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

A comparison of the American Association of Colleges of Nursing's basic principles and benefits of competency-based nursing education and Fink's taxonomy

For over a century, Bloom's hierarchical taxonomy has been the gold standard for writing objectives for curricula and courses in programs of nursing. Development of courses and curricula with demonstration of nursing competencies as the outcome requires a more robust taxonomy. The American Association of Colleges of Nursing (AACN) The Essentials: Core Competencies for Professional Nursing Education requires nursing students to meet competencies in assertive leadership, personal development around adapting to ambiguity and change, and professional life-long learning. The purpose of this review was to compare Fink's taxonomy with the AACN basic principles and benefits of competency-based education. In conclusion, Fink's taxonomy of significant learning experiences provides an integrative framework to meet competencies of foundational knowledge, application, and integration of knowledge. Moreover, Fink's taxonomy includes additional areas of learning needed in nursing education such as learning how to learn, leadership and interpersonal skills such as in a human dimension of learning, caring about learning, and the ability to adapt to change. Educators should consider all kinds of learning for nursing practice and should reconsider the use of a hierarchical and content-centered teaching approach, with learning objectives written only at the cognitive level.

Using a flipped teaching strategy in undergraduate nursing education: students' perceptions and performance

BACKGROUND

Flipped teaching is an interactive learning strategy that actively engages students in the learning process. Students have an active role in flipped teaching as they independently prepare for the class. Class time is dedicated to discussion and learning activities. Thus, it is believed that flipped teaching promotes students' critical thinking, communication, application of knowledge in real-life situations, and becoming lifelong learners. The aim of this study was to describe the students' perception of flipped teaching as an innovative learning strategy. And to assess if there was a difference in students' academic performance between those who participated in a traditional teaching strategy compared to those who participated in flipped teaching intervention.

METHOD

A quasi-experimental design with intervention and control groups. A purposive sampling technique of undergraduate nursing students was used.

RESULTS

A total of 355 students participated in both groups, and 70 out of 182 students in the intervention group completed the survey. The students perceived a moderate level of effectiveness of the flipped teaching classroom as a teaching strategy. The result revealed that there is a statistically significant difference in the mean students' scores for the intervention group (M = 83.34, SD = 9.81) and control group (M = 75.57, SD = 9.82).

CONCLUSION

Flipped teaching proves its effectiveness in improving students' learning experience and academic performance. Also, students had a positive perception about flipped teaching as it allowed them to develop essential nursing competencies. Future studies must consider measuring the influence of flipped teaching on students' ability to acquire nursing competencies, such as critical thinking and clinical reasoning.

10.17533/udea.iee.v42n2e16

Objective

To evaluate the pedagogical skills of third-year nursing students at Yangzhou University (China).

Methods

A multisite quasi-experimental design was used in this study. Fifty-five participants were selected by convenience sampling. The Objective Structured Teaching Evaluation (OSTE) scale was used to assess teaching skills. The evaluation included four different stages: Teaching Background Analysis (E1), Lesson Plan Presentation (E2), Mock Class (E3) and Teaching Reflection (E4). Prior to the assessment, the teachers assigned homework to the students to complete at the four stations.

Results

Fifty-five nursing students with an average age of 21.3±0.7 years participated in the study, with a predominance of female students (78.2%). The highest mean score was achieved in E1 (83.1), followed by E2 and E3 (82.5 and 82.3 respectively), while the lowest mean score was found in E4 (79.6). In E3, instructors gave lower scores for class organisation, class characteristics and overall performance compared to the self-reported scores of the standardised students (p<0.05). More than 80% of the students strongly agreed and recommended the OSTE as the primary method for assessing teaching skills in the classroom.

Conclusion

Deficits in teaching skills were identified in the participating students; this information will allow specific interventions to improve the situation. The OSTE instrument was a useful method for assessing the pedagogical skills of undergraduate nursing students.

Assessment of Readiness Toward Flipped Learning Among Novice Nursing Students on Fundamental Nursing Care in Puducherry, South India

Background This study aimed to assess the readiness toward flipped learning (FL) among novice nursing students in fundamental nursing care in Puducherry, South India.  Methodology A cross-sectional descriptive study was conducted among 176 first-year B.Sc. Nursing students from three private nursing colleges by purposive sampling technique. In theory and practical classes, the students were taught fundamental nursing procedures such as oral medication, intramuscular injection, peripheral intravenous cannulation, and nasogastric tube feeding as FL. The study was conducted from November 2021 to March 2022. The responses were collected using the Nursing Students' Readiness for Flipped Classroom (NSR-FC) scale with four domains such as personal, technological, environmental, and pedagogical readiness. Pearson correlation and chi-square tests were used to analyze data by incorporating IBM SPSS Statistics for Windows, Version 25.0 (IBM Corp., Armonk, NY, USA). Results Among 176 nursing students, 73.9% were aged between 17 and 19 years, the majority (76.7%) were females, and 98% of them used mobile phones to access online FL content. Of the novice nursing students, 69.88% agreed, 27.84% strongly agreed, and 2.27% were in a neutral state for readiness to adopt FL in their nursing curriculum with a mean (standard deviation, SD) value of 77.02 (6.27). Among the four domains of readiness, a positive correlation was found between personal with technological readiness (P = 0.001; r = 0.446) and pedagogical with personal readiness (P = 0.003; r = 0.223). Statistically, a significant association was found between students' readiness toward FL with the occupation of the head of the family, gadgets used to access the FL materials, and Wi-Fi/internet availability in the institutions with a P-value <0.05. Conclusions The study showed highly positive readiness for FL among nursing students in nursing subjects. It can be leveraged with educational institutions' environmental and technological support by properly utilizing mobile devices, computer laboratories, and access to the internet/Wi-Fi for students from their entry level to enhance FL.

