Small programs, big challenges: Reimagining the evaluation of clinical teaching in genetic counseling.

Within the health professions education system, a significant proportion of teaching and learning occurs in the clinical setting. As such, the need to measure effective teaching for accreditation standards, faculty development, merit pay, academic promotion, and for monitoring the safety of the learning environment has led to numerous universities developing instruments to evaluate teaching effectiveness in this context. To date; however, these instruments typically focus on the student perspective, despite evidence demonstrating that student evaluations of teaching (SETs) lack correlation with learning outcomes and are not a true measure of teaching effectiveness. This issue is further exacerbated in small health professional training programs, such as genetic counseling, where clinical teachers may only supervise 1-3 students per year. As a result, not only are SETs more confounded due to small sample sizes, but a direct conflict exists between respecting learner anonymity and providing timely and relevant feedback to faculty. In such contexts, even using SETs to evaluate the nature of the learning environment may be unreliable due to student concerns about identifiability and fear of retaliation for unfavorable evaluation. This paper will review the literature regarding SETs, barriers to this process within the clinical setting, and the unintended downstream consequences. Options for addressing issues related to the use of SETs will be considered, with particular focus on the process of reflection and the use of teaching consultations or peer support groups as a means to improve teaching effectiveness in this learning environment.

Analysis of different factors on dental students' perception of a flipped classroom model: A 6-year follow-up study.

INTRODUCTION: To evaluate different factors affecting two different cohorts of dental students' perceptions with the flipped classroom (FC) model in a preclinical dental course over six years. MATERIALS AND METHODS: In 2016 (cohort #1) and 2022 (cohort #2), second-year dental students participated in FC model in a preclinical dental course consisting of pre-class recorded videos and lectures along with classroom interactive exercises. Students then completed an anonymous pen-and-paper survey evaluating three factors influencing students' overall study experience with the FC model. Survey responses from cohort #1 and cohort #2 were compared to assess the effect of generation, student demographics and COVID-19 pandemic on students' perceptions. RESULTS: When asked to rate the FC experience out of 5, the mean ratings of cohort #1 and cohort #2 were 4.3 (±0.9) and 4.0 (±0.8), respectively. Cohort #2 preferred viewing slides and videos prior to class and had a higher agreement that pre-class course materials were beneficial to class preparation. Conversely, cohort #1 had a higher agreement that in-class discussion and exercises helped them to learn course content. From cohort #2, 88.6% of males and 71.6% of females preferred the FC approach over traditional lecture. CONCLUSION: Both cohorts reported positively with the FC model of teaching. Cohort #2 had higher positive reports with the pre-class work and cohort #1 had a higher positive report with in-class work. Course design should reflect the students' points of view and learning perspectives with careful consideration of the student population in the classroom.

Student evaluations of teaching and the development of a comprehensive measure of teaching effectiveness for medical schools.

The evaluation of courses and faculty is of vital importance in all higher education institutions including medical schools. Student Evaluations of Teaching (SETs) commonly take the form of completion of anonymous questionnaires and even though they were originally developed to evaluate courses and programmes, throughout the years they have also been used to measure teaching effectiveness and subsequently to guide important decisions related to the faculty's career progression. Nevertheless, certain factors and biases may influence SET rates and may not measure teaching effectiveness objectively. Although the literature on course and faculty evaluations is well-researched in general higher education, there are concerns with regards to the use of the same tools for evaluation of courses and teachers in medical programmes. Specifically, the SETs in general higher education cannot be directly applied to the structure of courses and delivery of curriculum in medical schools. This review provides an overview of how SETs can be improved at the levels of instrumentation, administration and interpretation. In addition, the paper supports that through the collection and triangulation of data from multiple sources, including students, peers, program administrators and self-awareness via the use of different methods such as peer reviews, focus groups and self-evaluations, it will be possible to develop a comprehensive evaluation system that will present an effective measure of teaching effectiveness, will support the professional development of medical teachers and will improve the quality of teaching in medical education.

Can peer mentoring improve online teaching effectiveness? An RCT during the COVID-19 pandemic.

Online delivery of higher education has taken center stage but is fraught with issues of student self-organization. We conducted an RCT to study the effects of remote peer mentoring at a German university that switched to online teaching due to the COVID-19 pandemic. Mentors and mentees met one-on-one online and discussed topics like self-organization and study techniques. We find positive impacts on motivation, studying behavior, and exam registrations. The intervention did not shift earned credits on average, but there is evidence for positive effects on the most able students.

