ArticleLiterature Review

Exploring Flipped Classrooms in Undergraduate Nursing and Health Science: A Systematic Review

August 2022
Nurse Education in Practice 64(27):103417

DOI:10.1016/j.nepr.2022.103417

Authors:

University of Ontario Institute of Technology

We conducted a systematic review to investigate the effect of implementing flipped classroom designs on academic performance, student satisfaction and self-efficacy in undergraduate health science disciplines. Blended learning approaches, including the flipped classroom, have been increasingly implemented in higher education. To date, studies examining the effectiveness of the flipped classroom in nursing and health sciences programs have reported mixed findings. We used the PRISMA framework and searched electronic databases (Education Source, ERIC via ProQuest, Scholars Portal, CINAHL, Pubmed) with the terms "flip* class", "health," and "undergraduate" or "higher education". Original research articles were limited to peer-reviewed, quantitative and/or mixed-methods studies published between 2010-2021. We extracted data through a full-text screening and of the articles. Three main themes emerged from the 16 articles reviewed, including positive gains in academic performance (n=8/12 studies reporting; 67% studies), student satisfaction (n=7/13 studies reporting; 54% studies) and increased self-efficacy (n=1/1 reporting; 100% studies). Effect sizes demonstrated significant heterogeneity in these outcome measures. Note that none of these studies reported a negative effect for flipped classroom interventions. Structured design of teaching strategies and curriculum appears to be an important determinant of performance, satisfaction and self-efficacy. Studies on flipped classrooms in undergraduate health sciences disciplines indicated positive changes in academic performance, student satisfaction and self-efficacy linked to well-designed curriculum. Methodological limitations in the studies reviewed include the absence of demographic analysis, minimal descriptions of the flipped classroom curriculum design, inadequate data reporting and the absence of randomized, comparison groups. Future research should focus on pre-class, in-class and post-class flipped classroom design, careful documentation of research methods and improving the quality of data collected.

Flipped Classroom and its Effects on Student's Academic Performance and Behaviour

Article

Full-text available

Sep 2024

Blended Learning and Flipped Classroom in Higher Engineering Education: Case Study and Students’ Perception in the Post-COVID-19 Period

Preprint

Full-text available

Jun 2024

Andrzej Ożadowicz

The period of the COVID-19 pandemic resulted in a rapid development of innovative education methods, in particular using e-learning and remote work tools. The effects of this development are also post-pandemic changes in formal teaching regulations, in particular in higher education, allowing classes and lectures to be carried out with Blended Learning or Flipped Classroom methods. This paper provides information about a case study of implementing ICT technologies with elements of the mentioned methods in one of the subjects at a technical university. The implemented tools and solutions in the field of e-learning and interactivity are presented, along with information regarding their perception by students during two academic years in the post-COVID-19 period. The analysis of results of these information and student evaluations indicates their generally positive approach to such innovations in the educational path, and at the same time shows significant challenges for teachers to increase the attractiveness and effectiveness of the teaching process and the development of practical, technical skills of students.

Blended Learning and Flipped Classroom in Higher Engineering Education: Students' Perception in the Post-COVID-19 Period

Preprint

Full-text available

May 2024

Andrzej Ożadowicz

Inverted classes as a successful tool to overcome teaching and learning challenges imposed by COVID-19 lockdown to food microbiology laboratory classes

Article

Full-text available

Mar 2023

This study evaluated if the online inverted classes (IC) model maintained high students’ learning engagement and performance on the laboratory component of Food Microbiology during an academic year dominated by COVID-19-lockdown, compared to pre-pandemic years. Porto University students from 2 courses (n = 36-Pharmaceutical Sciences; n = 59-Nutrition Sciences) were engaged. A high rate of students answered they prefer the IC rather than lecture-only style delivery mode and were involved in the IC learning process (prepared classes asynchronously; participated in case-studies resolution during synchronous classes). Very good laboratory final performances were maintained as in pre-pandemic years. Variable perceptions about work volume and adaptation to face-to-face laboratory classes were observed among both groups, potentially related to different course organization and defined learning outcomes/competences.

