Student engagement and language learning in a flipped ESP classroom: The role of Telegram

This paper describes the context, adaptation, and subsequent implementation of the Pan American Health Organization (PAHO) Caribbean Psychological First Aid (PFA) course to train first responders, healthcare personnel, educators, and community leaders in Barbados. The decision to adapt was guided by a previous needs assessment study and the Iterative Decision-making for Evaluation of Adaptations (IDEA) tool. Adaptations were reported using The Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME–IS). Community stakeholders reported limited knowledge and uptake of the original PFA course. The model PAHO training is virtual and self-paced. For the Barbados program, we employed a flipped classroom where completion of the virtual material was a prerequisite for synchronous online training. Content was augmented for Barbados by adding culturally appropriate videos and role plays. Importantly, adaptations occurred during the scale-up of national mental health and psychosocial support during the COVID-19 pandemic and were designed to increase relevance, reach, and engagement of the PFA component of MHPSS. Future directions for MHPSS in vulnerable SIDS are discussed in the framework of geopsychiatry.

Pediatric emergency medicine (PEM) training within emergency medicine (EM) residency programs varies widely in preceptor expertise, critical care exposure, and procedural opportunities. Despite the importance of pediatric airway management, real-world exposure to critically ill children remains limited and inconsistent across training sites. Current ACGME guidelines provide minimal direction on pediatric-specific content or mandatory procedures, leaving gaps in emergent airway training. To address perceived deficiencies in pediatric airway skills among EM residents, we implemented a longitudinal, simulation-based pediatric airway curriculum. The primary goal was to improve pediatric airway knowledge, confidence, procedural competency in airway equipment setup, bag-valve-mask (BVM) ventilation, troubleshooting, intubation techniques using a flipped classroom model, and rapid cycle deliberate practice (RCDP). Guided by Kern's curriculum design framework and selected components of Sawyer's six-step procedural learning model, the curriculum incorporated asynchronous learning and eight interactive simulation sessions over a 12-month period. 40 residents in four postgraduate years participated in two individualized RCDP sessions annually, supported by faculty trained in pediatric airway management. A novel checklist was used for objective performance assessment. Thirty-one residents completed baseline and post-intervention procedural assessments. Significant improvements were observed in equipment setup and intubation steps (p < 0.05), with first-pass intubation time reduced from 9 min and 12 s to 7 min and 9 s (p < 0.05). Self-reported confidence in pediatric airway management increased across all PGY levels (p < 0.05), and knowledge scores improved (7.8 vs. 9.7, p < 0.05). Resident feedback strongly endorsed the curriculum's value in building skills and confidence. A structured, simulation-based pediatric airway curriculum using RCDP effectively enhances EM residents' procedural performance and confidence. This model offers a scalable approach for addressing critical skill gaps in PEM training. Future directions include integrating advanced airway techniques and longitudinal retention assessments.

We conducted a systematic review to investigate the effect of implementing flipped classroom designs on academic performance and student satisfaction in undergraduate anatomy and physiology courses. We used the PRISMA framework and searched databases (EBSCO Medline and EBSCO Eric) with the terms "flip* class", "anatomy" and "physiology". Original research articles were limited to peer-reviewed, quantitative and/or mixed-methods studies published between 2010 and 2025. Three main themes emerged from the 11 articles reviewed, including positive gains in academic performance (n =10/11 studies reporting; 91 % studies) and student satisfaction (n =10/11 studies reporting; 91 % studies). While low effect sizes were found in most studies, none of these studies reported a negative effect for flipped classroom interventions. Structured teaching strategies and curriculum design appear to be important determinants of performance and satisfaction. Studies on flipped classrooms in undergraduate anatomy and physiology courses indicated positive changes in academic performance and student satisfaction linked to a well-designed curriculum. Methodological limitations in the studies reviewed include the absence of demographic analysis, minimal or absent descriptions of flipped classroom curriculum design, inadequate data reporting and the absence of randomized, comparison groups. Future research needs to focus on refining and standardizing the quality of pre-class materials and exploring strategies to enhance student compliance and engagement with pre-class content. Additional studies could all focus on identifying the factors that contribute to both the successes and limitations of the flipped classroom, particularly in complex courses such as anatomy and physiology, where unique challenges may arise.

