Impact of a hybrid flipped classroom and case-based learning model on learning outcomes and competency development in Epidemiology

Objective To evaluate the efficacy of a hybrid teaching model integrating the Flipped Classroom (FC) and Case-Based Learning (CBL) in undergraduate Epidemiology education, and to compare its outcomes with standalone CBL and traditional Lecture-Based Learning (LBL), thereby providing theoretical evidence for curricular reform. Methods A quasi-experimental design was employed involving students majoring in Preventive Medicine ( n = 100) and Clinical Medicine ( n = 98) at a university in Yunnan from January 2023 to December 2023. Participants were stratified into three groups: the Experimental Group (Preventive Medicine; 20% Flipped Classroom + 40% Case-Based Learning + 40% Lecture-Based Learning), the Internal Control Group (Preventive Medicine; 40% Case-Based Learning + 60% Lecture-Based Learning), and the External Control Group (Clinical Medicine; 100% Lecture-Based Learning). Outcome measures included competency enhancement, self-reported satisfaction, overall course evaluation, and knowledge acquisition assessed via pre- and post-course assessments. Results Significant differences were observed across the three groups regarding competency enhancement, specifically in the breadth of knowledge mastery ( Z = 8.871, p = 0.012), learning interest ( Z = 11.999, p = 0.002), self-directed learning agency ( Z = 6.736, p = 0.034), critical thinking ( Z = 7.511, p = 0.023), literature retrieval skills ( Z = 6.771, p = 0.034), and teamwork capabilities ( Z = 10.938, p = 0.004). In terms of satisfaction, significant variations were found in perceived overall learning effectiveness ( Z = 13.154, p = 0.001), instructional methods ( Z = 8.679, p = 0.013), instructional design ( Z = 10.920, p = 0.004), classroom atmosphere ( Z = 6.494, p = 0.039), and engagement ( Z = 6.555, p = 0.038). Regarding overall course evaluation, the hybrid model showed significant advantages in facilitating academic writing proficiency ( Z = 9.722, p = 0.008), professional technical skills ( Z = 19.378, p < 0.001), and preparation for advanced studies ( Z = 17.776, p < 0.001). Post-test scores differed significantly among the groups ( p < 0.001), with the Experimental Group achieving the highest mean score (68.2 ± 12.0), followed by the Internal Control Group (66.5 ± 10.6), and the External Control Group (59.6 ± 10.3). Conclusion The hybrid pedagogical model combining the Flipped Classroom and Case-Based Learning effectively enhances learning outcomes in undergraduate Epidemiology . It demonstrates distinct advantages in stimulating learning interest, fostering self-directed learning and critical thinking, and improving academic performance compared to traditional methods.