Traditional lectures versus flipped classroom in manual therapy education: a cross-sectional study of student engagement and learning perceptions

OBJECTIVE: To compare manual therapy students' preferences for traditional classes versus the Flipped Classroom, and to examine their effects on learning perception and behavioral, cognitive, and emotional engagement. METHODS: A within-subject educational intervention study was conducted with undergraduate physiotherapy students enrolled in a Manual Therapy course during the 2022-2023 academic year. The course comprised eight face-to-face sessions, four delivered using a traditional lecture-based approach and four using the Flipped Classroom methodology. Students' engagement (behavioral, cognitive, and emotional dimensions), preferences between teaching models, and perceptions of educational quality were assessed using validated questionnaires. Within-subject comparisons between traditional and Flipped Classroom models were performed. RESULTS: < 0.05), with 88.1% of students agreeing or strongly agreeing that their performance was better when learning through the FC approach. Students also reported positive perceptions of educational quality, particularly regarding teaching effectiveness, clarity of objectives, and integration of online and face-to-face learning. CONCLUSION: The Flipped Classroom methodology was associated with high levels of student engagement and positive perceptions of educational quality in manual therapy education. These findings support the use of Flipped Classroom as a promising learner-centered approach in physiotherapy training, particularly for subjects requiring extensive hands-on practice.