Lectures Versus Flipped-Classroom Learning in Anatomy: Cross-Testing Evidence on Performance, Transfer, and Student Satisfaction

Abstract

Evidence for flipped-classroom learning in the health professions is growing, yet its advantage over lectures when transferable learning is tested remains unclear. We conducted a cross-sectional, inter-institutional comparison of two European programs (anonymized as Center A—lecture-based; Center B—flipped classroom). Students in Years 1 to 3 completed two anatomy examinations (0–10 scale): their own institutional exam and the partner’s exam. A 10-item Likert questionnaire produced a 0 to 10 Global Satisfaction Index. Analyses included Welch’s t test, effect sizes, and 95% confidence intervals. Own scores were comparable between centers (mean difference ≈ +0.10; p = 0.66; Hedges’ g ≈ 0.07). Cross scores strongly favored Center B [difference ≈ −2.40; 95% CI −2.72 to −2.07; p < 10−32; g ≈ −1.87]. By course, the Own → Cross drop was large in Center A across Years 1 to 3, moderate in Center B, and nearly absent in Year 3. Satisfaction was higher in Center B; internal consistency of the 10-item scale was modest overall (α ≈ 0.61). When assessment demands transfer to an unfamiliar format, flipped-classroom exposure confers a large performance advantage and higher satisfaction, while differences vanish on familiar exams. The findings support aligning anatomy curricula with active, application-focused learning and mixed-format assessment to promote durable, transferable learning.