Impact of Attendance at Flipped Classroom Sessions on Renal Pathophysiology Scores

Introduction: Various teaching strategies emphasizing active learning have been used to enhance student engagement, but the impact of these strategies on student performance is not well-documented. This quality improvement project assessed whether non-mandatory, in-person flipped classroom sessions on renal physiology influenced renal pathophysiology exam scores during the renal-urinary block and explored students' attitudes toward these sessions. Additionally, we aimed to explore students' attitudes toward attending these non-mandatory flipped sessions. Methods and results: The study involved 180 sophomore medical students, 73 of whom voluntarily attended flipped sessions, while 107 did not. Our primary finding was that students who participated in flipped sessions had significantly higher end-of-block exam scores, with a dose-response relationship observed among those attending all sessions. Fewer students failed the block, and more achieved high-pass scores among participants who attended all flipped sessions. Secondary findings were that students who attended the flipped classroom sessions also performed better on both lower-order and higher-order cognitive multiple-choice questions. Student feedback on flipped sessions was mixed. Some thought that they were great for learning and wanted more, while others cited concerns about the number, scheduling, and preparation time required. Conclusion: While the data suggest an association with the flipped sessions and improved end-of-block performance, the lack of randomization leaves room for confounding factors. Higher scores could reflect unmeasured student characteristics, such as prior knowledge, academic background, time management skills, motivation, and a preference for active learning. To clarify the relationship between active learning strategies, classroom attendance, and performance, future studies should employ prospective randomized designs.