Effectiveness of the flipped classroom on self-efficacy among students: A meta-analysis

Long-term effects of flipped learning on nurses' self-efficacy and satisfaction in pressure injury management: A multi-center quasi-experimental study

AIMS

Investigate the long-term effects of a flipped education -based on adult learning theory and incorporating multimedia teaching and physical workshops-on nurses' self-efficacy in preventing and managing pressure injuries.

BACKGROUND

Pressure injuries remain a global challenge, requiring caregivers to blend theory with practice. Flipped learning has shown promise in boosting nurses' confidence and competence in managing these injuries through higher-level processes such as interaction, reflection, application, analysis and integration.

DESIGN

A single-blind, multicenter, quasi-experimental, two-group parallel repeated-measures design was conducted in seven medical institutions.

METHOD

A total of 404 participants adopted an adult self-directed learning model. The control group received PDF-based materials, while the intervention group additionally underwent a flipped education program that combined multimedia teaching with physical workshops. Self-efficacy in the four domains-assessment, planning, monitoring and decision-making-was measured at baseline, immediately post-intervention and at one- and three-months post-intervention. Data were analyzed using descriptive statistics, chi-square tests, t-tests and generalized estimating equations.

RESULTS

Following the intervention, both groups showed a significant increase in self-efficacy (p < .05). The intervention group scored higher in all domains, with improvements lasting three months and reported greater learning satisfaction.

CONCLUSION

Multimedia teaching enhances learners' motivation and improves the effectiveness of adult self-directed learning. Physical workshops focused on higher-level analysis, integration and hands-on teaching further strengthened care confidence and self-efficacy. These findings confirm the effectiveness of flipped education in pressure injury education, especially regarding its long-term impact and offer valuable insights for designing future nursing training programs.

Modified interteaching sessions as application-based examinations reduce student exam stress in an upper-level pathophysiology class

Testing is a highly important tool, used ubiquitously in academia, to assess student comprehension and understanding of material. Unfortunately, the emphasis placed on test grades has resulted in a modern epidemic of test-related anxiety, which can have adverse health effects on students. Over time, novel testing strategies have been developed to more precisely assess individual skills such as remembering, analyzing, and synthesizing. Yet, there exist few strategies that were also developed to simultaneously reduce stress in the testing environment. We posit here a teaching innovation whereby we modified the classic interteaching session developed in the social sciences to serve as a stress-reduction testing format that also builds student communication and critical thinking skills in an upper-level pathophysiology course. After implementing this novel testing approach, we anonymously surveyed the students in the class to understand how the testing format affected their self-perceived stress levels and their self-perceived learning and to identify their testing preferences. Of 28 students, 12 responded (43%). Our survey data highlight that students largely preferred partnered, open-response, case-based exams to multiple-choice exams. Moreover, students perceived themselves as having lower test-related stress when taking partnered, open-response, case-based exams, as well as a strong overall agreement that partnered, open-response, case-based exams enhanced their learning. We posit this application of modified interteaching can be employed in upper-level physiology or pathophysiology courses as a stress-reduction testing strategy.NEW & NOTEWORTHY We have identified an approach to testing in pathophysiology that can simultaneously enhance student learning while reducing test-related stress. In our study, students ubiquitously agreed that open-response, partnered, case-based exams were preferable to multiple-choice exams and that their stress levels were lower while learning was enhanced as a function of this testing strategy.