The effects of the flipped classroom in teaching evidence based nursing: A quasi-experimental study.
ABSTRACT: BACKGROUND:Evidence-based nursing (EBN) has been an important training mechanism for improving the quality of clinical care. At present, the pedagogy focuses on the application of e-learning and team-based learning to enhance learners' engagement and learning effectiveness. OBJECTIVES:This study applied the flipped classroom approach to conduct evidence-based nursing (EBN) teaching. The aim of this study is to elevate the learning effectiveness of the flipped classroom group to the traditional teaching group in terms of knowledge and self-efficacy in practice. DESIGN:A pretest-posttest nonequivalent control group with a quasi-experimental quantitative design. METHODS:The study recruited 151 nurses, of whom 75 were in the control group and 76 were in the experimental group. During the EBN course, the control group received training via traditional pedagogy while the experimental group engaged the flipped classroom approach. The learning effectiveness of EBN knowledge and self-efficacy in practice were evaluated across the three time points: pre-course, post-course, and one month after the course. RESULTS:In both group the scores of the EBN knowledge and self-efficacy in practice improved after training. The scores of the experimental group increased significantly than in the control group. However, the scores declined in both groups one month after the course. Even so, the experimental group's score of self-efficacy in practice was still higher than that of the control group. CONCLUSION:The implementation of the flipped classroom approach and team-based learning effectively enhanced the learners EBN knowledge accumulation and self-efficacy in practice. The research results can be used as an important reference for improving clinical nursing teaching quality.
Project description:BACKGROUND:New teaching strategies must be developed not only to enhance nurse's competence but also to allow nurses to respond to the complex health care needs of today's society. The purpose of this study was to explore the learning outcomes of a flipped classroom teaching approach in an adult-health nursing course for students in a two-year Bachelor of Science in Nursing program. METHODS:The study had a quasi-experimental design. An 18-week flipped classroom teaching approach was applied in an adult-health nursing course. In total, 485 nursing students enrolled in the study, with 287 in the experimental group and 198 in the control group. The Self-Evaluated Core Competencies Scale, Metacognitive Inventory for Nursing Students, Self-Directed Learning Readiness Scale, and self-designed learning satisfaction questionnaire were used to evaluate the students' learning outcomes. RESULTS:The experimental group showed a statistically significant increase in the overall scores for self-evaluated core competencies, the "self-modification" subscale of the Metacognitive Inventory for Nursing Students, and in overall self-directed learning readiness; further, they also showed high levels of course satisfaction. CONCLUSIONS:A flipped classroom teaching approach had a positive impact on student's learning motivation and contributed to better learning outcomes in an adult-health nursing course. The flipped classroom combined with hybrid teaching methods is a suitable and effective learning strategy for a registered nurse (RN) to Bachelor of Science in Nursing (BSN) program to tackle today's complex revolution in nursing curricula, and may enhance nursing students' abilities to address numerous challenges.
Project description:PURPOSE:The flipped classroom has been suggested as a method for efficient teaching in medical education. However, its feasibility and effectiveness in the educational environment are often overlooked. The authors redesigned an epidemiology course applying the flipped classroom method under a traditional curriculum consisting of heavily scheduled classroom hours and explored its feasibility and effectiveness. METHODS:In the fall semester of 2017, we flipped the 'practice of epidemiology' course for third-year medical students at Korea University College of Medicine. We provided online lectures and assigned readings as pre-class materials, and substituted group discussions and communicative activities for traditional lectures. We conducted pre- and post-course surveys to review students' perceptions. We also analyzed the pre-test results and final exam scores for quantitative comparison. RESULTS:Ninety-seven students out of 120 completed the course. Most students made use of the online lectures, but not the reading materials. Lack of time was the most frequently cited reason for under-preparedness. We observed improvements in preparedness, participation, and effectiveness at the end of the course, while changes in satisfaction were unclear. Students' perceptions of course relevance and difficulty were predictive of pre-test outcomes, but the effects of preparedness and length of materials were insignificant. The authors found no evidence of differing test scores before and after the course. CONCLUSION:This study supports the feasibility of the flipped classroom model even under a traditional, heavily scheduled medical curriculum. To encourage self-directed learning and achieve better learning outcomes, restructuring pre-existing curricular components should also be considered in parallel with new instructional methods.
