Evaluate flipped classroom learning to improve neurology knowledge and reduce neurophobia among Zambian medical students.

Zambia has few neurologists, and neurophobia is common among trainees. More effective teaching methods are needed to improve neurology knowledge, reduce neurophobia, and encourage students to pursue careers in neurology, especially in resource-limited settings.

5^th and 7^th year medical students were randomized to a traditional lecture or flipped classroom curriculum. Traditional: students attended neurology lectures and accessed corresponding clinical case presentation materials online. Flipped: students watched pre-recorded neurology lectures asynchronously before class, and class time was dedicated to interactive small group case-based discussions. Students completed anonymous pre- and post-course surveys which included a knowledge assessment, self-reported confidence in diagnosing/managing neurologic disorders, neurophobia survey, and course satisfaction survey. Mann-Whitney U tests were used to compare means before and after the educational intervention.

349 5^th years (180 flipped, 169 traditional) and 122 7^th years (66 flipped, 56 traditional) participated. Knowledge assessment scores improved more in the 5^th year flipped classroom group compared to traditional (p<0.001), but no difference was observed between 7^th year groups (p=0.44). There was a greater increase in composite confidence in diagnosing/managing neurologic conditions in the flipped classroom group in both 5^th and 7^th years (both p<0.001) and a higher course satisfaction composite score in the flipped classroom group in both 5^th and 7^th years (both p<0.001). All groups had a reduction in neurophobia scores but there was no significant difference between groups (p=0.06 5^th years; p=0.34 7^th years).

A flipped classroom approach improved neurology knowledge, confidence diagnosing/managing neurologic disorders, and course satisfaction in Zambian medical students compared to traditional lectures. The flipped classroom approach represents a promising pedagogical model for improving neurology education in resource-limited settings.