Knowledge Acquisition and Retention in a Flipped Nursing Course: A Quasiexperimental Study

BACKGROUND

Student knowledge acquisition and retention are essential in nursing training. This study examined differences in content knowledge acquisition and retention between traditional and flipped classroom (FC) formats.

METHOD

A pretest-posttest quasiexperimental design with a follow-up test was used for this study of associate degree nursing students in a Hong Kong community college. The control group (n = 141) included nursing students in a traditional classroom (TC) setting before COVID-19 compared with nursing students in an FC (n = 130) setting during the pandemic. The effects were evaluated before the course, postcourse, and 3 months after the course.

RESULTS

Content knowledge scores for both groups improved after the course. Students in the FC performed better in the short-term (posttest immediately after the course) and long-term (follow-up-test 3 months later) than students in the TC.

CONCLUSION

Implementing the FC method effectively promoted students' knowledge acquisition and retention. [J Nurs Educ. 2024;63(8):501-506.].

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.

Comparison of the teaching clinical biochemistry in face-to-face and the flex-flipped classroom to medical and dental students: a quasi-experimental study from IRAN

INTRODUCTION

Biochemistry is one of the main courses of basic sciences in the medical curriculum, along with other difficult subjects that are difficult to learn. The emergence of new technologies has made it possible to test new methods such as e-Learning. In this study, we compared two methods of Flex-Flipped Classroom (FFC) and face-to-face.

METHOD

A quasi-experimental research was done which involved both medical and dental students studying the clinical biochemistry course in the joint semester in 2019. A total of 100 medical students were trained in biochemistry through face-to-face teaching, and 60 dental students were trained in the same course through the FFC model. Three researcher-made tools were used to compare the two groups to assess the student's satisfaction, scores, and self-evaluation. The content validity of the tools was checked using the opinions of 10 experts through the CVI index. The results were analyzed using one-sample t-tests, independent t-tests, and ANOVA.

RESULTS

Both groups scored significantly more than the cut-off-point (Mean > 3.5) in their average scores of the total and sub-components of the self-evaluation questionnaire (P < 0.05). Face-to-face teaching was viewed more favorably than the FFC teaching except for considering the flexibility (4.14 ± 1.55), but the difference was not significant (P > 0.05). The students' knowledge score in the FFC was slightly higher than that in the face-to-face method, but this difference was not significant(P = 0.758).

CONCLUSION

Both face-to-face and FFC methods were effective according to the students, but the level of satisfaction with the face-to-face method was higher. It seems that teacher-student interaction is an important factor in students' preferences. However, the students preferred the flexibility of multimedia. It seems necessary to use the advantages of each method in a model appropriate to the students' conditions and available facilities.

Student engagement in flipped classroom in nursing education: An integrative review

AIM

To summarize the effect of the flipped classroom method (FCM) on student engagement in nursing education and provide the implications for future practice.

BACKGROUND

Technological advancement of learning approaches including flipped classroom has become increasingly popular in nursing education. However, no integrative review has been published that specially explore the behaviour engagement, cognitive engagement and emotional engagement of flipped classroom use in nursing education.

METHODS

Population, Intervention, Comparison, Outcomes and Study (PICOS) strategies were implemented to investigate the literature from published peer-reviewed papers from 2013 to 2021 in CINAHL, MEDLINE and Web of Science.

RESULTS

The initial search identified 280 potentially relevant articles. After comprehensively reviewing the initial catchment using several analytical phases, 16 articles were considered for the final review. Most of articles targeted on undergraduate nursing students and were conducted in the USA and Australia. The review primarily identified positive learning outcomes among nursing students in term of student engagement. However, a few studies reported contrasting findings, possibly due to students are still dependent on traditional lecture-based classroom.

CONCLUSION

This review suggests that use of the FCM in nursing education could promote students' behavioral engagement and cognitive engagement but yield a mixed outcome in emotional engagement. This review contributed to our understanding of the effect of the flipped classroom method on student engagement in nursing education, the strategies for promoting student engagement in future flipped classroom practice and recommendation for future research on flipped classroom.

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.

