Effectiveness of a flipped classroom model
for enhancing emergency physicians’ skills
in diagnosing high-risk pulmonary embolism
with point-of-care ultrasound: a randomized
controlled study

Effectiveness of a flipped classroom model
for enhancing emergency physicians’ skills
in diagnosing high-risk pulmonary embolism
with point-of-care ultrasound: a randomized
controlled study

Flipped classroom, Point of care ultrasound, High-risk pulmonary embolism

Abstract
Background High-risk pulmonary embolism is a significant cause of morbidity and mortality in the emergency
department. Point-of-care ultrasonography is a valuable tool for identifying high-risk pulmonary embolism at the
bedside, but many physicians lack proficiency. A flipped classroom model may enhance point-of-care ultrasound
training, but its effectiveness compared to standard teaching remains unclear.
Methods Emergency physicians and residents at a single academic centre were randomized to either a flipped
classroom or standard teaching after a baseline assessment of their ability to identify high-risk pulmonary embolism
using a database of ultrasound clips. The flipped classroom group completed an online module, while the standard
teaching group attended an in-person seminar. Both groups participated in an in-person workshop and subsequently
underwent post-training testing. The primary outcome was the difference in final test scores. Statistical analysis
included Student’s t-test for mean comparisons, while Fisher’s exact test and one-way ANOVA were used to assess
differences between teaching methods, with significance set at p≤0.05.
Results A total of 30 participants completed the study (15 in the flipped classroom and 15 in the standard teaching

group). Most (80%) reported low baseline confidence in identifying high-risk pulmonary embolism with point-of-
care ultrasound. There were no significant differences in baseline scores between the groups (65.0% ± 24.7% for

the flipped classroom vs. 64.3% ± 24.9% for standard teaching, p=0.93). Both groups demonstrated significant
improvement in scores on final testing (standard teaching: 11% increase, p=0.02; flipped classroom: 7.3% increase,
p=0.03). However, there was no significant difference in final test scores between the two groups (75.3% ± 20.1% for
standard teaching vs. 72.3% ± 21.4% for the flipped classroom, p=0.65).

Noman Ali1,2*, Alan Tan2

, Salman Muhammad Soomar1,3, Dominick Shelton2

, Rob Simard2

and Jordan Chenkin2

https://doi.org/10.1186/s12245-026-01129-w

2026

peri irawan

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