Exploring the pedagogical design features of the flipped classroom in undergraduate nursing education: a systematic review

Flipped Classroom Based on Outcomes-Based Education Improves Student Engagement and Clinical Analysis Competence in Undergraduates Ophthalmology Clerkship

Objective

To investigate the effectiveness of flipped classrooms (FC) based on outcomes-based education (OBE) on clinical ophthalmology clerkships.

Methods

Ninety-nine undergraduates were non-randomly assigned to the FC based on the OBE (FC-OBE) group or traditional lecture (TL) group in the ophthalmology clerkship. Pre- and post-tests were performed to assess student learning outcomes. Anonymous questionnaires were collected to compare students' attitudes and classroom engagements between the two groups.

Results

More participants agreed FC-OBE was helpful in developing teamwork ability and knowing the work standard. Teaching staff in the FC-OBE classroom received higher evaluations. More participants in the FC-OBE group had higher classroom engagement in skills and emotions than in the TL group. The post-class test scores, mainly case analysis scores were higher in the FC-OBE group than in the TL group.

Conclusion

FC-OBE classroom improves student engagement and clinical analysis competence in undergraduate ophthalmology clerkship.

Innovative cultural care training: the impact of flipped classroom methods on critical cultural competencies in psychiatric nursing: a quasi-experimental study

INTRODUCTION

Healthcare systems are encountering a growing number of diverse and multicultural clients due to globalization and migration. To effectively address the challenges associated with cross-cultural interactions, nurses require a comprehensive framework of critical cultural competencies. One potential approach to enhancing these competencies in mental health care settings is to use innovative methods such as the flipped classroom in cultural care training programs. This study evaluated the effect of using the flipped classroom method in cultural care training on the critical cultural competencies of nurses working in a psychiatric hospital.

METHODS

This quasi-experimental study involved 70 nurses working in a psychiatric hospital affiliated with the Kerman University of Medical Sciences in southeastern Iran. Through random sampling, the nurses were allocated into two groups of intervention (n = 35) and control (n = 35). The intervention group participated in a cultural care training program using the flipped classroom method, which consisted of four sessions conducted over a four-week period. To evaluate the nurses' critical cultural competence, the Almutairi's Critical Cultural Competence Scale was administered before the training and again one month later.

RESULTS

The study findings indicated no significant differences in the scores of critical cultural competencies between the intervention group (4.53 ± 0.64) and the control group (4.73 ± 0.42) during the pre-test stage (t = 1.53, p = 0.13). Both groups had a similar perception of critical cultural competencies, which was not particularly positive. However, in the posttest stage, the intervention group (5.33 ± 0.49) demonstrated a significant increase in critical cultural competencies compared to the control group (4.75 ± 0.44) (t = 5.14, p = 0.001).

CONCLUSION

The study results indicated that the use of the flipped classroom method in the cultural care training program effectively enhanced the critical cultural competencies of nurses. Given the importance of cultural care in both physical and psychiatric care settings for multicultural clients, it is crucial for nurses to receive ongoing in-service education that utilizes innovative and active methods such as the flipped classroom.

The effect of flipped-jigsaw learning models on ethical decision-making

BACKGROUND

Ethical decision-making education in nursing can be taught effectively by combining different teaching models that support the visualisation of taught concepts and integrating theory into practice.

OBJECTIVES

The study aims to examine the effect of flipped and jigsaw learning models on ethical decision-making and ethical sensitivity in nursing.

RESEARCH DESIGN

We used a nested mixed design. A pretest-posttest single-group quasi-experimental design was used in the quantitative part, and a case study method was used in the qualitative part.

PARTICIPANTS AND RESEARCH CONTEXT

This study was conducted in fall semester with second-year nursing students who studied an ethics course for the first time, using two different collaborative learning models. In the quantitative part, ethical dilemma and ethical sensitivity scales were made as pre-test with 117 and post-test with 128 students. In the qualitative part, a semi-structured three focus group interviews was conducted with 16 students.

ETHICAL CONSIDERATIONS

After obtaining the approval of the University's ethics committee, the study was carried out after obtaining participants' informed written and verbal consent.