Project description:BACKGROUND:Curriculum design and specific topic selection for on-site practical courses in clinical disciplines with limited teaching time is challenging. An electronic learning supported curriculum based on the flipped classroom principle has a high potential to effectively gain knowledge and education along with improving practical experience. Here, we demonstrate the introduction of a flipped classroom curriculum for practical courses in Otorhinolaryngology (ORL) in real world practice to improve the on-site time management and students' experience. METHODS:Educational aims of our practical curriculum were analysed and rearranged into a flipped classroom (FC) framework. Core knowledge was taught preliminary based on a moodle platform in predominantly interactive formats. Two quasi-randomized groups were formed with 212 participants either receiving or not receiving access to the e-learning program to reduce a potential allocation bias to the e-learning group. All students completed a questionnaire with learning related items. Focusing the study on the intervention group, we investigated if students using the flipped classroom more often felt better prepared for the practical course. RESULTS:The online learning platform was highly accepted and frequently used by 66% of participating students in the e-learning group. Students with frequent use of our e-learning platform significantly felt better prepared for the practical course (p =?0.001). The far majority of all students supports the idea of further development of e-learning. More than 70% were generally interested in ORL. Handouts were the overall most important learning resource and more than 50% relied solely on them. CONCLUSIONS:Flipped classroom curricula can save time and help improving the on-site experience in practical courses especially in smaller surgical disciplines. The acceptance of digital learning is high, and most students rely on handouts for learning ORL, emphasizing the need for guidance by the teacher e.g. through electronic learning. Our results underline the high potential of FC to address teaching challenges for smaller medical disciplines with limited teaching time like ORL.
Project description:In flipped-class pedagogy, students prepare themselves at home before lectures, often by watching short video clips of the course contents. The aim of this study was to investigate the effects of flipped classes on motivation and learning strategies in higher education using a controlled, pre- and posttest approach. The same students were followed in a traditional course and in a course in which flipped classes were substituted for part of the traditional lectures. On the basis of the validated Motivated Strategies for Learning Questionnaire (MSLQ), we found that flipped-class pedagogy enhanced the MSLQ components critical thinking, task value, and peer learning. However, the effects of flipped classes were not long-lasting. We therefore propose repeated use of flipped classes in a curriculum to make effects on metacognition and collaborative-learning strategies sustainable.
Project description:This paper outlines a pedagogical approach for entrepreneurship education, with a specific focus on students who do not necessarily identify as entrepreneurial. We advance seven essential and teachable entrepreneurial thinking skills (ET-7) to form future leaders: (1) problem solving, (2) tolerance for ambiguity, (3) failing forward, (4) empathy, (5) creativity with limited resources, (6) responding to critical feedback, and (7) teamwork approach. ET-7 offers an integrative framework that unites previously distinct perspectives of entrepreneurial competencies, and outlines how to teach and develop these skills in a 12-week mandatory entrepreneurship course through an innovative pedagogical approach. This approach to entrepreneurial education was built on the concept of a signature pedagogy (Shulman, 2005) and encompasses three components (i.e., the flipped classroom, learning through failure, and access to open educational resources). This pedagogical approach to entrepreneurial education supports entrepreneurial learning through experiential activities that simulate the environment entrepreneurs face. Thus, this paper contributes to the literature by outlining the entrepreneurial thinking skillset (ET-7) required to be successful in today's modern careers, along with considering the methods, tools, and pedagogy that is most likely to support ET-7 skill development. Highlights • Seven entrepreneurial thinking skills were identified and pedagogical methods for developing these skills are described.• This new approach to entrepreneurial education was built upon the concept of signature pedagogy.• Flipped classroom allows for concrete and operational learning to occur through a series of experiential activities.• Learning through failure, which conveys entrepreneurial knowledge by giving students the opportunity to “fail forward”.• The Open Educational Resource is designed to orient students and educators toward applying this pedagogical approach.
