Evaluation of the flipped classroom approach in a veterinary professional skills course

Abstract

Background: The flipped classroom is an educational approach that has had much recent coverage in the literature. Relatively few studies, however, use objective assessment of student performance to measure the impact of the flipped classroom on learning. The purpose of this study was to evaluate the use of a flipped classroom approach within a medical education setting to the first two levels of Kirkpatrick and Kirkpatrick's effectiveness of training framework.

Methods: This study examined the use of a flipped classroom approach within a professional skills course offered to postgraduate veterinary students. A questionnaire was administered to two cohorts of students: those who had completed a traditional, lecture-based version of the course (Introduction to Veterinary Medicine [IVM]) and those who had completed a flipped classroom version (Veterinary Professional Foundations I [VPF I]). The academic performance of students within both cohorts was assessed using a set of multiple-choice items (n=24) nested within a written examination. Data obtained from the questionnaire were analyzed using Cronbach's alpha, Kruskal-Wallis tests, and factor analysis. Data obtained from student performance in the written examination were analyzed using the nonparametric Wilcoxon rank sum test.

Results: A total of 133 IVM students and 64 VPF I students (n=197) agreed to take part in the study. Overall, study participants favored the flipped classroom approach over the traditional classroom approach. With respect to student academic performance, the traditional classroom students outperformed the flipped classroom students on a series of multiple-choice items (IVM mean =21.4±1.48 standard deviation; VPF I mean =20.25±2.20 standard deviation; Wilcoxon test, w=7,578; P<0.001).

Conclusion: This study demonstrates that learners seem to prefer a flipped classroom approach. The flipped classroom was rated more positively than the traditional classroom on many different characteristics. This preference, however, did not translate into improved student performance, as assessed by a series of multiple-choice items delivered during a written examination.

Keywords: active learning; assessment; didactic; flipped classroom; lecture; professional skills; student perception.

Figure 1

Factor 1 (“generic skills”): Likert responses to items grouped in Factor 1. Notes: Percentage values refer to the proportion of positive (orange), neutral (gray), and negative (green) responses. The difference in response between cohorts was tested for each question, and the Kruskal–Wallis results are presented alongside each question. There is a significant difference in mean response between cohorts (Kruskal–Wallis z=8.45; P=0.003). Abbreviations: VPF I, Veterinary Professional Foundations I; IVM, Introduction to Veterinary Medicine.

Figure 2

Factor 3 (“staff and teaching”): Likert responses to items grouped in Factor 3. Notes: Percentage values refer to the proportion of positive (orange), neutral (gray), and negative (green) responses. The difference in response between cohorts was tested for each question, and the Kruskal–Wallis results are presented alongside each question. There is a significant difference in mean response between cohorts (Kruskal–Wallis z=42.93; P<0.001). Abbreviations: VPF I, Veterinary Professional Foundations I; IVM, Introduction to Veterinary Medicine.

Figure 3

Factor 4 (“student expectations”): Likert responses to items grouped in Factor 4. Notes: Percentage values refer to the proportion of positive (orange), neutral (gray), and negative (green) responses. The difference in response between cohorts was tested for each question, and the Kruskal–Wallis results are presented alongside each question. There is a significant difference in mean response between cohorts (Kruskal–Wallis z=21.49; P<0.001). Abbreviations: VPF I, Veterinary Professional Foundations I; IVM, Introduction to Veterinary Medicine.

Figure 4

Factor 2 (“workload and content”): Likert responses to items grouped in Factor 2. Notes: Percentage values refer to the proportion of positive (orange), neutral (gray), and negative (green) responses. The difference in response between cohorts was tested for each question, and the Kruskal–Wallis results are presented alongside each question. There is a significant difference in mean response between cohorts (Kruskal–Wallis z=5.82; P=0.016). Abbreviations: VPF I, Veterinary Professional Foundations I; IVM, Introduction to Veterinary Medicine.

Figure 5

Overall student performance on a series of multiple-choice items. Notes: The proportion of IVM (traditional classroom; red points) and VPF I (flipped classroom; blue points) cohorts correctly answering individual exam questions. Abbreviations: VPF I, Veterinary Professional Foundations I; IVM, Introduction to Veterinary Medicine.

Figure 6

Topic-specific student performance. Notes: Proportional frequency histograms of the number of correct answers achieved by IVM (traditional classroom) students and VPF I (flipped classroom) students in each of the four topic areas. Abbreviations: VPF I, Veterinary Professional Foundations I; IVM, Introduction to Veterinary Medicine.