FINDINGS

Students' perspectives changed positively after training. This was related to six cases in section A of the Ethical Dilemma Scale. In part B, Practical Consideration (PC) and Principled Thinking (PT) mean scores were similar, showing no significant difference. For Familiarity in section C, it was determined that 68.4% of students in the pre-test and 77.3% in the post-test were familiar with similar dilemmas. The ethical sensitivity scale's total scores were in a similar range. In the qualitative stage, ethical decision-making, ethical sensitivity, ethical dilemma and the improvement process were obtained as a theme.

CONCLUSIONS

There was an increase in the level of ethical sensitivity and familiarity with ethical dilemmas of nursing students after education. Flipped and jigsaw learning models can be used for nursing ethics courses.

Blended learning in nursing pharmacology: elevating cognitive skills, engagement and academic outcomes

Pharmacological education is crucial for healthcare professionals to safely manage medications and reduce errors. Traditional lecture-based learning (LBL) often struggles to address this complexity, whereas newer methods, such as flipped classrooms and problem-based learning, yield mixed results, particularly in pre-clinical contexts, owing to students' limited experience. Our nursing pharmacology course under LBL recorded a high failure rate of 37.8% and marginal passing scores across five cohorts (n = 849 students). An analysis using Bloom's taxonomy revealed significant gaps in higher-order cognitive skills. As a remedy, the course was transformed into a novel blended learning format that integrated question-based learning (QBL) to enhance critical thinking across all cognitive levels. This model blends asynchronous and synchronous learning, is tailored to individual needs in large classes, and fosters continuous, student-centric learning. The redesign markedly decreased the failure rate by approximately 2.8-fold and increased the average grade by 11.8 points among 426 students. It notably improved the pass rates in advanced cognitive categories, such as "Evaluate" and "Create" by 19.0% and 24.2%, respectively. Additionally, the blended course showed increased student engagement, reflecting a dynamic and effective learning environment that significantly elevated participation and academic outcomes at all cognitive levels. This study demonstrated the profound impact of blended learning in pharmacology. By integrating QBL with various teaching methods, it surpasses traditional lecture-based limitations, enhancing engagement and understanding of complex topics by nursing students. Notable improvements in foundational and advanced learning suggest its broader application in health professionals' education, effectively equipping students for clinical pharmacology challenges.

Exploring the Evolution of Nursing Procedurals Skills, Mastery, and Competence Through Online Learning Among Students: A Qualitative Study

Introduction

Online learning has changed the educational environment and may influence the development of nursing skills, mastery, and competence in students.

Objective

The study aimed to investigate how nursing students acquire procedural skills, achieve mastery, and build competence through online learning, considering the growing use of technology in healthcare education.

Methods

This study utilized a qualitative descriptive research approach to investigate the experiences of 32 nursing students from the Nursing Department who had undergone online procedural learning. Semistructured interviews were conducted to collect in-depth insights. Purposive sampling was used to gather data with a profound understanding of the phenomenon. The data analysis encompassed a methodical content analysis coding procedure. Independent researchers reviewed the results to validate the findings.

Results

Content analysis of the data identified three key themes: achieving nursing procedural knowledge through online learning, achieving nursing procedural skills with the power of online learning, and gaining procedural competence through online social and collaborative learning.

Conclusions

Online learning played a significant role in shaping and enhancing nursing procedural knowledge, skills, and competence, emphasizing the importance of integrating technology training modules and staying updated with emerging technologies.

Development and Effectiveness of an End-of-Life Care Program for Faculty in the Critical Care Field: A Randomized Controlled Trial

In Japan, end-of-life care education in the critical care field is still insufficient. Therefore, this study developed and verified the effectiveness of an end-of-life care program for faculty in the critical care field in Japan through a randomized controlled trial. The study was implemented from September 2016 to March 2017. Participants were 82 college teaching staff and nurses working in the critical care field. Six months after the program, data of 37 members (84.1%) of the intervention and 39 members (84.8%) [corrected] of the control group were analyzed. The results demonstrated that the primary end point-"confidence in teaching" 6 months after program completion-differed significantly between the 2 groups (2.5 [0.69] in the intervention group vs 1.8 [0.46] in the control group, P < .001). It is suggested that attending this program will give faculty in the field of critical care continued confidence in their end-of-life care teaching, as well as allow them to implement end-of-life care teaching in their field.