The effects of ‘small private online course + flipped classroom’ teaching on job competency of nuclear medicine training trainees

Article

Full-text available

Dec 2024
BMC Med Educ

Background Nuclear medicine is an interdisciplinary field that integrates basic science with clinical medicine. The traditional classroom teaching model lacks interactive and efficient teaching methods and does not adequately address the learning needs and educational goals associated with standardized training for residents. The teaching model that combines Small Private Online Courses (SPOCs) with a flipped classroom approach is more aligned with the demands of real-life scenarios and workplace requirements, thereby assisting students in developing comprehensive literacy and practical problem-solving skills. However, this innovative teaching model has yet to be implemented in Nuclear medicine courses. This study aimed to explore whether the post-training competence for residents can be improved based on this new teaching model. Methods A total of 103 first-year residents from Sichuan Provincial People’s Hospital were randomly assigned to either an experimental group (n = 52) or a control group (n = 51) between July 2019 and June 2023. The experimental group utilized a SPOC and flipped classroom-blended teaching model, while the control group received traditional lecture-based learning (LBL). We assessed the theoretical evaluation scores and questionnaire responses from both groups to determine the effectiveness of the new pedagogical approach. Results Residents in the experimental group demonstrated a superior understanding of nuclear medicine content compared to those in the control group, achieving higher scores on pre-class assessments, after-class tests, and final exams (P < 0.01). A majority of the residents in the experimental group expressed that the innovative teaching model, which integrated SPOC and a flipped classroom approach, significantly enhanced their motivation and contributed to the development of their ‘professional skills,’ ‘patient care,’ ‘interaction and teamwork,’ ‘teaching proficiency,’ and ‘learning capabilities’. The teaching satisfaction survey indicated that the experimental group reported significantly higher levels of ‘overall satisfaction,’ as well as greater satisfaction with ' teaching methodologies ' and ' fulfillment of targeted clinical skills,’ compared to the control group (P < 0.01). Conclusions The SPOC and flipped classroom teaching model is better than traditional LBL in enriching residents’ professional knowledge and cultivating their post-training competence. It can effectively promote educational quality, improve residents’ learning, and enhance their satisfaction.

Decision Support Systems for Lifelong Learning: Leveraging Information Systems to Enhance Learning Quality in Higher Education

Article

Nov 2024

Qing Gao

This study investigates the impact of technology adoption—specifically AI Tools, Decision Support Systems (DSS), and Learning Management Systems (LMS)—on higher education. As these technologies reshape educational paradigms, understanding their effects on learning performance, satisfaction, and the adoption and usage of these tools is critical. The research aims to empirically examine the relationships between technology adoption, self-efficacy, and key educational outcomes. It explores the direct effects of AI Tools, DSS, and LMS on learning performance and satisfaction, as well as the role of self-efficacy as a mediator. Utilizing a quantitative approach, the study collected data from 356 students via a distributed questionnaire. Variables measured include technology adoption, self-efficacy, learning performance, satisfaction, and adoption and usage of educational tools. Data analysis was conducted using SPSS and Origin, incorporating regression, mediation, and moderation analyses. The study found significant positive effects of technology adoption on learning performance (β = 0.45, p < 0.01), satisfaction (β = 0.40, p < 0.01), and adoption and usage (β = 0.50, p < 0.01). Self-efficacy significantly mediated these relationships, indicating that higher confidence in using technology enhances its benefits. This research extends Bandura's social cognitive theory by empirically validating the mediating role of self-efficacy in technology adoption within educational contexts. The findings provide actionable insights for educators and policymakers, suggesting that boosting students' confidence in using technology can amplify its positive effects on learning outcomes.

