Transition from school to University requires students to learn new factual content and, in many cases, new learning styles. The delivery of physiological content has traditionally been provided, and commonly remains, by a series of didactic lectures that may be complemented by small group tutorials (SGT). Whilst appearing to fulfil the requirements of curriculum delivery, such methodology fails to enable students to gauge accurately, at an individual level, their understanding of the subject and their focus of learning may naturally shift towards the security of rote learning the new content being presented. Such shifts in learning style are reflected by the increasing student demands for more didactic teaching, slide-based handouts and lecture capture. In many cases, the first independent test of understanding comes at a summative assessment and thus could be a major cause of the present demands for increased feedback from students following such assessments. Respiratory physiology at the University of Birmingham is now taught to 350 year 1 MBChB students entirely using a ‘flipped classroom’ approach (Mazur, 2009). Students are provided with lecture podcasts (Panopto) via the VLE that they watch in their own time before attending non-didactic, question and answer sessions using interactive response technology (Turning Technologies). These sessions utilise peer teaching and lecturer-led explanations to test each student’s understanding of key concepts and to provide them with immediate, individualised feedback. The flipped classroom is different from other lectures, requiring greater student input and effort before and during the lecture sessions and in order to stretch the most able students without undermining the confidence of other students, we found it necessary to provide a range of question difficulty. Our evaluation strongly suggests that this methodology is successful and that students appreciate the opportunities it provides and data collected over the past 2 years shows a trend towards greater appreciation of this methodology (see table 1). The students received follow-up respiratory physiology SGT. Since the introduction of the flipped classroom these sessions have been able to focus more on the application of their knowledge in the context of clinical case scenarios, likely due to a higher level of core knowledge and understanding achieved prior to the SGT. We believe that this approach supports student learning by providing targetted and individualised feedback by enabling lecturers to tailor teaching towards the correction of misunderstandings.