Project description:A flipped-classroom environment generally strives to create more in-class time for activities that enhance student learning, while shifting some content delivery to outside the classroom through the use of short didactic videos. We compared a flipped-classroom setting with the traditional ("control") setting for an accelerated lower-division general biology course. Student self-reporting and video analytics functions showed ample and variable video viewing among individual students. Student learning was evaluated through quizzes administered after a set of concepts were covered (post 1) and at the end of the course (post 2). Students in the flipped sections had significantly higher quiz scores than students in the control sections for both post 1 and post 2. Analyses of variance analyzing the effect of and interactions between type of instruction, in-class activities, time, and Bloom's level of the quiz questions found significant differences in the overall model and all the factors, except for the presence and level of activities. Significant differences between students in the flipped and control sections were observed for low-level Bloom's questions only. Thus, the positive effect of the flipped-classroom approach on student learning may be due to improvements in recall of basic concepts and a better understanding of biology vocabulary in their first biology course.
Project description:Although the flipped classroom model has been widely adopted in medical education, reports on its use in graduate-level public health programs are limited. This study describes the design, implementation, and evaluation of a flipped classroom redesign of an introductory epidemiology course and compares it to a traditional model.One hundred fifty Masters-level students enrolled in an introductory epidemiology course with a traditional format (in-person lecture and discussion section, at-home assignment; 2015, N =?72) and a flipped classroom format (at-home lecture, in-person discussion section and assignment; 2016, N =?78). Using mixed methods, we compared student characteristics, examination scores, and end-of-course evaluations of the 2016 flipped classroom format and the 2015 traditional format. Data on the flipped classroom format, including pre- and post-course surveys, open-ended questions, self-reports of section leader teaching practices, and classroom observations, were evaluated.There were no statistically significant differences in examination scores or students' assessment of the course between 2015 (traditional) and 2016 (flipped). In 2016, 57.1% (36) of respondents to the end-of-course evaluation found watching video lectures at home to have a positive impact on their time management. Open-ended survey responses indicated a number of strengths of the flipped classroom approach, including the freedom to watch pre-recorded lectures at any time and the ability of section leaders to clarify targeted concepts. Suggestions for improvement focused on ways to increase regular interaction with lecturers.There was no significant difference in students' performance on quantitative assessments comparing the traditional format to the flipped classroom format. The flipped format did allow for greater flexibility and applied learning opportunities at home and during discussion sections.
Project description:<h4>Objective</h4>The aim of the study is to report the creation of a flipped ophthalmology course and preclinical medical student perceptions and knowledge gains before and after a flipped ophthalmology course.<h4>Design</h4>The form of the study discussed is an observational study.<h4>Subjects</h4>The subjects involved in the study are second-year (U.S.) United States medical students at the University of Miami, Miller School of Medicine (<i>n</i> = 401).<h4>Methods</h4>Second-year medical students participated in a 1-week "flipped classroom" ophthalmology course geared toward primary care providers at the University of Miami, Miller School of Medicine. Eleven hours of traditional classroom lectures were condensed into 4.5 hours of short videos with self-assessment quizzes, small group discussions, and a large group case-based discussion. Fifty-seven short videos (<9 minutes) focused on major ophthalmology topics and common conditions were viewed by the students at their leisure. Students completed a pre- and post-course evaluation on their perceptions and opinions of the flipped classroom approach. Final exam scores in the flipped classroom cohort were compared with the final exam scores in the traditional didactic format used in years prior.<h4>Main outcome measures</h4>The main outcome measures include: student final exam performance; student satisfaction, opinions, and perceptions.<h4>Results</h4>Over the course of 2 years, 401 second-year U.S. medical students participated in the flipped classroom ophthalmology course. The majority of students enjoyed the flipped classroom experience (75.3%) and expressed interest in using the approach for future lessons (74.6%). The flipped classroom videos were preferred to live lectures (61.2%). Over 90% of students stated the self-assessment quizzes were useful, 79% reported that the small group discussions were an effective way to apply knowledge, and 76% cited the large group case-based discussion as useful. Pre-course knowledge assessment scores averaged 48%. Final examination scores in the flipped group (average ± standard deviation [SD] = 92.1% ± 6.1) were comparable to that of the traditional group when evaluating identical questions (average ± SD = 91.7% ± 5.54), <i>p</i> = 0.34.<h4>Conclusion</h4>The flipped classroom approach proved to be a well-received and successful approach to preclinical medical education for ophthalmology. This was achieved using 35% less course time than our traditional course. This innovative approach has potential for expansion to other medical schools, medical education abroad, and for other medical school modules.
