Flipping the medical school classroom

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When Fiona Hanly-Jorda, MPH, now a second-year medical student, was considering what medical school she wanted to attend, she was drawn to the University of Miami Leonard M. Miller School of Medicine because of its approach to teaching.

"I'm much more of a hands-on learner," Hanly-Jorda says. "Everybody learns differently. Being able to approach study methods in whatever ways fit best gives people a lot of autonomy over their learning."

One instructional method used at the Miller School of Medicine that attracted Hanly-Jorda's interest is known as the flipped classroom approach. The idea has been around for nearly two decades but has slowly been gaining popularity in medical schools.

The idea behind the method is that students are given materials to learn on their own before class, leaving the class time open for questions, discussion, and more application-based exercises.

"It came from the realization that just talking at someone for a long time doesn't really facilitate learning," says Latha Chandran, MD, MPH, MBA, executive dean for education and policy and a professor of medical education and pediatrics at the Miller School of Medicine. "Rather than a lecturer - as they call it, 'a sage on the stage' - faculty become a guide by the side."

This method is particularly relevant in medical school, Chandran says, because students are already coming in with significant educational experience and they are highly motivated to learn. Medicine is a field with great ambiguity that requires creative thinking, problem solving, and teamwork - all skills that can be cultivated with the more interactive classroom approach.

Encouraging active learning

A body of research shows that active learning - which uses various methods to engage students with the material as opposed to relying only on passive listening or reading - is more effective at helping students understand and retain information, both in children and in students pursuing higher education. The methods can include problem solving, team-based learning, analysis, peer-group discussion, and examining case studies.

One review published in August 2025 that focused on medical education found that students taught with the flipped classroom method had significantly better scores on knowledge assessments and often reported higher satisfaction than students learning with the traditional lecture-based method. The review included 141 studies, 37 of which were randomized controlled trials, across which students in the flipped classroom model outperformed 74% of those using a traditional model on material knowledge tests. The study's authors argue that the range of evidence supports broader integration of the flipped classroom across medical education, but pointed out that successful integration relies on several factors, including faculty preparedness and effective use of active learning in the classroom.

Priti Mishall, MD, a professor at the Albert Einstein College of Medicine in New York, had heard about the flipped classroom method and was intrigued by the idea of implementing it in her own embryology and anatomy courses. She thought embryology in particular lent itself to the method, since the development of the embryo changes so quickly, making rote memorization less helpful.

The first year she taught using the method took a lot of planning. She enlisted the help of an instructional designer to record 10-minute videos that combined lectures, slides, and other visual materials for the students to watch before class. Mishall was careful to make sure the production value of the videos engaged the learners, using graphic features to keep their attention. In class, she would go over case studies, challenging students to apply what they learned and answering their questions. After her first semester working this way, Mishall received such positive feedback from the students that she has continued to incorporate this style of learning.

Her own experience made her curious about how other medical schools were implementing the flipped classroom, so she decided to conduct a literature review on the topic.

"I soon realized during the review, there are not many medical schools that conduct a flipped classroom approach," she says.

While several other medical schools have instituted the method in one way or another, including Harvard Medical School, Rush Medical College and Alice L. Walton School of Medicine, implementation has not yet been widespread or consistent.

As promising as the method may be, it can also be challenging to change faculty and student expectations.

Mishall says that inconsistent adoption of the method can frustrate students who struggle to keep up with the combination of prework for flipped classroom sessions and the homework from traditional lectures at the same time. And because of the flipped classroom structure, if students do not do the prework it can make the class time unproductive.

"It becomes a cognitive overload," Mishall says. "That's why we're limited in implementing it."

Flourishing with flexibility

At the Miller School of Medicine, where the curriculum underwent a complete overhaul in 2020, administration and faculty try to be clear with applicants about the expectations, should they decide to enroll, Chandran says.

"We tell students before they come, 'If you want to be spoon fed, don't come here.' So we get a different kind of student anyway," she says. "They are really smart and creative. We let them do their own thing and they flourish."

To fully implement the flipped classroom, Chandran says that getting buy-in from faculty is imperative.

"You definitely need to get all of the key faculty to be part of the solution," she says. "Otherwise, it's not going to work."

For Hanly-Jorda, who took two gap years between graduating from Boston College and starting at the Miller School of Medicine, adapting to a flipped classroom felt natural. She says that the method teaches her how to learn, as opposed to memorizing facts, which has already been helpful as she's experienced different clinical rotations. Adaptability has proven key to her success so far.

"I prefer this method," Hanly-Jorda says. "It sets you up from the beginning for the way medical education truly is throughout the rest of your career. It's nice to see that medical education is transforming to meet what we know about learning."