Student-Centered Learning: Some Issues and Recommendations for Its Implementation in a Traditional Curriculum Setting in Health Sciences

Abstract

This review article discussed the challenges faced during the implementation of active learning methods within the traditional teaching environment at the Complutense University of Madrid. These challenges encompass interactions with colleagues, students, and the classroom itself. It is essential for educators to have confidence that the outcomes achieved through these teaching approaches will not be adversely impacted by the quality assessment system of surveys. The university should adopt a teaching quality assessment framework that differentiates between the instructor’s efficiency and the effectiveness of teaching methods. Students need to recognize the significance of developing critical thinking skills over rote memorization throughout their academic journey and understand the importance of this for their future professional development. Suggestions are also made for improving teamwork in traditional classrooms, which typically follow standard teaching methods.

1. Introduction

Why did we consider introducing active methods into the teaching of anatomy? Today, everyone can be a “Google Doctor” because all medical information is on the Internet and easily accessible to anyone who searches for it. And all of this is enhanced by the possibilities offered using artificial intelligence (AI); anyone can be an AI Doctor. It is a fact that medical knowledge is growing exponentially every day, and it is impossible for the teacher to explain everything that is known about a particular subject, nor for the student to learn it. If anyone can be a “Google Doctor”, what is it that the teacher should give to a student throughout their training that will make the difference? The health sciences need to produce professionals who can provide solutions to the problems that arise throughout their professional lives because they have learned to obtain the necessary information, to reflect on it, and to use this information to solve problems [1]. Student-centered learning (SCL) is a type of active learning in which the learner moves from a more passive role to being at the center of learning. SCL and active learning are closely related, with active learning being a core component of SCL. Both approaches emphasize student engagement, responsibility, and the development of critical thinking skills [2]. Active learning as a method of teaching develops students’ skills other than memorization, which does not mean that they do not have to study; it teaches students to think, solve problems, and develop a critical thinking and other skills that will be very necessary throughout their careers and professional futures [3]. Active learning involves students taking an active role in their learning process through activities such as group discussions, problem solving, and applied activities. This approach contrasts with traditional passive learning methods, where students are typically passive recipients of information provided by the instructor. Active teaching methods involve students in the learning process, encouraging them to participate actively, think critically, and apply their knowledge in practical scenarios. By shifting the focus from rote memorization to active engagement, students are better equipped to develop problem-solving skills, improve their understanding of complex concepts, and foster a deeper level of understanding. This interactive approach not only promotes a more dynamic and engaging learning environment but also empowers students to take ownership of their education and become lifelong learners [4]. SCL focuses on tailoring educational experiences to students’ individual needs and interests. It emphasizes student autonomy, collaboration, and self-directed learning. This approach recognizes that each student has unique learning styles and preferences and aims to create a supportive environment that fosters their intellectual growth [5]. At the same time, the European Community’s education policy, as set out in the Maastricht Treaty of 1992, plays a key role in promoting quality education by encouraging cooperation between Member States. It aims to support and complement their efforts and to ensure that educational standards are maintained. However, it also recognizes and respects the autonomy of Member States in determining the content of teaching and the structure of their education systems, including cultural and linguistic diversity. By encouraging cooperation and providing assistance where necessary, the Community seeks to improve the overall quality of education in the Member States while recognizing and respecting their respective responsibilities and identities in the field of education [6]. As a result, the European Higher Education Area (Bologna Plan), which calls for a change in the teaching/learning philosophy from teacher-centered to student-centered [7]. The European Association of Establishments for Veterinary Education (EAEVE) is the official accreditation body for veterinary schools in Europe. Every 5 years, the European Union evaluates veterinary schools to ensure that they meet the minimum quality standards required of institutions responsible for training future veterinarians in Europe. The guide to be used for the evaluation of faculties is that developed by EAEVE [8]. In relation to how the curriculum should be delivered in veterinary schools, it states that it should be based on the acquisition of competencies by students and that both teaching and assessment should be student-centered, noting the importance of encouraging and monitoring that learning is also performed by the student on an individual basis, i.e., self-learning. Competency-based learning is not developed through rote learning of content presented in an expository way by the teacher in a theoretical or practical class. SCL means that the student becomes the center of learning and is no longer in a passive role (notetaking, memorization, and examination) but in an active role, including independent study or self-learning, group discussion and problem solving, which is called active learning. Independent study means that the student must take responsibility for his or her own learning, always under the guidance of the teacher. One factor influencing teachers’ response to the implementation of these new teaching methods is the possibility that their implementation may penalize them in surveys conducted by their own university, which affects their academic promotion and rewards in the form of prizes and awards for excellence [9]. The EAEVE emphasizes the importance of evaluating the quality of teaching in veterinary education. According to their guidelines, the evaluation of teaching quality should consider factors such as the effectiveness of teaching methods, student engagement, the relevance of the curriculum to current industry standards, and the overall impact on student learning outcomes. EAEVE also emphasizes the importance of continuous improvement of teaching practices through feedback mechanisms, professional development opportunities for educators and the integration of innovative teaching approaches to enhance the overall quality of veterinary education. The EAEVE provides guidelines on how learning outcomes should be assessed to ensure quality standards in veterinary education across countries. While EAEVE sets these guidelines, it is up to individual countries to decide whether to make them mandatory for their veterinary education programs or to decide which evaluation program to implement. Following the last EAEVE visit to the Faculty of Veterinary Medicine of the UCM in Madrid, the European Committee for Veterinary Education (ECOVE), in its final report, recognized the importance of the use of flipped learning in anatomy and recommended its use in other subjects of the veterinary curriculum [10]. Compliance with EAEVE recommendations is often seen as beneficial for maintaining high educational standards and international recognition in the veterinary field, but the final word on which quality evaluation program is mandatory is always given by national legislation. Regarding student opinion, the EAEVE emphasizes the importance of student opinion in veterinary education. Institutions should actively seek feedback from students to understand their perspectives on the learning experience, teaching methods, and overall program quality. It is essential that institutions address any concerns or suggestions raised by students to enhance the educational experience and ensure continuous improvement. By valuing and acting upon student feedback, institutions can create a more student-centered and effective learning environment in veterinary education. The Complutense University follows the Docentia Programme for the assessment of teaching quality [11]. The Docentia Programme is developed by Spain’s National Agency for Quality Assessment and Accreditation (ANECA).

On the adequacy of teaching space for student-centered methods, the EAEVE Guidelines for Quality Standards emphasize the importance of providing adequate teaching space for student-centered methods. Physical environment plays a crucial role in facilitating effective teaching and learning experiences, especially when implementing student-centered approaches. Ensuring that classrooms are conducive to collaborative group work, interactive discussions and hands-on activities is essential to promote student engagement and active participation in the learning process. By prioritizing the provision of appropriate teaching spaces that support student-centered methodologies, educational institutions can improve the overall quality of education and promote a more dynamic and interactive learning environment.

The objective of this review is to explore the challenges teachers face when integrating SCL approaches into a traditional classroom setting. It is important to consider the concept of the classroom setting as a multifaceted environment that plays a crucial role in the educational process. It is not only a physical space but also a social and psychological context that influences the dynamics of teaching and learning [12]. It aims to explore the different barriers that teachers face and their strategies for overcoming these challenges through different experiences of student-centered active learning methods. It starts with an overview of active learning and how it can be adapted step by step to traditional teaching and the experience of introducing the flipped classroom method for the theory sessions.