Effectiveness of the flipped classroom methodology on the learning of evidence-based practice of nursing students: Quasi-experimental design

BACKGROUND

International organizations recognize the importance of evidence-based practice (EBP) for nurses. The objective of teaching EBP in the Nursing degree is to train future nurses on this subject. Different teaching models exist for this, from less active traditional models to more active ones such as the flipped classroom.

OBJECTIVE

To compare the degree of EBP competence of undergraduate nursing students after an EBP course, through the application of a traditional methodology versus a flipped classroom methodology.

DESIGN

Quasi-experimental study of non-equivalent groups.

SETTING

The study was composed by a group of students who received training on EBP with the traditional model (face-to-face), and another intervention group with whom the flipped classroom model was utilized, using the online teaching platform EBP-eToolkit.

PARTICIPANTS

The study was conducted with 4th-year Nursing degree students enrolled in the course evidence-based practice, in academic years 2019/20 and 2021/2022.

METHODS

Before and after the course, the students completed a questionnaire about EBP competence (EBP-COQ), and an objective test was given at the end of the year.

RESULTS

A sample of 152 students in the face-to-face group (control), and 143 students in the flipped classroom group (intervention) participated. The intervention group significantly improved its competence on attitude (p = 0.01, η² = 0.022), skills (p = 0.019, η² = 0.018), and global competence in EBP (p = 0.003, η² = 0.030), with respect to those who were taught using the traditional method. However, there were no significant differences in the impact on knowledge, neither through the self-report dimension of the EBP-COQ (p = 0.188) nor the final test score, control group 6.89 (SD: 1.35) and flipped classroom group 7.12 (SD: 1.53) (p = 0.206).

CONCLUSIONS

The flipped classroom model is adequate for the teaching of EBP to undergraduate nursing students. It produced a slight increase in attitude, as well as in skills and global competence in EBP. Nevertheless, this increase was not significantly different from face-to-face learning in terms of impact on EBP knowledge.

Using cognitive load theory to evaluate and improve preparatory materials and study time for the flipped classroom

BACKGROUND

Preclinical medical education is content-dense and time-constrained. Flipped classroom approaches promote durable learning, but challenges with unsatisfactory student preparation and high workload remain. Cognitive load theory defines instructional design as "efficient" if learners can master the presented concepts without cognitive overload. We created a PReparatory Evaluation Process (PREP) to systematically assess and measure improvement in the cognitive-load efficiency of preparatory materials and impact on study time (time-efficiency).

METHODS

We conducted this study in a flipped, multidisciplinary course for ~ 170 first year students at Harvard Medical School using a naturalistic post-test design. For each flipped session (n = 97), we assessed cognitive load and preparatory study time by administering a 3-item PREP survey embedded within a short subject-matter quiz students completed before class. Over three years (2017-2019), we evaluated cognitive load- and time- based efficiency to guide iterative revisions of the materials by content experts. The ability of PREP to detect changes to the instructional design (sensitivity) was validated through a manual audit of the materials.

RESULTS

The average survey response rate was ≥ 94%. Content expertise was not required to interpret PREP data. Initially students did not necessarily allocate the most study time to the most difficult content. Over time, the iterative changes in instructional design increased the cognitive load- and time-based efficiency of preparatory materials with large effect sizes (p < .01). Furthermore, this increased the overall alignment of cognitive load with study time: students allocated more time to difficult content away from more familiar, less difficult content without increasing workload overall.

CONCLUSIONS

Cognitive load and time constraints are important parameters to consider when designing curricula. The PREP process is learner-centered, grounded in educational theory, and works independently of content knowledge. It can provide rich and actionable insights into instructional design of flipped classes not captured by traditional satisfaction-based evaluations.

