Effectiveness of Virtual Flipped Classroom in Teaching Proprioceptive Neuromuscular Facilitation to Physiotherapy Students: A Quasi-Experimental Study

Purpose The virtual flipped classroom (VFC) is a virtual instructional strategy that engages students through active learning strategies and supports both synchronous and asynchronous virtual education components. This study examined the efficacy of the VFC instructional method in a Proprioceptive Neuromuscular Facilitation course for physiotherapy students. Method In this quasi-experimental study, 16 instructional sessions were randomly assigned to a cohort of 55 fifth-semester physiotherapy students. Based on the nature of the content (theoretical vs practical), 8 sessions were delivered asynchronously using the Virtual Lecture-Based Learning (VLBL) approach, while 8 were delivered through the VFC method. To reduce carryover effects, the 2 instructional methods were alternated weekly with a one-week washout interval. Of the 16 sessions, 10 (5 VLBL and 5 VFC) were randomly selected to include both a pretest and a posttest to assess students’ learning progress. After the course, students’ satisfaction, attitudes, and knowledge associated with both instructional methods were measured and compared. Results Students demonstrated significantly higher overall knowledge, satisfaction, and attitude scores under the VFC approach compared with VLBL ( P < .001). Across the 5 assessed sessions, the VFC method also produced significantly higher pretest and posttest scores than VLBL (all P < .001). Although absolute performance was consistently greater in the VFC sessions, pre- to posttest improvement did not differ between methods ( P > .05), indicating comparable learning gains. Both instructional methods, however, showed significant gains relative to baseline (all P < .001). Conclusion The findings suggest that the VFC is an effective instructional approach for enhancing second-year physiotherapy students’ knowledge, satisfaction, and attitudes toward learning.