An empirical study of student perception towards pedagogy, teaching style and effectiveness of online classes.

PURPOSE OF THE RESEARCH: With online education taking centerstage in recent times, the primary objective of this study is to find out the student perception of online classes from teachers who had no past experience of online teaching, with respect to their teaching effectiveness, teaching style and pedagogy in an online classroom. This study is exploratory in nature. Using a structured questionnaire, 356 completed responses were received and analysed using the available research tools. PRINCIPLE RESULTS: The dynamics of education have changed overnight. The findings of the study indicate that pedagogy, teaching style and teaching effectiveness significantly affect student perception towards online classes by first time online teachers. MAJOR CONCLUSIONS: The role of the teachers has changed drastically and there is a need for them to prepare themselves for the new normal using the suitable pedagogical tools for creating an effective online classroom.

An exploratory investigation of the use and effects of academic instant messaging groups among university students.

The use of instant messaging groups for various academic purposes is a rising, but largely understudied, trend in higher education institutions. In the present study we investigate the use purposes and outcomes of three types of academic instant messaging groups or AIMGs. Formal AIMGs are created and managed by teaching staff, class AIMGs are created by students and joined by all members of a particular class, and study AIMGs are smaller groups created by students that know each other personally or collaborate in group assignments. To advance understanding of the role of these groups in students' wellbeing and academic development, we pose research questions concerning their associations with academic performance, academic stress, and students' course experiences. We adopt an exploratory frame and survey methodology to collect data from a large sample of undergraduate students (n = 1752). Our findings indicate that, at the institution where data were collected, high rates of AIMG participation is the norm, with class AIMGs emerging as particularly popular. We find statistically significant interaction between formal and study AIMGs and academic performance, as well as between study AIMGs and academic stress. Participation in these groups also predicts students' social experience of a learning community, as well as their perception of the teaching they receive. Throughout, however, the observed effects are small and their practical significance is questioned.

Comparison between students' self-assessment, and visual and digital assessment techniques in dental anatomy wax-up grading.

INTRODUCTION: Digital technology has the potential to provide a bias-free evaluation instrument for practical examination grading. E4D Compare software was designed for teaching institutions to allow comparison between scanned models prepared by students and master models prepared by instructors. The aim of this study was to determine the tolerance value for the E4D compare software (E4D Technologies LLC, Richardson, TX, USA) that provides scores comparable with faculty grades for wax-ups #23 and #19. Additionally, this study sought to assess the correlation between students' self-assessments, visual and digital grades and the reliability of the software. METHODS: Student wax-ups (n = 112) were uploaded into the software and then compared with faculty-generated master wax-ups. Digital grading was performed at tolerances 200-800 µm in 50 µm increments and was repeated twice. RESULTS: A tolerance of 350 µm was the closest to faculty grades for #23 and 500 µm was the closest for #19. Visual and digital grades showed moderate to high correlation for both wax-ups. Correlations between students' self-assessments and visual and digital grades improved with #19 versus #23. A near-perfect correlation was found between grades at the first and second digital grading sessions. CONCLUSIONS: The tolerance that closely matches faculty grades differs according to the tooth type. The software provided consistent grades and correlated well with faculty grades. Students' self-assessment skills improved as they proceeded throughout the course. Further studies are necessary to ascertain the role of the software in improving students' self-assessment skills.

The mediating effect of literacy of LMS between self-evaluation online teaching effectiveness and self-directed learning readiness.

The aim of this study was to analyze whether the self-evaluation online teaching effectiveness (SEOTE) and literacy of learning manage system (LLMS) did significantly have effect on the level of self-directed learning readiness (SDLR). Furthermore, it was another purpose to examine whether the LLMS was a significant mediating effect between SEOTE and SDLR. Pearson correlation, multiple linear regression, and mediated regression analysis were conducted for this study. This study included 210 online college students in Korea who responded to three web-survey questionnaires (SEOTE, LLMS, and SDLR). The bivariate (Pearson) correlation analysis showed that SEOTE significantly influenced on SDLR (r=524, p<.01) and LLMS was positively associated with SDLR (r=487, p<.01). The multiple linear regression revealed that SEOTE and LLMS significantly predicted SDLR and explained 31.4% of variance in SDLR. The results of mediated regression analysis revealed that LLMS did have a significant indirect or mediating effect with SEOTE in predicting SDLR.

A BEME systematic review of teaching interventions to equip medical students and residents in early recognition and prompt escalation of acute clinical deteriorations: BEME Guide No. 62.