BackgroundAlthough palliative care competencies appear on USMLE examinations, pre-clinical curricula devote minimal time to end-of-life education. Traditional lectures cannot cover foundational knowledge and clinical application in a single hour. A flipped classroom approach-where students learn core content before class, and use face-to-face time for application-offers a solution. We redesigned a one-hour Introduction to Palliative Care session using this model.ApproachWe created a 30-minute interactive online module in Articulate 360™ for first year students covering palliative care definitions, eligibility criteria, and care settings. The module incorporated matching, sorting, multiple-choice questions with feedback, process maps, and flashcards. In-class time was restructured to small group case discussions distinguishing primary palliative care, specialty palliative care, and hospice. Students received the module one week before class and were reminded that material could appear on examinations.EvaluationThrough a quasi-experimental, retrospective cohort study using a pre-post design, we compared examination performance and student perceptions across four academic years (2020-2024, N = 371). Correct responses on a palliative care examination question improved from 57% (2020-2021, virtual lecture) to 66%, 67%, and 80% in subsequent years with the flipped intervention. The pre-work engaged students in learning (79-89% agreement), enabled focus on advanced topics during class (73-77% agreement), and was described as interactive and helpful in teacher evaluations.ImplicationsThe flipped classroom successfully transformed a content-heavy lecture into interactive learning and is transferrable to other institutions. The results are only suggestive of an impact on knowledge-based outcomes. Resources are freely available from the corresponding author.

This literature review integrates information and communications technology in the context of English literature literacy instruction to carve deep understanding and critical analysis skills in learners. Flipped classrooms are analyzed for learner self-direction, thinking skills application, and sophisticated text engagement as per 21st-century educational shifts. Peer-reviewed research conducted from 2015 – 2025 was synthesized to study the integration of Information and Communication Technology in flipped classrooms and literature teaching for higher education. It challenges disparity in digital resource availability, attitudinal and competency issues of teachers toward technology, and the relevance of ICT resources to adopted pedagogy. This review explores the role of professional learning, organizational change, and collaboration in learning design toward the resolution of these issues. Despite the robust affordances of flipped classrooms for student engagement and higher-order thinking skill development, ICT-supported pedagogy optimized for engagement requires more deliberate efforts toward harnessed educator or lecturer willingness, planning, and adaptable implementations. The findings enhance recommendations for the reform of English literature curricula and demonstrate the promise of flipped learning in the teaching of English literature.

IntroductionThe flipped classroom is a blended teaching approach in which students receive content prior to attending face-to-face lessons. It typically comprises three phases: pre-class, in-class and post-class. Previous research has predominantly focused on the flipped classroom in general higher education, nursing education and anatomy education for medical students; however, its specific use in anatomy education among nursing students remains understudied.ObjectiveThis study aimed to explore and describe nursing students’ experiences with a flipped classroom in a human anatomy course.MethodsThe flipped classroom approach was used once a week for a second-semester human anatomy class for first-year undergraduate nursing students, while the other days adhered to the traditional approach. Subsequently, an exploratory, descriptive qualitative study was conducted, with constructivism as its theoretical foundation. A sample of 18 nursing students was selected through convenience sampling to participate in the study. Data were collected through individual interviews, using an interview guide. The data were transcribed verbatim and then manually thematically analysed, following six stages of the iterative process of analysing interview data.ResultsThe three themes identified are: the flipped classroom promotes active learning, the flipped classroom is not the preferred method for learning human anatomy, and improving the flipped classroom approach.ConclusionFindings indicate both positive and negative experiences with the flipped classroom in human anatomy. These may help develop a step-by-step guide to teaching human anatomy using the flipped classroom approach. Future researchers might explore how the flipped classroom can be utilised to enhance the application of human anatomy in clinical practice among nursing students.

