Abstract:

Introduction:
Higher Education Health Sciences students frequently struggle with abstract, terminologically dense, or legally oriented content, leading to low engagement and decreased attendance. To address this challenge, we implemented an instructional innovation combining structured brainstorming with a flipped classroom model in two foundational Physiotherapy courses at the University of Valencia: Knowledge and History of Physiotherapy (1st year) and Pathophysiology (2nd year). The aim was to transform the lesson students perceived as the “the least attractive” and assess the feasibility of integrating student-generated proposals into the lesson redesign.

Methods:
A total of 113 students participated (50 first-year; 63 second-year across three groups). Each group identified the most difficult topic through guided discussion and voting. Students then engaged in structured brainstorming to propose strategies, tools, and resources that could make the topic more accessible and motivating. Proposals included visual tables, diagrams, timelines, summary explanations, real clinical anecdotes, videos, guiding questions, and the use of Kahoot!® after and/or before and after instruction.
Feasible proposals were incorporated into a tailored flipped classroom design. Data collection included attendance records, in-class participation, post-session reflections, and qualitative comments regarding perceived usefulness and engagement.

Results:
First-year students, despite dealing with a humanities-based subject, produced the most diverse and creative proposals, including contextualisation strategies, peer testimonials, and historical timelines.
Their session recorded the highest attendance, surpassing even the more clinically oriented second-year Pathophysiology groups.
Second-year students proposed more targeted and pragmatic strategies, centred on diagrams, explanatory images, and interactive quizzes. Across all groups, visual materials emerged as the most requested resource, while Kahoot!® was consistently valued for activating prior knowledge, promoting competition, and enabling before/after progress comparison. When implemented, these elements generated increased participation, improved perceived comprehension of complex concepts, and a more positive learning atmosphere.
The students reported that the co-design phase increased their sense of preparedness for the flipped session.

Conclusion:
Integrating brainstorming into the Flipped Classroom design is a highly effective strategy for fostering engagement with challenging Health Sciences content in the early years. Students demonstrated the ability to clearly identify their motivational obstacles and propose viable improvements.
First-year students showed unexpectedly high levels of creative participation and attendance at these activities, underscoring the importance of early engagement initiatives. The visual tools and gamified strategy proved universally appealing and impactful. This participatory flipped classroom model is practical, adaptable, and replicable across all Health Sciences programs, contributing to more meaningful and student-centered learning environments.

Keywords:

Flipped classroom, brainstorming, student engagement, Health Sciences education, active learning, follow-up questionnaires.