# Impact of integrating paper-based pulmonary function test case group discussions into flipped classroom on residents’ COPD grading assessment competency

## TL;DR

Using paper-based case discussions in a flipped classroom improved residents' ability to assess COPD severity and increased their confidence and exam scores.

## Contribution

Demonstrates that integrating paper-based pulmonary function test case discussions in flipped classrooms enhances COPD assessment competency in residents.

## Key findings

- Intervention group had higher COPD grading accuracy immediately and one month after instruction.
- Residents in the intervention group scored better on comprehensive exams and reported higher self-efficacy.
- Teaching satisfaction was significantly higher in the flipped classroom with case discussions.

## Abstract

The flipped classroom model combined with case-based learning has emerged as a promising educational approach in medical residency training. However, the specific impact of integrating paper-based pulmonary function test case discussions on residents’ ability to accurately assess COPD severity remains underexplored.

To investigate the effect of incorporating paper-based pulmonary function test case group discussions within a flipped classroom framework on residents’ competency in COPD grading assessment, comprehensive examination performance, and self-efficacy.

This single-center, retrospective cohort study analyzed 100 residents who completed respiratory medicine rotations between 2022 and 2024. Participants were divided into an intervention group (n = 50) receiving flipped classroom instruction with paper-based case discussions and a control group (n = 50) receiving traditional didactic teaching. Outcomes included COPD grading accuracy rates, comprehensive examination scores, and self-efficacy levels measured by the Self-Efficacy for Professional Tasks (SEPT) scale.

The intervention group demonstrated significantly higher COPD grading accuracy rates both immediately post-instruction (86.4% vs. 68.2%, p < 0.001) and at one-month follow-up (82.6% vs. 64.8%, p < 0.001). Comprehensive examination scores were superior in the intervention group (88.2 ± 6.4 vs. 78.6 ± 8.2, p < 0.001), as were self-efficacy scores (4.2 ± 0.5 vs. 3.4 ± 0.6, p < 0.001). Teaching satisfaction ratings were also higher in the intervention group (4.6 ± 0.4 vs. 3.8 ± 0.7, p < 0.001).

Integrating paper-based pulmonary function test case discussions into flipped classroom teaching significantly enhances residents’ COPD grading assessment competency, examination performance, and professional self-efficacy. This innovative pedagogical approach merits wider implementation in respiratory medicine residency training programs.