The Big Flipping Question: Do Students Who Participate in a Flipped Classroom Model Perform Better Than Those in a Traditional Lecture-Style Model on Cognitive Exams?

Introduction—Flipped classrooms—in which lectures are watched at home as homework and skills and content are done in the classroom—are believed by some to enhance student-teacher interaction, satisfaction and feedback. Evidence from other disciplines reports improved student learning in a flipped setting; however, no examples were found relating to the EMS classroom. The UCLA Flipped Classroom Project compared a traditional lecture-style delivery of obstetrics content to a flipped classroom delivery by measuring and comparing cognitive competency via examinations.

Hypothesis—Students assigned to the flipped classroom method will score higher on cognitive exams than students in a traditional lecture setting.

Methods—EMT programs from 12 educational institutions across the United States self-identified to participate in the study. Students under 18 were excluded. Students were randomly assigned to the control group, which received traditional lecture-style presentation, or the experimental group, which received a flipped classroom delivery. The flipped classroom used similar material online via Jones & Bartlett Navigate 2, followed by specific interactive learning activities in the classroom. After completion both groups of students took the 75-question Fisdap OB/Peds unit exam (KR-20 0.86). Differences in means between experimental and control groups were calculated in SPSS using t-tests. IRB approval was obtained from Santa Fe Community College.

Results—Eighty-one students from five geographically diverse states participated in the study (40 controls, 41 experimental). Of those, 38 in the control group and 35 in the experimental group completed the exam. Independent sample t-tests of the scores between the three portions of the test—OB normal, OB abnormal and OB combined—had mixed results. The experimental group scores for OB abnormal were higher than the control group and statistically significant at p=0.009. The scores for OB normal and OB combined were not significantly different (p=0.687, p=0.170).

Conclusion—EMT students in the flipped classroom had equal or higher cognitive scores than students in a traditional classroom on one section of a cognitive test of obstetrics content. While further research is needed to generalize these findings to an entire EMT class, they do align with evidence from other disciplines suggesting that students have higher cognitive competency in a flipped classroom setting.