Perspectives on opportunities and challenges in a predominantly flipped classroom-based pharmacy curriculum: A qualitative study

Introduction: To adapt to flipped classroom pedagogy in universities, factors such as the amount of the program that is flipped, students' pre-existing educational experiences, and cultural back-ground may influence adjusting to the approach. We investigated students' perspectives across four years of a predominantly flipped classroom-based pharmacy curriculum in a low to middle income country.Methods: We conducted five semi-structured focus groups with 18 pharmacy students from years one to four of the bachelor of pharmacy program at Monash University Malaysia where students came from different pre-university backgrounds. Focus group recordings were transcribed verbatim and thematically analysed. Interrater reliability was performed to ascertain reliability of themes.Results: Three major themes were identified. Firstly, students cited issues moving past the initial barrier when starting flipped classrooms in terms of education background impacting adaptability and how/why they eventually adapted. Another theme was how flipped classrooms helped development of life skills such as adaptability, communication, teamwork, self-reflection, and time management. The final theme was on requiring a sufficient safety net and support system in flipped classrooms that included well designed pre-classroom materials and well-implemented feedback mechanisms.Conclusions: We have identified students' perspectives on the benefits and challenges associated with a predominantly flipped classroom pharmacy curriculum in a low to middle income country setting. We suggest using scaffolding and effective feedback approaches to guide the imple-mentation of flipped classrooms successfully. This work can aid future educational designers in preparation and supporting a more equitable learning experience regardless of student background.