Multilevel factor analysis of flipped classroom in dental education: A 3-year randomized controlled trial

Abstract

Purpose Previous studies have rarely attempted to test the confounding factors that may affect learning outcomes of the flipped classroom. The purpose of this study was to assess how flipped classrooms affect the acquisition of knowledge in clinical dental education based on multilevel factor analysis. Method The authors conducted a 3-year (2017, 2018, and 2019) randomized controlled trial in a series of introductory prosthodontics courses in dental education. A total of 137 participants were randomly assigned to flipped classroom (n = 70, 51%) or lecture (n = 67, 49%) formats. The flipped group was instructed to self-learn knowledge-based content through online preparation materials, including videos and text, while the lecture group was given text only. Both groups were provided with the same study content and opportunities for different styles of learning. The session attendance rate and number of times the materials were accessed were monitored. Individual and team readiness assurance tests (IRAT/TRAT) were conducted to evaluate knowledge acquisition. A multilevel linear regression analysis was conducted on both instructional styles (flipped vs. lecture) as an intervention factor, and confounding factors that could affect the outcomes were implemented. Results The average number of online accesses was 2.5 times per session in the flipped group and 1.2 in the lecture group, with a significant difference (p < .05). The average IRAT score was significantly higher in the flipped than in the lecture group (effect size [ES] 0.58, p < .001). The number of online accesses was significantly and positively correlated with IRAT scores (0.6 [0.4, 0.8]). The instructional style was significantly and positively correlated with TRAT scores (coefficient [95% confidence interval]: 4.6 [2.0, 7.3]), but it was not correlated with IRAT (4.3 [-0.45, 9.0]). Conclusions The flipped classroom was more effective than the lecture format regarding knowledge acquisition; however, the decisive factor was not the instructional style but the number of individual learning occasions. The employment of the flipped classroom was the decisive factor for team-based learning outcomes.

The Effect of Flipped Classroom Model on Knowledge, Practice, Attitude and Satisfaction of Dentistry Students; A Quasi-Experimental Study

“…The results showed that the ipped method was more effective. This result is in line with the research of Gallardo et al, Wang et al, and Ozcan, who compared the nal scores of dental students in the ipped classroom and face-to-face training (49)(50)(51).…”

Study on the reporting quality of randomized controlled trials of flipped classroom in medical education

“…Fourteen duplicated studies, one non‐RCT study and seven studies that had no association with flipped classroom were excluded after the title and abstracts were read. Finally, we identified 15 eligible articles (Beom et al, 2018; Dombrowski et al, 2018; Elledge et al, 2018; He et al, 2019; Kühl et al, 2017; Ling et al, 2016; Lu et al, 2021; Moll‐Khosrawi et al, 2021; Nakanishi et al, 2017; Riddell et al, 2017; Rose et al, 2016; Rui et al, 2017; Tang et al, 2017; Wang et al, 2021; Yang et al, 2020). Table 2 summarizes the characteristics of these papers.…”

“…There is more than one index for evaluating the effect of teaching in medical education, but many RCTs only focus on a single index, which makes it difficult to compare and evaluate their results. In addition, the teaching effect of flipped classroom still remains uncertain, and relatively few studies have assessed the factors affecting its effectiveness (Wang et al, 2021). Good quality RCTs are very important for studying the effectiveness of flipped classroom.…”

“…There is more than one index for evaluating the effect of teaching in medical education, but many RCTs only focus on a single index, which makes it difficult to compare and evaluate their results. In addition, the teaching effect of flipped classroom still remains uncertain, and relatively few studies have assessed the factors affecting its effectiveness (Wang et al, 2021) Data from each article were reviewed and extracted by two welltrained investigators. When the researchers believed that the experimental group was better than the control group in measurements of the main indicators, the results of the RCT were defined as "positive.…”

A silver lining for pandemic-weary libraries: How blended and flipped instructional programs have improved upon pre-pandemic norms

“…It has been frequently noted that relatedness between students as peers, as well as between students and their instructors is important to persistence and the achievement of desired learning outcomes ( Bower et al, 2015 ; Chickering & Gamson, 1991 ; Kuh et al, 2010 ; Raes et al, 2020 ). While some research has shown relatedness is hampered for students learning in the virtual realm ( Raes et al, 2020 ), others have noted the design and thoughtful deployment of virtual instruction can temper this shortcoming ( Strayer, 2012 ; Wang et al, 2021 ). For example, employing a blended rather than exclusively virtual approach has often proven an effective strategy as has the deployment of flipped classroom instructional elements.…”