Impact of integrating paper-based pulmonary function test case group discussions into flipped classroom on residents' COPD grading assessment competency.

The temporal pattern of accuracy changes differed between groups ( Figure 2 ), with the intervention group showing only modest decline over the one-month period (3.8 percentage points) compared to a more substantial decrease in the control group (3.4 percentage points), though this group-by-time interaction did not reach statistical significance ( p = 0.72).

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