Objectives: To determine if a flipped classroom improved student end of module exam performance in a pharmacotherapy oncology module. Method: Third year pharmacy students in the Class of 2013experienced the Pharmacotherapy Oncology Module (15 contact hours) as traditional lectures with optional case studies as supplemental homework (ungraded). The Class of 2014 experienced the same module content with a flipped classroom approach. The middle 10 contact hours were flipped as follows: 10 Vodcasts (8 hours total time) and 6 hours of in-class case studies in place of optional case studies. Students were instructed to watch Vodcasts before in-class case studies, but were not held accountable (i.e. quizzed) for pre-class preparation. The exam questions were identical in both cohorts. Performance on exam questions covered with the flipped approach was compared between the two cohorts using ANCOVA with prior academic performance variables (GPA) as covariates. Results: The students experiencing the flipped classroom approach performed poorer on exam questions covering flipped topics than the cohort that received traditional lecture with optional case studies with previous GPA used as a covariate (p , 0.05). Implications: A flipped classroom approach to incorporate active learning does not necessarily improve student performance. Limitations of this flipped classroom experiment include long vodcasts (30 to 50 minutes) and lack of student accountability for watching vodcasts. Further research is needed to determine optimal classroom flipping techniques that result in improved student performance.