2. Background

Active learning is a method of teaching in which the student actively engages with the subject matter through group discussion, problem solving, using a case as a learning tool, role playing, or any other method that encourages the student to take an active role in their learning. For learning to be considered active, students need to do more than just listen and take notes; they need to read, write, discuss, and solve problems. More importantly, students need to be involved in developing deep reflection, analysis, synthesis, and evaluation [13]. For Bonwell and Eison, active learning is anything that involves learners performing activities related to and thinking about what they are learning. Active learning focuses on cognitive development rather than the acquisition of facts and the transmission of information. Active learning requires students to be involved in their learning, thinking, discussing, investigating, and creating. It has been shown that attention in an expository class drops off after 15–20 min of lecture; the various active learning techniques help to reactivate and focus the class. In active learning classes, students are asked to practice their skills, solve problems, think through complex issues, propose solutions, explain different ideas in their own words by writing them down and discussing them. Compared to traditional lecture-based learning, active learning methods have been shown to be more effective in engaging students in learning [14,15]. The benefits of using active learning are as follows:

• Reinforces the acquisition of content, concepts and skills.
• Provides immediate and frequent feedback.
• Provides opportunities to think, talk, and process course material.
• Students make personal connections to the material, which increases their motivation to learn.
• Allows students to practice important skills such as working with peers and teamwork.
• It builds self-esteem through communication with other students.
• It creates a sense of cooperation in the classroom through student–student and teacher–student interaction.

Active learning should be introduced gradually, starting with the teacher’s efforts. Active elements can be introduced gradually [16], in a gradual way that teachers feel comfortable with. This includes short, structured, and well-planned experiences, focusing on topics that are not abstract or controversial and with which teachers and students are familiar. Briefing sessions should be developed. At the level of the teaching group, we should hold regular working sessions to share experiences and propose activities. Finally, the experience should be followed up. The application of this type of learning is feasible from the moment it can be introduced in the lectured-based class and in the practical sessions. It is a question of slowly and progressively initiating a change of mentality. The authors made a personal proposal on how to introduce active learning as part of the teaching methodology after presenting the proven and effective experiences of renowned teaching institutions in both veterinary and human medicine. When starting the approach to implement active learning in the discipline of anatomy and embryology, the different techniques proposed by experts in active learning were considered [13,15,17] and adapted and incorporated into the format of theoretical and practical sessions that existed for teaching anatomy and embryology in the traditional way. The idea was to introduce activities that create expectations and attention to the content of the lesson. To introduce the new activities, first of all, the rules of conduct and behaviors have to be established and explained to the students so that the participation is correct, and the desired objectives are achieved. It should be explained in time what active learning is and what its benefits are. It should be made clear to the students that they will meet the learning material in different ways. Then, depending on the content to be explained, different cognitive exercises should be used to focus the students’ attention on a particular topic. It is important to vary the activities and cognitive exercises so that they are not predictable. It is very important to plan the time before and after each activity or exercise to introduce a new topic and define possible tasks. When introducing any new technique or improvement, consideration should be given to surveying learners to determine its effectiveness. Active learning techniques do not work the same for all learners, so we should try to involve as many learners as possible using different formulas. We should bear in mind that it may take time for both teachers and students to adapt to these new techniques.

2.1. How to Gradually Introduce Active Learning into the Theoretical Sessions

We cannot and should not reject the masterclass [18], but we can modify it. It is necessary to introduce a dynamic into the lesson, involving the students so that they discuss the content of the lesson. There are many recommendations for incorporating active learning into the lecture [19], and we have adapted six simple activities as an example of how active learning can be incorporated into a traditional theory class. These activities should take no more than 10 min of actual class time.

2.1.1. Take Breaks During the Lesson

Take two or three 2 min breaks per session to allow students to think, assimilate and learn what has been explained. This formula makes students learn more and better [20].

2.1.2. Ask the Class a Question

We start the class in the usual way; for 20 min, we conduct the usual explanation. The class stops, a question is asked, and each student has 3 min to write their answer. They can send the answers by cell phone (Wooclap, Mentimeter, Socrative, and so on) or send the answers to the teacher in writing. We check the answers and select them for later use if we feel it is necessary. At this point, we may ask some students or groups of students to share their reflections and we try to incorporate their comments into the next steps of the lesson. Different types of questions can be asked and depending on the length of the expected answer, we need to allow enough time for reflection and response. Students’ answers can be used to assess learning. By checking the answers, we can identify the most common errors and send comments to the class (through the Virtual campus) for assessment and correction. It is advisable to balance the questions with other activities as too many questions can be distracting.

2.1.3. Ask Students to Develop an Anatomical Reasoning

At the end of the session, ask students to develop at least one anatomical reasoning related to the material covered during the session.

2.1.4. Ask the Students to Highlight the Most Interesting Points of the Theory Session

During a break or at the end of the session, ask the students to write down what they think are the most interesting points of the day’s lesson and what would be the way for them to apply the identified concepts in a real situation.

2.1.5. Ask the Students to Formulate One or Two Questions

We can ask the class to ask one or two questions related to what has been discussed so far. They can do this in pairs and discuss the questions, which we will then collect. Again, we can check what they are learning, and the questions can be used in future tests.

2.1.6. Ask the Students to Share Their Doubts

This activity can be introduced at any time during the lesson. Ask students to share their notes and possible questions in pairs for a few minutes. Ask them to formulate possible questions. If there are few questions, answer them on the spot and move on. If there are many questions, it may be worth slowing down or even going back and reviewing what has been explained.

2.2. How the Lecture-Based Classroom Can Be Transformed into a Flipped Classroom

The flipped classroom was introduced in stages, with part of the class flipped first [16] and then, after demonstrating its effectiveness, the whole class flipped the following year [21]. The effectiveness of flipped learning was demonstrated by measuring skills other than memorization and understanding of content, so questions were designed to measure four cognitive levels, knowledge (level 1), comprehension (level 2), application (level 3), and analysis (level 4), according to the adaptation of Bloom’s taxonomy to the teaching of anatomy [22]. This was accomplished by evaluating the same didactic content, explained by the same teacher, with expository and active learning teaching, using comparable questions at the four pre-established cognitive levels. There was no difference between the two methods used in the results of the cognitive level 1, memorization questions, but there was a higher performance of the students on the higher cognitive level questions in the courses where the inverted method was used [21,23]. When planning flipped learning methods, it is important to use backward course design as a compelling strategy for achieving outcomes based in active learning and SCL. The backward course design approach is to first identify the student learning outcomes, then the means of assessing the outcomes, and finally the classroom activities that would support the learning outcomes [24].

