Changing the landscape of medical anatomy education: impact of flipped classroom pedagogy on learning outcomes and perceptions of medical students in practical gastrointestinal anatomy

Abstract

Abstract

BACKGROUND: Anatomy education faces challenges such as reduced teaching hours and limited cadaver access, emphasizing the need for innovative instructional strategies. The flipped classroom model, which shifts knowledge acquisition to pre-class activities and fosters active learning during class, has shown promise but remains underexplored in practical gastrointestinal anatomy teaching. METHODS: This quasi-experimental study involved 63 medical students at Mashhad University of Medical Sciences, Iran, assigned to either a flipped classroom (n = 28) or traditional lecture-based group (n = 35). Knowledge acquisition was assessed through blueprint-based multiple-choice tests, and perceptions of the learning environment were evaluated using the validated Anatomy Education Environment Measurement Inventory (AEEMI). RESULTS: Pretest scores did not differ significantly between groups (p = 0.073). The flipped classroom group demonstrated significantly higher post-test scores than the control group (20.34 ± 3.10 vs. 17.42 ± 3.22, p < 0.001, Cohen's d = 0.87). AEEMI results showed that the flipped group reported more positive perceptions of resources, effort, and overall learning environment (p < 0.001). Regression analysis identified instructional approach as the strongest predictor of favorable perceptions (β = 0.816, p < 0.001). CONCLUSIONS: The flipped classroom approach enhances both learning outcomes and perceptions of the educational environment in gastrointestinal anatomy education. By integrating pre-class preparation with in-class collaborative learning, it fosters deeper understanding and engagement. These findings support integrating flipped pedagogy into anatomy curricula to improve student performance and satisfaction.