Effectiveness of a flipped classroom combined with team-based learning in standardized training of general practice residents: a randomized controlled trial
- 1Department of General Practice, First Affiliated Hospital of Huzhou Normal University, The First People’s Hospital of Huzhou, Huzhou, China
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.
Objective: 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.
Methods: 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.
Results: 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).
Conclusions: 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.
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BibTeX
@article{xiao2026effectiveness,
title = {{Effectiveness of a flipped classroom combined with team-based learning in standardized training of general practice residents: a randomized controlled trial}},
author = {Meixia Xiao and Yashu Wang and Yujian Gao and Shengming Shi and Can Qian},
journal = {Frontiers in Medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1931590},
url = {https://doi.org/10.3389/fmed.2026.1931590},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Effectiveness of a flipped classroom combined with team-based learning in standardized training of general practice residents: a randomized controlled trial
AU - Meixia Xiao
AU - Yashu Wang
AU - Yujian Gao
AU - Shengming Shi
AU - Can Qian
PY - 2026
DA - 2026/10/21
JO - Frontiers in Medicine
DO - 10.3389/fmed.2026.1931590
UR - https://doi.org/10.3389/fmed.2026.1931590
AB - 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. Objective: 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. Methods: 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. Results: 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). Conclusions: 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.
SN - 2296-858X
ER -