Background: Current educational interventions and teaching for acute deteriorations seem to address acute care learning in discreet segments. Technology enhanced and team training methodologies are in vogue though well studied in the nursing profession, teaching avenues for junior 'doctors in training' seem to be a lacuna.Aims: The BEME systematic review was designed to (1) appraise the existing published evidence on educational interventions that are intended for 'doctors in training' to teach early recognition and prompt escalation in acute clinical deteriorations (2) to synthesise evidence & to evaluate educational effectiveness.Methodology: The method applied was a descriptive, justification & clarification review. Databases searched included PubMed, PsycINFO, Science Direct and Scopus for original research and grey literature with no restrictions to year or language. Abstract review, full text decisions and data extraction were completed by two primary coders with final consensus by a third reviewer.Results: 5592 titles and abstracts were chosen after removal of 905 duplications. After exclusion of 5555 studies, 37 full text articles were chosen for coding. 22 studies met final criteria of educational effectiveness, relevance to acute care. Educational platforms varied from didactics to blended learning approaches, small group teaching sessions, simulations, live & cadaveric tissue training, virtual environments and insitu team-based training. Translational outcomes with reduction in long term (up to 3-6 years) morbidity & mortality with financial savings were reported by 18% (4/22) studies. Interprofessional training were reported in 41% (9/22) of studies. Recent evidence demonstrated effectiveness of virtual environment and mobile game-based learning.Conclusions: There were significant improvements in teaching initiatives with focus on observable behaviours and translational real patient outcomes. Serious game-based learning and virtual multi-user collaborative environments might enhance individual learners' cognitive deliberate practice. Acute care learning continuum with programmatic acute care portfolios could be a promise of the future.

The relationship between learner engagement and teaching effectiveness: a novel assessment of student engagement in continuing medical education.

BACKGROUND: Continuing medical education (CME) often uses passive educational models including lectures. However, numerous studies have questioned the effectiveness of these less engaging educational strategies. Studies outside of CME suggest that engaged learning is associated with improved educational outcomes. However, measuring participants' engagement can be challenging. We developed and determined the validity evidence for a novel instrument to assess learner engagement in CME. METHODS: We conducted a cross-sectional validation study at a large, didactic-style CME conference. Content validity evidence was established through review of literature and previously published engagement scales and conceptual frameworks on engagement, along with an iterative process involving experts in the field, to develop an eight-item Learner Engagement Instrument (LEI). Response process validity was established by vetting LEI items on item clarity and perceived meaning prior to implementation, as well as using a well-developed online platform with clear instructions. Internal structure validity evidence was based on factor analysis and calculating internal consistency reliability. Relations to other variables validity evidence was determined by examining associations between LEI and previously validated CME Teaching Effectiveness (CMETE) instrument scores. Following each presentation, all participants were invited to complete the LEI and the CMETE. RESULTS: 51 out of 206 participants completed the LEI and CMETE (response rate 25%) Correlations between the LEI and the CMETE overall scores were strong (r = 0.80). Internal consistency reliability for the LEI was excellent (Cronbach's alpha = 0.96). To support validity to internal structure, a factor analysis was performed and revealed a two dimensional instrument consisting of internal and external engagement domains. The internal consistency reliabilities were 0.96 for the internal engagement domain and 0.95 for the external engagement domain. CONCLUSION: Engagement, as measured by the LEI, is strongly related to teaching effectiveness. The LEI is supported by robust validity evidence including content, response process, internal structure, and relations to other variables. Given the relationship between learner engagement and teaching effectiveness, identifying more engaging and interactive methods for teaching in CME is recommended.

Interplay between prior knowledge and communication mode on teaching effectiveness: Interpersonal neural synchronization as a neural marker.

Teacher-student interaction allows students to combine prior knowledge with new information to develop new knowledge. It is widely understood that both communication mode and students' knowledge state contribute to the teaching effectiveness (i.e., higher students' scores), but the nature of the interplay of these factors and the underlying neural mechanism remain unknown. In the current study, we manipulated the communication modes (face-to-face [FTF] communication mode/computer-mediated communication [CMC] mode) and prior knowledge states (with vs. without) when teacher-student dyads participated in a teaching task. Using functional near-infrared spectroscopy, the brain activities of both the teacher and student in the dyads were recorded simultaneously. After teaching, perceived teacher-student interaction and teaching effectiveness were assessed. The behavioral results demonstrated that, during teaching with prior knowledge, FTF communication improved students' academic performance, as compared with CMC. Conversely, no such effect was found for teaching without prior knowledge. Accordingly, higher task-related interpersonal neural synchronization (INS) in the left prefrontal cortex (PFC) was found in the FTF teaching condition with prior knowledge. Such INS mediated the relationship between perceived interaction and students' test scores. Furthermore, the cumulative INS in the left PFC could predict the teaching effectiveness early in the teaching process (around 25-35 s into the teaching task) only in FTF teaching with prior knowledge. These findings provide insight into how the interplay between the communication mode and students' knowledge state affects teaching effectiveness. Moreover, our findings suggest that INS could be a possible neuromarker for dynamic evaluation of teacher-student interaction and teaching effectiveness.