2.3. Efficiency and/or Effectiveness of Learning Methods: What Is the Difference?

Defining efficiency and effectiveness of teaching is controversial. Cowan [25] made the distinction between efficiency and effectiveness. Efficiency is referred to the production of output, whereas effectiveness emphasizes the quality of output. Hajdin and Pažur [26] conducted research to distinguish between teacher effectiveness and teaching effectiveness. They defined teacher quality as related to the teacher’s qualifications and experience, while teaching quality is related to the methods used to teach the subject. They emphasized that both aspects are crucial for successful learning. Teaching quality focuses on pedagogy and teaching strategies, while teacher quality relates to the teacher’s qualifications and professional background. Both are essential to successful learning. Teaching quality is primarily about the pedagogy and teaching strategies used, while teacher quality is about the qualifications and experience of the teacher. The authors believe that the quality of teaching and the quality of learning are interrelated, that both are critical to student success, and that both must be part of any assessment of the quality of education. Coe et al. [27] have identified four main priorities for teachers to facilitate student learning: understanding the content they are teaching, creating a supportive environment, managing the classroom, and stimulating their students’ thinking. The authors agree with Dorfner et al.’s [28] assertion that teaching quality encompasses three key aspects: classroom management, a supportive climate, and cognitive activation. It is evident from the above that the assessment of the quality of teaching is a complex issue and that there is no single method by which it can be identified.

2.4. Docentia-UCM Teaching Quality Assessment Programme

To date, student surveys have been one of the most commonly used methods in empirical educational research to evaluate the effectiveness of teaching. Students play a crucial role in the classroom environment and have valuable insights. However, concerns have been raised about the accuracy of their assessments, leading to debates about the appropriate use and interpretation of student surveys as a measure of teaching quality.

The evaluation framework of the DOCENTIA program is organized around the three main dimensions of higher education evaluation: the strategic dimension, the methodological dimension, and the dimension of results, review, and improvement. In addition, the model for the evaluation of teaching activities includes four general dimensions for analyzing and assessing the performance of teaching staff: 1. Planning and organization of teaching. 2. Teaching development. 3. Outcomes. 4. Processes of reflection, improvement and updating of teaching activity (

Table 1. Dimensions, evaluation criteria, and indicators of the DOCENTIA-UCM Programme.

Dimension	Criteria	Indicators
Planning	Adequacy	Information about the subject
		Participation in co-ordination activities (subject, department and degree)
	Satisfaction	Organization of the subject
Development	Adequacy	Consistency of planning
	Satisfaction	Didactic aspects
		Relational aspects
Results	Adequacy	Minimum rate of learning outcomes
	Satisfaction	Student satisfaction with the teacher’s teaching activity
	Efficiency	Contribution to student learning and motivation
Processes of reflection, improvement, and updating of the teaching activity	Orientation towards innovation	Identification and analysis of strengths in teaching planning, development, and outcomes
		Identification and analysis of ways to improve the planning, development, and results of teaching
		Participation in teaching innovation projects (at UCM or other institutions)
		Participation in teaching training activities (as a teacher or lecturer)
		Participation in congresses, conferences, or seminars on university teaching and/or teaching innovation
		Authorship of teaching publications

Source: Docentia-UCM Programme 2023/24.

). In order to analyze these aspects in more detail and to find out how the Docentia Programme is performing overall, the authors will discuss some of the key aspects of the program. The Appendix A contains additional data taken from the evaluation model of the teaching activity of UCM teachers: Docentia Programme 2023–2024. The total weighting of the sources of information gives a value of 65.50% to the students’ opinion, 27.50% to what is provided by the teacher in the self-report, 4% to what is referred to as academic activities, and 3% to what is referred to as university bases (

Table 2. Weighting by sources of information.

Sources	Percent
University Data	3%
Teacher	27.5%
Academic Authorities	4%
Students	65.5%

Source: Docentia-UCM Programme 2023/24.

).

The questionnaire to be filled in by the students is presented in Figure A1 in the Appendix A; the value of this information in the total number, as we have just said, is 65.5%. This 65% is divided into three dimensions: 14% planning, 30.50% development, and 21% outcomes (

Table 3. Weighting by model dimensions and information sources.

Information Sources
Dimension	University Data	Teacher	Academic Authorities	Students	Total
Planning			2%	14%	16%
Development			2%	30.5%	32.5%
Results	3%			21%	24%
Processes of reflection, improvement, and updating of teaching activity		27.5%			27.5%
Total	3%	27.5%	4%	65.5%

Source: Docentia-UCM Programme 2023/24.

).

Table A1. Weighting by descriptors.

Dimension	Criteria	Indicators	Sources	Instruments	Descriptors	Descriptor Weighting
Planning	Adequacy	Information about the subject	Department Director	Department Director Questionnaire	1.1. Complies with the deadlines established for the organization and planning of teaching (delivery of files, bibliography, exams, practical and seminars).	1%
					1.2. Attends the organization, coordination, planning and teaching quality meetings.
			Students	Students Questionnaire	1.3. The teacher gives clear information on the objectives of the subject.	3.5%
					1.4. The teacher provides clear information on the assessment system.	3.5%
					1.5. The lecturer provides clear information on the teaching activities (assignments, seminars, visits, field work, laboratories, etc.).	3.5%
		Participation in co-ordination activities (subject, department and degree)	Dean’s Office	Centre Questionnaire	1.6. The teacher attends organization, coordination, planning or quality meetings.	1%
	Satisfaction	Organization of the subject	Students	Students Questionnaire	1.7. The teacher organizes and structures the lessons well.	3.5%
Development	Adequacy	Consistency with planning	Students	Students Questionnaire	2.1. The teacher complies with the subject syllabus.	6%
			Dean’s Office	Centre Questionnaire	2.2. The teacher complies with the established deadlines for handing in the minutes.	2%
	Satisfaction	Didactic aspects	Students	Students Questionnaire	2.3. The teacher explains the subject in a clear and comprehensible manner.	4,5%
					2.4. The materials used and/or recommended are useful for taking the subject (bibliography, material on the Virtual Campus, etc.).	4%
					2.5. The teacher is competent in the subject he/she is explaining.	4%
					2.6. The evaluation system allows the student to reflect the knowledge and competences acquired.	4%
		Relational aspects			2.7. The teacher resolves doubts and helps students when needed.	4%
					2.8. The teacher is accessible to students.	4%
Results	Adequacy	Minimum rate of learning outcomes	UCM databases	GEA	3.1. The failure rate of students is less than 85% in the ordinary examination.	3%
	Satisfaction	Student satisfaction with the teacher’s teaching activity	Students	Students Questionnaire	3.2. I am satisfied with the teacher’s teaching.	7%
					3.3. In my opinion, he/she is a good teacher.	7%
	Efficiency	Contribution to student learning and motivation			3.4. The teacher arouses my interest in the subject/practicals.	3.5%
					3.5. This teacher’s teaching helps me to acquire knowledge and skills.	3.5%
Processes of reflection, improvement and updating of the teaching activity.	Innovation orientation	Identification and analysis of strengths in teaching planning, development and outcomes	Teacher	Qualitative self-evaluation questionnaire	4.1. Identification and commentary on noteworthy or particularly positive aspects of the planning, development and results of the teaching.	7%
		Identification and analysis of ways to improve the planning, development and results of teaching.			4.2. Identification and commentary on aspects that could be improved in the planning, development and results of teaching. Specification of actions for improvement.	14%
		Participation in teaching innovation projects (at UCM or other institutions).		Accredited teaching merits	4.3. The teacher participates in teaching improvement and innovation projects.	2%
		Participation in teaching training activities (as a teacher or lecturer).			4.4. The teacher participates in teacher training activities.	1.25%
		Participation in congresses, conferences or seminars on university teaching or teaching innovation.			4.5. The lecturer participates in congresses, conferences or seminars on university teaching or teaching innovation.	1.25%
		Authorship of teaching publications			4.6. The lecturer is the author of publications oriented towards university teaching and/or teaching innovation.	2%

Source: Docentia-UCM Programme 2023/24.

in the Appendix A shows the dimensional weightings, with percentages for each descriptor.