Mapping Simulated-Based Learning Experiences Incorporated Into Professional Placements in Allied Health Programs: A Scoping Review

SUMMARY STATEMENT

Emerging literature continues to demonstrate the use of innovative practices such as simulated-based learning experiences to prepare students for professional placements. This scoping review aimed to provide a broad overview of how simulated-based learning experiences have been implemented within or immediately before the professional practice placements of entry-level allied health programs. Four databases (MEDLINE, EMCARE, CINAHL, and Scopus) were searched up to August 2020. Kirkpatrick's evaluation framework was used to categorize outcomes, and the Simulation-Based Research Extension for the CONSORT statement was used to appraise the quality of simulation reporting. The search revealed 6584 unique abstracts with 321 full-text articles reviewed. Forty-eight studies met the inclusion criteria. This review has shown a clear trend toward using simulation within or immediately before the professional practice placements of allied health programs. Using Kirkpatrick's evaluation framework, most studies reported on student reaction (level 1) and learning (level 2) obtained during the simulation experience. There was limited evidence showing how the benefits gained in simulation translated to the clinical environment (level 3) or impacted the organization (level 4). Further research is required to review the optimal proximity of simulation to allied health professional placements and how gains are obtained from simulation transition to the clinical environment. In addition, more consistent reporting of simulation methodologies and evaluation methods are needed to strengthen the evidence base.

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.

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.

Evaluating Usability in Blended Learning Programs Within Health Professions Education: a Scoping Review

Knowledge was mapped about how usability has been applied in the evaluation of blended learning programs within health professions education. Across 80 studies, usability was explicitly mentioned once but always indirectly evaluated. A conceptual framework was developed, providing a foundation for future instruments to evaluate usability in this context.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-021-01295-x.

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

Background

In recent years, technological advancement has enabled the use of blended learning approaches, including flipped classrooms. Flipped classrooms promote higher-order knowledge application – a key component of nursing education. This systematic review aims to evaluate the empirical evidence and refereed literature pertaining to the development, application and effectiveness of flipped classrooms in reference to undergraduate nursing education.

Methods

A PRISMA systematic review protocol was implemented to investigate the literature pertaining to the development, implementation and effectiveness of flipped classroom pedagogy in undergraduate nursing education. Seven databases (Scopus, PsycINFO, CINAHL, ERIC, MEDLINE, Cochrane, Web of Science) were utilised to survey the salient literature. Articles were appraised with respect to their level of evidence, the origin of study, study design, the aims/s of the study, and the key outcomes of the study. A qualitative synthesis was then conducted to summarise the study findings.

Results

The initial search identified 1263 potentially relevant articles. After comprehensively reviewing the initial catchment using several analytical phases, 27 articles were considered for the final review, most of which were conducted in the USA and South Korea. A range of research designs were applied to measure or discuss the outcomes and design features of the flipped classroom pedagogy when applied to undergraduate nursing education. The review indicated that a common operational flipped classroom model involves three key components, namely pre-classroom activities, in-classroom activities and post-classroom activities, guided by two instructional system design principles. The review predominantly identified positive learning outcomes among undergraduate nursing students, after experiencing the flipped classroom, in terms of skills, knowledge and attitudes. However, a few studies reported contrasting findings, possibly due to the incompatibility of the flipped classroom pedagogy with the traditional learning culture.

Conclusions

Current evidence in this systematic review suggests that incorporating the flipped classroom pedagogy could yield positive educational outcomes in undergraduate nursing education. There are promising pedagogical models available for adapting or developing the flipped classroom pedagogy in undergraduate nursing education.

Technological literacy in nursing education: A scoping review

BACKGROUND

Nurses are the key professionals in the introduction, implementation, and use of technology in clinical practice. A lack of technical expertise and technological understanding poses a challenge to the quality of health services and possibly to the safety, dignity, and quality of life of patients. Therefore, possessing technological literacy upon completing nursing baccalaureate studies is essential. However, no previous scoping review has mapped the existing studies of technological literacy in nursing education.

OBJECTIVES

To map and assess the published studies on technological literacy in nursing education and to identify how educational institutions operationalize, teach, measure, and maintain students' technological literacy throughout their educational programs.

DESIGN

A scoping review was conducted using the methodological framework of Arksey and O'Malley. The reporting was guided by the PRISMA extension for Scoping Reviews.

METHODS

A comprehensive systematic search of the MEDLINE, EMBASE, PsycINFO, ERIC, and CINAHL was performed for studies published from January 2008 through March 2020. Two authors independently assessed eligibility and extracted data. The reference lists of the included studies were also examined.

RESULTS

The review included 28 papers from 27 studies. Three thematic groupings with their respective subgroups were identified among the included papers: 1) the acquisition (simulated electronic documentation, diversified learning methods, and evaluation learning focus), 2) the measurement (digital/computer literacy/competence, nursing informatics competence, technology acceptance, and students' interests and preferences in technology), and 3) the maintenance (follow-up evaluation) of technological knowledge and skills.

