Studying physiology within a flipped classroom: The importance of on‐campus activities for nursing students’ experiences of mastery

Nursing students' experiences with test-enhanced learning in teams: A cross-sectional study

BACKGROUND

Many nursing students struggle with the disciplines of biosciences, particularly Anatomy, physiology, and biochemistry, which are introduced in the first year. Nursing students' motivation, prior knowledge, and academic performance matter, but teaching methods may also influence students' learning process. Retrieving knowledge through testing has previously proven to enhance learning to a greater extent than time spent on other classroom activities.

OBJECTIVE

The aim of this study was to explore nursing students' experiences with test-enhanced learning as a way of enhancing learning in Anatomy, physiology, and biochemistry.

DESIGN

The lectures in each topic were followed by testing five days later. The tests were typically multiple-choice tests with short reply-times. The effect was measured in terms of students' self-reported level of satisfaction with test-enhanced learning, and their performance on the final exam in Anatomy, physiology, and biochemistry. The tests were performed in teams to avoid stressful situations that could negatively affect the students' learning process.

RESULTS

A key achievement from introducing test-enhanced learning in the Anatomy, physiology, and biochemistry course was a perceived higher learning outcome and increased engagement and motivation among the students, resulting in resulting in more students achieving the highest grades (A and B). However, the students' academic results from upper secondary school also seemed to matter for their achievements on the final exam.

CONCLUSION

These results indicated that many students benefited from test-enhanced learning, suggesting that test-enhanced learning can be an important teaching strategy in nursing education, particularly for biosciences.

Nursing students' experiences of flipped classroom teaching method in higher education: a systematic review

BACKGROUND

During the COVID-19 pandemic face-to-face activities were suspended, boosting the delivery of online teaching. As students returned to campuses, the delivery of active learning teaching methods followed a blended learning style. The flipped classroom, which is a student-centred approach, appears to be an effective teaching method, generating improved learning outcomes. No systematic review has so far explored students' experiences of this teaching method - a knowledge gap that this review aims to address.

METHODS

Studies published between 2012 and 2023 were identified from seven databases. The JBI critical appraisal tool was adopted to select high-quality studies and add credibility. Following extraction of qualitative data, meta-aggregation was used to identify synthesised findings.

RESULTS

The findings were aggregated into seven categories. Based on meaning similarity, three synthesised findings were identified to answer the research question on how nursing students experience the flipped classroom method.

CONCLUSION

Several factors affect the student experience. Although variables are interrelated and complex to analyse, this approach is a valuable teaching method, positively experienced by students with the potential to improve engagement and learning outcomes. The group activities used as a feature of the flipped classroom can be seen as an instrument to deliver a safer and high quality of care.

The use of instructional videos to compensate for flexible physiology learning during the pandemic of COVID 19

BACKGROUND

This study aimed at using instructional videos in physiology created by students to improve the process of learning Physiology especially during the COVID-19 Pandemic which enforced the lectures to be online. Additionally, it allowed students to visualize and understand clinical scenarios and the physiological reasons behind them while assessing how much they stand to gain from the experience.

METHODS

This study is a project to implement FAIMER, ASU MENA-FRI Institute, Cairo, Egypt. In a foundation course for first-year medical students, the instructor utilized a variety of instructional methods including lecture, small group discussion, individual assignments, and reflection. Students were randomly allocated into 18 groups, then a topic in their physiology curriculum was chosen and they formulated a related case scenario, thereafter a video was made by themselves. This intervention was rewarded by activity mark in their course. Post-project questionnaire was used, and an external reviewer evaluated the videos presented by students. This study obtained IRB approval from the Faculty of Medicine, Ain Shams Medical Ethics committee.

RESULTS

the project helped students to improve their skills in problem-solving, teamwork, active learning, communication, planning, and time management. In addition, it also increased their confidence in their abilities to learn, face unexpected challenges, and achieve goals, while considering new life opportunities, those which became an option when the students searched by themselves and learned more about the different angles of medicine.

