Flipped Learning in Physiotherapy Education

Effectiveness of Flipped Learning in Physiotherapy and Rehabilitation Education: A Quasi-Experimental Mixed-Methods Study in Urogenital and Maternal Health

This study will evaluate the effectiveness of flipped learning in an undergraduate physiotherapy and rehabilitation course on urogenital and maternal health. In flipped learning, students review digital learning materials before class, while class time is used for case discussions, problem-solving activities, group work, and clinical reasoning exercises.

Third-year physiotherapy and rehabilitation students enrolled in the Urogenital and Maternal Health in Physiotherapy and Rehabilitation course will be invited to participate. The study will compare students' clinical decision-making and academic performance after conventional teaching and after flipped learning activities. Student satisfaction with the flipped learning method will also be assessed. In addition, individual interviews will be conducted with a subgroup of volunteer students to explore their learning experiences.

Participation in the research will be voluntary and will not affect course grades. The study involves educational activities, questionnaires, written assessments, and optional audio-recorded interviews; no medical intervention or biological sample collection will be performed. The findings may help improve student-centered teaching approaches in physiotherapy and rehabilitation education.

Study Overview

• Status: Not yet recruiting
• Conditions: Education; Physiotherapy and Rehabilitation; Flip Learning
• Intervention / Treatment: Other: Flipped Learning

Detailed Description

This single-group quasi-experimental mixed-methods study will evaluate the effectiveness of flipped learning in undergraduate physiotherapy and rehabilitation education. The study will be conducted within the "Urogenital and Maternal Health in Physiotherapy and Rehabilitation" course among third-year students enrolled in the Physiotherapy and Rehabilitation Department at Lokman Hekim University.

The study aims to examine the effects of flipped learning on students' clinical decision-making skills, academic achievement, satisfaction with the learning method, and learning experiences. In addition, students' perceptions of flipped learning and conventional teaching will be explored through semi-structured individual interviews.

All students will receive the course content in two sequential educational phases. During the first phase, topics will be taught using the conventional teaching method, consisting of instructor-led presentations and question-and-answer sessions. During the second phase, flipped learning will be implemented. Before each flipped learning session, students will receive digital learning materials, including recorded videos, readings, quizzes, audio presentations, and short assessment questions. Students will be expected to review these materials before class. Class time will then be used for a brief topic review, case discussions, problem-solving activities, group work, and clinical reasoning exercises.

At the end of each flipped learning session, students will complete a reflective practice form based on the Reflective Practice Cycle. These forms will encourage students to identify the clinical problem in the case, describe challenging aspects of the learning process, explain the clinical knowledge used in decision-making, consider alternative assessment or treatment approaches, and reflect on how the activity may influence future clinical practice.

Quantitative assessments will be conducted after the conventional teaching period and after the flipped learning period. Clinical decision-making skills will be assessed using case analysis and Objective Structured Clinical Examination-like scenarios. Academic achievement will be evaluated using multiple-choice knowledge tests. Each test will include 25 five-option multiple-choice questions and a case-based clinical reasoning component scored using a rubric.

At the end of the flipped learning period, student satisfaction will be assessed using a five-item satisfaction questionnaire. The questionnaire will evaluate overall learning satisfaction, adequacy of digital content, quality of in-class activities, participation and motivation, and preference for flipped learning compared with conventional teaching. Course evaluation scores obtained from the university student information system may also be compared with the corresponding course evaluation results from the previous academic year.

For the qualitative component, approximately 8 to 12 volunteer students representing different levels of academic achievement will participate in semi-structured individual interviews after the flipped learning implementation. Interviews will explore students' experiences with conventional teaching and flipped learning, perceived effects on clinical reasoning, preparation process, motivation, participation, challenges, and recommendations for future course delivery. Interviews will be audio-recorded, transcribed, and analyzed using thematic or content analysis.

Participation in the research will be voluntary. Students who do not wish to participate will continue receiving the regular course content through conventional teaching methods and will not be disadvantaged academically. Participation or non-participation will not affect course grades or academic evaluations. All collected data will be stored securely and used only for scientific purposes. No medical intervention, biological sample collection, or physical examination will be performed.