CONCLUSIONS

Pedagogical models designed to teach an entire process for the acquisition, measurement, and maintenance of technological literacy are lacking. Studies are needed that bring technological competencies to a higher level, including problem-solving and critical thinking. Educators' competencies should be enhanced. Educational institutions need to ensure the readiness of future nurses for a technology-enriched environment by providing the necessary knowledge in technological literacy. "TWEETABLE ABSTRACT": Due to the importance of technological literacy to the nursing profession, educational institutions must ensure that it is taught to nursing students.

The trends and outcomes of flipped learning research between 2012 and 2018: A descriptive content analysis

As an innovative active learning method, flipped learning provides students with several opportunities. This study was conducted to reveal the trends and outcomes in research into the flipped learning approach published between 2012 and 2018. Descriptive content analysis was used to review 316 research and conceptual articles published in academic journals included in five significant databases that ascribe to journals the highest impact factor. The results indicate that most of the studies are conducted with students as the most frequent study group and with a mixed-method research design in the subject areas of education and medicine. The flipped learning approach is mostly conducted in higher education. As a region, Asia has taken the lead in flipped learning studies. Finally, the outcomes of flipped learning indicate an increase in student performance and positive influence on cognitive, affective, and soft skills.

Development and validation of a measurement scale to assess nursing students’ readiness for the flipped classroom in Sri Lanka

PURPOSE

The aim of this study was to develop and validate a scale to measure nursing students’ readiness for the flipped classroom in Sri Lanka.

METHODS

A literature review provided the theoretical framework for developing the Nursing Students’ Readiness for Flipped Classroom (NSR-FC) questionnaire. Five content experts evaluated the NSR-FC, and content validity indices (CVI) were calculated. Cross-sectional surveys among 355 undergraduate nursing students from 3 state universities in Sri Lanka were carried out to assess the psychometric properties of the NSR-FC. Principal component analysis (PCA, n=265), internal consistency (using the Cronbach α coefficient, n=265), and confirmatory factor analysis (CFA, n=90) were done to test construct validity and reliability.

RESULTS

Thirty-seven items were included in the NSR-FC for content validation, resulting in an average scale CVI of 0.94. Two items received item level CVI of less than 0.78. The factor structures of the 35 items were explored through PCA with orthogonal factor rotation, culminating in the identification of 5 factors. These factors were classified as technological readiness, environmental readiness, personal readiness, pedagogical readiness, and interpersonal readiness. The NSR-FC also showed an overall acceptable level of internal consistency (Cronbach α=0.9). CFA verified a 4-factor model (excluding the interpersonal readiness factor) and 20 items that achieved acceptable fit (standardized root mean square residual=0.08, root mean square error of approximation=0.08, comparative fit index=0.87, and χ2/degrees of freedom=1.57).

CONCLUSION

The NSR-FC, as a 4-factor model, is an acceptable measurement scale for assessing nursing students’ readiness for the flipped classroom in terms of its construct validity and reliability.

The Effective Use of Information Technology and Interactive Activities to Improve Learner Engagement

Student engagement in the learning process is the key to successful delivery of teaching and learning. Teachers face several challenges to engage learners in different disciplines, including computer science. This research conducts a review of BSc (Computer Science) programmes and introduces interactive activities to enhance learner engagement. The study was conducted using a repeated measure design involving 24 participants. The findings revealed that the use of technology, and collaborative and interactive activities in groups may positively influence learner engagement. The participants’ feedback before and after introduction of group tasks and interactive activities showed a significant (p < 0.001) and increasing trend in response to questions-related learner engagement. The participants agreed that their learning experience and engagement enhanced with the use of technology and interactive and collaborative activities.

Development and evaluation of flipped learning using film clips within a nursing informatics course

AIM

To develop flipped learning classes by using film clips for undergraduate nursing students in an online nursing informatics course, based on the Analysis, Design, Development, Implementation, and Evaluation model, and to evaluate the effectiveness and students' responses to this method of teaching.

METHODS

Sixty-four second-year nursing students participated in the course. The nursing students' knowledge was assessed at the beginning and end of each of the five classes. Moreover, their intention to recommend the classes to other students and additional comments were elicited by using semistructured questionnaires.

RESULTS

Knowledge about each core concept of nursing informatics reflected significant improvement. Regarding the intention to recommend the class to others, 62 (96.8%) students answered "strongly recommend" or "recommend."

CONCLUSION

Integrating flipped learning classes by using film clips in an online nursing informatics course improved the nursing students' knowledge and is a format that is desired by students.