Journal of Emergency Practice and Trauma

Effect of Flipped Classroom, Team-based Learning, and Lecture-based Classroom on knowledge and Student Satisfaction: A Quasi-Experimental Study

Document Type : Original Article

Authors

Amin Beigzadeh 1
MahmoodReza Dehghani 2
Sara Heydari 3

1 Education Development Center, Sirjan School of Medical Sciences, Sirjan, Iran

2 Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

3 Department of Medical Education, Medical Education and Development Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

https://doi.org/Doi:10.34172/jept.2025.17
Abstract
Background: Active teaching is widely used in medical education to engage students and promote active learning. However, there is a paucity of research on how active teaching strategies can be applied to English Language learning in a Medical Education context. This study aimed to evaluate the effects of flipped classroom, and team-based learning on knowledge, and learning satisfaction of health sciences students.  
Methods: This quasi-experimental study was undertaken with 82 students who were divided into 3 groups, Flipped Group (FG), Team-based Learning (TBL), and Lecture Group (LG) at Sirjan School of Medical Sciences in 2023. Prior to study, the Oxford Quick Placement Test (OQPT) of 50 items was administered to homogenize students. To compare knowledge, a researcher-made knowledge test of English was administered at the baseline and after the intervention. Students’ satisfaction and their perspectives were obtained through a survey. Data were analyzed by Chi-squared, one-way ANOVA, Post hoc Tukey test, and Kruskal-Wallis H tests using SPSS software version 26, and content analysis for the open-ended responses.
Results: Of the 117 students participating in the OQPT, 82 (70.10%) entered the study. They included, 21 (25.60%) males, and 61 (74.40%) females with the mean age of 19.57±1.52 years old. In the post-intervention, the FG scored significantly higher (56.71±16.48) than TBL (51.00±14.23), and the LG (39.41±11.45) (p<0.001). Satisfaction levels were highest in the FG. Students’ perspectives varied and were classified into two categories: advantages and challenges, corresponding to each teaching approach.  
Conclusions: The FG and TBL approaches significantly enhanced learning and student satisfaction compared to LG. These findings underscore the importance of active engagement in medical education, suggesting that innovative teaching strategies can effectively improve student experiences and academic success.