ABSTRACT Objective To compare manual therapy students’ preferences for traditional classes versus the Flipped Classroom, and to examine their effects on learning perception and behavioral, cognitive, and emotional engagement. Methods A within-subject educational intervention study was conducted with undergraduate physiotherapy students enrolled in a Manual Therapy course during the 2022–2023 academic year. The course comprised eight face-to-face sessions, four delivered using a traditional lecture-based approach and four using the Flipped Classroom methodology. Students’ engagement (behavioral, cognitive, and emotional dimensions), preferences between teaching models, and perceptions of educational quality were assessed using validated questionnaires. Within-subject comparisons between traditional and Flipped Classroom models were performed. Results Forty-two students were included in the analysis. Students showed high levels of engagement across all three dimensions, with mean scores above 4.5 on a 5-point Likert scale. A significant preference for the Flipped Classroom model over the traditional model was observed (mean ± SD: 4.4 ± 1.1 vs. 2.8 ± 1.4; p < 0.05), with 88.1% of students agreeing or strongly agreeing that their performance was better when learning through the FC approach. Students also reported positive perceptions of educational quality, particularly regarding teaching effectiveness, clarity of objectives, and integration of online and face-to-face learning. Conclusion The Flipped Classroom methodology was associated with high levels of student engagement and positive perceptions of educational quality in manual therapy education. These findings support the use of Flipped Classroom as a promising learner-centered approach in physiotherapy training, particularly for subjects requiring extensive hands-on practice.

This study focuses on the application of the flipped classroom combined with postgraduate-undergraduate collaboration (FC-PUC) teaching model in stomatological education. It aims to evaluate the impact of this integrated model on undergraduate students' clinical operational competence, critical thinking, and learning satisfaction in stomatology courses. A mixed-methods research approach was adopted. A total of 120 undergraduate students majoring from Hainan Medical University were randomly divided into three groups, which received traditional teaching (Lecture-based Learning, LBL), conventional flipped classroom teaching, and the flipped classroom combined with postgraduate-undergraduate collaboration teaching, respectively. By comparing the assessment scores, skill operation ratings, and student feedback across the three groups, the teaching effectiveness of the FC-PUC model was thoroughly investigated. No statistically significant difference was observed in the scores on basic knowledge questions among the three groups (p > 0.05). In contrast, scores on case analysis questions, total theoretical scores, and the performance in three practical skills-tooth preparation for full crown restoration, pit and fissure sealing, and intraoral suturing-all exhibited a significant gradient difference (PUC-FC group > FC group > LBL group, p < 0.05). The satisfaction survey indicated that, except for the dimension of rationality of class hour arrangement where no inter-group difference was found, the PUC-FC group achieved significantly higher ratings than the FC and LBL groups in other dimensions including course quality, teaching resources, and practical sessions. The flipped classroom combined with postgraduate-undergraduate collaboration model significantly improves students' operational precision, case analysis ability, and learning satisfaction. This study provides a novel pathway for optimizing stomatological education.

