The impacts of blended learning design in first year medical studies.

In the first year of medical studies in France, students prepare for a highly selective entrance exam limited by numerus clausus into the second year. We have discontinued live lectures, made maximum use of new information and communication technologies and introduced tutorials in an attempt to make the first year more equitable and to personalise teaching. The reform is based on blended learning with flipped classroom organized into a four-week cycles of different activities. Each cycle corresponds to a learning module. The teachers' and students' opinions were analysed to evaluate the reforms and allow teaching methods to be adapted accordingly. The student profiles at registration and success in the exams following the reform are described. The tutorial's notes are correlated to the final scores at the entrance exam. The keys to success seem to be modified by the reform providing greater equality of opportunity between students. The factors associated to success are baccalaureate highest grades, high School Specialisation (maths, physics or earth and life sciences) and repeating the first year class. The use of blended learning allows us to face the increase of student enrolment, and to facilitate the acceptance of these pedagogical methods for both students and teachers.