The effect of flipped learning on blood pressure knowledge and self-directed learning skills of first-year nursing students: A randomized controlled trial

AIM

This study investigated the effect of flipped learning on first-year nursing students' blood pressure knowledge levels and self-directed learning skills.

BACKGROUND

Flipped learning is an innovative approach that helps nursing students learn about blood pressure and how to measure how to measure blood pressure accurately. Flipped learning also promotes active and student-centered learning settings and encourages nursing students to develop self-directed skills.

DESIGN

This study adopted a pretest-posttest open-label randomized controlled trial.

METHOD

The sample consisted of 94 first-year nursing students randomized into experimental (n = 48) and control groups (n = 46). The experimental group participants were trained using the flipped learning model. Data were collected using a personal information form, the Blood Pressure Knowledge Test (BPKT) and the Self-Directed Learning Skills Scale (SDLSS).

RESULTS

There was no significant difference in pretest BPKT scores between the experimental and control groups. However, there was a significant difference in posttest BPKT scores between the experimental and control groups (p = 0.011). Moreover, there was a significant difference between the experimental group's mean pretest, posttest and follow-up SDLSS scores (p = 0.009).

CONCLUSION

The experimental group had a significantly higher mean posttest BPKT score than the pretest score. They had significantly higher mean posttest SDLSS total and "self-monitoring," "motivation," and "self-confidence" subscale scores than the pretest score.

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 impact of the transition from flipped classroom to online lectures on learning outcomes and student satisfaction in a rehabilitation medicine clerkship during the COVID-19 pandemic

BACKGROUND

The flipped classroom (FC) is a well-known active learning module that activates the prior knowledge of students and promotes their cognitive skills during in-class activities. However, most on-site teaching during the COVID-19 pandemic had to be conducted online. The FC in our rehabilitation medicine clerkship curriculum was also shifted to online asynchronous lectures (OLs), without real-time interactions. There is no previous comparison of effectiveness between these two methods. Therefore, this study aimed to compare learning outcomes and student satisfaction in both FC and OL models.

METHODS

The study design was a historically controlled study. A physical modality was chosen for the content. The FC group (n = 233), in the academic years 2018 and 2019, was assigned to perform a pre-class activity consisting of reading study materials. Thereafter, the in-class activity comprised a small-group case-based discussion. The OL group (n = 240) in the academic years 2020 and 2021 followed an online model during the COVID-19 lockdown. They were also asked to read the online materials and then watch a self-paced recorded lecture video on Learning Management Systems. The learning outcomes, including their multiple-choice questions (MCQs) scores, final exam scores, grade points, and letter grades, were evaluated. Their overall course satisfaction ratings were also collected.

RESULTS

The OL group had an overall higher MCQ score for the physical modality portion than the FC group (p = 0.047). The median (lower quartile, upper quartile) of the total 50-MCQ scores were 34 (31, 37) in the OL group and 33 (29, 36) in the FC group (p = 0.007). The median final exam scores of the OL and FC groups were 69.5 and 68.3, respectively (p = 0.026). The median grade points and the letter grades were not significantly different between the groups. The proportions of satisfaction were significantly higher in the FC group than in the OL group.

CONCLUSIONS

The OL group revealed significantly higher learning outcomes than the FC group. However, the FC group showed more satisfaction with interactivity than the OL group. The authors are of the view that a combination of both FC and OL methods will likely result in better outcomes.

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.

Utilizing gamification effect through Kahoot in remote teaching of immunology: Medical students' perceptions

INTRODUCTION

Gamification of learning is a novel pedagogical approach in education, and Kahoot is one of the game-based learning platforms widely used for formative assessments in real-time. This study aimed to explore the medical students' perception of using Kahoot in remote learning.

METHODS

The mixed-method study was carried out among 72 medical students (in third-year) at Eastern University, Sri Lanka, following a formative assessment on immunology conducted via zoom video conferencing and Kahoot. The students' perception was collected through a google form, which consisted of 13 statements with a 5-point Likert scale and an open-ended question. Descriptive statistics and Mann-Whitney test were computed using SPSS ver. 25. A content analysis was employed to interpret the qualitative statements.

RESULTS

The participants' age ranges from 23-28 years with male-female ratio of 1:1.57. The majority of the students felt happy (73.6%) while playing Kahoot remotely and recommended it (84.7%) for formative assessment in future. The participants agreed that Kahoot increased the focus, understanding of the subject, helped retain knowledge, motivated them to learn, provided fun during learning, and kept them active throughout. The majority of the participants agreed that Kahoot was an effective tool for distance learning. Internet connectivity and switching between two applications were identified as difficulties while playing remote mode Kahoot quizzes.

CONCLUSION

The online gaming platform Kahoot has a positive impact on learning immunology. Kahoot maintains its fun and enjoyable nature and motivates students to learn during remote teaching of immunology.