Diverse teaching strategies, including flipped classroom (FC) approaches, are increasingly used in anatomy education to enhance learning outcomes. However, their implications are difficult to interpret when instructional methods vary alongside cohort characteristics such as instructional language. This study examined academic performance, learning satisfaction, and state anxiety in two pre-existing cohorts of first-year dental medicine students differing in instructional sequence and language. This quasi-experimental study included 186 volunteer first-year dental medicine students (Turkish-language cohort [TC]: n = 93; English-language cohort [EC]: n = 93) who took anatomy for the first time in spring 2025. The TC received the traditional education model in both the third and fourth curricular blocks (Committee 3 and Committee 4), whereas the EC received FC instruction in Committee 3 and the traditional education model in Committee 4. Accordingly, the study represents a cohort comparison within a natural dual-language educational setting rather than a design intended to isolate an independent instructional effect. Academic achievement was assessed using identical 40-item multiple-choice theory examinations at the end of each committee. Satisfaction was assessed using separate 10-item, method-specific Likert questionnaires administered after Committee 4 and was interpreted exploratorily because the instruments were not identical across cohorts. State anxiety was measured with the State-Trait Anxiety Inventory, State scale (STAI-S). Mean theory scores were higher in the EC than in the TC in both Committee 3 (53.48 ± 18.85 vs. 46.25 ± 20.00) and Committee 4 (52.38 ± 22.67 vs. 39.66 ± 18.42). Adjusted analyses indicated that the magnitude of the between-cohort difference varied across committees and that the adjusted contrasts remained in the same direction across both committees, although effect sizes were small. Because instructional sequence, instructional language, and cohort membership were not independent, these findings are interpreted as adjusted cohort-level contrasts rather than evidence of an isolated FC effect. Post-course STAI-S scores were similar across cohorts. Satisfaction findings are presented as exploratory summaries because different method-specific questionnaires were used across cohorts. This study characterizes cohort-level differences in theory examination performance, state anxiety, and satisfaction within a quasi-experimental dual-language anatomy education setting among first-year dental medicine students. Beyond these descriptive findings, the results demonstrate how performance differences can emerge in dual-language contexts where instructional methods and language tracks are structurally confounded. For dental medicine anatomy educators, this carries a clear practical implication that comparisons across dual-language cohorts may conflate instructional and language effects and therefore require anatomy-specific baseline assessment and equivalent learner-report measures for meaningful interpretation.

ABSTRACT The post-COVID-19 era has accelerated technology integration in education, yet research on the Flipped Classroom Model (FCM) remains limited, particularly regarding non-English-speaking university geography instructors. The FCM is an instructional approach in which students engage with learning materials before class, freeing in-person time for active, collaborative exercises. Although well-established in higher education, there is insufficient understanding of how instructors perceive the FCM compared to traditional methods, how they prepare for its implementation, and what factors influence its adoption. This study explores Saudi university geography instructors’ perceptions and adoption factors. The research identifies two central themes: perceived advantages and significant obstacles. Instructors acknowledged the model’s potential to expand time for applied geographical practice, foster student independence, and increase motivation through active learning. However, these benefits are constrained by substantial barriers, most prominently excessive teaching workloads, a lack of institutional support for technology, and inadequate English language proficiency. The findings suggest that successful FCM integration requires more than instructor willingness; it necessitates institutional reforms to reduce workloads, provide targeted professional development and infrastructure, and address language access. Future research should explore instructors’ perspectives through targeted interventions.

Introduction: Considering the essential role of cardiopulmonary resuscitation (CPR) training in enhancing the clinical competence of emergency medical students, along with the limitations of traditional teaching methods, the adoption of innovative approaches such as the flipped classroom has gained increasing attention. The aim of this study was to determine the effectiveness of flipped classroom instruction on CPR competence among undergraduate emergency medical students. Methods: This study was designed and conducted as a randomized controlled trial. A total of 102 undergraduate emergency medical students were randomly assigned to either the intervention group or the control group. The intervention group underwent CPR training through the flipped classroom approach, whereas the control group received CPR training through traditional instruction. In the control group, traditional education included in-person lectures, classroom discussions, and practical exercises. To assess students’ performance and clinical competence, the Mini-CEX form was applied to evaluate individual clinical skills, and the OSCE was employed to assess practical competence in performing CPR. These evaluations were conducted at three time points: baseline (pre-test), week eight, and week twelve. Results: Findings indicated that the intervention group, compared to the control group, achieved higher scores both in the assessment of clinical skills using the Mini-CEX and the practical competence assessment (OSCE) related to CPR performance. The differences in mean scores at post-test time points were statistically significant (p &lt; 0.001). Specifically, the mean OSCE scores in the intervention group increased by approximately 8.8 points from baseline to week eight, by 11.8 points from baseline to week twelve, and by 3 points between week eight and week twelve. These results demonstrated a significant upward trend in clinical competence among participants in the intervention group over time. Conclusion: Based on the findings, flipped classroom instruction may be regarded as an effective and student-centered approach for CPR training and may serve as a foundation for curriculum reforms in emergency medical education.