Keywords

Medical Education
Flipped Classroom
Team-based Learning
Lecture-based Classroom
Subjects
1. Nguyen TK, Truong VC. Enhancing engineering education through a combined flipped classroom and team-based learning approach with team leaders. Int J Mech Eng Educ. 2024:03064190241302405. doi:10.1177/03064190241302405
2. Dent J, Harden RM, Hunt D. A Practical Guide for Medical Teachers, E-Book. Elsevier Health Sciences; 2021.
3. Nguyen HT, Nguyen HT, Nguyen HV, Nguyen TT. Local challenges to global needs in English language education in
Vietnam: the perspective of language policy and planning. In: Un(intended) Language Planning in a Globalising World:
Multiple Levels of Players at Work. Walter de Gruyter; 2018. p. 214-33.
4. Nguyen TA. The Internationalization of Higher Education in Vietnam: National Policies and Institutional Implementation at Vietnam National University, Hanoi. Waseda University Global COE Program, Global Institute for Asian Regional Integration (GIARI); 2009.
5. Nazarieh M, Delzendeh M, Beigzadeh A. Motivation as an integral factor in English language learning for medical
students. Res Dev Med Educ. 2023;12(1):7. doi: 10.34172/rdme.2023.33133
6. Meng Y. English learning demotivating factors among nonEnglish majors in medical university. Theory Pract Lang Stud. 2022;12(5):931-6. doi: 10.17507/tpls.1205.13
7. Sadeghi B, Moshtaghi Kashanian N, Maleki A, Haghdoost A. English language proficiency as a predictor of academic
achievement among medical students in Iran. Theory Pract Lang Stud. 2013;3(12):2315-21. doi: 10.4304/tpls.3.12.2315-2321
8. Beigzadeh A, Bazyar H, Delzendeh M, Razmi MH, Sharifi N. Comparing the effect of lecture method and cooperative
teaching method on the learning, communication skills, and attitudes of students: a quasi-experimental study. Front Educ. 2024;9:1449538. doi: 10.3389/feduc.2024.1449538
9. Beigzadeh A, Haghani F. Active learning methods: a way of tackling large classroom setting, perspective. Stride Dev Med Educ. 2016;13(1):107-13.
10. Michaelsen LK, Knight AB, Fink LD. Team-Based Learning: A Transformative Use of Small Groups in College Teaching.
Taylor & Francis; 2023.
11. Chang YH, Yan YC, Lu YT. Effects of combining different collaborative learning strategies with problem-based learning in a flipped classroom on program language learning. Sustainability. 2022;14(9):5282. doi: 10.3390/su14095282
12. Wang J, An N, Wright C. Enhancing beginner learners’ oral proficiency in a flipped Chinese foreign language classroom. Comput Assist Lang Learn. 2018;31(5-6):490-521. doi:10.1080/09588221.2017.1417872
13. Mardani M, Jahanbazian T. A study into the effects of competitive team-based learning and ‘learning together’ on
the oral performance of intermediate EFL learners. Res Eng Lang Pedagog. 2015;3(1):60-73.
14. Ngo HK, Yunus M. Flipped classroom in English language teaching and learning: a systematic literature review. Int J
Acad Res Bus Soc Sci. 2021;11(3):185-96. doi: 10.6007/IJARBSS/v11-i3/8622
15. Nazarieh M, Delzendeh M, Beigzadeh A. Flipped learning in medical education: enhancing engagement through
innovative pedagogy. Res Dev Med Educ. 2024;13(1):20. doi:10.34172/rdme.33258
16. Pires E, Meeuwissen SN, Savelberg H. From theory to practice: the impact of team-based learning on medical students’ communication skills. Perspect Med Educ. 2025;14(1):74-84. doi: 10.5334/pme.1595
17. Ivanytska N, Dovhan L, Tymoshchuk N, Osaulchyk O, Havryliuk N. Assessment of flipped learning as an innovative
method of teaching English: a case study. Arab World Engl J. 2021;12(4):476-86. doi: 10.24093/awej/vol12no4.31
18. Pongpanich W, Chomthong W, Choeykhunthot A, Tammati K, Rangkharat P, Jantakoon T. Exploring flipped classrooms in EFL teaching: a comprehensive systematic review. High Educ Stud. 2025;15(2):23-36. doi: 10.5539/hes.v15n2p23
19. Fischer ID, Yang JC. Flipping the flipped class: using online collaboration to enhance EFL students’ oral learning skills. Int J Educ Technol High Educ. 2022;19(1):15. doi: 10.1186/s41239-022-00320-2
20. Kareem NO. Using team-based learning in teaching English to EFL undergraduate students: a pilot study evaluation. Koya Univ J Hum Soc Sci. 2021;4(1):91-103. doi: 10.14500/kujhss.v4n1y2021.pp91-103
21. Nayak KR, Punja D, Suryavanshi CA, Kamath A. Application of case-based readiness assurance process as a model
for case-based pedagogy and collaborative learning in physiology. Med Sci Educ. 2020;30(2):869-77. doi:
10.1007/s40670-020-00967-4
22. Punja D, Kalludi SN, Pai KM, Rao RK, Dhar M. Teambased learning as a teaching strategy for first-year medical
students. Australas Med J. 2014;7(12):490-9. doi: 10.4066/amj.2014.2244
23. Taşpolat A, Özdamli F, Soykan E. Programming language training with the flipped classroom model.
Sage Open. 2021;11(2):21582440211021403. doi:10.1177/21582440211021403
24. Hendrik H, Hamzah A. Flipped classroom in programming course: a systematic literature review. Int J Emerg Technol
Learn. 2021;16(2):220-36.
25. Willett LR, Rosevear GC, Kim S. A trial of team-based versus small-group learning for second-year medical students: does the size of the small group make a difference? Teach Learn Med. 2011;23(1):28-30. doi: 10.1080/10401334.2011.536756
26. Haidet P, Morgan RO, O’Malley K, Moran BJ, Richards BF. A controlled trial of active versus passive learning strategies in a large group setting. Adv Health Sci Educ Theory Pract. 2004;9(1):15-27. doi:10.1023/b:Ahse.0000012213.62043.45