Comparison of education using the flipped class, gamification and gamification in the flipped learning environment on the performance of nursing students in a client health assessment: a randomized clinical trial

Article

Full-text available

Aug 2024
BMC Med Educ

Background Since effective education is one of the main concerns of every society and, in nursing, can lead to the education of successful people, the development of learning and teaching methods with greater effectiveness is one of the educational priorities in every country. The present study aimed to compare the effect of education using the flipped class, gamification and gamification in the flipped learning environment on the performance of nursing students in a client health assessment. Methods The present study was a Parallel randomized clinical trial study. The participants were 166 nursing students. The clinical trial data was collected from December 14, 2023, to February 20, 2024. The inclusion criteria were nursing students who had passed the first semester, who were willing to participate and install the app on their mobile devices, and who had no experience with the designed application for this study. The participants were allocated to four groups with colored carts. In the first group, teaching was performed via gamification in a flipped learning environment; in the second group, teaching was performed via the gamification method. A flipped class was implemented in the third group. In the fourth group, the usual lecture method was used. The practical performance to assess the physical health assessment with 10 questions using the key-feature questions, along with the satisfaction and self-efficacy of the students, was also checked with questionnaires. Results In this study, 166 nursing students, (99 female and 67 male), with an average (standard deviation) age of 21.29 (1.45) years, participated. There was no statistically significant difference in the demographic characteristics of the participants in the four intervention groups (P > 0.05). Comparing the results before and after the intervention, the results of the paired t test indicated a significant difference in the satisfaction, learning and self-efficacy of the learners (P < 0.001). In the comparison of the four groups, the ANOVA results for the comparison of the average scores of knowledge evaluation and satisfaction after intervention among the four groups indicated a statistically significant difference (P < 0.001). When the knowledge evaluation scores of the groups were compared, the scores for gamification in the flipped learning environment were significantly different from the other methods (P < 0.05), and there was no significant difference between the scores for the flipped class and lecture methods (P = 0.43). According to the ANOVA results, when comparing the satisfaction scores of the groups, the students in the flipped learning environment and gamification groups were more satisfied than the flipped class and lecture groups (P < 0.01). Conclusion Based on the results of the present research, it can be concluded that teaching methods have an effect on students’ learning and satisfaction. The teaching method has an effect on the satisfaction of the students, and the use of the flipped class method with the use of gamification was associated with more attractiveness and satisfaction in addition to learning. Teachers can improve the effectiveness of education with their creativity, depending on situation, time, cost, and available resources, by using and integrating educational methods.

Use of Generative AI Tools to Facilitate Personalized Learning in the Flipped Classroom

Chapter

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Feb 2024

With the development of technology, AI has been the subject of intense research in the field of education, with ChatGPT, the adoption of generative AI in education. But generative AI has only gained attention in the last few years. Therefore, there are not many research results on the application of generative AI in flipped classrooms, and there are many questions that need to be explored and verified by researchers. In this study, a flipped classroom combined with generative AI tools to promote personalized learning was studied. A theme in the music course was selected for course design and a pilot study was conducted. The results show that teachers and students have very different views on this research, and this phenomenon is summarized and analyzed, and finally some suggestions are made to help better use generative AI tools to promote personalized learning in the flipped classroom.

Use-of-Generative-AI-Tools-to-Facilitate-Personalized-Learning-in-the-Flipped-Classroom

Chapter

Feb 2024

Different perceptions of international MBBS students to flipped classroom model in comparison with native Chinese students in the Biochemistry module

