Flipping e-Learning for Teaching Medical Terminology: A Study of Learners’ Online Experiences and Perceptions



Since e-Learning has become popular in recent years, research studies have been conducted about which instructional methods are the most effective in online learning environments. The purpose of this study is to apply the flipped classroom model to a Medical Terminology Course that was provided fully online as part of a Medical Documentation and Secretarial associate degree program in a vocational college, and to analyze learners’ experiences associated with this application. Based on this method, as asynchronous activities, learners were required to study interactive multimedia content and applications. For synchronous activities, mainly learner-centered approaches, collaborative learning, problem solving and discussion, led the learning process. In the context of this study, learners’ usage of the system, submissions to the study process questionnaire, and academic achievement were collected as quantitative data; whereas, learners’ opinions towards the flipped classroom model were obtained as qualitative data. Hence, the study was designed as a mixed methods research. According to the results, it was found that learners’ academic achievement significantly related to their perceptions of deep learning and their time spent on learning activities. Moreover, learners indicated problematic aspects to the flipped classroom as time expectancies, insufficiency of instructional materials, and lack of advice received from the instructor.


medical terminology, flipped classroom, deep learning, learning process, online learning

Full Text:



Bennett, B., Bergmann, J., Cockrum, T., Fisch, K., Musallam, R., Overmyer, J., …Spencer, D. (2013, July 9). The flipped class manifest. The Daily Riff. Retrieved September 12, 2018, from http://www.thedailyriff.com/articles/the-flipped-class-manifest-823.php

Bergmann, J., & Sams, A. (2012). Flip your classroom: Reach every student in every class every day. Alexandria, VA: International Society for Technology in Education; ASCD.

Bhagat, K. K., Chang, C. N., & Chang, C. Y. (2016). The impact of the flipped classroom on mathematics concept learning in high school. Educational Technology & Society, 19(3), 134-142.

Biggs, J., Kember, D., & Leung, D.Y.P. (2001). The revised two-factor study process questionnaire: R-SPQ-2F. British Journal of Educational Psychology, 71, 133-149. doi: 10.1348/000709901158433

Biggs, J.B., & C. Tang. (2007). Teaching for quality learning at university, 3rd ed. Berkshire: Open University Press.

Brown, J., Lewis, L., Ellis, K., Stewart, M., Freeman, T. R., & Kasperski, M. J. (2011). Conflict on interprofessional primary health care teams–can it be resolved? Journal of Interprofessional Care, 25(1), 4-10.

Chen, F., Lui, A. M., & Martinelli, S. M. (2017). A systematic review of the effectiveness of flipped classrooms in medical education. Medical Education, 51(6), 585-597.

Chen, Y., Wang, Y., & Chen, N. S. (2014). Is FLIP enough? Or should we use the FLIPPED model instead?. Computers & Education, 79, 16-27. doi:10.1016/j.compedu.2014.07.004

Clark, K. R. (2015). The effects of the flipped model of instruction on student engagement and performance in the secondary mathematics classroom. Journal of Educators Online, 12(1), 91-115.

Creswell, J. W. (2007). Qualitative Inquiry and Research Design: Choosing Among Five Approaches (2nd ed.). Thousand Oaks, CA: Sage Publications.

Critz, C. M., & Knight, D. (2013). Using the flipped classroom in graduate nursing education. Nurse Educator, 38(5), 210-213.

Danker, B. (2015). Using flipped classroom approach to explore deep learning in large classrooms. IAFOR Journal of Education, 3(1), 171-186.

Davies, J. J. (2007). Essentials of medical terminology (3rd ed). Clifton Park, NY: Delmar Learning.

Floyd, K. S., Harrington, S. J., & Santiago, J. (2009). The effect of engagement and perceived course value on deep and surface learning strategies. Informing Science: the International Journal of an Emerging Transdiscipline, 12, 181-190.

Galway, L. P., Corbett, K. K., Takaro, T. K., Tairyan, K., & Frank, E. (2014). A novel integration of online and flipped classroom instructional models in public health higher education. BMC Medical Education, 14(1), 181.

Gilboy, M. B., Heinerichs, S., & Pazzaglia, G. (2015). Enhancing student engagement using the flipped classroom. Journal of Nutrition Education and Behavior, 47(1), 109-114.

Gostelow, N., Barber, J., Gishen, F., & Berlin, A. (2018). Flipping social determinants on its head: Medical student perspectives on the flipped classroom and simulated patients to teach social determinants of health. Medical Teacher, 40(7), 1-8. doi: 10.1080/0142159X.2018.1436757

Gylys, B. A., & Wedding, M. E. (2009). Medical Terminology: A Body Systems Approach. F. A. Davis. https://www.fadavis.com/product/medical-terminology-med-term-body-systems-gylys-wedding-8#/collapseOne.

