{
  "abstract": "Background: This study evaluated the effectiveness of a flipped classroom combined with team-based learning (TBL) training model in improving clinical reasoning, teamwork skills, self-directed learning ability, and teaching satisfaction among general practice residents in standardized training.\n\nObjective: This study aimed to: (1) compare theoretical knowledge mastery between the Flipped-TBL group and the traditional LBL group; (2) evaluate the effects of the Flipped-TBL model on residents’ clinical reasoning, teamwork skills, and self-directed learning ability; (3) examine differences in learning engagement, teaching satisfaction, and perceived stress between the two teaching models; and (4) provide an effective and innovative teaching approach for standardized general practice residency training.\n\nMethods: A 12-week randomized controlled trial was conducted with 56 general practice residents randomly assigned to either the FC-TBL group (n = 28) or traditional lecture-based learning (LBL) group (n = 28). The primary outcome was clinical reasoning ability, measured by the Lasater Clinical Judgment Rubric at baseline (T0), immediately post-intervention (T1), and four-week follow-up (T2). Secondary outcomes included theoretical knowledge, Mini-CEX, DOPS, and teaching satisfaction. Statistical significance was set at p < 0.05.\n\nResults: All 56 participants completed the study. The FC-TBL group demonstrated significantly greater improvement in clinical reasoning at T1 (14.68 ± 1.89 vs. 11.21 ± 1.76, p < 0.001) and T2 (13.96 ± 1.67 vs. 10.82 ± 1.58, p < 0.001) compared to the LBL group. Improvement from baseline to T1 was also significantly greater in the FC-TBL group (6.79 ± 1.45 vs. 3.17 ± 1.32, p < 0.001). The FC-TBL group significantly outperformed the LBL group across all secondary outcomes, including theoretical knowledge, all Mini-CEX and DOPS domains, teamwork skills, self-directed learning ability, learning engagement,and all teaching satisfaction dimensions (all p < 0.001). Perceived stress was transiently higher in the FC-TBL group at T1 (p < 0.001) but resolved by T2 (p = 0.892).\n\nConclusions: The FC-TBL model is significantly more effective than traditional LBL in improving clinical reasoning, theoretical knowledge, clinical competency, procedural skills, self-directed learning ability, learning engagement, and teaching satisfaction among general practice residents. The transient increase in perceived stress resolved over time. This innovative model represents a promising pedagogical approach for standardized general practice residency training.",
  "abstract_shown": true,
  "affiliations": [
    "Department of General Practice, First Affiliated Hospital of Huzhou Normal University, The First People’s Hospital of Huzhou, Huzhou, China"
  ],
  "article_type": "methods article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Meixia Xiao"
    },
    {
      "affs": [
        0
      ],
      "name": "Yashu Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Yujian Gao"
    },
    {
      "affs": [
        0
      ],
      "name": "Shengming Shi"
    },
    {
      "affs": [
        0
      ],
      "name": "Can Qian"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3sbvgmnk4ghr9.bib",
  "cited_by": 0,
  "doi": "10.3389/fmed.2026.1931590",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13730861/",
  "id": "3sbvgmnk4ghr9",
  "issns": [
    "2296-858X"
  ],
  "landing_url": "https://doi.org/10.3389/fmed.2026.1931590",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Curriculum, Instruction, and Pedagogy"
    ],
    [
      "openalex",
      "3304|Innovations in Medical Education"
    ]
  ],
  "openalex": "W7223102651",
  "pdf_url": "https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1931590/pdf",
  "pmcid": "PMC13730861",
  "pmid": "42984534",
  "published": "2026-10-21",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/3sbvgmnk4ghr9.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:23:50Z",
      "native_id": "PMC13730861",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fmed.2026.1931590"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Effectiveness of a flipped classroom combined with team-based learning in standardized training of general practice residents: a randomized controlled trial",
  "title_text": "Effectiveness of a flipped classroom combined with team-based learning in standardized training of general practice residents: a randomized controlled trial",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:21:10Z",
  "url": "https://research.draconitic.com/paper/3sbvgmnk4ghr9",
  "venue": "Frontiers in Medicine",
  "versions": []
}