Type of Article:  Original Research

Volume 6; Issue 3.2 (August 2018)

Page No.: 5494-5500

DOI: https://dx.doi.org/10.16965/ijar.2018.253


Rajprasath. R *1, Dinesh Kumar. V 2, Gunasegaran JP 3.

*1 Assistant Professor, Department of Anatomy, Pondicherry Institute of Medical Sciences, Puducherry, India

2 Assistant Professor, Department of Anatomy, JIPMER, Puducherry, India.

3 Professor, Department of Anatomy, Pondicherry Institute of Medical Sciences, Puducherry, India.

Address for Correspondence:  Dr. Rajprasath. R. Assistant Professor, Department of Anatomy, Pondicherry Institute of Medical Sciences, Puducherry, India. E-Mail: rajprasathanat@gmail.com


Introduction:  Learning histology often pose a unique challenge to first year students. It has a central visual component by which students have to analyse and interpret the micrographic images. Development of an active learning strategy where students understand the rationale of what they learn and apply the newly gained knowledge to specific problems. Flipping the class allows the students to go over the lower levels of learning in Bloom’s taxonomy (knowledge and understanding) individually. The aim of the present pilot initiative was to assess the effectiveness of flipped classroom teaching in improving students’ learning outcomes.

Methodology: In the present study, a pilot histology curriculum of three systems was implemented among 150 first year medical students in a flipped classroom format at our institute. We developed a learner-centred instructional design model and applied strategies reflecting Kolb’s four styles of learning. A questionnaire was administered to document the perceptions of students.

Results: 45% of students agreed and 41% students strongly agreed that the sessions were useful in learning histology in a better way; Majority of students agreed that the sessions were useful in understanding the topic as a whole. 98% students felt that flipped histology teaching method was more effective than the traditional method for improving their knowledge on histology and found the sessions interesting and more engaging.

Discussion: This pilot study suggests that flipped classroom approach can be used to improve histology education among first year medical students. We hope that by applying the principles of adult learning and learner-centred instructional design to design laboratory sessions could help us in developing self-directed learners. However, further concrete studies are required before reliably implementing our format as a teaching modality.

Key words: Histology, medical education, anatomy education, flipped classroom, Bloom’s taxonomy.