Hao, Y. (2016). Exploring undergraduates’ perspectives and flipped learning readiness in their flipped classrooms. Computers in Human Behavior, 59(C), 82-92.

Jones-Bonofiglio, K. D., Willett, T., & Ng, S. (2017). An evaluation of flipped e-learning experiences. Medical Teacher, 1-9. doi:10.1080/0142159X.2017.1417577.

Koo, C. L., Demps, E. L., Farris, C., Bowman, J. D., Panahi, L., & Boyle, P. (2016). Impact of flipped classroom design on student performance and perceptions in a pharmacotherapy course. American Journal of Pharmaceutical Education, 80(2), 33.

Marton, F. & Säljö, R. (1976). On qualitative differences in learning: 1-outcome and process. British Journal of Educational Psychology, 46, 4–11. doi:10.1111/j.2044-8279.1976.tb02980.x.

McLaughlin, J. E., Roth, M. T., Glatt, D. M., Gharkholonarehe, N., Davidson, C. A., Griffin, L. M.,...Mumper, R. J. (2014). The flipped classroom: a course redesign to foster learning and engagement in a health professions school. Academic Medicine, 89(2), 236-243.

McLean, S., Attardi, S. M., Faden, L., & Goldszmidt, M. (2016). Flipped classrooms and student learning: not just surface gains. Advances in Physiology Education, 40(1), 47-55.

Missildine, K., Fountain, R., Summers, L., & Gosselin, K. (2013). Flipping the classroom to improve student performance and satisfaction. Journal of Nursing Education, 52(10), 597-599.

Morgan, H., McLean, K., Chapman, C., Fitzgerald, J., Yousuf, A., & Hammoud, M. (2015). The flipped classroom for medical students. The Clinical Teacher, 12(3), 155-160.

Önder, İ., & Beşoluk, Ş. (2010). Düzenlenmiş İki Faktörlü Çalışma Süreci Ölçeği’nin (R-SPQ-2F) Türkçeye Uyarlanması. Eğitim ve Bilim, 35(157), 55-67.

Park, S. E., & Howell, T. H. (2015). Implementation of a flipped classroom educational model in a predoctoral dental course. Journal of Dental Education, 79(5), 563-570.

Pierce, R., & Fox, J. (2012). Vodcasts and active-learning exercises in a “Flipped Classroom” model of a renal pharmacotherapy module. American Journal of Pharmaceutical Education, 76(10):196.

Presti, C. R. (2016). The flipped learning approach in nursing education: A literature review. Journal of Nursing Education, 55(5), 252-257.

Prober, C. G., & Heath, C. (2012). Lecture halls without lectures – A proposal for medical education. New England Journal of Medicine, 366(18), 1657-1659.

Roehl, A., Reddy, S. L., & Shannon, G. J. (2013). The flipped classroom: An opportunity to engage millennial students through active learning strategies. Journal of Family & Consumer Sciences, 105(2), 44-49.

Sharma, N., Lau, C., Doherty, I., & Harbutt, D. (2015). How we flipped the medical classroom. Medical teacher, 37(4), 327-330.

Street, S. E., Gilliland, K. O., McNeil, C., & Royal, K. (2015). The flipped classroom improved medical student performance and satisfaction in a pre-clinical physiology course. Medical Science Educator, 25(1), 35-43.

Tekin, P. Ş. (2009, October). Bir Meslek Olarak Tıbbi Sekreterlik ve Ülkeler Arası Karşılaştırmalı Analizi. Paper presented at the 8. Ulusal Büro Yönetimi ve Sekreterlik Kongresi.

Tekin, P. Ş. (2010). Tıbbi Terminoloji 1-2 (Revised 2nd ed.): Ankara: Ankara Üniversitesi Uzaktan Eğitim Yayınları.

Tucker, B. (2012). The flipped classroom. Education Next, 12(1), 82-83.

Willis, M. C. (2008). Medical terminology: a programmed learning approach to the language of health care (2nd ed). Baltimore, MD: Lippincott Williams & Wilkins.

Yılmaz, F. G. K., Öztürk, H. T., & Yılmaz, R. (2017). The Effect of Structure in Flipped Classroom Designs For Deep and Surface Learning Approaches. In A. İşman, J. Willis, A. Donaldson, F. Dabaj, E. Z. Liu (Eds.), The Turkish Online Journal of Educational Technology - November 2017 (pp. 732-750). Retrieved from http://www.tojet.net/special/2017_11_1.pdf

DOI: http://dx.doi.org/10.24059/olj.v24i2.2030

Copyright (c) 2020 Perihan SENEL TEKIN, Hale ILGAZ, Gülgün AFACAN ADANIR, Denizer YILDIRIM, Yasemin GÜLBAHAR

License URL: https://creativecommons.org/licenses/by/4.0/