Planning (14%): The questions students are asked to quantify in this dimension are as follows:

“The instructor gives clear information about the objectives of the subject/practices” (3.5%).

“The instructor gives clear information about the evaluation system” (3.5%).

“The instructor gives clear information about teaching activities (papers, seminars, visits, fieldwork, laboratories, practice training reports, exams, etc.)” (3.5%).

Development (30.50%): The questions asked of students and quantified by them in this dimension are classified as follows:

Adequacy (6%):

“The instructor complies with the program of the subject/practices”.

Satisfaction (16.5%):

“The instructor explains in a clear and understandable way” (4.5%).

“The materials used and/or recommended are useful for the subject/practices (bibliography, material on Virtual Campus, etc.)” (4%).

“The instructor shows competence in the subject” (4%).

“The evaluation system allows the student to reflect the knowledge and competencies acquired” (4%).

Relational aspects (8%):

“The instructor resolves questions and helps students when they need it” (4%).

“The instructor is accessible to students” (4%).

Outcomes (21%): the questions students are asked to quantify in this dimension are:

Satisfaction (14%):

“I am satisfied with the instructor’s teaching work” (7%).

“In my opinion, he/she is a good instructor” (7%).

Efficiency (7%):

“The instructor gets me interested in the subject/practices” (3.5%).

“The teaching work of this instructor helps me to acquire knowledge and skills” (3.5%).

The outcome dimension has a value of 24%, and the additional 3% is provided by the university databases and is defined by a student failure rate of less than 85% in the regular examination.

We will analyze the students’ ability to answer certain questions and other factors that were considered determinant and of interest for this analysis given the high value that the Docentia Programme places on students’ opinions and the subjective nature of the data. The students’ opinions have a 16.5% value for adequacy, 7% for efficiency, and 42% for satisfaction (

Table 4. Weighting by model criteria and information sources.

Information Sources
Criteria	University Data	Teacher	Academic Authorities	Students	Total
Adequacy	3%		4%	16.5%	23.5%
Efficiency				7%	7%
Satisfaction				42%	42%
Innovation and orientation		27.5%			27.5%
Total	3%	27.5%	4%	65.5%

Source: Docentia-UCM Programme 2023/24.

).

The value for the teacher’s self-report is 27.50% and is valued as follows:

Based on students’ survey answers, teachers must identify and comment on noteworthy or particularly positive aspects of the planning, delivery, and outcomes of teaching (7%).

Based on students’ survey answers, teachers must identify and comment on aspects that can be improved in the planning, development, and outcomes of teaching. The specification of measures for improvement (14%) is as follows:

Participation of the teacher in teaching improvement and innovation projects (2%).

Participation of the teacher in teacher training activities (1.25%).

The teacher attends congresses, conferences, or seminars on higher education teaching or teaching innovation (1.25%).

The teacher is author of publications on university teaching and/or teaching innovation (2%).

3. Implementing SCL: Barriers and Strategies

Despite its different definitions, the core elements of SCL include actively involving students in their learning process, adapting to their needs, and promoting their autonomy and agency. This flexible and comprehensive framework can help educators, researchers, and policy makers to better understand and implement SCL in different educational contexts [29]. In addressing the barriers to implementing SCL, we distinguish between those related to teachers, students, the teaching space, and the traditional curriculum itself.

3.1. Teachers Facing SCL

The implementation of student-centered learning faces several challenges, including issues with assessment and feedback, cultural and hierarchical barriers, tendencies towards traditional teaching methods, student engagement, resource limitations, and power dynamics [30]. Addressing these challenges requires comprehensive training for teachers, cultural shifts in educational practices, and better resource allocation to support SCL principles [31]. Initially, teachers find it difficult to move towards student-centered learning [32,33]. Niemi [34] researched active learning in schools and teacher education, identifying several obstacles to its implementation. These included teaching methods that render student teachers passive, incompetent educators of student teachers, insufficient time and time pressure in studying, the separation of theoretical and practical studies, and student teachers’ own passivity and lack of metacognitive skills. One of the barriers to integrating active learning techniques into large lecture-based courses is convincing teachers who are traditionally trained in didactic lecture-based teaching that these new methods will improve student learning and retention [35,36]. Teachers accustomed to the traditional lecture format may be reluctant to adopt active learning strategies due to concerns about effectiveness and student engagement [37]. In essence, the adoption of new ideas requires a change in teachers’ mindset and approach to their work [38], which is challenging, especially when it involves increased planning and preparation for classroom activities [39]. However, teachers can confirm what research has shown: that active learning techniques such as group discussions, hands-on activities, and collaborative learning can significantly improve student comprehension, retention, and overall academic performance. The current study and some other research [34,40] found that active learning methods were implemented by only a few educators, mainly through relatively closed tasks. Open learning environments, which require student initiative, self-directed learning, planning, experimentation, elaboration, and self-evaluation, still seemed rare. The more teachers and the more subjects who participate in the experience, the better the result.

High student attendance is one of the reasons for convincing colleagues of the benefits of the flipped classroom. One of the problems identified in the 2023/24 course review meeting at the UCM Faculty of Veterinary Medicine, and mentioned in the ECOVE final report following the EAEVE visit to the UCM Veterinary School in Madrid [10], was the lack of student attendance in lecture-based courses. We do not have accurate data on attendance in traditional theory classes, but the average attendance in flipped classrooms was 42% of students in 2022/23 and 69% of students in 2023/24. These data suggest that active learning may be a motivator for class participation, considering that they were informed in the active learning orientation meeting that they could choose whether to participate in the flipped class, as all videos and PDFs were always available as much as they needed in the anatomy repository created in TEAMS, called “Anatomoteca” [21].

Another challenge that teachers may face when incorporating active teaching methods is how to align these innovative approaches with the university’s assessment criteria for evaluating teaching quality. The Docentia-UCM Programme seems to be designed to evaluate teaching activities of the university’s faculty and to recognize their efforts in all the tasks they undertake [11]. But, what is it that the Docentia-UCM is measuring? The authors will evaluate the program to distinguish between genuine assessments of teaching effectiveness and potential punishment against teachers who seek to implement active methods in their teaching practice. After considering the information on the Docentia Programme presented above, it can be concluded that 7% of the survey measures bureaucratic data and that in most cases departments and the university give the highest score to all teachers, and the weight of the survey is also considered. Based on the students’ opinion report, teachers will elaborate their self-report (21%). Therefore, the weight of measuring teaching quality is directly related to student satisfaction (65.5%). Although the Docentia Programme states that student opinion can determine the adequacy (16.5%) and efficiency (7%) of a teacher, the reality is that, due to the lack of training of students to assess these skills in a teacher, all these dimensions are assessed on the basis of student satisfaction which, as stated above, is not objective and susceptible to influence. Finally, there are only four items that can be objectively quantified, which assess teachers’ university publications, participation in innovation projects, training activities, congresses, seminars, etc., with a total value of 6.5%. From this, it can be concluded that only 13.5% of the survey assessing teaching quality in the Docentia-UCM Programme is objectively quantified, 7% is bureaucratic data, and 6.5% is teaching improvement activities. There are a number of problems associated with student quality-of-teaching evaluations that can negatively affect their validity. For example, some researchers argue that students’ perceptions of teaching quality may be influenced by their personal characteristics, such as gender, age, academic achievement, or interest in the subject [41,42], as well as by teacher characteristics, such as gender, experience, interpersonal closeness with students, and students’ expectations of the teacher [43,44]. In addition, the framing and wording of the questionnaire can also influence responses [45]. This is particularly worrying when there is a very serious lack of reading comprehension among students, as evidenced by the fact that 64% of students were unable to answer a level 1 cognitive question due to reading comprehension problems [23]. Furthermore, students lack professional knowledge and didactic or pedagogical expertise [46]. Student surveys can be seen as text material, where students have to read and interpret a question in order to understand its meaning [47]. Other authors have noted that even commonly used surveys can be a linguistic challenge, especially for younger respondents [48,49]. This can lead to a less objective assessment of teaching and to misunderstandings about the items used in student surveys [50].

