Flipped classroom narrows the performance gap between low- and high-performing dental students in physiology.

The flipped classroom has been shown to have positive outcomes in learning. However, relatively little has been reported on the implementation of it in dental education. The purpose of this study was to evaluate the impact of the flipped classroom on predoctoral dental students' learning. Two consecutive classes of dental students learned the physiology of the autonomic nervous system through the nonflipped (traditional lecture) or the flipped approach. Students' learning was assessed with an identical quiz at the end of the module. The mean score in the flipped approach was higher than that in the nonflipped approach ( P < 0.01). Mean score on the content-based quiz questions in the flipped approach was higher than that in the nonflipped approach ( P < 0.05). Performance on case-based questions did not show a significant difference ( P = 0.12). Mean quiz performance of the lower 27% scorers in the flipped approach was higher than that in the nonflipped approach ( P < 0.05). Mean quiz performance of the upper 27% scorers showed an increase in the flipped approach as well ( P < 0.05), but to a less extent than that of the lower 27% scorers ( P < 0.01). The flipped approach also increased peer collaboration ( P < 0.01). In summary, the flipped classroom improved dental students' performance on content-based questions in physiology. The flipped classroom narrowed the performance gap between the low- and high-performing dental students.