Effectiveness of a flipped classroom combined with case-based learning in the clinical training of pediatric interns: a randomized controlled study

Background To explore the effectiveness of a flipped classroom (FC) combined with case-based learning (CBL) in pediatric clinical training. Methods 115 undergraduate medical students undergoing pediatric clinical rotation were randomly assigned to either an intervention group receiving FC combined with CBL (FC + CBL) or a control group receiving traditional lecture-based teaching. Learning outcomes were objectively assessed using a theoretical knowledge test, Objective Structured Clinical Examination (OSCE), and routine performance evaluation. Subjective evaluation was conducted using the Self-Assessment Scale for Active Learning and Critical Thinking (SSACT) and a course satisfaction questionnaire. Correlation analysis was performed to explore underlying learning mechanisms. Results Baseline characteristics were comparable between the two groups. In terms of objective assessment, the intervention group scored significantly higher than the control group in total score, theoretical knowledge, and OSCE ( p < 0.05), while no significant difference was observed in routine performance. Regarding subjective assessment, the intervention group reported significantly higher scores than the control group in active learning, critical thinking, learning efficiency, teamwork and communication, problem-solving ability, practical skills training, learning motivation, and overall teaching effectiveness ( p < 0.01). Correlation analysis revealed stronger positive associations between active learning, critical thinking, learning motivation, and objective performance outcomes in the intervention group compared to the control group. Conclusion The FC + CBL approach significantly improves both objective learning outcomes and subjective learning experiences in pediatric clinical training. The enhancement of active learning and critical thinking abilities may play a key mediating role in this process.