CONCLUSION

Compared to the traditional lecture format that focuses on memorizing definitions and theoretical structures, instructional videos can be regarded as an innovative teaching tool and a unique medical education method that allowed students to participate more in the learning process even if their lectures were online. This article proposes an active learning method in undergraduate medical education which compensate for limited face-to-face attended during the pandemic.

Examining the effects of student-centered flipped classroom in physiology education

BACKGROUND

The flipped classroom approach has gained increasing popularity in medical education. Physiology is a basic medical course that studies the phenomena and laws of human life activities, and is a crucial link course connecting preclinical courses and clinical courses. However, there is a paucity of data showing the effectiveness of the flipped classroom model for the entirety of physiology course in medical undergraduate students.

METHOD

131 sophomore students with clinical medicine major at Harbin Medical University were recruited and they were randomly allocated into two groups: the control group which was subjected to traditional lecture teaching (n = 69), and the experimental group which was subjected to flipped classroom teaching (n = 62). To assess the effect of flipped teaching, the usual performance and final exam scores were used to evaluate the physiology learning effectiveness of students. The correlation between the usual performance and final exam scores by Pearson method was also conducted in the two teaching groups. After course completion, an anonymous questionnaire survey was conducted among the subjects of flipped classroom group to assess students' opinion regarding the flipped classroom teaching.

RESULTS

Our results showed that the usual performance and final exam scores of students in the flipped classroom were both significantly higher than that in the traditional teaching class (P < 0.05). Moreover, our results also showed that the usual performance of students was significantly correlated with the final exam scores in the flipped classroom (r = 0.3945, P < 0.01), but not in the traditional teaching group (r = 0.1522, P = 0.2119). The results of questionnaire survey showed that 77.58% of the students believed flipped classroom teaching improved their knowledge acquisition. 70%~86% of students perceived that flipped classroom enhanced their learning abilities, including self-study ability, collaborative learning and problem-solving skills, and clinical thinking ability. In addition, about 60% of students acknowledged the teaching design and teaching environment, more students' engagement and presentation of group learning in the flipped classroom.

CONCLUSION

The flipped classroom teaching significantly improved students' learning effectiveness in physiology course, as indicated by final exam score and usual performance. It also promoted higher-order ability-set acquisition and allowed a rationalized formative evaluation system.

Scaffolding in Health Sciences Education Programmes: An Integrative Review

The complexity of health sciences programmes justifies scaffolding to support students in becoming competent health professionals. This article reports on an integrative review that aimed to describe the application of scaffolding in health sciences programmes. Twenty-nine sources, inclusive of theoretical and empirical studies, were reviewed. The sequencing of educational activities, the application of scaffolding tools or resources, frameworks for applying scaffolding, modelling, and fading represented the application of scaffolding in health sciences programmes. Awareness of the application of scaffolding in health sciences programmes could contribute to enhancing competence development among students when applied across all learning platforms.

Flipped versus traditional classroom and student achievement and cognitive engagement in an associate degree nursing fundamental course

BACKGROUND

There is a call for instructional transformation in nursing education to include an innovative approach. This study aimed to investigate the effects of the flipped classroom method on student achievement and engagement in an associate degree nursing course. This study investigated associate degree nursing studies students' achievement and cognitive engagement under traditional learning (n = 141) and flipped learning (n = 130). This study was conducted in two first-year cohorts enrolled in their nursing fundamental course, before and during the COVID-19 pandemic respectively at a Hong Kong community college.

METHOD

A mixed methods approach was used with quantitative (examination scores) and qualitative (semi-structured focus group interview) measures applied.

RESULTS

There was a significant increase in final exam scores for the flipped classroom, all p < 0.01, with a medium-to-large (d = 0.60) effect size. Students commented flipped classroom method promoted their cognitive engagement and the benefits that contributed to such a positive student achievement included more peer interaction and more opportunity to apply their knowledge.

CONCLUSION

This study contributed to our understanding of the effect of the flipped classroom method on student engagement in nursing education.