Let us go back to Dorfner and colleagues’ [28] assertion that teaching quality must encompass three key aspects: classroom management, a supportive climate, and cognitive activation. Moreover, the most widely accepted measure of educational success is student achievement [51]. Classroom management involves establishing rules and routines to minimize disruption, dealing effectively with interruptions and providing structured lessons. Student support includes providing individual assistance, giving constructive feedback, and fostering a positive learning environment. Cognitive activation refers to the quality of learning opportunities provided to students and the extent to which these opportunities stimulate higher-level learning processes [28]. The Docentia-UCM survey does not have any form of measurement of cognitive activation or student performance.

In the Complutense University, students are not trained to provide valid assessment of teaching quality. It is important to consider that students lack professional knowledge and didactic or pedagogical expertise. This can lead to less objective evaluations of teaching and misunderstandings about the items used in student surveys. In the Docentia-UCM survey, several questions are asked of students that require didactic or pedagogical expertise and for which they are not qualified (Figure A1).

Student evaluation of teaching is influenced by student preference factors that violate human rights legislation, such as ethnicity and accent [9]. In addition, student evaluation of teaching can be easily manipulated by factors such as the ease of the course and chocolates and other incentives [9], such as raising grades or lowering the bar or difficulty in the exam or when reviewing the examination, and this raises some points. This can be a problem if the teacher knows the names of the students who may be assessing him/her; this is how it is performed at the Faculty of Veterinary and Human Medicine of the UCM. However, student ratings of teachers can still be useful for very limited purposes, such as providing formative feedback and raising concerns about ineffective teaching practices. The way the survey is designed in the Docentia-UCM can make teachers feel that they are being judged on a personal level. Currently, students can insult or defame a teacher behind the anonymity of the survey. In addition, the lack of complete anonymity of the process is a critical issue. In that sense, there is a legal issue The Ryerson University case in Toronto [52] is a wake-up call about the uninformed use of student evaluation of teaching and a reminder that student evaluation of teaching is not valid as a measure of faculty teaching effectiveness [9]. The fact that in the Docentia-UCM evaluating system teachers can find out about the group of students who might respond to their survey compromises the anonymity and the validity of the process. After a review of the literature, Uttl [9] convincingly shows that student evaluation of teaching is not a valid measure of teaching effectiveness, that students do not learn more from more highly rated teachers, and that student evaluation of teaching is significantly influenced by numerous irrelevant teacher effectiveness factors, student preference factors, and factors detrimental to student learning. And student assessment of teaching may be one of the main contributors to grade inflation. The reason why its use is so widespread and the reason why there is so much support for its use is that student assessments of teaching are quick and cheap to collect, the means and standard deviations of the surveys have an aura of precision and scientific validity, and they provide tangible, seemingly objective figures for both high-stakes decision making and public accountability purposes [9]. In addition, student participation in Docentia’s Teaching Quality Assessment Programme at the Complutense University is very low at our school, as mentioned in the ECOVE final report following the EAEVE visit to the UCM Veterinary School in Madrid [10], although their participation is rewarded with raffles and small gifts.

3.2. Students Facing SCL

It is also initially difficult for students to make the shift to a student-centered approach to learning and to challenge the assumptions they take for granted [32,33]. There are several reasons for this difficulty:

3.2.1. Comfort with Traditional Learning Methods

Students are often used to traditional, teacher-centered learning methods where they play a passive role, listening to lectures and taking notes [18]. This familiar approach requires less active engagement and to think more maturely and more critically on their part.

3.2.2. Fear of Failure

In a student-centered classroom, students are encouraged to explore, experiment, and sometimes fail. This trial-and-error process is essential for deep learning, but it can be uncomfortable for students who are afraid of making mistakes or appearing ignorant in front of their peers [53].

3.2.3. Developing New Competences

SCL requires the development of new competences such as solving problems, critical thinking, self-evaluation, and collaboration [54]. These skills are not always emphasized in traditional educational settings, so students may need time to understand and support to develop them.

3.2.4. Passive Learning Culture

Many students have developed a passive learning culture where they rely on the teacher to provide information and dictate the pace and structure of learning. Shifting to a model where they must take the initiative and drive their own learning can be a significant adjustment [55].

Three categories of barriers are mentioned in the study by Niemi [34]; these barriers included students’ passive learning culture, lack of motivation and initiative, and lack of self-confidence. This was also found by Aksit et al., 2016, in Turkey [40]. The most common obstacle was that the passive learning culture, where students had become accustomed to listening to a lecture, was not only a more familiar role for students, but it was also much easier. Many preferred to continue this tradition at university. The second barrier was a lack of motivation and initiative. Some students lacked the drive to develop themselves, did not take responsibility for their own learning, or did not want to leave their comfort zone, having become used to passive participation in class. The third significant barrier was a lack of self-confidence. Students made various critical comments, such as “We have been brought up with a tradition of behavior training throughout our educational life, so it is easy to continue this tradition at university”, “Participating in these activities is childish”, “Fear of criticism”, “Fear of speaking in front of the class”, and “Being shy”. These feelings felt by the students could be confirmed in this experience, especially at the beginning [53].

One of the challenges of incorporating active learning techniques into large lecture-based courses is overcoming the resistance of students who are used to traditional didactic, lecture-based teaching methods [35,36]. Students may be skeptical about the effectiveness of new techniques in improving their learning and retention, especially if they have not experienced the benefits of active learning firsthand, especially if it requires more study and preparation.

The previous section explained that student satisfaction should not be the sole measure of teaching quality. However, the opinion of students is essential as they are the main participants in the educational experience. Continuous feedback is necessary to understand what is happening at a personal level for students. In this experience, students’ opinions were asked at the beginning and at the end of the flipped classroom session and at the end of the thematic block and at the end of the experience [23]. In this way we obtained a continuous feed about personal experience and were able to identify problems and solve them. In education, it is often observed that students tend to prioritize the acquisition of theoretical knowledge over the practical application of newly acquired information [56]. In the survey of all students at the end of active learning experience (year 2023/24), the percentage of students who preferred expository teaching was 52% (76/155) compared to those 48% (69/155) who preferred active methods. It is interesting to note that in the first survey carried out with the students in the orientation session, after the flipped classroom methodology had been explained, the students were asked which form of teaching they identified with: 5% identified with expository teaching and 93% preferred active teaching to learn to think and use the content learned in class [23]. This can be attributed to the challenge students faced in differentiating between learning and memorizing and the fact that an excellent teacher was one who provided them with detailed notes so that other resources were not necessary [36]. Teachers need to show students that while theoretical knowledge is the foundation for understanding a subject, the application of this knowledge is crucial for developing real-world problem-solving and critical-thinking skills. Encouraging them to engage in hands-on activities, case studies, and practical projects can help bridge the gap between theory and application, leading to a deeper understanding of the subject matter and better retention of information [57]. By striking a balance between theoretical learning and practical application, educators can help students develop a more holistic and comprehensive understanding of the material, preparing them for success in both academic and real-world settings.