This study investigated the influence of teachers’ instructional strategies on students’ academic performance in electrical technology education in universities in North-East Nigeria. A descriptive survey research design was adopted, involving a population of twenty-six lecturers and fifty-eight 300-level students from three universities offering electrical technology education. Data were collected using a validated Instructional Strategies Questionnaire (ISQ) with a reliability coefficient of 0.940. Descriptive statistics and linear regression analysis were used to analyze the data. Findings revealed that teachers employ instructional strategies at a moderate level (grand mean = 3.23), with greater emphasis on traditional methods such as lecturing, demonstration, and group discussions, while innovative approaches like flipped classroom and gamification were minimally utilized. The regression analysis indicated no significant influence of instructional strategies on students’ academic performance (R = 0.039, R² = 0.002, p &gt; 0.05). The study concluded that the moderate and limited application of diverse instructional strategies may not be sufficient to significantly impact students’ performance. It was recommended that lecturers adopt more innovative, learner-centered, and technology-integrated instructional approaches to enhance learning outcomes.

The integration of STEM (Science, Technology, Engineering, and Mathematics) in physics education is gaining increasing global attention due to its role in developing 21st-century competencies such as critical thinking, creativity, and technological literacy. This study presents a systematic literature review (SLR) of STEM-based physics education research published in Scopus-indexed journals between 2016 and 2025. Following the PRISMA protocol, 57 articles meeting the criteria were analysed through thematic and descriptive synthesis. The results of the analysis indicate a significant increase in research activity after 2018, with a peak in publications occurring in 2023. Indonesia, Malaysia, and the United States emerged as the main contributors. This review also revealed that Project-Based Learning (PjBL) and Problem-Based Learning (PBL) are the most widely used pedagogical models, whilst technology-based strategies such as Arduino-based digital learning and the flipped classroom appear to be growing in prominence. Although STEM research is growing globally, there remains a gap in theoretical coherence, namely that most studies have not elucidated how the integration of STEM components (S, T, E, M) is applied in research. Furthermore, no studies have examined teachers’ digital readiness when implementing STEM in physics education, and there are limitations in studies across certain educational levels. Future research is recommended to use a longitudinal and mixed-methods approach to examine how STEM integration can enhance scientific literacy and higher-order thinking skills in physics education

The aim of this study is to develop, test, and evaluate the effectiveness of a pedagogical model integrating artificial intelligence tools and “the flipped classroom” blended learning technology for developing key management competencies of students of an economic university. Materials and methods. The study utilized a combination of methods: theoretical analysis, a pedagogical experiment, expert assessment, and statistical data processing. The experiment was conducted at the Minsk branch of the Plekhanov Russian University of Economics during the 2021-2025 academic years with students majoring in “Business Informatics”, “Management”, and “Economics”, divided into control and experimental groups. Results. A comparison of the results of educational activities of students in the experimental and control groups demonstrates the high potential of a pedagogical model integrating artificial intelligence tools and “flipped classroom” technology for developing students’ management competencies, which in turn has a positive impact on their other educational and academic achievements. Conclusion. The integration of artificial intelligence technologies and “the flipped classroom” model creates a powerful educational foundation for the targeted development of management competencies of economic university’s students. This approach transforms the educational process from passive information acquisition into an active, practical learning environment, closely aligned with the realities of digital business. The key success lies in the synergy: artificial intelligence takes over the routine personalization and training of basic knowledge, while students and faculty focus on developing the unique qualities needed by future economic leaders — competence, communication skills, critical thinking, creativity, emotional intelligence, leadership potential, and self-confidence. The conclusion confirms the high effectiveness of the proposed integration, which ensures personalization, interactivity, and a practice-oriented educational process. The model can be scaled to other areas of management training.

Effect of flipped classroom and screen-based simulation on nursing students' clinical judgment: A quasi-experimental study.

