature, their pedagogical efficacy and value are continually questioned. The “flipped” lecture is one approach with the potential to increase student collaboration and interactivity within the lecture theatre environment. Increasingly, medical teachers are introducing flipped lectures, reflecting the increasing use of active learning techniques and digital technologies across the higher education sector more generally. This intervention is seen as a solution to the problems of a traditional lecture, yet whether the use of flipped lectures in medical school programmes enhances learning for all students is not clear. This study investigates whether flipped lectures are perceived as a valuable learning resource by undergraduate medical students. By introducing a flipped lecture at two stages of the curriculum to three student cohorts, and determining students’ observations and perceptions of each experience, we discuss why a flipped lecture does not always meet the needs of the increasingly diverse range of students in medical education and propose exercising caution when considering the introduction of flipped lectures to undergraduate programmes.


Bligh, D. A. (2000) What's the Use of Lectures? San Francisco: Jossey -Bass Publishers.
Bonwell, C. C., & Eison, J. A. (1991). Active Learning: Creating Excitement in the Classroom. 1991 ASHE-ERIC Higher Education Reports. ERIC Clearinghouse on Higher Education, The George Washington University, One Dupont Circle, Suite 630, Washington, DC 20036-1183. Retrieved from https://files.eric.ed.gov/fulltext/ED336049.pdf
Bossaer, J. B., Panus, P., Stewart, D. W., Hagemeier, N. E., & George, J. (2016). Student performance in a pharmacotherapy oncology module before and after flipping the classroom. American journal of pharmaceutical education, 80(2), 31. Retrieved from https://www.ajpe.org/doi/pdf/10.5688/ajpe80231
Brooks, D. C. (2011). Space matters: The impact of formal learning environments on student learning. British Journal of Educational Technology, 42(5), 719-726. Retrieved from https://doi.org/10.1111/j.1467-8535.2010.01098.x
Brown, G., & Manogue, M. (2001). AMEE Medical Education Guide No. 22: Refreshing lecturing: a guide for lecturers. Medical teacher, 23(3), 231-244. Retrieved from https://doi.org/10.1080/01421590120043000
Burke, A. S., & Fedorek, B. (2017). Does “flipping” promote engagement? A comparison of a traditional, online, and flipped class. Active Learning in Higher Education, 18(1), 11-24. Retrieved from https://doi.org/10.1177/1469787417693487
Critz, C. M., & Knight, D. (2013). Using the flipped classroom in graduate nursing education. Nurse educator, 38(5), 210-213. doi: 10.1097/NNE.0b013e3182a0e56a
Dodiya, D., Vadasmiya, D. S., & Diwan, J. (2019). A comparative study of flip classroom teaching method versus traditional classroom teaching method in undergraduate medical students in physiology. National Journal of Physiology, Pharmacy and Pharmacology, 9(6), 551-555. doi:10.5455/njppp.2019.9.0310829032019
Fischer, E., & Hänze, M. (2019). Back from “guide on the side” to “sage on the stage”? Effects of teacher-guided and student-activating teaching methods on student learning in higher education. International Journal of Educational Research, 95, 26-35. Retreived from https://doi.org/10.1016/j.ijer.2019.03.001
Gilboy, M. B., Heinerichs, S., & Pazzaglia, G. (2015). Enhancing student engagement using the flipped classroom. Journal of nutrition education and behavior, 47(1), 109-114. Retrieved from https://doi.org/10.1016/j.jneb.2014.08.008
Haidet, P., Morgan, R. O., O'malley, K., Moran, B. J., & Richards, B. F. (2004). A controlled trial of active versus passive learning strategies in a large group setting. Advances in Health Sciences Education, 9(1), 15-27. Retrieved from https://link.springer.com/content/pdf/10.1023/B:AHSE.0000012213.62043.45.pdf
Hartnett, M., George, A. S., & Dron, J. (2014). Exploring motivation in an online context: A case study. Contemporary Issues in Technology and Teacher Education, 14(1), 31-53.