Article

Dec 2023

In the past few decades, more and more international students have been studying in Chinese medical universities. This study aimed to examine the satisfaction of international Bachelor of Medicine & Bachelor of Surgery (MBBS) students in the 'flipped classroom' for medical courses and to analyze their perception in comparison to native Chinese students. The course chosen to evaluate the flipped classroom model (FCM) for students was Biochemistry. Seventy-seven second-year MBBS students and one hundred and seven Chinese students participated in the study module. Pre-class material was provided to study before class, while the in-class session included a pre-quiz, interactive lectures, and group discussions. A self-administered questionnaire was filled out by the students to check their perception named as FCM-perceived goals questionnaire (FCM-PGQ). Compared with Chinese group, which shows a positive response is 63.83%, 74.65% of international students show positive response and are more satisfied with FCM than Chinese students (p < 0.05). This teaching model provided them benefits in cognitive effectiveness (78.4%), acquisition of student skills (76.2%), obtaining an advanced learning environment (76.7%), and better self-assessment & course evaluation/satisfaction (66.3%). It is noteworthy that one of the differences between international and Chinese students is their attitude toward time management of FCM. Chinese students think that the period taken by FCM is suitable, while international students think that FCM is a time-consuming method (p < 0.05). Although it takes more time to fulfill the learning needs of international students, FCM would be more helpful for international MBBS students in the Biochemistry course than for Chinese students.

Cultivation of Professional Ethics and Professional Quality in Teacher Education—An Emergence on the Fit between Social Needs and Training of Normal Students

Article

Full-text available

Dec 2023

Wei Wei

Use of active learning classrooms in health professional education: A scoping review

Article

Full-text available

Nov 2023

Background: Active learning approaches, such as the use of active learning classrooms, can be an important measure to prepare health professional students for work-life. In addition to teaching approaches, the design of the classroom or learning spaces could facilitate learning. Although active learning classrooms are used in health professional education, no previous scoping review has investigated their use and associated outcomes. Objective: A scoping review was conducted to provide an overview of existing studies on the use of active learning classrooms in health professionals’ education. Design: Scoping review using the framework of Arksey and O'Malley Methods: A systematic search was performed in ERIC, CINAHL, PsycINFO, Ovid MEDLINE, and Ovid EMBASE for papers published between January 2012 and January 2023. Hand searches of the reference lists of the included studies were also conducted. Inclusion criteria were as follows: studies using qualitative, quantitative, or mixed methods; studies including undergraduate, graduate, or postgraduate health professional students or teachers; studies that investigated students’ and teachers’ use of active learning classrooms or similar concepts in higher education; and studies published in English, Swedish, Danish, Norwegian, Spanish, or Portuguese in peer-reviewed journals. Pairs of authors independently assessed the eligibility of the studies and extracted the data, which were thematically grouped. The scoping review protocol was published with the Open Science Framework prior to the study selection process. Results: The review included 11 papers from 10 studies. Most studies were published between 2018 and 2022, exploring students’ perspectives. Three thematic groups were identified, suggesting that active learning classrooms (1) enhance a positive atmosphere and engagement but can be challenging; (2) facilitate students’ interactions; and (3) have the potential to stimulate active learning and co-construction. Conclusions: The use of active learning classrooms in health professional education can facilitate interactions among students, between students and teachers, and between students and class content. However, the design of active learning classrooms can both enhance and challenge students’ engagement and active participation. Teachers do not necessarily change their teaching approaches when compared to teaching in a traditional classroom. Future research should explore how to facilitate teachers’ use of the opportunities in active learning classrooms in health professional education and students’ learning outcomes, as well as the effect of high-technology active learning classrooms versus low-technology active learning classrooms on the intended learning outcome.

Japanese Flipped Classroom Knowledge Acquisition Based on Canvas Web-Based Learning Management System

Article

Full-text available

Aug 2023

INTRODUCTION: Since 2010, flipped classrooms and Canvas-based online learning spaces have been widely recognized by colleges and universities, changing the traditional Chinese learning space. OBJECTIVES: To ensure that students learn effectively, learning management systems must be applied. The issue of integrating classroom space and electronic learning management systems gives students the freedom and flexibility to manage their time after school. METHODS: In this study, Japanese language skills were learned through questionnaires, interviews, and classroom observations, and two students with similar disciplines and conditions were selected from the experimental and control categories for a learning reform experiment during the semester's learning cycle. RESULTS: By comparing the characteristics and effectiveness of the experimental and tutorial courses, an appropriate Japanese language course was designed and developed, and some constructive suggestions were made for the application of the Canvas network to Japanese language courses. CONCLUSION: The use of flipped teaching methods and structured e-learning methods in the education of basic Japanese language majors can improve students' academic performance and sense of cooperation.

