The effects of flipped classroom characterized by situational and collaborative learning in a community nursing course: A quasi-experimental design

Abstract

Background: Since traditional teaching could not help to develop competences, flipped classroom has caught the sight of researchers. Despite the uptake of flipped classroom in other disciplines, there is a dearth of evidence available about the use in nursing curricula. In addition, there is no consensus on how to best implement a flipped classroom.

Objective: This study aimed to (1) develop a flipped classroom underpinned by constructivism theory and (2) to verify its effectiveness.

Design: This study adopted a quasi-experimental design.

Setting and participants: This study was conducted in 2018 spring semester at a University in East China with 6th semester undergraduate nursing students in four parallel classes in Community Nursing Course.

Methods: A flipped classroom characterized by situational and collaborative learning was developed and carried out with two classes (intervention group, n = 98). In-class lectures was applied for the other two classes (control group, n = 90). Course examination score, experience (course experience questionnaire, CEQ), and students' appraisal were used to verify the effectiveness of flipped classroom.

Results: Compared to control group, the examination score was higher for intervention group. As for the four domains of CEQ, good teaching domain rating was lower, learning burden domain rating was higher for the intervention group. There was no statistical difference in classroom quality and harvest domains. More students in intervention group chose the course helped them in developing "critical thinking" and "self-cognition and evaluation" abilities. Satisfaction rating of groups was not statistically different.

Conclusions: Flipped classroom was efficient in improving students' academic performance and promoting development of higher-level thinking abilities; however, it failed in improving students' satisfaction and course experience. These findings suggest that active learning strategies such as situational and collaborative learning of group problem solving and discussion should be integrated into nursing curriculum and refinement to flipped classroom are needed to create students' buy-in.

Keywords: Collaborative learning; Constructivism theory; Course experience; Critical thinking; Flipped classroom; Learner-centered teaching; Pedagogy; Situational learning.