Quasi-experimental trial of flipped classroom with microteaching and PBL-oriented discussion in dental education: student outcomes and perceptions

Traditional lecture-based teaching remains widely used in undergraduate dental education, but it may provide limited opportunities for student engagement, active recall, and application of knowledge. Blended active-learning approaches, such as flipped classroom, problem-based discussion, and microteaching, may enhance learning outcomes and student participation. This study aimed to evaluate the effectiveness of a blended active-learning model combining pre-class flipped materials, in-class question-based problem discussion, and targeted microteaching on undergraduate dental students’ knowledge performance and perceptions. A non-randomized, cluster-allocated quasi-experimental study was conducted among second-year undergraduate dental students. Six pre-existing academic subgroups constituted the units of allocation: subgroups A-C received the traditional lecture model and subgroups D-F received the blended active-learning model. The intervention combined pre-class video, audio, text, and training questions with in-class question-based/PBL-oriented discussion and targeted microteaching. Knowledge was assessed one week later using a five-question MCQ course quiz randomly drawn from the reviewed and piloted 15-item question bank, with questions selected at a comparable intended difficulty level. All students completed the course quiz irrespective of research participation. The quiz mark formed part of routine academic assessment, whereas research participation status was not considered in calculating the final course grade; research consent governed only whether individual assessment data could be used in the study. Because teaching condition was assigned at subgroup level, subgroup-level comparison was the principal basis for inferential interpretation, while student-level analyses were descriptive or exploratory. Student perceptions were collected from the intervention group using a piloted questionnaire. A total of 194 valid post-test scores were available (97 students per teaching model). In the principal subgroup-level analysis, the mean of the three blended subgroup means was 4.47 compared with 3.73 for the three traditional subgroup means (difference = 0.74 points; Welch t = 1.55, df = 2.27, p = 0.247; approximate 95% CI -1.10 to 2.58). With only three clusters per arm, this estimate was highly imprecise and was not statistically conclusive. Student-level descriptive analyses showed higher mean scores in the blended group than in the traditional group (4.47 ± 0.68 vs. 3.70 ± 1.57 out of 5), but these observations did not account for subgroup-level allocation. Among 88 intervention-group perception respondents, 90.9% considered the model useful, 86.4% reported better engagement, and 78.4% preferred the question-based model. Student-level descriptive results and intervention-group perceptions favored the blended active-learning model, but the subgroup-level estimate—the analysis aligned with the unit of allocation—was highly imprecise and not statistically conclusive. Because only six intact subgroups were included, baseline knowledge was not measured, and the intervention was multicomponent, the findings do not establish a causal effect. Further studies with more clusters, baseline assessment, and longer follow-up are warranted.