An international exploration of blended learning use in pre-registration nursing and midwifery education

AIM

To explore international experiences of using blended learning in preparing nursing and midwifery students for initial professional registration to inform future education policy.

BACKGROUND

The global nursing and midwifery skills shortage and need for an expanded nursing workforce that is fit for contemporary care delivery is widely acknowledged. The immense pressure the profession was already under because of austerity, staff shortages and increasingly complex healthcare needs has been worsened by the Covid-19 pandemic. The UK is extending and evaluating the use of blended learning programmes for pre-registration nursing and midwifery students to help address these issues. This study sought to explore relevant nursing and midwifery experiences from outside the UK to help inform future health professional education policy here and elsewhere.

DESIGN

Cross-sectional, sequential, mixed methods study PARTICIPANTS/SETTINGS: Nursing/nurse education leaders from across International Council of Nurses regions METHODS: Exploratory online survey (n = 32) and three follow-up case studies (March-May 2021). Participants' knowledge and experiences of blended learning were examined along with any perceived benefits for workforce development and successful strategies for addressing the challenges blended learning presents in this context. Case studies were developed inductively from survey responses and follow up telephone calls to provide more detailed information about reported successes.

RESULTS

Participants reported flexibility, cost effectiveness, increased student/tutor and student/student communication and interaction as benefits of blended learning. Challenges included the design and use of interactive learning resources, appropriate preparation and support for staff and students, the potential of blended learning to exacerbate otherwise hidden disadvantage and the need for multi-stakeholder cost/benefit evaluation.

CONCLUSIONS

Blended learning is used globally in the pre-registration education of nurses, midwives and other healthcare professionals. These results broadly mirror the literature regarding the benefits blended learning offers healthcare students, staff and organisations and the strategies employed to mitigate risk. As the deployment of blended learning nursing and midwifery programmes expands, further work is needed to address gaps in the current evidence base regarding the practice and impact of this approach. These concern adequate preparation and support of students and staff, ensuring access to appropriate equipment and connectivity, exploration of student perceptions that online learning is of lesser value and comprehensive multi-stakeholder, exploratory evaluation to uncover any hidden factors and impact.

TWEETABLE ABSTRACT

Blended learning plays an effective part in the education of pre-registration nursing and midwifery students to help tackle global workforce shortages, but further work is needed to address gaps in the current evidence base regarding the practice and impact of this approach.

Ters Yüz Sınıf Modelinin Hemşirelik Öğrencilerinin Yaşamsal Belirti Becerileri Üzerindeki Öğrenme Etkileri: Yarı Deneysel Bir Çalışma

Amaç: Bu çalışmanın amacı, ters yüz sınıf sınıf öğrenme modeli ile verilen eğitimin hemşirelik psikomotor, bilişsel ve becerilerine etkisini değerlendirmektir.Yöntem: Çalışmada yarı deneysel deney (n=40) ve kontrol gruplu (n=40), ön son test ölçümleri olan bir bir tasarım kullanıldı. Deney grubu yaşamsal bulgular modülünde teorik ve pratik öğretimde ters yüz eğitim modeli ile eğitim alırken, kontrol grubunda sadece geleneksel öğretim modeli ile eğitim aldılar. Öğrenci performanslarını değerlendirmek için bir bilgi testi ve beceri kontrol listesi kullanıldı.Bulgular: Post-test bilgi sınavı ve beceri sınavlarında en yüksek puanları ters yüz sınıf eğitimi alan öğrenciler aldı (sırasıyla X̄ =62.15±16.55; X̄ =45.25±14.77). Ayrıca gruplar arası psikomotor beceri sınavı post-test toplam puanları incelendiğinde, deney grubunun kontrol grubuna göre daha yüksek puanlar aldığı bulundu (sırasıyla X̄=38.92±0.85, X̄=30.79±1.41).Sonuç: Ters yüz sınıf modelinin hemşirelik eğitiminde kullanılmasının hem teorik bilgileri hem de psikomotor beceri kazanımını olumlu yönde etkilediği bulundu.

