Background: Flipped classroom methodologies have gained popularity and undergone much research scrutiny in recent years. However, there have been no studies examining the effects of flipping an English, first-year, basic medical history taking, oral communication skills course in Japan.Methods: A 1-year prospective cohort of students (n = 135) enrolled in an English, basic medical history taking course (30 hours) was taught using a flipped approach. A historical cohort of students (n = 128) was taught using a more conventional task-based communicative approach (45 hours) for comparison. Baseline metrics indicated that there was adequate similarity for comparison between the two groups. Performance examination scores were analyzed to assess effectiveness in 4 categories: Spoken English Proficiency (SEP); Communication and Interpersonal
Skills (CIS); Integrated Clinical Encounter (ICE); Comprehension (Comp.).Results: The overall average examination score increased from 67.5 ± 1.5% (mean ± SE) in 2014 to 77.5 ± 1.5% in 2015 (mean difference between the groups, 9.6%; [95 percent CI, 5.5% to 13.7%], P < .001) indicating a significant improvement in student performance. Largest gains were observed in SEP and CIS and there were no significant changes in the ICE and Comp. categories.Conclusion: It appears that students performed significantly better in a basic history taking examination with a simulated patient in English after having been taught using the "Flipped Classroom" method, despite having had 15 fewer classroom hours. Therefore, it is worth considering this innovative methodology as a means to improve educational effectiveness.