# Effectiveness of a flipped classroom combined with case-based learning in the clinical training of pediatric interns: a randomized controlled study

## TL;DR

A flipped classroom combined with case-based learning improves both objective and subjective learning outcomes for pediatric interns compared to traditional lectures.

## Contribution

Demonstrates the effectiveness of FC + CBL in enhancing clinical training for medical students.

## Key findings

- The intervention group scored higher in theoretical knowledge and OSCE compared to the control group.
- The FC + CBL group reported better subjective learning experiences like active learning and critical thinking.
- Stronger correlations were found between active learning and objective outcomes in the intervention group.

## Abstract

To explore the effectiveness of a flipped classroom (FC) combined with case-based learning (CBL) in pediatric clinical training.

115 undergraduate medical students undergoing pediatric clinical rotation were randomly assigned to either an intervention group receiving FC combined with CBL (FC + CBL) or a control group receiving traditional lecture-based teaching. Learning outcomes were objectively assessed using a theoretical knowledge test, Objective Structured Clinical Examination (OSCE), and routine performance evaluation. Subjective evaluation was conducted using the Self-Assessment Scale for Active Learning and Critical Thinking (SSACT) and a course satisfaction questionnaire. Correlation analysis was performed to explore underlying learning mechanisms.

Baseline characteristics were comparable between the two groups. In terms of objective assessment, the intervention group scored significantly higher than the control group in total score, theoretical knowledge, and OSCE (p < 0.05), while no significant difference was observed in routine performance. Regarding subjective assessment, the intervention group reported significantly higher scores than the control group in active learning, critical thinking, learning efficiency, teamwork and communication, problem-solving ability, practical skills training, learning motivation, and overall teaching effectiveness (p < 0.01). Correlation analysis revealed stronger positive associations between active learning, critical thinking, learning motivation, and objective performance outcomes in the intervention group compared to the control group.

The FC + CBL approach significantly improves both objective learning outcomes and subjective learning experiences in pediatric clinical training. The enhancement of active learning and critical thinking abilities may play a key mediating role in this process.