The attributes of an effective teacher differ between the classroom and the clinical setting.

Most training programs use learners' subjective ratings of their teachers as the primary measure of teaching effectiveness. In a recent study we found that preclinical medical students' ratings of classroom teachers were associated with perceived charisma and physical attractiveness of the teacher, but not intellect. Here we explored whether the relationship between these variables and teaching effectiveness ratings holds in the clinical setting. We asked 27 Internal Medicine residents to rate teaching effectiveness of ten teachers with whom they had worked on a clinical rotation, in addition to rating each teacher's clinical skills, physical attractiveness, and charisma. We used linear regression to study the association between these explanatory variables and teaching effectiveness ratings. We found no association between rating of physical attractiveness and teaching effectiveness. Clinical skill and charisma were independently associated with rating of teaching effectiveness (regression coefficients [95 % confidence interval] 0.73 [0.60, 0.85], p < 0.001 and 0.12 [0.01, 0.23], p = 0.03, respectively). The variables associated with effectiveness of classroom and clinical teachers differ, suggesting context specificity in teaching effectiveness ratings. Context specificity may be explained by differences in the exposure that learners have to teachers in the classroom versus clinical setting-so that raters in the clinical setting may base ratings upon observed behaviours rather than stereotype data. Alternatively, since subjective ratings of teaching effectiveness inevitably incorporate learners' context-specific needs, the attributes that make a teacher effective in one context may not meet the needs of learners in a different context.

Validation of the 25-Item Stanford Faculty Development Program Tool on Clinical Teaching Effectiveness.

UNLABELLED: CONSTRUCT: The 25-item Stanford Faculty Development Program Tool on Clinical Teaching Effectiveness assesses clinical teaching effectiveness. BACKGROUND: Valid and reliable rating of teaching effectiveness is helpful for providing faculty with feedback. The 25-item Stanford Faculty Development Program Tool on Clinical Teaching Effectiveness was intended to evaluate seven dimensions of clinical teaching. Confirmation of the structure of this tool has not been previously performed. APPROACH: This study sought to validate this tool using a confirmatory factor analysis, testing a 7-factor model and compared its goodness of fit with a modified model. Acceptability of the use of the tool was assessed using a 6-item survey, completed by final year medical students (N = 119 of 156 students; 76%). RESULTS: The testing of the goodness of fit indicated that the 7-factor model performed poorly, χ(2)(254) = 457.4, p < .001 (root mean square error of approximation [RMSEA] = 0.08, comparative fit index [CFI] = 0.91, non-normed fit index [NNFI] = 0.89). Only standardized root mean square residual (SRMR) indicated acceptable fit (0.06). Further exploratory analysis identified 10 items that cross-loaded on 2 factors. The remainder of the items loaded on factors as originally intended. By removing these 10 items, repeat confirmatory factor analysis on the modified 15-item, 5-factor model demonstrated a better fit than the original model: SRMR = 0.075, NNFI = 0.91, χ(2)(80) = 150.1, p < .001; RMSEA = 0.09; CFI = 0.93. Although 75% of the participants stated they were willing to fill the tool on their preceptors on a biweekly basis, only 25% were willing to do so on a weekly basis. CONCLUSIONS: Our study failed to confirm factor structure of the 25-item tool. A modified tool with fewer, more conceptually distinct items was best fit by a 5-factor model. Further, the acceptability of use for the 25-item tool may be poor for rotations with a new preceptor weekly. The abbreviated tool may be preferable in that setting.

Faculty Online Teaching Effectiveness Scale (FOTES): Instrument development and content validation.