Flipped classroom approach to global outreach: cross-cultural teaching of horizontal strabismus to Chinese ophthalmology residents

AIM

To evaluate the flipped classroom model for teaching horizontal strabismus didactics in an ophthalmology residency program in China as part of a visiting professorship from the United States.

METHODS

Residents from an ophthalmology residency program in China were invited to participate in flipped classroom sessions taught by an experienced American ophthalmology faculty in 2018. Residents were instructed to watch a pre-class video lecture prior to the in-class-case-based activity. Content tests (5 Ophthalmic Knowledge Assessment Program style questions) and surveys were administered before and after the classroom sessions (100% response rate). These results were compared to that of an American cohort who were taught the same content.

RESULTS

The Chinese cohort of 12 residents preferred the flipped classroom to the traditional classroom at higher rates than the American cohort of 40 residents (92% vs 55%, P=0.04) and felt that all ophthalmology topics would be appropriate for the flipped classroom teaching style (P-values between 0.008 and <0.001). In both Chinese and American cohorts, we found that the exotropia curriculum saw a small but significant improvement in performance following the flipped classroom session (P=0.025 for Chinese residents; P=0.001 for US residents), whereas scores in both groups for the esotropia course did not significantly improve.

CONCLUSION

This is the first study to evaluate the flipped classroom model implemented by a visiting ophthalmology professor in a global outreach setting. The flipped classroom sessions are viewed favorably by the Chinese residents relative to the US cohort with a modest impact on knowledge. Decreased in-person interpreter requirement and increased student engagement make this model valuable in cross-cultural visiting professorship settings. Finally, the flipped classroom may lend itself well to a virtual format to prevent the transmission of COVID-19, although such a format requires further study.

Implementation of a Web-Based Educational Intervention for Promoting Flipped Classroom Pedagogy: A Mixed-Methods Study

Introduction

Flipped classroom pedagogy (FCP) is recognised as an effective and efficient teaching-learning method. However, nursing students and teachers may be hesitant to adopt FCP due to technophobia and time constraints linked to academic and clinical responsibilities. This necessitates the provision of promotional training for adopting FCP. However, there is a dearth of research regarding how the practice of FCP could be promoted and in demonstrating its efficacy in developing countries. Thus, this study aimed to examine the educational impact of a web-based education intervention, branded as the Flipped Classroom Navigator (FCN), for promoting FCP in nursing education in Sri Lanka.

Methods

This mixed-methods study employed pre- and post-training knowledge tests, the Instructional Materials Motivation Survey (IMMS), the Perceived Transfer of Learning Questionnaire survey, and collected students' and teachers' open-ended responses to evaluate the impact of the FCN. Fifty-five undergraduate nursing students and 15 university teachers participated in the study from two state universities in Sri Lanka. Repeated-measures ANOVA, t-tests, Levene's test of homogeneity, Cohen's d, and an inductive thematic approach were employed in the data analysis.

Results

Post-training knowledge test scores were significantly higher than the pre-training knowledge test scores indicating improved understanding of FCP. Participants were also highly motivated to learn in the FCN instructional materials. Participants exhibited positive attitudes towards FCN training with transfer of learning to their teaching-learning practice. The inductive thematic analysis identified the following themes: user experiences, FCN learning content, behaviour changes, and suggested improvements.

Conclusion

Overall, the FCN enhanced both students' and teachers' knowledge and understanding of FCP in undergraduate nursing education.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-022-01706-7.

The effect of blended task-oriented flipped classroom on the core competencies of undergraduate nursing students: a quasi-experimental study

BACKGROUND

The flipped classroom (FC) method is becoming increasingly popular in China's nursing education. It is an important breakthrough improvement in the quality of learning in nursing education reforms.

PURPOSE

This study aimed to determine the effects of blended task-oriented flipped classroom (TFC) on nursing students undertaking the Fundamentals of Nursing course.