Active learning in the classroom has been shown to have many benefits for students, including improved performance and the promotion of a more inclusive learning environment. The authors of the study experienced a positive impact on group dynamics, particularly in their relationship with a student on the autism spectrum. Some other authors [58] have found positive gains in learning and social skills achieved by incorporating children with restricted interests into classroom practice. Collaborative learning, when implemented with other active learning strategies, can promote active participation, social integration and shared responsibility. However, it is very important to increase individual involvement in self-directed learning and to encourage individual participation in class discussion. This approach not only improves academic performance but also fosters a sense of belonging and acceptance within the classroom, leading to a more supportive and inclusive learning environment for all students [23].

3.3. The Learning Space and SCL

The flipped classroom model is a departure from traditional teaching methods and puts the student at the center of the learning process. This pedagogical approach focuses on practical education lessons designed as student-centered activities that include peer discussion, peer feedback, and interactive engagement with teachers. The success of this model depends heavily on the physical space in which learning takes place. Overcrowded classrooms can hinder effective peer discussion and the creation of an active learning environment [59]. The space itself needs to support these activities, but traditional-style classrooms designed for one-way lectures are often unsuitable for the dynamic, collaborative nature of flipped learning environments. Other authors highlight that the unsuitable conditions of the classroom pose a significant obstacle to implementing active learning methods. Their students have complained about the inflexibility of classes due to the presence of stationary tables and desks [40].

There are several challenges with traditional style classrooms.

3.3.1. Fixed Seating Arrangements

Traditional style classrooms typically feature fixed, tiered seating facing a central podium or stage. This layout is ideal for one-way communication from instructor to students, but it discourages group work and peer interaction [60].

3.3.2. Inflexibility for Group Activities

The rigid structure does not allow for the fluid movement required for group discussions [61] and other interactive activities central to the flipped classroom model.

3.3.3. Limited Interaction

In a traditional setting, students are often physically separated from one another, making it difficult to engage in face-to-face discussions and group exercises. Although this was not the case in this experience (the students were not physically separated), they sat in single file, one behind the other, and interaction was also limited.

3.4. Traditional Curriculum and SCL

While the student-centered approach to learning is fundamentally pedagogical and should be implemented by individual educators in their classrooms, an institutional shift towards SCL needs to be organized, consistent, and transparent. For educators in higher education, moving to and sustaining a student-centered approach to learning is not an easy task [62]. Teachers accustomed to a teacher-centered environment, like their students, may find it challenging to question long-held assumptions. A change in teaching/learning philosophy is needed, and it is very important that this change involves all disciplines in the curriculum [63], as recommended by ECOVE in its final report following the evaluation of the Madrid UCM Veterinary School [10].

When curricular revision is proposed, it is often not recognized as a fundamental change in teaching philosophy. This misconception can significantly hinder the successful implementation of innovative educational approaches such as SCL and active learning methods. Understanding the deeper implications of curricular revision is crucial for educators, administrators, and students to fully embrace and effectively integrate these changes. In some studies [40], resistance to change was identified as a common barrier to curriculum revision, with the strong influence of educational tradition being a major reason for criticism from educators. Pellert [7] debated the need to overthrow the resistance by carrying out a new approach in higher education institutions. Pellert also noted that the issue of change is often controlled from the top down by the management of these institutions. Many studies [13,34,64,65,66] have found that resistance to change is the biggest barrier of all.

Traditional educational paradigms emphasize a teacher-centered approach, where the teacher is the primary source of knowledge, and students are passive recipients. In contrast, modern educational paradigms, such as those proposed in curricular revision, advocate a student-centered approach that emphasizes active learning, critical thinking, and collaborative engagement. The student-centered approach to learning involves an ongoing reflexive process for teachers, requiring them to ‘think about their thinking’ to improve their conventional pedagogy and redefine their teaching methods. In a revised curriculum, the role of the educator shifts from being the sole authority and provider of knowledge to becoming a facilitator and guide who supports students in their learning journey. This philosophical shift requires educators to adopt new teaching strategies and mindsets that promote student autonomy and responsibility.

Educators and students alike may resist changes that challenge long-standing educational traditions and comfort zones. This resistance may stem from a lack of understanding or appreciation of the benefits of new teaching philosophies. Educational institutions often have established practices and policies that are slow to change. Overcoming institutional inertia requires strong leadership and a clear vision for the future of education.

Educators may lack the training and support needed to implement new teaching philosophies effectively. Professional development and ongoing support are essential to help educators transition to new pedagogies.

Effective leadership is crucial in driving curricular revision and fostering a culture of innovation and continuous improvement. The philosophy of SCL requires a new way of planning the whole curriculum. A new, in a sense backward, course design that starts with desired student outcomes and works backward to define content coverage, creating a new core system structure with increased student control and integrated curriculum assessment opportunities [67]. Leaders should champion the new teaching philosophies and provide the necessary resources and support for their implementation.

Other universities have identified various barriers to implementing active learning in a traditional curriculum setting, including limited teaching time, the density of the curriculum, the potential difficulty of using active learning in large classes, the lack of materials, equipment or resources, and the conservative attitudes of fellow students who were reluctant to participate in active learning methods [40].

4. Solutions and Recommendations

4.1. Strategies to Support Teachers in the Transition to a Student-Centered Approach

4.1.1. Convincing Teachers of the Benefits of Active Methods by Demonstrating Their Effectiveness

To address this concern, it is essential to provide teachers with evidence-based research and examples of successful implementation of active learning in similar educational settings. Professional development workshops, training, and resources can also help educators understand the benefits of active learning and provide them with the tools and support they need to incorporate these techniques into their teaching practices [68,69]. By demonstrating the positive impact of active learning on student outcomes and fostering a culture of continuous improvement, teachers can be encouraged to adopt new teaching methods that enhance student learning and engagement in large lecture-based courses. To persuade teachers to move from a teacher-centered to a student-centered methodology, they need to understand the benefits of incorporating active teaching methods. Active learning methods offer many benefits, including increased student engagement, better retention of information, improved critical thinking skills, better collaboration between students, and a more interactive and dynamic learning environment [70]. These methods also promote a deeper understanding of the material, encourage creativity and problem-solving skills, and cater for different learning styles. In addition, active learning can increase student motivation, confidence and overall academic performance. In addition to raising awareness of the benefits of active learning, it is crucial to provide teachers with concrete examples and case studies of successful implementation of this methodology.

Table 5. Students’ performance in answering questions at 4 cognitive levels. Expository teaching vs. active teaching.