Enhancing the effectiveness of flipped classroom in health science education: a state-of-the-art review

BACKGROUND

In a flipped classroom, students acquire knowledge before class and deepen and apply this knowledge during class. This way, lower-order learning goals are achieved before class and higher-order skills are reached during class. This study aims to provide an overview of the factors that contribute to the effectiveness of the flipped classroom and how these factors can be stimulated. The effectiveness of the flipped classroom is conceptualized in this study as test scores, the achievement of higher learning goals, and student perceptions.

METHODS

A state-of-the-art review was conducted. The databases MEDLINE, PsycINFO, PubMed, Web of Science, and Scopus were consulted. The timeframe is 2016 till 2020. The studies were qualitatively analyzed according to the grounded theory method.

RESULTS

After screening the studies based on the inclusion-and exclusion criteria, 88 studies were included in this review. The qualitative analysis of these studies revealed six main factors that affect the effectiveness of the flipped classroom: student characteristics, teacher characteristics, implementation, task characteristics, out-of-class activities, and in-class activities. Mediating factors are, amongst other factors, the learner's level of self-regulated learning, teacher's role and motivation, assessment approach, and guidance during self-study by means of prompts or feedback. These factors can be positively stimulated by structuring the learning process and focusing the teacher training on competencies and learning-and teaching approaches that are essential for the flipped classroom.

CONCLUSION

This paper provides insight into the factors that contribute to the effectiveness of the flipped classroom and how these factors could be stimulated. In order to stimulate the effectiveness of the flipped classroom, the positively and negatively affecting factors and mediating factors should be taken into account in the design of the flipped classroom. The interventions mentioned in this paper could also be used to enhance the effectiveness.

Postgraduate Students' Experience of Using a Learning Management System to Support Their Learning: A Qualitative Descriptive Study

Introduction

Educational institutions worldwide have implemented learning management systems (LMSs) to centralise and manage learning resources, educational services, learning activities and institutional information. LMS has mainly been used by teachers as storage and transfer of course material. To effectively utilise digital technologies in education, there is a need for more knowledge of student experiences with digital technology, such as LMSs and especially regarding how LMSs can contribute to student engagement and learning.

Objective

This study aimed to gain knowledge about postgraduate nursing students’ experiences with the use of LMS in a subject in an advanced practice nursing master's programme.

Methods

A qualitative method with a descriptive design was employed. Two focus group interviews were performed with eight postgraduate nursing students from an advanced practice nursing programme at a university college in Norway. Data were analysed using qualitative content analysis.

Results

Three themes emerged from the data material: 1) A course structure that supports learning; 2) LMS tools facilitate preparation, repetition and flexibility; and 3) own responsibility for using the LMS for preparation before on-campus activities.

Conclusion

The course structure within the LMS seemed to be important to enhance postgraduate students’ ability to prepare before on-campus activities. Implementation and use of LMS tools can facilitate preparation, repetition and flexibility, especially when postgraduate students study difficult topics. Postgraduate students seem to have different views regarding their own responsibility for using the LMS to prepare before on-campus activities.

The Impact of the COVID-19 Global Pandemic on Undergraduate Nursing Students' Study of Anatomy and Physiology

The COVID-19 global pandemic caused major disruptions to the delivery of human Anatomy and Physiology courses to nursing students worldwide. The aim of the current study is to evaluate nursing students' experiences and perceptions of transitioning from a blended to a purely online study mode for first year Anatomy and Physiology courses during the global pandemic. Qualitative and quantitative methodologies were used with a sample of undergraduate nursing students enrolled at a regional Australian university across its three campuses. Descriptive statistical analysis was used to describe the study population. Content analysis was used to evaluate the participants' use of resources, experiences, and preferences in studying anatomy and physiology. There were 101 participants recruited in the study. Results indicated that face-to-face study mode (41.86%) was the preferred method of delivery during the global pandemic and participants were having a renewed appreciation for the blended study mode (38.37%). Online study mode was the least preferred (19.77%), with the participants' opinions of this mode of study not altered by the global pandemic. Although the COVID-19 global pandemic shifted the traditional teaching of anatomy and physiology in nursing programs to an online environment, the long-term impacts of this disruption have yet to be ascertained.

