Faculty priorities for lecture, flipped classroom, and problem-based learning in anesthesiology education: a fuzzy AHP–SAW multi-criteria decision analysis

Abstract Background Selecting an appropriate teaching method is critical in anesthesia education, where learners must develop rapid decision-making, teamwork, and problem-solving skills. This study used a multi-criteria decision analysis (MCDA) to prioritize lecture, flipped classroom (FC), and problem-based learning (PBL) from faculty perspectives. Methods This cross-sectional MCDA study included faculty members from five Iranian Universities of medical sciences with ≥ 3 years of teaching experience and prior use of lecture, FC, and PBL. Evaluation criteria were identified through a scoping review of studies published from 2011 to 2025 and refined by an expert panel. A researcher-made instrument comprising seven domains and 25 items underwent face and content validation. Five experts completed pairwise comparisons, which were analyzed using fuzzy analytic hierarchy process (FAHP), and 15 faculty raters evaluated the teaching methods for simple additive weighting (SAW). Time limitation and need for technology were treated as cost criteria. Robustness was examined through sensitivity analyses of all seven domain weights, rater-specific rankings, and 10,000 bootstrap resamples. Results Quality (0.2987), perceived effectiveness (0.2292), and interaction (0.1795) received the highest weights. PBL ranked first (0.9701), followed by FC (0.9148) and lecture (0.6068). PBL produced the largest weighted contributions in quality, interaction, perceived effectiveness, and performance; FC had the largest contribution in flexibility, whereas lecture had the largest contribution in availability. The ranking remained unchanged across all specified domain-weight scenarios. Concordance among rater-specific rankings was high (Kendall’s W = 0.804; p < 0.001), and PBL retained first position in 99.99% of bootstrap resamples. Conclusions This faculty-based MCDA provides a context-specific decision-support framework for selecting teaching strategies in anesthesiology education. The findings support consideration of active-learning approaches alongside local educational priorities, available resources, and implementation conditions, while prospective studies should evaluate learner outcomes and clinical competence.