Cognitive Level	Level 1	Level 2	Level 3	Level 4
Expository teaching n = 158	4.31	3.05	2.9	2.76
Active teaching n = 180	4.15	4.8	4.62	5.68
For each question asked at a cognitive level, the average score obtained by the group of students is shown.

Source: Martin-Alguacil and Avedillo, 2024 [23].

shows a comparison between the results obtained by students taught with lecture-based methods and those obtained by students taught with flipped classroom methods, comparing the results of comparable questions on the four cognitive levels already described [23]. Data were obtained from the subject test which included questions formulated with different cognitive levels to measure knowledge (level 1), comprehension (level 2), application (level 3), and analysis (level 4). The content was taught by the same teacher and very similar questions were used to compare the expository and active teaching methods. With this type of assessment, it is possible to measure not only performance but also other skills, not only the acquisition of content but also the acquisition of other competences necessary for the future career of a veterinary student.

4.1.2. Pedagogical Training for Teachers

It is very important for teachers to have the pedagogical training necessary to implement active learning correctly, as the thorough pedagogical training of educators has a major impact on student learning, especially in tasks that require critical thinking and problem-solving skills [71]. In addition, assessments of pedagogical expertise, which includes understanding of learning processes, teaching techniques, and curriculum design, are often shown to have a greater impact on teaching effectiveness than subject-specific knowledge [72]. Prioritizing pedagogical issues such as ‘lifelong learning’ and ‘productive pedagogy’ has significant benefits for teacher preparation and overall classroom effectiveness [73]. Teachers should also be encouraged to participate in workshops or training sessions focused on active learning strategies to enhance their understanding and implementation skills. Furthermore, incorporating feedback mechanisms and assessment tools that can quantitatively measure the impact of active learning on student outcomes can help demonstrate the effectiveness of this approach [74]. Collaboration with educational researchers and experts in the field can also provide valuable insights and evidence-based practices to support the implementation of active learning in the classroom.

4.1.3. University Program for Evaluating Teaching Effectiveness

Experts agree that effective teaching should lead to student learning [75]. The quality of teaching assessment needs a major revision to measure cognitive activation and student performance. There have been several studies to determine the degree of idiosyncrasy in student assessment by comparing it to alternative assessment methods [42,43,44,45,46]. These studies have shown that student ratings, particularly those assessing learning support and cognitive activation, show significant differences from classroom observations or teacher self-report data. This might lead to the conclusion that students are less able to provide valid information about teaching quality and its theoretically proposed dimensions [76]. The students should be trained to be aware that the only way to help their teachers to improve is to be constructive and that it is important to have a collaborative attitude. An effective way of measuring the quality of teaching it is complex and requires a multidimensional approach [77]. It goes beyond student satisfaction. Here are some alternative methods for assessing teaching effectiveness, based on a review of the literature:

• External peer observation and evaluation. Have peers observe teaching and provide structured feedback based on specific criteria or collaborative assessments [78].
• Self-evaluation and reflection but certainly not based on a student survey. Teachers could be asked to put together a portfolio that includes lesson planning, teaching pedagogy, and reflections on their experience of teaching. Create self-assessment tools to evaluate teaching practices and methods used [77]. Based on feedback and self-reflection, develop and review personal teaching improvement plans.
• Classroom observation by professionals. Involve an educational expert or an instructional coach to observe the classroom and provide feedback. Create observation rubrics to ensure consistent and comprehensive assessment of teaching practice [79] or a combination of classroom-based observations and student achievement [80].
• Assess student learning outcomes. Measure student performance on standardized tests to assess the effectiveness of instruction. One way in which it is already being presented is through the design of questions that are formulated at different cognitive levels to measure other competences other than memorization [21]. Measure the impact of the teaching process by comparing student performance before and after a course.
• Obtain students’ and teachers’ feedback. Collect feedback from former students on how well the course has prepared them for their future career aspirations [81]. Ask teachers and trainers about the competences acquired by the students.
• Classroom interactions. Measure student engagement through participation in discussions, group work, and interactive activities [82]. Assess the implementation and outcomes student-centered learning or any other active learning method such as the flipped classroom.
• Evaluate the effective use of educational technology and innovative teaching methods [83].

By using a combination of these methods, universities can gain a more comprehensive and accurate assessment of teaching quality, leading to more effective teaching practices and improved student outcomes.

4.2. Strategies to Support Students in the Transition to a Student-Centered Approach

To address the students’ resistance to the incorporation of active learning, educators can provide clear explanations and evidence-based research on the benefits of active learning, such as increased engagement, improved critical thinking skills, and better retention of information. In addition, incorporating interactive demonstrations, group activities, and real-world applications into the curriculum can help students see the practical benefits of active learning in improving their understanding and mastery of subject matter [84]. By gradually introducing and reinforcing active learning techniques, educators can gradually change students’ perceptions and attitudes towards a more interactive and engaging learning experience [16]. Here are some strategies to help overcome the problem:

4.2.1. Provide Students with a Lot of Information About the SCL Methodology

It is necessary to show students that active learning is not just a method. It is a way of teaching that is very rewarding for them. Students in active classrooms learn more, but they feel like they learn less due to increased cognitive effort required during active learning [55]. Niemi [34] explained that learning that requires active reflection and a high degree of responsibility helps students to overcome their own limitations. Clearly communicate the goals and benefits of SCL and help students understand why these changes are being made. Provide explicit instruction and practice in the skills needed for SCL, such as collaboration, critical thinking, and self-assessment. In this study, prior to the initiation of the SCL methods, an information session was required for all students planning to participate in the active learning experience [16].

4.2.2. Gradual Implementation

Introduce student-centered activities gradually, allowing students to become familiar with the new methods over time. This group had the opportunity to confirm the effectiveness of the gradual introduction of active methods [16,21]. It is not only good for the students to get used to the new system but also for the teachers to feel comfortable and to constantly monitor the efficiency of the methods used.

4.2.3. Supportive Environment

Create a supportive classroom environment where mistakes are seen as learning opportunities and students feel safe to take risks and express their ideas [85]. The flipped classroom methods used in this study had produced good results, with excellent communication between students and teachers in the classroom and high-quality discussions.

4.2.4. Ongoing Feedback

Provide regular, constructive feedback to help students understand their progress and areas for improvement. It is necessary to ask students about their experience from the beginning to the end of the process [16]. In this case, surveys were conducted in each class at the beginning to ask if the video flipping was useful for them to learn and at the end of the class to ask them about the effectiveness of the session. There was also a survey at the end of the thematic block and another at the end of all active learning experiences.

4.2.5. Peer Support

Encourage peer learning and support networks that enable students to learn from and with each other [86]. In this experience, the students were happy to work in groups, most of them preferring it to answering the cognitive questions on their own or in pairs.

4.3. Improving Active Learning Spaces

4.3.1. Flexible Seating Arrangements

Classrooms should be equipped with movable furniture, such as tables and chairs, that can be easily reconfigured for different activities [60]. This flexibility allows for quick transitions between individual work, small group discussions, and larger group interactions. This is not the case in traditional classrooms, which have rigid structures consisting of continuous benches. In this experience, we divided the students into groups and marked them with colors on the benches. At the entrance we handed out the color cards so that the students could arrange themselves in the designed space. In each group, the students sitting in the front row should turn around to form a group with the students in the row behind them. When we asked the students if they were uncomfortable, they assured us that they were fine and that this position was good for them to share with their group.