METHODS

A pre-and post-test quasi-experimental design was adopted. This study was conducted in the Autumn semester, 2021 academic year in a Chinese university. Using cluster sampling technique, this study enrolled second-year undergraduate nursing students from six classess who were studying Fundamentals of Nursing course. A blended TFC was developed and implemented with three classes (experimental group: n = 152). In-class traditional lectures were applied to the other three classes (control group: n = 151). The Self-Directed Learning Instrument, Problem-Solving Inventory, and California Critical Thinking Disposition Inventory were used to evaluate students' learning outcomes, and final examinations were conducted at the end of after course. In addition, students in the flipped classroom group were required to answer five open-ended questions concerning their flipped classroom learning experiences.

RESULTS

Students in the experimental group showed significant improvement in academic performance compared to those in the control group (p = 0.001). Considering total scale and factors, students in the experimental grouped recorded significantly higher scores in self-directed learning ability, problem-solving skills, and critical thinking ability compared to those in the control group (p < 0.05). Furthermore, improved abilities and skills such as team cooperation, communication, presentation, identifying /solving clinical problems, and accountability were reported.

CONCLUSION

A blended TFC teaching approach positively impacted students' core competencies and improved learning outcomes in the Fundamentals of Nursing course.

Empirical research of emerging trends and patterns across the flipped classroom studies using topic modeling

This study presents topic modeling based bibliometric characteristics of the articles related to the flipped classroom. The corpus of the study consists of 2959 articles published in the Scopus database as of the end of 2021. In addition to the bibliometric characteristics of the field, research interests and trends were also revealed with the study, which was based on the topic modeling-based bibliometric analysis method. According to the results of the study, an increase in the number of publications has been observed since 2015. Nearly one-third of the studies are of United States origin. According to the findings of the topic analysis in which the research interests and trends in the studies were revealed, the articles in this field were gathered under 16 topics. Considering the number of publications of the topic, it was seen that the three most voluminous topics were "Performance and perception", "Nursing education" and "Effectiveness and motivation", respectively. It is thought that the results of the study will provide a general perspective to the researchers in this field and provide important outputs in the context of monitoring the issues that may become prominent in the future.

Hot topics and frontier evolution in college flipped classrooms based on mapping knowledge domains

With the outbreak of COVID-19 and the development of online teaching, the online flipping teaching mode has attracted increasing attention. Systematic analysis of the research status and development trend of the flipped classrooms is significant for guiding the improvement of the quality of online flipped teaching. This study used the metrology software CiteSpace to draw a scientific knowledge map of relevant research in the web of science database from 2013 to 2021. It performed visual analysis of research authors, research institutions and countries, keyword clustering, keywords co-occurrence, and keyword time zone distribution. The results showed that: (1) The flipped classrooms research has attracted increasing attention from the social and educational circles, however, the relationship between relevant research authors, institutions, and countries is not close enough, and there is little cooperation. We need to strengthen cooperation further and realize the sharing of high-quality resources; (2) Based on keyword co-occurrence cluster analysis, this study identified three hot topics, namely, preparation before class, classroom activities and consolidation after class; (3) According to the keyword time zone map, this study divided three frontier evolution trends: exploration period, adaptation period, and growth period; (4) Finally, with the spread of novel coronavirus, it is suggested to promote the online flipped classroom teaching mode, and put forward reasonable suggestions from the perspective of teachers, students and researchers, and look forward to the future digital development direction of the flipped classroom.

Developing and evaluating an educational web-based tool for health professions education: the Flipped Classroom Navigator

BACKGROUND

Flipped classroom pedagogy is a blended learning approach applied in undergraduate health professions education. However, teachers and students may require training to effectively engage in flipped classroom pedagogy. Thus, this study aimed to design, develop, and evaluate a web-based tool for fostering flipped classroom pedagogy in undergraduate health professions education.

METHODS

This is an educational design-based research with a descriptive evaluation component which was conducted in two steps: (i) design & development and (ii) evaluation of an educational website. An expert panel was formed to evaluate the website by using a website evaluation questionnaire (WEQ). Descriptive statistics were employed to calculate the experts' agreement level.