27. Sivaraman SI, Krishna D. Blooms taxonomy-application in exam papers assessment. Int J Multidiscip Sci Eng.
2015;6(9):5-8.
28. Timakova Y, Bakon KA. Bloom’s taxonomy-based examination question paper generation system. Int J Inf Syst Eng.
2018;6(2):76-92. doi: 10.24924/ijise/2018.11/v6.iss2/76.92
29. Stringer JK, Santen SA, Lee E, Rawls M, Bailey J, Richards A, et al. Examining Bloom’s taxonomy in multiple choice
questions: students’ approach to questions. Med Sci Educ. 2021;31(4):1311-7. doi: 10.1007/s40670-021-01305-y
30. Bloom BS. Taxonomy of Educational Objectives. Longmans, Green & Co; 1964.
31. Geranpayeh A. A quick review of the English Quick Placement Test. Research Notes. 2003;12(3):8-10.
32. Jones NE. BULATS: a case study comparing computer-based and paper-and-pencil tests. Research Notes. 2000;3(4):10-3.
33. Anderson NJ. Active Skills for Reading 1. Boston: Heinle ELT; 2013.
34. Alamoudi AA, Al Shawwa LA, Gad H, Tekian A. Team-based learning versus traditional didactic lectures in teaching
clinical biochemistry at King Abdulaziz University; learning outcomes and student satisfaction. Biochem Mol Biol Educ.
2021;49(4):546-59. doi: 10.1002/bmb.21501
35. Tang F, Chen C, Zhu Y, Zuo C, Zhong Y, Wang N, et al. Comparison between flipped classroom and lecture-based
classroom in ophthalmology clerkship. Med Educ Online.
2017;22(1):1395679. doi: 10.1080/10872981.2017.139567936. Assarroudi A, Heshmati Nabavi F, Armat MR, Ebadi A,
Vaismoradi M. Directed qualitative content analysis: the description and elaboration of its underpinning methods and
data analysis process. J Res Nurs. 2018;23(1):42-55. doi:10.1177/1744987117741667
37. ’Connor C, Joffe H. Intercoder reliability in qualitative research: debates and practical guidelines. Int J
Qual Methods. 2020;19:1609406919899220. doi:10.1177/1609406919899220
38. Nishigawa K, Omoto K, Hayama R, Okura K, Tajima T, Suzuki Y, et al. Comparison between flipped classroom and teambased learning in fixed prosthodontic education. J Prosthodont Res. 2017;61(2):217-22. doi: 10.1016/j.jpor.2016.04.003
39. Amini M, Roohani A, Jafarpour A. Effect of flipped learning on Iranian high school students’ L2 grammar achievement and their foreign language anxiety. Teaching English Language. 2022;16(2):169-201. doi: 10.22132/tel.2022.158977
40. Kang HY, Kim HR. Impact of blended learning on learning outcomes in the public healthcare education course: a review of flipped classroom with team-based learning. BMC Med Educ. 2021;21(1):78. doi: 10.1186/s12909-021-02508-y
41. Coyne E, Rands H, Frommolt V, Kain V, Plugge M, Mitchell M. Investigation of blended learning video resources to teach health students clinical skills: an integrative review. Nurse Educ Today. 2018;63:101-7. doi: 10.1016/j.nedt.2018.01.021
42. Herreid CF, Schiller NA. Case study: case studies and the flipped classroom. J Coll Sci Teach. 2013;42(5):62-6. doi:
10.2505/4/jcst13_042_05_62
43. Silberman D, Carpenter R, Takemoto JK, Coyne L. The impact of team-based learning on the critical thinking skills of
pharmacy students. Curr Pharm Teach Learn. 2021;13(2):116-21. doi: 10.1016/j.cptl.2020.09.008
44. Nederveld A, Berge ZL. Flipped learning in the workplace. J Workplace Learn. 2015;27(2):162-72. doi: 10.1108/jwl-06-2014-0044
45. Canoso JJ, Saavedra M, Pascual-Ramos V, Sánchez-Valencia MA, Kalish RA. Musculoskeletal anatomy by self-examination: a learner-centered method for students and practitioners of musculoskeletal medicine. Ann Anat. 2020;228:151457. doi:10.1016/j.aanat.2019.151457
46. Matsuyama Y, Nakaya M, Okazaki H, Lebowitz AJ, Leppink J, van der Vleuten C. Does changing from a teacher-centered to a learner-centered context promote self-regulated learning: a qualitative study in a Japanese undergraduate setting. BMC Med Educ. 2019;19(1):152. doi: 10.1186/s12909-019-1550-x
47. Garrison DR, Vaughan ND. Blended Learning in Higher Education: Framework, Principles, and Guidelines. John Wiley
& Sons; 2008.
48. Zajda J. Constructivist learning theory and creating effective learning environments. In: Globalisation and Education
Reforms: Creating Effective Learning Environments. Cham: Springer International Publishing; 2021. p. 35-50. doi:
10.1007/978-3-030-71575-5_3
49. Yorganci S. The impact of synchronous online discussions and online flipped learning on student engagement and selfregulation among preliminary undergraduates in a basic math course. Educ Technol Res Dev. 2025;73(3):1569-600. doi: 10.1007/s11423-025-10459-0
50. Ruder P, Maier MH, Simkins SP. Getting started with team-based learning (TBL): an introduction. J Econ Educ.
2021;52(3):220-30. doi: 10.1080/00220485.2021.1925187
51. Freeman S, Eddy SL, McDonough M, Smith MK, Okoroafor N, Jordt H, et al. Active learning increases student performance in science, engineering, and mathematics. Proc Natl Acad Sci U S A. 2014;111(23):8410-5. doi: 10.1073/pnas.1319030111
52. Heydari S, Beigzadeh A. Medical students’ perspectives of reflection for their professional development. BMC Med Educ. 2024;24(1):1399. doi: 10.1186/s12909-024-06401-2
Journal of Emergency Practice and Trauma
Volume 10, Issue 2
July 2024
Pages 97-110

  • Receive Date 03 August 2025
  • Revise Date 22 September 2025
  • Accept Date 26 October 2025

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