  1. Vygotsky LS. Interaction between learning and development (1978). In: Gauvin M, Cole M, editors. From Mind and Society. Readings on the development of children. New York, NY: W.H. Freeman and Company, Cambridge, MA; Harvard University Press. 1997:79–91.
  2. Taylor D, Hamdy H. Adult learning theories: Implications for learning and teaching in medical education: AMEE Guide No. 83, Medical Teacher, 2013;35:11:e1561-e1572.
  3. Bloom BS. Taxonomy of Educational Objectives, Handbook I: Cognitive Domain. 1st Ed. New York, NY: David McKay Co. 1956;201.
  4. Kumar RK, Freeman B, Velan GM, De Permentier PJ. Integrating histology and histopathology teaching in practical classes using virtual slides. Anat Rec, 2006; 289B:128–133.
  5. Mione S, Valcke M, Cornelissen M. Remote histology learning from static versus dynamic microscopic images. Anat Sci Educ, 2016;9:222–230.
  6. Dinesh Kumar V, Rajprasath R, Bhavani Prasad G, VK Nim. Catering what they need – a self-reported percipience of the teaching-learning methodologies in anatomy by first year medical students. Int J Anat Res 2017;5(2.3):3905-3912.
  7. Notzer N, Aronson M. Differential evaluation of students’ performance in histology. All questions are equal but some are more equal than others. Med Educ, 1979;13:79–81.
  8. Knowles MS. The Modern Practice of Adult Education: From Pedagogy to Andragogy. Englewood Cliffs, NJ: Prentice Hall. 1980, PP 400.
  9. Granmo M, Bengtsson F. Teaching anatomy in the multimedia world – Using digital tools for progressive learning over time. Creativ Educ 2015;6:1193–1200.
  10. Mortensen CJ, Nicholson AM. The flipped classroom stimulates greater learning and is a modern 21st century approach to teaching today’s undergraduates. J Anim Sci 2015;93:3722–3731.
  11. Sharma N, Lau CS, Doherty I, Harbutt D. How we flipped the medical classroom. Med Teach 2015;37:327–330.
  12. Selvig D, Holaday LW, Purkiss J, Hortsch M. Correlating students’ educational background, study habits, and resource usage with learning success in medical histology. Anat Sci Educ 2015;8:1–11.
  13. Pandey P, Zimitat C. Medical students’ learning of anatomy: Memorisation, understanding and visualisation. Med Educ 2006;41:7–14.
  14. Kolb DA. Experiential Learning: Experience as the Source of Learning and Development. 1st Ed. Upper Saddle River, NJ: Prentice Hall. 1984; 256 p.
  15. Bloodgood RA, Ogilvie RW. Trends in histology laboratory teaching in United States medical schools. Anat Rec 2006;289B:169–175.
  16. Crouch CH, Mazur E. Peer instruction: Ten years of experience and results. Am J Phys 2001;69:970–977.
  17. Masters K, Ellaway R. e-Learning in medical education Guide 32 Part 2: technology, management and design. Med Teach. 2008;30(5):474–489.
  18. Gross D, Pietri ES, Anderson G, Moyano-Camihort K, Graham MJ. Increased preclass preparation underlies student outcome improvement in the flipped classroom. CBE Life Sci Educ 2015;14:ar36.
  19. Moffett J. Twelve tips for “flipping” the classroom. Med Teach. 2015;37(4):331–336.
  20. de Fátima Wardenski R, de Espíndola MB, Struchiner M, Giannella TR. Blended learning in biochemistry education: analysis of medical students’ perceptions. Biochem Mol Biol Educ. 2012;40(4):222–228.
  21. Sajid MR, Laheji AF, Abothenain F, Salam Y, AlJayar D, Obeidat A.Can blended learning and the flipped classroom improve student learning and satisfaction in Saudi Arabia? Int J Med Educ. 2016;7:281–285.
  22. Belfi LM, Bartolotta RJ, Giambrone AE, Davi C, Min RJ. “Flipping” the introductory clerkship in radiology: impact on medical student performance and perceptions. Acad Radiol. 2015;22(6):794–801.
  23. O’Connor EE, Fried J, McNulty N, et al. Flipping radiology education right side up. Acad Radiol. 2016;23(7):810–822.
  24. Cheng X, Ka Ho Lee K, Chang EY, Yang X. The “flipped classroom” approach: Stimulating positive learning attitudes and improving mastery of histology among medical students. Anat Sci Educ 2017;10:317–327. doi:10.1002/ase.1664.
  25. Gilboy MB, Heinerichs S, Pazzaglia G. Enhancing student engagement using the flipped classroom. J Nutr Educ Behav 2014;47:109–114.
  26. Luft J, Ingham H. The JoHari window, a graphic model of interpersonal awareness. Proceedings of the western training laboratory in group development. 1955; Los Angeles, CA: UCLA.
  27. Novak JD, Canas AJ. The origins of the concept mapping tool and the continuing evolution of the tool. Inform Visual 2006;5:175–184.
  28. Ausubel DP. The use of advance organizers in the learning and retention of meaningful verbal material. J Educ Psychol, 1960;51:267–272.
  29. Daley BJ, Torre DM. Concept maps in medical education: An analytical literature review. Med Educ 2010;44:440–448.
  30. Lallier TE. Introducing evidence-based dentistry to dental students using histology. J Dent Educ, 2014;78:380–388.
  31. Eisenstein A, Vaisman L, Johnston-Cox H, Gallan A et al. Integration of basic science and clinical medicine: The innovative approach of the cadaver biopsy project at the Boston University School of Medicine. Acad Med 2014;89:50–53.
  32. Serrat MA, Dom AM, Buchanan JTJ, Williams AR et al. Independent learning modules enhance student performance and understanding of anatomy. Anat Sci Educ 2014;7:406–416.
  33. Smirle J, Parent AD, Canuel M, Mandato CA. Undergraduate histology education: Fostering an engaging and interactive environment is the key. Med Sci Educ 2012;22: 244–249.
  34. Cotter JR. Laboratory instruction in histology at the University of Buffalo: recent replacement of microscope exercises with computer applications. Anat Rec (New Anat) 2001;265:212–221.

Cite this article: Rajprasath. R, Dinesh Kumar. V, Gunasegaran JP. FLIPPED HISTOLOGY CLASSES – ASCENDING BLOOM’S TAXONOMY TO ACHIEVE EFFECTIVE LEARNING: A PILOT FEASIBILITY STUDY. Int J Anat Res 2018;6(3.2):5494-5500. DOI: 10.16965/ijar.2018.253