Comparison of a Flipped Classroom Format Exercise Physiology Course to a Traditional Lecture Based Format
Purpose/Hypothesis: The flipped classroom model (FCM ) is an educational model where learning activities are flipped; learners acquire new information outside of class and use class time for application of this material through discussion, case studies or other higher level learning activities. The FCM has been shown to facilitate deeper, higher level learning and improved application of material in learners compared to a traditional lecture format course (LFC) in a number of health professions. Despite this, there are few studies of its use in physical therapy education. The purpose of this study was to compare first-year DPT student performance in an exercise physiology course taught using a FCM to the same LFC. Number of Subjects: 59 student records were analyzed: 29 in the FCM and 30 in the LFC. Materials and Methods: The LFC was taught in the spring 2017 using traditional lecture, lab activities, homework, quizzes and final exam. In the FCM, students watched pre-recorded, preparatory lectures and were quizzed at the beginning of each class on this material. In the FCM class time was spent doing team-based application activities, problems, group quizzing and lab activities. Both cohorts were taught by the same instructor and were given the same final exam on a computer based testing platform. Final exam questions were coded based on Blooms Taxonomy as either application based or remembering based questions. Reliability of test item coding was checked by two independent instructors who are experts in test construction. An Independent sample t-test was used to compare mean incoming gpa, final course average, final exam average and the percentage of items correct in both the remembering and application categories. Significance was set at < 0.05. Difference in performance was also analyzed based on quartile rank between the two teaching methods. This study was approved by the College Institutional Review Board. Results: : Undergraduate grade point average (GPA), prerequisite science GPA and DPT program GPA were lower in the FCM cohort but this was not significant. Mean final exam scores in the LFC was 85.31+5.47 versus 87.78 + 7.0 for the FCM. Mean percent correct of application question was 89.28 +7.1 for the LBC versus 89.81+7.0 for the FCM. Mean percent correct of questions coded as remembering was 86.3 + 6.5 in the LBC versus 86.25 + in the FCM. When performance was analyzed based on quartile rank the students in the lowest quartile had a higher mean percent correct in application questions in the FCM (88.9 + 1.8) compared to the first quartile in the LBC (84.7 + 2.4) class. Although those in the FCM performed better on some outcomes the difference was not statistically significant. Conclusions: There is no significant difference in student performance between courses delivered in a FCM versus a LBC. The FCM may lend itself to improved application of material in lower performing student. Clinical Relevance: Although the FCM did not show a statistically significant difference in the learning outcomes in this study, student performance was slightly better in the FCM despite these students entering with lower undergraduate and prerequisite GPAs. Additionally, students in the lowest quartile performed 4 points higher in the FCM versus the LBC. Although not statistically significant, this can be a very meaningful outcome for a student who has academic difficulty.