Enhancing Active Learning in a Medical Gross Anatomy and Embryology Course: A Flipped Classroom Approach
Authors: Harrell Kelly M 
Published: November 2023

Over a century after Flexner's report on the status of medical education in the US, pre‐clinical medical curriculum continues to rely heavily on outdated, passive teaching methods that fail to account for an evolving adult learner population, swift technological advancements, and a complex health care system. In an effort to move away from passive teaching methods, educators are implementing innovative methods, such as the flipped classroom, to promote active learning while catering to a variety of learning styles and preferences. This study describes a unique flipped classroom approach to teaching elaborate topics in a first year medical gross anatomy and embryology course and discusses the effectiveness of the application. Two 50‐minute flipped classroom sessions were added to the course curriculum to cover gross and clinical anatomy of the brachial plexus (session 1‐BP) and the pterygopalatine and infratemporal fossae (session 2‐PPF/ITF). Students were given access to study materials one week in advance to each session. Each session was divided into three parts: (1) Gross anatomy review; (2) Clinical scenarios; and (3) Wrap‐up activity. First year medical and graduate students (n=84) were placed in small groups based on learning preferences, and worked in these groups to complete each part of the flipped classroom session. Teaching faculty were present to moderate each session, stimulate discussion, and promote higher‐order thinking. On lecture and laboratory exam questions pertaining to flipped classroom session 1 and 2 content, students performed −1.88%/+4.41% and +2.79/+5.47% when compared to the overall exam averages, respectively. While the structure of each session remained the same, organizational improvements were made between sessions 1 and 2, which may partially account for the improvement in exam performance. Voluntary student evaluations (BP: n=77; PPF/ITF: n=76) were administered after both sessions were completed. Results revealed that 91% of respondents agreed/strongly agreed that the flipped classroom session enhanced their understanding of BP and PPF/ITF anatomy. Ninety‐two percent and 91% agreed/strongly agreed that the flipped classroom session enhanced their understanding of BP and PPF/ITF clinical anatomy, respectively. Ninety‐one percent and 90% agreed/strongly agreed that the flipped classroom session promoted active learning within the small group, for session 1 and 2, respectively. Surprisingly, only 60% and 72% agreed/strongly agreed that the flipped classroom session improved exam performance, for session 1 and 2, respectively. Eighty‐nine percent of respondents would like to have more flipped classroom sessions in the course. Major barriers noted were intra‐session time management, timing of sessions within each exam block, and extended accessibility to materials. Overall, incorporating flipped classroom sessions enhanced the inherent active learning component of the course and provided learners with structured, faculty‐supported opportunities to further develop critical thinking and problem solving skills needed to successfully practice medicine.

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