Grounded in Self-Determination Theory (SDT), this research delves into the effectiveness of integrating process drama into the flipped classroom model to enhance learners' motivation and engagement in an English as a Foreign Language (EFL) speaking course. A mixed-methods study was carried out on 67 first-year English majors over an 8-week experiment. The experimental group underwent drama-based flipped teaching, while the control group received traditional teaching. Subsequently, semi-structured interviews were conducted with 16 students and one course lecturer. Quantitative findings revealed that the combination of process drama and the flipped classroom significantly boosted learners' motivation, as well as their behavioural, emotional, and cognitive engagement, with large effect sizes. Qualitative results indicated that both students and the teacher perceived that the integrated teaching model satisfied students' needs for autonomy through "the freedom of script creation", their needs for competence via "the authentic, low-risk language practice", and their needs for relatedness through "the social bonding". This study empirically validates the efficacy of the drama-based flipped classroom model within the context of Chinese EFL teaching and learning. It also offers practical implications for EFL instruction and establishes a foundation for future research on drama-integrated flipped teaching.

Numerous studies have explored how the flipped classroom affects satisfaction, learning outcomes, and attitudes of both teachers and students. However, there is a gap in research regarding its impact on higher-order thinking. This meta-analysis aims to fill this gap by assessing the effect size of the flipped classroom model on students’ mathematical higher-order thinking. Data from 30 primary studies, including journal articles, proceedings, theses, and dissertations, were analyzed using Comprehensive Meta-Analysis (CMA) Version 4 Software. These studies included 1,043 students in the experimental groups and 970 in the control groups. The analysis revealed a pooled effect size of 1.094, indicating a significant positive impact. Notably, the effect size remained consistent across various educational levels, sample sizes, years of study, types of learning media, and higher-order thinking indicators. This suggests the versatility and effectiveness of the flipped classroom model across different educational settings, including middle school, high school, and college, regardless of class size or learning media used.

The study aimed to establish the effect of flipped learning on enhancing grammar in secondary school students learning English. The method used in this research was a pre and post-test quasi-experimental research of a single group to investigate the effect of the flipped classrooms. The subjects of the present study were 15 female students selected using purposive sample techniques from Kasturba Sevikashram Higher Secondary School located in the Dindigul district of Tamil Nadu. Statistical techniques or tests, including the normality test, percentage analysis, Wilcoxon signed rank test, Kruskal-Wallis H test, and the Mann-Whitney U test, were used to analyze the data collected in the study. The findings revealed an enhancement in participants' grammar usage by the end of the study because there was an enhancement in the mean score between pre and post-test results. This work contributes to the existing literature on the flipped classroom to enhance the students' grammar proficiency, deficient proficient students. However, as clearly seen in the example of the given model, the study calls for further investigations of its application in different learning contexts and its integration with modern technologies to enhance language learning.

Most students struggle to write argumentative essays due to a lack of schemata, so resources are needed to enrich them. The purpose of this study was to investigate the impact of SVVR-assisted immersive teaching using a flipped classroom model on argumentative essay writing skills, class engagement, and student perceptions. A quasi-experimental method was used, involving 200 university students majoring in Indonesian language education. The participants were divided into two groups with the same number of 100 students each: the experimental group received the intervention of spherical video virtual reality in a flipped classroom model, while the control group received conventional teaching. The instruments used were a rubric for assessing argumentative writing skills, a class engagement questionnaire, a rubric for assessing the lexical complexity of argumentative essays and interview questions. The data analysis included the Wilcoxon signed-rank test, the Quade test, paired-sample t-test, and one-way analysis of covariance (ANCOVA). The findings indicated that SVVR-assisted immersive teaching with a flipped classroom model improved argumentative essay writing skills, class engagement, and student perceptions. Improved argumentative writing skills were evident in the use of evidence and data to support arguments, which were presented more robustly and scientifically, resulting from the observation of objects. Improvements in the quality of argumentative essays were also evident in the increased lexical complexity across all aspects of lexical density, lexical sophistication, and lexical variety. Increased class engagement was evident in cognitive engagement, behavioral engagement, and emotional engagement. Positive perceptions were evident in the experience, emotion, active motivation, and strategies used for improving writing learning. Thus, improvements in all competencies occurred because the intervention enhanced realistic and context-rich experiences, critical thinking skills, and evidence-based reasoning. This research suggests that the use of virtual reality technology can enhance the students' understanding of difficult concepts and create positive impressions of the learning process.