A blended learning teaching strategy strengthens the nursing students' performance and self-reported learning outcome achievement in an anatomy, physiology and biochemistry course - A quasi-experimental study

In nursing, bioscience is regarded as one of the cornerstones of nursing practice. However, bioscience disciplines as anatomy, physiology and biochemistry are considered challenging for students and the failure rate is high. In this study we explore a blended learning teaching strategy in an anatomy, physiology and biochemistry course for first year Bachelor nursing students. In the blended learning teaching strategy, short narrated online digital resources of bioscientific terms and concepts were integrated into the teaching design along with digital metacognitive evaluations of learning outcomes. Results show that compared to students receiving traditional face-to-face teaching, the students with a blended learning approach performed better on their national exam with a small to medium effect size (Cohen's d=0.23). Student course evaluations supported the blended learning delivery with small to medium effect sizes. The students reported that the digital resources supported their learning outcome achievement, that they better understood the teacher's expectations and that they were more satisfied with their virtual learning environment. This study adds to the growing literature of blended learning effectiveness in higher education, and suggests the use of digital resources as an enrichment of teaching and enhancement of students' study experience.

Impact of a Heutagogical, Multimedia-Based Teaching Concept to Promote Self-Determined, Cooperative Student Learning in Clinical Radiology

PURPOSE

 To date, didactic lecturing is a common method of university medical training. However, higher levels of competence to solve complex issues are hardly to be achieved with a largely passive learning style. We established and evaluated a heutagogical blended learning concept to investigate self-determined learning with a multimedia-based, interactive approach in the lecture room to teach clinical radiology.

MATERIALS AND METHODS

 In the 2019/2020 winter semester, we included 266 medical students in their fourth academic year in our prospective, observational study. Students participated in a series of 11 radiological lectures given by 10 lecturers. They were requested to prepare for lectures by watching learning videos. During the lecture, students had to answer key-feature questions (KFQ) in small groups and to jointly submit their answers by means of an audience response system (ARS). After each lecture and the exam, we conducted surveys and compared results with a historical control group. A focus group interview with lecturers was performed after conclusion of the lecture series.

RESULTS

 The students' overall impression of the "flipped classroom" concept and their examination grades were superior to historical controls (overall impression: 1.5 [95 % CI 1.4-1.6] vs. 2.7 [95 % CI 2.5-2.9] rated on a scale from 1 to 6, p < 0.001; examination grades: 1.8 [95 % CI 1.7-1.9] vs. 2.0 [95 % CI 1.9-2.0] rated on a scale from 1 to 5, p < 0.001). Most students agreed that learning videos (76.6 %), ARS (88.5 %), KFQ (76.5 %), and solution-oriented small group discussions (83.7 %) were useful. Lecturers stated an improved convergence of demands on learning and clinical competence. However, they also emphasized an increased initial effort for implementation.

CONCLUSION

 Students rated the overall benefit from the heutagogical "flipped classroom" concept as high. Examination grades improved. According to lecturers, the "flipped classroom" concept better matched later professional demands than traditional lectures.

KEY POINTS

  · The benefit of the "flipped classroom" concept for radiological lectures was rated high by students.. · Most students were satisfied with the multimedia and interactive elements of lectures.. · Lecturers considered heutagogical learning demands as appropriate for later clinical requirements..

CITATION FORMAT

· Teichgräber U, Ingwersen M, Mentzel H et al. Impact of a Heutagogical, Multimedia-Based Teaching Concept to Promote Self-Determined, Cooperative Student Learning in Clinical Radiology. Fortschr Röntgenstr 2021; 193: 701 - 711.