4.3.2. Technology Integration

Effective flipped classrooms integrate technology to facilitate learning [83]. Interactive whiteboards, projectors, and personal devices allow students to easily access and share resources, enhancing the active learning experience. The technology integration in this experience was correct, but it can always be improved by the incorporation of new technologies in the teaching process.

4.3.3. Acoustic Considerations

Good acoustic design is essential to minimize distractions and ensure that students can hear each other during discussions [87]. Sound-absorbing materials and strategic placement of partitions can help create an optimal auditory environment. In this experience, as the classes were very large, with an average of 12 groups of five to six students, it was very useful that several teachers participated in the session and that microphones were placed in the groups and with the teachers. Thumbs up and thumbs down palettes were also used between groups and teachers to indicate agreement or disagreement.

4.4. Institutions Supporting the Implementation of SCL

More resources need to be devoted to the professional development of teachers; simply offering innovative courses is not enough. Professional development needs to be embedded not only in teachers as individuals but also in schools and education systems [88].

5. Conclusions

There are many indicators, which demonstrate the efficiency of active learning on learning outcomes, but there are still many obstacles to be solved. This chapter review article focuses on the challenges faced in the transition from passive learning to active teaching methods at the Complutense University of Madrid. It explores the obstacles encountered in this shift with colleagues, students, and classroom dynamics and with the traditional curriculum itself. Teachers need to be confident that the institution’s quality assessment system will not unfairly judge the results of innovative teaching methods. The university’s teaching quality assessment framework should be able to distinguish between the skills of teachers and the impact of student-centered approaches. Given the information available, it appears that Docentia-UCM’s current assessment practices at Complutense University favor passive learning styles and may not adequately recognize the benefits and effectiveness of active learning strategies. As a result, teachers who use SCL methods may be unfairly disadvantaged. Assessment is primarily based on student satisfaction, which may not accurately reflect the value of active learning as it requires more effort. This imbalance could pose a challenge for educators who wish to adopt student-centered methodologies. While student satisfaction is important, assessing the quality of teaching requires considering many aspects that need to be quantified. It should therefore be balanced with other methods to provide a more accurate and complete assessment. The Docentia-UCM Programme needs to improve its evaluation methods by using a combination of feedback sources to ensure that the assessment not only captures the subjective experience of students but, most importantly, measures the effectiveness of teaching. Students’ evaluation of teaching like Docentia-UCM do not measure teaching effectiveness and students do not learn more from more highly rated teachers. Students should be encouraged to prioritize critical thinking skills over memorization for their future professional development. By recognizing and addressing the initial difficulties students face in moving to a student-centered approach, educators can facilitate a smoother transition and create a more effective and engaging learning environment. Recommendations are also made to improve collaborative group work in traditional style classrooms, which have historically been associated with passive learning approaches. For the flipped classroom model to reach its full potential, the physical space must be thoughtfully designed to support its pedagogical goals. Moving away from traditional style classrooms to more flexible, technology-integrated and interactive environments can greatly enhance the active learning experience. By optimizing the use of classroom space, educators can create an environment that not only supports but enhances the student-centered, interactive learning principles at the heart of the flipped classroom model. Meanwhile, teachers need to use the resources at their disposal and develop strategies to facilitate effective learning. Recognizing curricular revision as a central shift in teaching ideology is essential for its smooth implementation. Embracing deeper pedagogical change, rather than superficial adaptations, has the potential to revolutionize education and meet the demands of today’s learners. By removing barriers to change, providing holistic support, and fostering a culture of collaboration and creativity, universities can create dynamic educational environments that equip students with the competences and skills they need to meet the professional challenges of the future. Veterinary education aims to develop a comprehensive set of competencies in graduates, including communication, clinical skills, professionalism, collaboration, cultural competence, business sense, empathy, critical thinking, public health, and lifelong learning. These competencies can be developed through SCL by enhancing communication skills, supporting competency-based education, integrating active learning techniques, promoting ethical competence, improving faculty teaching methods, and encouraging multidisciplinary and reflective learning; SCL prepares veterinary students for successful professional practice [89]. Active learning is gradually being integrated into traditional university curricula through evidence-based practice, technological advances, and a shift towards SCL philosophies.

6. Future Research Directions: Bridging the Gap Between Traditional Educational Models and Student-Centered Practices

The future and directions for effective implementation of active learning methods, such as SCL, in universities with traditional curricula are likely to involve a gradual but steady integration of these innovative teaching strategies. Several factors and trends will shape this development:

6.1. Hybrid Learning Models

Universities may increasingly adopt hybrid models that combine traditional lectures with active learning activities [90]. This approach allows for a smoother transition from teacher-centered to student-centered methods, providing a balanced educational experience, as explained earlier in this text.

6.2. Pedagogical Training for Educators

Teachers need to fully understand the philosophy of this type of teaching, and good pedagogical training of teachers is very important; it takes time, but the results are worth it [71]. Universities will need to invest in training programs that equip educators with the skills and knowledge to implement active learning techniques effectively.

6.3. Technology Integration

It is not essential to use digital tools to implement active learning. However, it is true that their use is very useful and motivating for students. The use of technology will continue to play an important role in active learning [83]. Tools such as interactive whiteboards and collaborative software will facilitate active learning activities and make them more accessible and engaging for students.

6.4. Curriculum Redesign

As the benefits of active learning become more widely recognized, universities may gradually redesign their curricula to incorporate more active learning opportunities. This could involve restructuring courses to include more hands-on projects, group work, and problem-based learning activities in their backward design. Backward design should begin at the level of the degree program, by describing what students should know and be able to do when they have completed their degree. The ultimate aim must be to deliver all disciplines in a student-centered way, encouraging self-learning and students’ responsibility for their own learning.

6.5. Flexible Learning Spaces

The physical layout of classrooms will evolve to support active learning [60]. Universities will invest in flexible learning spaces with movable furniture, breakout areas and technology that encourages interaction and collaboration.

6.6. Research and Evidence-Based Practices

Ongoing research into the effectiveness of active learning techniques and their implementation in different subjects will continue to influence their widespread adoption. As more evidence emerges showing the positive impact of active learning on student outcomes [23], universities will be more motivated to integrate these practices into their traditional curricula.

6.7. Institutional Support and Leadership

The successful integration of active learning requires strong leadership and institutional support. University administrations will need to embrace these changes, provide the necessary resources, and create a culture that values and supports innovative teaching methods.

6.8. Improved Methods for Assessing Learning Outcomes

Assessment practices will also need to evolve to align with active learning approaches. Traditional exams and quizzes may be supplemented or replaced by assessments that measure students’ ability to apply knowledge and think critically. It will be very useful to create cognitive exercises with different cognitive levels, as described in this study [23].

Traditional exams and quizzes can be supplemented or replaced by assessments that measure students’ ability to apply knowledge, engage in discussion, and think critically.

6.9. Tackling Resistance to Change

Resistance to change will remain a major challenge. Universities will need to address this by fostering a culture of openness and continuous improvement, encouraging both staff and students to embrace new methods and approaches.

6.10. Global Trends and Benchmarking

Global trends in education will influence the adoption of active learning. Universities can look to successful models and best practices from institutions around the world that have effectively integrated active learning into their curricula.