RESULTS

An innovative website design was used to provide access to a range of digital devices. The development process occurred concurrently in two steps: (i) website development and (ii) learning content development. The educational website was branded as the Flipped Classroom Navigator (FCN). Based on WEQ scores, the FCN obtained a good level of agreement (≥ 80%) for its' ease of use, hyperlinks, structure, relevance, comprehension, completeness, and layout.

CONCLUSIONS

The FCN is an effective method for providing training to promote flipped classroom pedagogy in health professions education. The FCN achieved good evaluation scores and comments from experts. However, it is also necessary to obtain acceptance from the end-users, which could be the focus of future research. Nonetheless, the expert panel pinpointed areas for further development before introducing the FCN to end-users.

Flipped or traditional online teaching? Two different strategies to handle teaching in nursing education during the COVID-19 pandemic

OBJECTIVES

The aim of this study was to investigate differences in academic achievement between two groups of students who were taught the same course online within the nursing program but through two different teaching strategies and to examine the students' attitudes towards flipped classroom.

METHODS

Online lectures using Zoom was given to teach a course regarding the immune system and another course was taught the same subject in flipped classroom approach using video lectures followed by seminars. Academic achievement were compared between the groups, and perspectives on flipped classroom were investigated using a questionnaire.

RESULTS

The main findings were that participation in flipped classroom seminars had a positive effect on academic achievement (OR 2.3 (CI [1.001-5.1]), and that students preferred the flipped classroom approach over traditional lectures.

CONCLUSIONS

This study suggests that a student centered teaching strategy like flipped classroom is an effective way to increase the students' engagement and academic achievements.

Student Satisfaction with Audio-Visual Flipped Classroom Learning: A Mixed-Methods Study

The purpose of this mixed-methods study was to investigate the influential factors of student satisfaction with online digital audio-visual flipped classroom learning. A total of 103 students enrolling in the two-credit compulsory code course participated in this flipped classroom research. Descriptive data analysis and grey relational analysis demonstrated that student respondents were most satisfied with repeated practice (1st), followed immediately by peer learning (2nd), and active learning (3rd). In terms of qualitative data, three themes emerged from the focus group analysis, including: improving independent learning, enhancing peer learning, and increasing teacher-student interaction. The flipped classroom model provided opportunities for students to strengthen their self-directed learning capabilities, improved students' learning motivation, and to be a team player among third-year nursing students. The results were consistent with the actual circumstance. The results integrated descriptive data, the mathematic model, and interviews to validate the accuracy and rationality of the data. According to this study, an online digital audio-visual flipped classroom could improve student independent learning and enhance peer communication. The results provide an accurate assessment tool suitable for Taiwanese nursing students' flipped classroom model learning experience.

Examining effects of the flipped classroom approach on motivation, learning strategies, urinary system knowledge, and urinary catheterization skills of first-year nursing students

AIM

In nursing education, innovative approaches are crucial to enhancing students' competence and preparing them to respond to the complex healthcare needs of society. The aim of the current study was to compare the efficacy of the flipped classroom and traditional educational approaches on the acquisition of urinary system knowledge and skill level, and on the motivation and learning strategies of first-year nursing students.

METHODS

This study was implemented with a single blind and randomized controlled design in the nursing department of a university's faculty of health sciences between December 2018 and December 2019, with 94 first-year undergraduate nursing students (47 in the experimental group adopting a flipped classroom approach, 47 students in the traditional approach control group). The study was conducted over pre-test and posttest phases for both groups.

RESULTS

The experimental group had higher mean scores than the controls in intrinsic goal orientation, task value, self-efficacy, rehearsal, elaboration, and organization and effort regulation, but lower scores in test anxiety (p < 0.001). The theoretical and skill exam scores of the experimental group were higher than those of the control group (p < 0.001).

CONCLUSION

The flipped classroom approach was effective for improving urinary system knowledge and skill level, and for the motivation and learning strategies of nursing students. This innovative education approach can be recommended as a student-centered method in nursing education for teaching theoretical knowledge and evidence-based practices.