Hidi, S., & Renninger, K. A. (2006). The four-phase model of interest development. Educational psychologist, 41(2), 111-127. Retrieved from https://doi.org/10.1207/s15326985ep4102_4
Hopkins, L., Hampton, B. S., Abbott, J. F., Buery-Joyner, S. D., Craig, L. B., Dalrymple, J. L., ... & Wolf, A. (2018). To the point: medical education, technology, and the millennial learner. American journal of obstetrics and gynecology, 218(2), 188-192. Retrieved from https://doi.org/10.1016/j.ajog.2017.06.001
Ilic, D., Hart, W., Fiddes, P., Misso, M., & Villanueva, E. (2013). Adopting a blended learning approach to teaching evidence-based medicine: a mixed methods study. BMC medical education, 13(1), 169. Retrieved from https://doi.org/10.1186/1472-6920-13-169
Jensen, S. A. (2011). In-class versus online video lectures: Similar learning outcomes, but a preference for in-class. Teaching of Psychology, 38(4), 298-302. doi: 10.1177/0098628311421336
Krathwohl, D. R. (2002). A revision of Bloom's taxonomy: An overview. Theory into practice, 41(4), 212-218. Retrieved from https://doi.org/10.1207/s15430421tip4104_2
Lage, M. J., Platt, G. J., & Treglia, M. (2000). Inverting the classroom: A gateway to creating an inclusive learning environment. The Journal of Economic Education, 31(1), 30-43. Retrieved from https://doi.org/10.1080/00220480009596759
McLaughlin, J. E., Griffin, L. M., Esserman, D. A., Davidson, C. A., Glatt, D. M., Roth, M. T., Gharkholonarehe, N. & Mumper, R. J. (2013). Pharmacy student engagement, performance, and perception in a flipped satellite classroom. American journal of pharmaceutical education, 77(9), 196. Retrieved from https://www.ajpe.org/doi/pdf/10.5688/ajpe779196
McLaughlin, J. E. Roth, M. T., Glatt, D. M, Gharkholonarehe, N, Davidson, C. A , Griffin, L. M., Esserman, D. A.,& Mumper, R. J. (2014). The Flipped Classroom: A Course Redesign to Foster Learning and Engagement in a Health Professions School. Academic Medicine, 89(2), 236-243. doi: 10.1097/ACM.0000000000000086
Merlin‐Knoblich, C., & Camp, A. (2018). A Case Study Exploring Students’ Experiences in a Flipped Counseling Course. Counselor Education and Supervision, 57(4), 301-316. doi: 10.1002/ceas.12118
Michel, N., Cater III, J. J., & Varela, O. (2009). Active versus passive teaching styles: An empirical study of student learning outcomes. Human resource development quarterly, 20(4), 397-418. doi: 10.1002/hrdq.20025
Molesworth, M., Nixon, E., & Scullion, R. (2009). Having, being and higher education: The marketisation of the university and the transformation of the student into consumer. Teaching in higher Education, 14(3), 277-287. Retrieved from https://doi.org/10.1080/13562510902898841
Morgan, H., McLean, K., Chapman, C., Fitzgerald, J., Yousuf, A., & Hammoud, M. (2015). The flipped classroom for medical students. The clinical teacher, 12(3), 155-160. Retrieved from https://doi.org/10.1111/tct.12328
Ogden, L. (2015). Student perceptions of the flipped classroom in college algebra. Primus, 25(9-10), 782-791. Retrieved from https://doi.org/10.1080/10511970.2015.1054011
Poniatowski, K. (2019). Assessing Flipped Versus Traditional Classrooms: Is Flipping Really Better? Journalism & Mass Communication Educator, 1077695819835037.Retrieved from https://doi.org/10.1177/1077695819835037
Ramnanan, C. J., & Pound, L. D. (2017). Advances in medical education and practice: student perceptions of the flipped classroom. Advances in medical education and practice, 8, 63. doi: 10.2147/AMEP.S109037
Ramsden, P. (2003). Teaching strategies for effective learning. In Learning to teach in higher education. Routledge.
Renkl, A. (2009). Why constructivists should not talk about constructivist learning environments: A commentary on Loyens and Gijbels (2008). Instructional Science, 37(5), 495-498. doi: 10.1007/s11251-009-9098-5
Sharma, N., Lau, C. S., Doherty, I., & Harbutt, D. (2015). How we flipped the medical classroom. Medical teacher, 37(4), 327-330 Retrieved from http://informahealthcare.com/doi/full/10.3109/0142159X.2014.923821
Steen-Utheim, A. T., & Foldnes, N. (2018). A qualitative investigation of student engagement in a flipped classroom. Teaching in Higher Education, 23(3), 307-324. Retrieved from https://doi.org/10.1080/13562517.2017.1379481
Strayer, J. F. (2012). How learning in an inverted classroom influences cooperation, innovation and task orientation. Learning environments research, 15(2), 171-193. doi:10.1007/s10984-012-9108-4
Street, S. E., Gilliland, K. O., McNeil, C., & Royal, K. (2015). The flipped classroom improved medical student performance and satisfaction in a pre-clinical physiology course. Medical Science Educator, 25(1), 35-43. Retrieved from doi: 10.1007/s40670-014-0092-4
Sun, Z., Xie, K., & Anderman, L. H. (2018). The role of self-regulated learning in students' success in flipped undergraduate math courses. The Internet and Higher Education, 36, 41-53. Retrieved from https://doi.org/10.1016/j.iheduc.2017.09.003
Tam, M. (2000). Constructivism, instructional design, and technology: Implications for transforming distance learning. Educational Technology & Society, 3(2), 50-60. Retrieved from https://www.jstor.org/stable/jeductechsoci.3.2.50
Young, M. S., Robinson, S., & Alberts, P. (2009). Students pay attention! Combating the vigilance decrement to improve learning during lectures. Active Learning in Higher Education, 10(1), 41-55. doi: 10.1177/1469787408100194






Original Research