This study aimed to develop and psychometrically test the Faculty Online Teaching Effectiveness Scale (FOTES) based upon both student and faculty perspectives of online teaching and learning in higher education. Online teaching effectiveness is a crucial component of quality education, but it has not been well-defined conceptually, and few studies have been conducted, using relevant domains, to accurately measure online teaching effectiveness. The impact of online course delivery on teaching effectiveness remains unclear. An exploratory sequential mixed methods design was employed with three phases of instrument development and psychometric testing. The FOTES comprises 50 items in seven domains: teaching philosophy, self-efficacy, relationships, course content, learning activities, teaching practices, and satisfaction. The instrument underwent initial testing, yielding positive expert appraisals with good-excellent psychometrics. All domains of the scale were significantly correlated, except for teaching philosophy. The preliminary results of the FOTES provide the empirical evidence to advance additional psychometric validation. This newly developed instrument has the potential to enhance faculty capacity and skill in self-evaluating their teaching effectiveness in online courses, providing a valid and reliable measure. The resulting instrument is poised to promote outcome evaluation and strengthen teaching and learning processes.

Teaching Through the Student Lens: Qualitative Exploration of Student Evaluations of Teaching.

OBJECTIVE: The purpose of this study is to use feedback from student evaluations of teaching (SETs) to define and describe themes associated with perceived teaching effectiveness. METHODS: We retrospectively analyzed SETs for instructors in required didactic courses from one academic year using qualitative content analysis. The analysis included student responses to the following questions: "Describe the strongest aspect of the instructor's teaching." and "What could the instructor do to improve his/her teaching effectiveness?" RESULTS: Five themes were developed from 4683 coded segments and are described with example quotations. These themes included clarity of instruction and learning activities, alignment of learning and assessment activities, examples that offer practice or demonstrate relevance, engaging learning environment, and concern for student learning and success. Aspects of each theme are described with example coded segments. CONCLUSION: These themes and supportive quotes offer a deeper understanding of the student perspective on similar ideas that are present throughout the teaching and learning literature and represent broad aspects of teaching, such as material design, in-class practices, and interpersonal characteristics. These themes can provide guidance for specific domains of faculty development in teaching.

From Tradition to Innovation: Analyzing Strategies and Support for Enhancing Badminton Course Teaching Quality through Educational Technology.

This study aims to explore the impact of Multimedia-Assisted Teaching (MAT) on the quality of physical education (PE) instruction in universities, with a particular focus on badminton courses. A quasi-experimental design was employed, including pre-tests and post-tests, involving two badminton classes at Ming Chuan University, with a total of 101 students. These two classes were assigned to an experimental group (using MAT) and a control group (traditional teaching methods). The research instrument used was the Physical Education Teaching Quality Scale (PETQ), which includes four factors: course content, teaching strategies, classroom management, and learning assessment. The results indicated that, compared to traditional teaching methods, the use of MAT significantly enhanced students' perception of the quality of PE instruction. The experimental group scored significantly higher than the control group across all scale factors, suggesting that MAT is more effective in capturing students' attention and improving learning outcomes. The conclusion suggests that MAT has significant advantages in improving the quality of physical education instruction. The integration of MAT enables more flexible lesson planning and enhances the learning process through the features of multimedia-assisted teaching. It is recommended that physical education teachers consider applying multimedia technologies to aid teaching, in order to increase student engagement and effectiveness.

Foreign language teachers' PERMA well-being and life satisfaction: Mediating role of teaching effectiveness.

BACKGROUND: Teacher well-being, encompassing emotional, psychological, and social dimensions, significantly influences teaching effectiveness. Understanding the factors that enhance teacher well-being and effectiveness is crucial, particularly amidst global teacher shortages and high turnover rates. METHOD: The present study gathered data from 252 university-level foreign language teachers from eight provinces in China. Participants completed measures assessing well-being (using the PERMA model), teaching effectiveness, and life satisfaction scales through online surveys. Data were analyzed using JASP and SPSS for regression and mediation analyses. RESULTS: The findings revealed that Positive emotions and relationships significantly predicted life satisfaction, while accomplishment significantly predicted teaching effectiveness. Both teaching effectiveness and overall well-being were significant predictors of life satisfaction. However, teaching effectiveness did not significantly mediate the relationship between overall well-being and life satisfaction, indicating that these factors independently contribute to life satisfaction. CONCLUSION: Our findings share the inclusion of PERMA principles in enhancing teaching effectiveness and life satisfaction among foreign language teachers. Constructive future directions are suggested for professional development for improving teacher well-being and effectiveness.

Teaching nursing students: As an umbrella review of the effectiveness of using high-fidelity simulation.