• Study Type: Interventional
• Enrollment (Estimated): 60
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Demet Öztürk, Phd; Phone Number: +905068394288; Email: demett.ozturkk@gmail.com

Study Locations

• Turkey (Türkiye)
  • Ankara
    • Ankara, Ankara, Turkey (Türkiye), 06370
      • Lokman Hekim University, Ankara, Ankara
      • Contact: Demet Öztürk; Phone Number: 05068394288; Email: demett.ozturkk@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Enrolled as a third-year undergraduate student in the Physiotherapy and Rehabilitation Department at Lokman Hekim University.
• Registered for the "Urogenital and Maternal Health in Physiotherapy and Rehabilitation" course during the study period.
• Willing to participate voluntarily and able to provide informed consent.

Exclusion Criteria:

• Declines participation or withdraws consent at any stage of the study.
• Attends fewer than half of the flipped learning sessions.
• Does not complete the required research assessments.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Sequential Conventional Teaching and Flipped Learning; All participants will receive both teaching approaches sequentially within the same course. The first module will be delivered using conventional instructor-led teaching with presentations and question-and-answer sessions. The second module will use a flipped learning approach, in which students review digital learning materials before class and participate in case discussions, problem-solving activities, group work, and clinical reasoning exercises during class.

Other: Flipped Learning; The flipped learning intervention will be delivered during the second module of the "Urogenital and Maternal Health in Physiotherapy and Rehabilitation" course. Before each class session, students will receive digital learning materials at least one week in advance, including recorded video lectures, readings, book chapters, articles, audio presentations, quizzes, and short assessment questions. Students will review the assigned materials before attending class. During class, the instructor will provide a brief 10-15-minute review of the topic, followed by active learning activities including case discussions, clinical problem-solving, group work, and clinical reasoning exercises. At the end of each session, students will complete a reflective practice form based on the Reflective Practice Cycle. The intervention will be implemented as part of the regular course curriculum. Participation in research-related assessments will be voluntary and will not affect students' course grades.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinical Decision-Making Skills	Clinical decision-making will be assessed using case-based written scenarios and OSCE-like clinical scenarios developed for the course content. Students will be asked to identify the clinical problem, select appropriate assessment methods, plan physiotherapy interventions, and justify their decisions. Responses will be scored using a structured rubric. Higher scores indicate better clinical decision-making performance.	Through study completion, after 16 academic weeks
Academic Achievement	Academic achievement will be assessed using 25-item, five-option multiple-choice knowledge tests developed for each course module. Each test will assess theoretical knowledge related to the relevant urogenital and maternal health topics. Higher scores indicate greater academic achievement.	Through study completion, after 16 academic weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Student Satisfaction with Flipped Learning	Student satisfaction will be evaluated using a five-item questionnaire rated on a 5-point Likert scale from 1 = strongly disagree to 5 = strongly agree. The questionnaire will assess overall learning satisfaction, adequacy of digital learning materials, quality of in-class activities, participation and motivation, and preference for flipped learning compared with conventional teaching. Higher scores indicate greater satisfaction with the flipped learning approach.	Through study completion, after 16 academic weeks
Qualitative Learning Experiences	Semi-structured individual interviews will be conducted with approximately 8-12 volunteer students selected to represent different academic achievement levels. Interviews will explore students' experiences of conventional teaching and flipped learning, including perceived effects on clinical reasoning, preparation process, motivation, participation, challenges, and recommendations. Audio-recorded interviews will be transcribed and analyzed using thematic analysis.	Through study completion, after 16 academic weeks

Collaborators and Investigators

• Sponsor: Lokman Hekim University

Study record dates

Study Major Dates

• Study Start (Estimated): August 1, 2026
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): December 20, 2026

Study Registration Dates

• First Submitted: July 1, 2026
• First Submitted That Met QC Criteria: July 10, 2026
• First Posted (Actual): July 16, 2026

Study Record Updates

• Last Update Posted (Actual): July 16, 2026
• Last Update Submitted That Met QC Criteria: July 10, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Flipped Classroom
• Other Study ID Numbers: 2026-XXT

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No