Medical education is a domain with fast-changing knowledge and attention to knowledge application and higher order thinking; therefore, how to implement effective teaching is a crucial issue. Based on the technology-based learning model, this study provides a multi-dimensional analysis of published papers on the flipped classroom in medical education from the SCOPUS database, including the form of the learning materials, learning system or player, learning strategies, educational technology, application domains, research issues, participants, and research methods. Based on the results, the application of flipped classrooms in medical education has grown rapidly over the past decade, with the number growing dramatically from 7 papers in 2014, to 16 papers in 2015, and 22 papers in 2016. It was found that a great number of studies adopted instructional videos uploaded on online learning systems or used existing online videos to conduct before-class teaching in the before-class stage of the flipped classroom; moreover, most studies involved no online discussion in the before-class stage. As for learning strategies in the in-class stage, the most frequently adopted strategies were issue discussion, practicing or doing exercises, and problem-based learning. This implies that most studies mainly emphasized basic knowledge understanding and skills training, while little attention was paid to developing learners’ higher order thinking skills. In addition, the majority of studies explored students’ learning interest/satisfaction, learning experience, and performance on the cognitive aspect, while little research was found to investigate their preparation degree or cognitive loading. Based on the review results, this study provides the research trends and potential research issues of flipped medical education to serve as a reference for researchers, instructors, and decision makers.

Background: Sepsis will induce stroke, new-onset atrial fibrillation (AF) increase ischemic stroke (IS) in in-hospitalization and long-term period after sepsis. Physicians must alert this condition and given suitable treatment. Aim: The associated of IS and new-onset AF in septicemia survivors after discharge have to be evaluated. Design: The inpatient data was used of the Taiwan National Health Insurance Database (NHIRD) in 2010. We identified patients suffered their first occurrence of septicemia (International Classification of Disease, Ninth Revision, Clinical Modification [ICD-9-CM] is 038, 003.1, 036.1) and excluded less than 18 years old. Patients had AF (ICD-9-CM to 427.3×) during the same admission or after septicemia hospitalization discharged were defined as new-onset AF. The outcome was IS happened after septicemia discharge (ICD-9-CM as 433–437). Methods: The factors related to IS after septicemia survival were established using multivariate logistic regression with forward stepwise selection. Results: There were 1286 new-onset AF and 1026 IS happened after septicemia discharge. The crude odds ratio (OR) were 3.88 (95% confidence interval [C.I.]: 1.69–8.89) and 1.62 (95% C.I.: 1.14–2.3) in middle-aged and elderly septicemia survivors with new-onset AF induced IS. The risk of IS after septicemia survivors was noticed adjusted OR 1.74 (95% C.I.: 1.26–2.41) for new-onset AF. Conclusion: The middle-aged and elderly septicemia survivors suffered from new-onset AF had increased incidence of IS within three months. New-onset AF was a mediator factor of IS in septicemia survivors of Asian population.

Rapid global population aging has led to a considerable increase in the number of people with dementia, which was estimated at 50 million by the World Alzheimer Report 2021 with an expected increase to 152 million by 2050. As diseases progress in older adults, significant resources are invested for treatment, with an estimated cost of […]