ABSTRACT
BACKGROUND: The flipped classroom blended learning model has been proven effective in the teaching of undergraduate medical courses as shown by student acceptance and results. Since COVID-19 necessitated the application of online learning in Histology practical for MBBS students, the effectiveness of the blended learning model on teaching quality has required additional attention. METHODS: A blended learning of histology practical was flipped in a virtual classroom (FVCR-BL) or in a physical classroom (FPCR-BL) in School of Medicine, Zhejiang University in China. Students were split into FVCR-BL group (n = 146) due to COVID-19 pandemic in 2020 or were randomly allocated into FPCR-BL group (n = 93) in 2021, and retrospectively, students with traditional learning in 2019 were allocated into traditional learning model in a physical classroom (PCR-TL) group (n = 89). Same learning requirements were given for 3 groups; all informative and summative scores of students were collected; a questionnaire of student satisfaction for blended learning activities were surveyed in 2021. Data of scores and scales were analyzed with Kruskal-Wallis test and Kolmogorov-Smirnov test in SPSS Statics software. RESULTS: The results clarified that FPCR-BL students obtained higher final exam scores and were more likely to engage in face-to-face interactions with instructors than FVCR-BL students. FPCR-BL and FVCR-BL students had higher classroom quiz scores than the PCR-TL students owing to the contribution of blended learning. The results of the questionnaire showed that participants of FPCR-BL positively rated the online learning and preview test, with a cumulative percentage of 68.31%, were more satisfying than other learning activities of blended learning. There were significant correlations (r = 0.581, P < 0.05) between online learning and the other three blended learning strategies. CONCLUSIONS: In the flipped classroom with a blended learning process of histology practical, enhancing the quality of online learning boosts student satisfaction and improves knowledge learning; peer-to-peer interactions and instructor-to-peer interactions in the physical classroom improved knowledge construction.