AIM: To conduct an umbrella review of the effectiveness of using high-fidelity simulation in nursing student teaching, thereby supporting continuous improvement in teaching practitioners' implementation of high-fidelity simulation intervention strategies. BACKGROUND: Several systematic reviews have investigated the effectiveness of high-fidelity simulation in nursing student teaching in recent years. However, conclusions vary and a systematic assessment is lacking. DESIGN: This review encompasses an umbrella review. METHODS: A search of PubMed, Embase, Cochrane Library, Web of Science and OVID databases was conducted to retrieve data on an umbrella review of high-fidelity simulation effectiveness in nursing student teaching from database inception to November 2023. The quality of the included systematic reviews was independently assessed by two reviewers using the AMSTAR 2 and PRISMA scales. Outcome indicators from the included systematic reviews were graded using the GRADE system. RESULTS: Twelve systematic reviews focusing on high-fidelity simulation effectiveness in nursing student teaching were included. Notably, all 12 systematic reviews exhibited very-low methodological quality, with 9 exhibiting some degree of reporting deficiencies, 2 exhibiting severe information deficiencies and 1 reporting relatively complete information. A total of 22 outcome indicators and 53 pieces of evidence were included. The results revealed 15 pieces of low-quality evidence and 38 pieces of very-low-quality evidence. Mounting evidence suggests that high-fidelity simulation teaching effectively enhances nursing students' theoretical performance, practical skills and various clinical comprehensive abilities, highlighting a positive teaching effect. However, further validation through high-quality, large-sample studies is warranted. CONCLUSION: The overall evidence quality of the current systematic reviews evaluating high-fidelity simulation effectiveness in nursing student teaching is low. Additionally, the methodological quality and the degree of reporting standardization require further improvement. Therefore, high-quality, large-sample randomized controlled trials are essential for further substantiating high-fidelity simulation effectiveness in nursing student teaching.

Enhancing General Surgery Clerkships: The Application and Value of Standardized Patient-Based Situational Simulation Teaching.

OBJECTIVE: We explored the value of a standardized patient-based situational simulation teaching method in general surgery internships. METHODS: A prospective, single-blind, randomized controlled trial was conducted with clinical medicine undergraduates from the 2020 cohort of our university as subjects. These students were randomly divided into a traditional teaching (TT) group and a combined teaching (CT) group based on their internship schedules. The TT group followed the conventional teaching model, while the CT group engaged in the standardized patient-based situational simulation teaching method. The study compared differences in pre-internship theoretical scores, post-internship theoretical scores, medical record writing quality, and student satisfaction between the two groups. RESULTS: The CT group (n=108) significantly outperformed the TT group (n=104) in post-internship theoretical scores and medical record writing quality (all P<0.05) and showed marked improvement in stimulating students' interest in learning (P=0.015), enhancing clinical diagnostic and treatment abilities (P<0.001), improving doctor‒patient communication skills (P<0.001), strengthening medical mission sense (P<0.001), reinforcing physicians' sense of responsibility (P<0.001), and facilitating the application of learned knowledge (P<0.001). These differences were statistically significant. CONCLUSION: The standardized patient-based situational simulation teaching method (CT) in general surgery internships has been highly recognized by students and can enhance their clinical competency, offering considerable value for broader.

Effects of simulation-based flipped classroom in developing head and neck examination skills in dental students.

OBJECTIVES: To evaluate the effectiveness of a simulation-based flipped classroom in developing dental students' head and neck examination skills. METHODS: Second-year dental students (n = 118) participated in a simulation-based flipped classroom experience. A pre-class recorded lecture and video were posted online one week before the simulation date. In class, students completed a pre-quiz assessing pre-class coursework understanding of head and neck examination content. Then, students attended a question-and-answer session before the patient simulation. A formative assessment of head and neck examination simulation on a patient in the clinic was completed. Lastly, students completed an in-class post-quiz assessing understanding of head and neck examination content after the simulation, classroom simulation discussion, and open-response survey. RESULTS: Student post-quiz scores were significantly higher than pre-quiz scores, with an average improvement of 4.8 ± 7.2 percentage points. There was no difference between male and female improvement in scores. Student survey responses indicated that students liked combining simulation and flipped classroom methodology, flexibility with their schedules, learning at their pace, and opportunities for a deeper level of learning. Students reported wanting more practice sessions for their technical skills and more accessibility to faculty. CONCLUSIONS: According to this study's results, students had significantly higher post-quiz scores than pre-quiz scores and reported positive perceptions of this combined teaching technique. A simulation-based flipped classroom might be an effective teaching approach for developing head and neck examination skills that can be applied at other dental facilities with potentially similar results.