Project description:<h4>Introduction</h4>The flipped classroom is a pedagogical model in which the typical lecture and homework/self-study elements of a course are reversed or ?flipped'. The flipped model differs from distance and online learning, since students still have face-to-face contact with tutors. Studies have shown that the flipped classroom approach can be effective with clinical skills learning by paramedics, but it is not clear whether anatomy, physiology, pathophysiology and pharmacology can effectively be taught using a flipped approach.<h4>Methods</h4>A flipped classroom approach was taken for a three-hour theory session on the Diploma of Higher Education in Paramedic Practice that would usually have been taught by traditional lecture. Participants, 20 student paramedics already employed by the Ambulance Service as Emergency Care Assistants, completed a two-part questionnaire after the session. Part one comprised 22 Likert style questions, with part two allowing qualitative data with five open ended questions.<h4>Results</h4>All students preferred the traditional lecture over a flipped approach. Time constraints and preparation were seen as major disadvantages of the flipped classroom, as was being unable to ask questions in real time. Flexibility was seen to be an advantage of online lectures, and a blended/combination approach of online resources and traditional lecture was seen as valuable.<h4>Conclusion</h4>The demographic of students may have had an impact upon the results of the study and the lack of popularity of the flipped approach. Employed students have the added pressure of full-time work, and further research is needed into whether different methods should be employed when choosing how to educate employed paramedic students versus those who enter via the undergraduate route and study full time.
Project description:Recent reform of medical education highlights the growing concerns about the capability of the current educational model to equip medical school students with essential skills for future career development. In the field of ophthalmology, although many attempts have been made to address the problem of the decreasing teaching time and the increasing load of course content, a growing body of literature indicates the need to reform the current ophthalmology teaching strategies. Flipped classroom is a new pedagogical model in which students develop a basic understanding of the course materials before class, and use in-class time for learner-centered activities, such as group discussion and presentation. However, few studies have evaluated the effectiveness of the flipped classroom in ophthalmology education. This study, for the first time, assesses the use of flipped classroom in ophthalmology, specifically glaucoma and ocular trauma clerkship teaching. A total number of 44 international medical school students from diverse background were enrolled in this study, and randomly divided into two groups. One group took the flipped glaucoma classroom and lecture-based ocular trauma classroom, while the other group took the flipped ocular trauma classroom and lecture-based glaucoma classroom. In the traditional lecture-based classroom, students attended the didactic lecture and did the homework after class. In the flipped classroom, students were asked to watch the prerecorded lectures before the class, and use the class time for homework discussion. Both the teachers and students were asked to complete feedback questionnaires after the classroom. We found that the two groups did not show differences in the final exam scores. However, the flipped classroom helped students to develop skills in problem solving, creative thinking and team working. Also, compared to the lecture-based classroom, both teachers and students were more satisfied with the flipped classroom. Interestingly, students had a more positive attitude towards the flipped ocular trauma classroom than the flipped glaucoma classroom regarding the teaching process, the course materials, and the value of the classroom. Therefore, the flipped classroom model in ophthalmology teaching showed promise as an effective approach to promote active learning.