Comparison of Flipped vs Traditional Classroom Teaching for Primary Surgical Skills in Postgraduate Surgical Trainees

NCT07729176 | Enrolling By Invitation DMC

• 1 other identifier: UHS/DPS-25/450
• Study Type: interventional
• Target: 92
• Locations: 1 country
• Sites: 2

Brief Summary

The aim of this study is to evaluate the effectiveness of the flipped classroom approach in improving the surgical skills of MS Surgery and allied specialty trainees compared with the traditional classroom method. Traditional classroom teaching relies on face-to-face lectures, demonstrations, textbooks, and classroom discussions. Although it facilitates direct interaction between faculty and trainees, recent advances in educational technology have emphasized the need for learner-centered approaches that promote active learning, critical thinking, and practical skill development. The flipped classroom is an instructional model in which trainees study theoretical content before class using videos, reading materials, and other online resources. Classroom time is then used for interactive discussions, case-based learning, simulation, hands-on practice, and instructor feedback. This approach encourages self-directed learning while allowing faculty to focus on reinforcing concepts and developing clinical and technical skills. Although the flipped classroom has shown promising results in undergraduate medical education, evidence regarding its effectiveness in postgraduate surgical training remains limited, particularly in low- and middle-income countries. Surgical education requires the integration of theoretical knowledge, technical competence, clinical decision-making, and teamwork. Evaluating innovative teaching strategies in this context may improve training quality and optimize available educational resources. This randomized controlled trial will include 92 MS Surgery and allied specialty trainees from Services Hospital and Jinnah Hospital, Lahore. Participants will be randomly allocated to either the traditional classroom or flipped classroom group. Both groups will receive instruction on identical surgical topics and practical skills from the same faculty using standardized learning objectives. Outcomes will be assessed through a standardized 10-station Objective Structured Clinical Examination (OSCE). Data will be analyzed using SPSS version 23. Descriptive statistics will summarize participant characteristics, while paired and independent t-tests will compare performance within and between groups. Statistical significance will be set at p ≤ 0.05 with a 95% confidence interval. The findings will provide evidence on the effectiveness of the flipped classroom in postgraduate surgical education and may support its incorporation into surgical training curricula to enhance trainee competence and clinical preparedness.

Conditions

FLIPPED CLASSROOM METHODS; Traditional Classroom-Based Learning; Surgical Skill Training

Keywords

flipped; traditional; primary surgical skills

Outcome Measures

Primary Outcomes (1)

• OSCE

  The effectiveness of the teaching methodologies will be assessed using both practical and theoretical outcome measures. Practical surgical skills will be objectively evaluated through a standardized 10-station Objective Structured Clinical Examination (OSCE) using validated checklists. Theoretical knowledge will be assessed using a standardized written examination comprising multiple-choice questions and concept-inventory style questions designed to evaluate conceptual understanding, clinical reasoning, and application of knowledge. Together, these assessments will provide a comprehensive evaluation of participants' competence in primary surgical skills.

  6 MONTHS

Study Arms (2)

cases

EXPERIMENTAL

taught via flipped method: All 1st-year MS trainees in surgery and allied at Services Hospital Lahore and Jinnah Hospital Lahore. * Trainees who have not previously participated in any formal workshop or structured training program focused on primary surgical skills. * Trainees who provide written informed consent to participate in the study. * Trainees who are available and committed to complete the full 8-week intervention and follow-up OSCE assessment. * Trainees with no physical or cognitive impairments that would limit their ability to perform surgical skills or participate fully in the training sessions.

Other: flipped classroom

controls

ACTIVE COMPARATOR

taught via traditional method: • All 1st-year MS trainees in surgery and allied at Services Hospital Lahore and Jinnah Hospital Lahore. * Trainees who have not previously participated in any formal workshop or structured training program focused on primary surgical skills. * Trainees who provide written informed consent to participate in the study. * Trainees who are available and committed to complete the full 8-week intervention and follow-up OSCE assessment. * Trainees with no physical or cognitive impairments that would limit their ability to perform surgical skills or participate fully in the training sessions.

Other: traditional method of teaching,

Interventions

flipped classroom OTHER

Participants will be randomly assigned to either the flipped classroom (FC) group or the traditional classroom (TC) group, with 46 trainees in each group. Randomization will be carried out using the lottery method with sealed, opaque envelopes prepared separately for each institution. Each participant will select one envelope in the presence of two independent witnesses to ensure transparency and maintain allocation concealment. The group assignment will be recorded immediately after the envelope is opened.

cases

traditional method of teaching, OTHER

Trainees in the traditional classroom group will attend conventional face-to-face lectures followed by demonstrations and supervised practical sessions.

controls

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Trainees who have not previously participated in any formal workshop or structured training program focused on primary surgical skills.
• Trainees who provide written informed consent to participate in the study.
• Trainees who are available and committed to complete the full 8-week intervention and follow-up OSCE assessment.
• Trainees with no physical or cognitive impairments that would limit their ability to perform surgical skills or participate fully in the training sessions.

You may not qualify if:

• Trainees who have completed more than one year of MS surgical training or are beyond the 1st year level.
• Trainees who have previously attended any workshop, course, or formal training specifically targeting primary surgical skills.
• Trainees currently involved in other interventional studies or educational programs that may confound the outcomes of this study.
• Trainees unwilling or unable to provide informed consent or commit to the full duration of the study.
• Trainees with any medical condition or disability that could compromise their ability to safely perform surgical tasks or participate in the OSCE evaluation.
• Trainees who miss more than 20% of scheduled training sessions during the 8-week period.

Sponsors & Collaborators

• University of Health Sciences Lahore: lead

Study Sites (2)

Jinnah Hospital Lahore

Lahore, Punjab Province, 54000, Pakistan

Location

Services hospital lahore

Lahore, Punjab Province, 54000, Pakistan

Location

Study Officials

• Amina Ahmed, MHPE

  CMH Lahore Medical College and IOD

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PROFESSOR

Study Record Dates

• First Submitted: July 10, 2026
• First Posted: July 27, 2026
• Study Start: December 5, 2025
• Primary Completion: July 5, 2026
• Study Completion (Estimated): December 5, 2026
• Last Updated: July 27, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (2)