Improved Learning Outcomes After Flipping a Therapeutics Module: Results of a Controlled Trial

Purpose To evaluate the impact on learning outcomes of flipping a pain management module in a doctor of pharmacy curriculum. Method In a required first-professional-year pharmacology and therapeutics course at the University of Maryland School of Pharmacy, the pain therapeutics content of the pain management module was flipped. This redesign transformed the module from a largely lecture-based, instructor-centered model to a learner-centered model that included a variety of preclass activities and in-class active learning exercises. In spring 2015, the module was taught using the traditional model; in spring 2016, it was taught using the flipped model. The same end-of-module objective structured clinical exam (OSCE) and multiple-choice exam were administered in 2015 to the traditional cohort (TC; n = 156) and in 2016 to the flipped cohort (FC; n = 162). Cohort performance was compared. Results Learning outcomes improved significantly in the FC: The mean OSCE score improved by 12.33/100 points (P <.0001; 95% CI 10.28-14.38; effect size 1.33), and performance on the multiple-choice exam's therapeutics content improved by 5.07 percentage points (P <.0001; 95% CI 2.56-7.59; effect size 0.45). Student performance on exam items assessing higher cognitive levels significantly improved under the flipped model. Grade distribution on both exams shifted, with significantly more FC students earning an A or B and significantly fewer earning a D or F compared with TC students. Conclusions Student performance on knowledge-and skill-based assessments improved significantly after flipping the therapeutics content of a pain management module.