Changing the landscape of medical anatomy education: impact of flipped classroom pedagogy on learning outcomes and perceptions of medical students in practical gastrointestinal anatomy

Anatomy education faces challenges such as reduced teaching hours and limited cadaver access, emphasizing the need for innovative instructional strategies. The flipped classroom model, which shifts knowledge acquisition to pre-class activities and fosters active learning during class, has shown promise but remains underexplored in practical gastrointestinal anatomy teaching. This quasi-experimental study involved 63 medical students at Mashhad University of Medical Sciences, Iran, assigned to either a flipped classroom (n = 28) or traditional lecture-based group (n = 35). Knowledge acquisition was assessed through blueprint-based multiple-choice tests, and perceptions of the learning environment were evaluated using the validated Anatomy Education Environment Measurement Inventory (AEEMI). Pretest scores did not differ significantly between groups (p = 0.073). The flipped classroom group demonstrated significantly higher post-test scores than the control group (20.34 ± 3.10 vs. 17.42 ± 3.22, p < 0.001, Cohen’s d = 0.87). AEEMI results showed that the flipped group reported more positive perceptions of resources, effort, and overall learning environment (p < 0.001). Regression analysis identified instructional approach as the strongest predictor of favorable perceptions (β = 0.816, p < 0.001). The flipped classroom approach enhances both learning outcomes and perceptions of the educational environment in gastrointestinal anatomy education. By integrating pre-class preparation with in-class collaborative learning, it fosters deeper understanding and engagement. These findings support integrating flipped pedagogy into anatomy curricula to improve student performance and satisfaction.