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Background: During the COVID-19 pandemic, some instructors transitioned their courses into a fully online environment by adopting flipped learning. In this context, this review examined the challenges to fully online flipped learning and identified useful course-design elements for practicing this instructional approach in health professions education. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement for selecting relevant articles. Thirty-three empirical studies (with 32 unique interventions) published between 2020 and 2021 (i.e., the first 2 years of the pandemic) were selected for analysis. Results: When the instructors in the reviewed studies designed and implemented their online flipped courses, numerous challenges emerged, which could be broadly categorized into student-related challenges (e.g., unfamiliarity with online flipped learning; N = 5), faculty challenges (e.g., increased workload; N = 8), and operational challenges (e.g., students' technical problems; N = 9). Nevertheless, we identified various useful elements for online flipped learning practice and organized them based on the following components of the Revised Community of Inquiry (RCoI) framework: cognitive presence (e.g., application of knowledge/skills; N = 12), social presence (e.g., peer interaction; N = 11), teaching presence (e.g., instructors' real-time demonstration/facilitation; N = 17), and learner presence (e.g., care and emotional support; N = 4). Conclusions: Based on the findings from the review and the RCoI framework, we developed nine principles for the effective practice of online flipped learning. These principles appear crucial for sustaining quality health professions education in a fully online flipped learning environment. [ABSTRACT FROM AUTHOR]

Background: In the time of the coronavirus disease 2019 (COVID-19) pandemic, in-person lectures had to be shifted to online learning. This study aimed to evaluate students' and lecturers' perception and effectiveness of a virtual inverted classroom (VIC) concept on clinical radiology in comparison to a historic control. Methods: In the winter semester 2020/21, 136 fourth year medical students who completed the clinical radiology VIC during the pandemic, were included in the single centre, prospective study. Results were compared with a historic control that had finished the physical inverted classroom (PIC) in the immediately preceding year. The VIC consisted of an initial phase of self-determined preparation with learning videos and a second interactive phase of clinical case studies alternating between the virtual lecture hall and virtual buzz groups. At the end of the lecture series, students rated the lecture on a scale of 1 (most positive assessment) to 6 (most negative assessment) through an online survey platform. Additionally, they reported their impressions in free-form text. Lecturers were invited to comment on the VIC in a group interview. Main outcomes were final grades and student perception of the VIC. Results: Students' general impression of VIC was lower than that of PIC (median value of 3 [IQR 4, 2] and 1 [IQR 0, 0], p < 0.001), respectively, p < 0.001). The highest rating was achieved concerning use of the audience response system (median 1 [IQR 1, 0]), and the lowest concerning the buzz groups (median 4 [IQR 5, 3]). Students stated that they would have appreciated more details on reading images, greater focus on plenary case studies, and provision of exam related scripts. Lecturers would have liked better preparation by students, more activity of students, and stronger assistance for group support. Exam grades after VIC were better than after PIC (median 1 [IQR 2, 1] and 2 [IQR 2,1], respectively, p < 0.001). Conclusions: Students' overall perception of VIC was satisfactory, although worse than PIC. Final grades improved compared to PIC. Provided an adapted buzz group size and support, VIC may serve as complement in medical education once the pandemic is over. [ABSTRACT FROM AUTHOR]

Background: In recent years, technological advancement has enabled the use of blended learning approaches, including flipped classrooms. Flipped classrooms promote higher-order knowledge application – a key component of nursing education. This systematic review aims to evaluate the empirical evidence and refereed literature pertaining to the development, application and effectiveness of flipped classrooms in reference to undergraduate nursing education. Methods: A PRISMA systematic review protocol was implemented to investigate the literature pertaining to the development, implementation and effectiveness of flipped classroom pedagogy in undergraduate nursing education. Seven databases (Scopus, PsycINFO, CINAHL, ERIC, MEDLINE, Cochrane, Web of Science) were utilised to survey the salient literature. Articles were appraised with respect to their level of evidence, the origin of study, study design, the aims/s of the study, and the key outcomes of the study. A qualitative synthesis was then conducted to summarise the study findings. Results: The initial search identified 1263 potentially relevant articles. After comprehensively reviewing the initial catchment using several analytical phases, 27 articles were considered for the final review, most of which were conducted in the USA and South Korea. A range of research designs were applied to measure or discuss the outcomes and design features of the flipped classroom pedagogy when applied to undergraduate nursing education. The review indicated that a common operational flipped classroom model involves three key components, namely pre-classroom activities, in-classroom activities and post-classroom activities, guided by two instructional system design principles. The review predominantly identified positive learning outcomes among undergraduate nursing students, after experiencing the flipped classroom, in terms of skills, knowledge and attitudes. However, a few studies reported contrasting findings, possibly due to the incompatibility of the flipped classroom pedagogy with the traditional learning culture. Conclusions: Current evidence in this systematic review suggests that incorporating the flipped classroom pedagogy could yield positive educational outcomes in undergraduate nursing education. There are promising pedagogical models available for adapting or developing the flipped classroom pedagogy in undergraduate nursing education. [ABSTRACT FROM AUTHOR]

Background: Differential diagnosis is a crucial skill for primary care physicians. General practice plays an increasing important role in undergraduate medical education. Via general practice, students may be presented with an overview of the whole spectrum of differential diagnosis in regard to common symptoms encountered in primary care. This project evaluated the impact of a blended learning program (using the inverted classroom approach) on student satisfaction and development of skills and knowledge. Methods: An elective seminar in differential diagnosis in primary care, which utilized an inverted classroom design, was offered to students. Evaluation followed a mixed methods design: participants completed a pre- and post-test, a questionnaire, and a focus group discussion. Interviews were transcribed verbatim and answers were grouped according to different themes. Test results were analysed using the Wilcoxon matched-pairs signed-ranks test. Results: Participants (n = 17) rated the course concept very positively. Especially the inverted classroom approach was appreciated by all students, as it allowed for more time during the seminar to concentrate on interactive and practice based learning. Students (n = 16) showed a post-test significant overall gain in skills and knowledge of 33%. Conclusions: This study showed a positive effect of the inverted classroom approach on students’ satisfaction and skills and knowledge. Further research is necessary in order to explore the potentials of this approach, especially the impact on development of clinical skills. [ABSTRACT FROM AUTHOR]