Evaluating the Flipped Classroom Approach for Enhancing Orthodontic and Cephalometric Competencies in Dental Undergraduates: A Quasi-experimental, Non-randomized Study

Background and objective Cephalometric analysis is a critical component of orthodontic diagnosis, requiring precise measurements, interpretation, and practical application. Traditional lecture-based instruction may not fully engage students or foster the analytical and problem-solving skills necessary for clinical practice. The flipped classroom model, which integrates pre-class learning with interactive in-class activities, provides a potentially more effective approach. This study aimed to evaluate the effectiveness of the flipped classroom model versus traditional lectures in improving knowledge, engagement, and satisfaction among undergraduate dental students studying cephalometric analysis. Methods A quasi-experimental, non-randomized, two-group pre-test/post-test design was used, involving 72 final-year undergraduate dental students. Participants were evenly assigned to a control group (traditional lecture) and an experimental group (flipped classroom). The flipped classroom group received pre-class instructional videos, guided reading materials, and a self-assessment quiz, followed by an interactive session featuring case-based discussions, hands-on tracing, and peer teaching. The control group received a conventional lecture covering the same content. Outcomes measured included knowledge gain (assessed using multiple-choice questions (MCQs) and clinical scenario questions) and engagement/satisfaction (assessed using a Likert-scale questionnaire). Statistical analysis was conducted using paired and independent t-tests, two-way ANOVA, and effect size calculations. Results The flipped classroom group achieved significantly higher post-test scores (mean = 7.69, standard deviation (SD) = 0.67) compared to the lecture group (mean = 5.28, SD = 1.21), t(70) = 10.49, p < 0.001, Cohen's d = 2.47. No significant gender differences were found, and no interaction between model and gender was observed. Engagement and satisfaction scores were markedly higher in the flipped group. Conclusions The flipped classroom model led to significant improvements in cognitive outcomes, knowledge retention, engagement, and student satisfaction compared to traditional lectures. Its learner-centered, active approach is particularly well-suited for complex orthodontic topics and has the potential for broader implementation in dental education.