Contribuições da pedagogia freireana para o ensino da fenomenologia em enfermagem: relato de experiência

RESUMO Objetivo: Relatar a experiência de aprendizagem discente na disciplina “Fenomenologia, Formação e Pesquisa”, e analisar o planejamento pedagógico de sua problematização no processo de construção do conhecimento, em programa stricto sensu em Enfermagem e Saúde. Método: Relato descritivo-analítico do plano de ensino ofertado com enquadramento teórico dos dados sob a perspectiva freireana. Resultados: A disciplina foi ofertada a seis discentes na modalidade remota e organizada em três unidades: a primeira composta por cinco encontros síncronos e um assíncrono; a segunda por três encontros síncronos e a terceira com sete síncronos e um assíncrono. Destacaram-se como metodologias aplicadas: aula expositiva de convidados externos,sala de aula invertida e mapa conceitual. Foram abordadas as linhas de pensamento husserliana e heideggeriana. Conclusão: A construção do conhecimento da fenomenologia por pós-graduandos ocorreu de acordo com a estrutura pedagógica de Freire, tendo como destaque, o constructo da problematização.

Escape Room vs. Traditional Assessment in Physiotherapy Students' Anxiety, Stress and Gaming Experience: A Comparative Study

Escape Rooms can serve multiple academic and educational purposes and can be used as part of the evaluation of a learning program. The aim of this study was to analyze the levels of anxiety and stress perceived in the evaluation using the Escape Room compared to the traditional evaluation, as well as to analyze the gaming experience. Methods: A comparative study was carried out in students of the Degree in Physiotherapy, with a total of 56 participants who underwent 2 evaluation processes. The variables analyzed were the State—Trait Anxiety Inventory, the Perceived Stress Questionnaire, and the Gaming Experience Scale. A comparative analysis was performed between the groups using the Mann Whitney U test and Student’s T test. Results: The levels of state-anxiety and trait-anxiety were higher in the traditional assessment group. Although no differences were found in the qualification obtained by the students, statistically significant differences were found between the two evaluation systems in terms of the overload factor, the energy factor, and the fear-anxiety factor of the perceived stress questionnaire. Conclusions: The Escape Room can be considered as an alternative to the traditional evaluation in Physiotherapy Degree students due to its lower levels of anxiety and perceived stress.

Assess the feasibility of flipped classroom pedagogy in undergraduate nursing education in Sri Lanka: A mixed-methods study

Background

The nursing education system has evolved with an increased emphasis on student-centred education, such as implementing flipped classroom pedagogy. Given the promising positive educational outcomes, the trend of using flipped classroom pedagogy has become increasingly popular in undergraduate nursing education. However, little is known about how these flipped classroom methods impact on nursing educational practices in limited-resource settings situated in South Asia.

Objective

To assess the feasibility of implementing flipped classroom pedagogy in undergraduate nursing education from the nursing students’ perspective.

Methods

This mixed-methods study employed a quantitative survey and six focus group discussions conducted in three state universities in Sri Lanka. The Nursing Students’ Readiness for Flipped Classroom (NSR-FC) questionnaire was used to collect quantitative data. The semi-structured focus group discussions were conducted by using 18 reflective and open-ended questions. Descriptive statistics and multivariate analysis of variance methods were employed when analysing quantitative data. An inductive thematic analysis approach was used to summarize the focus group discussions.

Results

The questionnaire survey revealed that nursing students reported high levels of personal, technical, and pedagogical readiness across all three universities, while environmental readiness was perceived as low. The inductive thematic analysis identified three themes, namely: enablers, challenges, and benefits. Specifically, nursing students valued the student-centred approach. They were ready to utilize their own devices to overcome limited technological provision; however, a short training session about how to engage in the flipped classroom was desirable. Also, their exposure to basic educational technology was perceived as adequate and they were aware of the positive outcomes of flipped classroom pedagogy.

Conclusion

Nursing students were ready to enrol in a flipped classroom programme. The provision of technological resources in the education environment was identified as a great challenge for flipped classroom implementation. Overall, the findings indicate there are promising feasibilities for the flipped classroom implementation.