Effectiveness of Combined Flipped and Classroom-based Instruction in Teaching Pulmonary Ultrasound to First-year Medical Students


Background and Objectives of the Study

The study aimed to determine the effectiveness of combining flipped classroom on pulmonary ultrasound instruction in first-year medical students with traditional classroom-based instruction and compared it to traditional classroom-based instruction alone. The insights of the teachers and the students on the implementation of both interventions were also evaluated.

Research Methodology

This is a mixed qualitative (concurrent triangulated) and quantitative research. Baseline procedural knowledge and skills of a total of 282 students on the lung ultrasound scanning using pre-test 20-item summative test, multiple-choice question type of examination, and a pre-test narrative test on lung ultrasound were obtained. A post-intervention summative assessment and narrative test were administered. Statistical analyses were done to compare the scores. A thematic analysis was done to evaluate the responses to the survey.


138 students were randomly assigned to the classroom-based instruction group, while 144 students in the combined flipped and classroom-based instruction group. The number of students who passed the summative (MCQ) test and were given flipped classroom and classroom-based instruction increased (6.3% to 79.9%; p<0.001) and the number of students given classroom-based instruction only, significantly increased (4.3% to 79.9%; p<0.001).

The number of students who passed the narrative test and were given flipped classroom and classroom-based instructions increased (2.1% to 84.0%; p<0.001) and the number of students given the classroom-based instruction only, also significantly increased (3.6% to 84.2%; p<0.001). 

The students appreciated the classroom-based instruction because of the knowledgeable facilitators, the very concise approach, that is understandable and done in real-time. In addition, the flipped classroom was likewise helpful and a good introduction before the classroom-based instruction. The facilitators have noticed that the ease in instruction was influenced by the student’s enthusiasm and willingness to learn.


Flipped classroom in addition to classroom-based instruction, and classroom based instruction were effective in teaching pulmonary ultrasound to First-year medical students


Key words: flipped classroom, lung ultrasound, pulmonary ultrasound, medical school, medical students, medical education, blended classroom, classroom-based instruction, ultrasound, ultrasound medical education, video-based instruction

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