Using cognitive load theory to evaluate and improve preparatory materials and study time for the flipped classroom

Article

Full-text available

May 2023
BMC Med Educ

Background Preclinical medical education is content-dense and time-constrained. Flipped classroom approaches promote durable learning, but challenges with unsatisfactory student preparation and high workload remain. Cognitive load theory defines instructional design as “efficient” if learners can master the presented concepts without cognitive overload. We created a PReparatory Evaluation Process (PREP) to systematically assess and measure improvement in the cognitive-load efficiency of preparatory materials and impact on study time (time-efficiency). Methods We conducted this study in a flipped, multidisciplinary course for ~ 170 first year students at Harvard Medical School using a naturalistic post-test design. For each flipped session (n = 97), we assessed cognitive load and preparatory study time by administering a 3-item PREP survey embedded within a short subject-matter quiz students completed before class. Over three years (2017–2019), we evaluated cognitive load- and time- based efficiency to guide iterative revisions of the materials by content experts. The ability of PREP to detect changes to the instructional design (sensitivity) was validated through a manual audit of the materials. Results The average survey response rate was ≥ 94%. Content expertise was not required to interpret PREP data. Initially students did not necessarily allocate the most study time to the most difficult content. Over time, the iterative changes in instructional design increased the cognitive load- and time-based efficiency of preparatory materials with large effect sizes ( p < .01). Furthermore, this increased the overall alignment of cognitive load with study time: students allocated more time to difficult content away from more familiar, less difficult content without increasing workload overall. Conclusions Cognitive load and time constraints are important parameters to consider when designing curricula. The PREP process is learner-centered, grounded in educational theory, and works independently of content knowledge. It can provide rich and actionable insights into instructional design of flipped classes not captured by traditional satisfaction-based evaluations.

The application of flipped classroom teaching model combining scientific research expansion in the teaching of thoracic surgery

Article

Nov 2024
Tech Health Care

Background The Department of Thoracic Surgery of the First Clinical Medical College of Guangdong Medical University took the lead in introducing the flipped classroom teaching mode combining scientific research expansion into the undergraduate teaching of clinical medicine in 2018. This teaching mode has achieved good teaching effects. Objective Through the flipped classroom based on role exchange, it is observed whether students can achieve a comprehensive understanding of lung cancer, whether they have basic scientific research quality, innovative application ability and stimulate students’ enthusiasm for learning. Methods During the research process, teachers prepare their lessons meticulously. Students interpret the study materials line by line as required, identify difficulties, and engage in discussions to resolve them. If unable to resolve, they can ask questions through various channels such as QQ, WeChat, or email. This allows students to choose their study time independently, achieving personalized learning. Teachers adjust in real-time and effectively formulate teaching plans, objectives, and progress. Results For this teaching method reform, most students believed that this teaching improved their teamwork skills, PPT creation skills, and active problem-solving abilities, improved their understanding of scientific research, stimulated their interest in scientific research, deepened their understanding and understanding of lung cancer diagnosis and treatment, and enhanced their enthusiasm for learning. Conclusion This not only stimulated students’ enthusiasm for learning thoracic surgery but also improved their scientific research and clinical thinking abilities, resulting in good teaching outcomes.

Embedding the Flipped Classroom Approach to Support Student Learning in Animal Handling and Clinical Skills: Practical Classes Throughout a Veterinary Curriculum

Article

Dec 2024
J VET MED EDUC

A comprehensive bank of flipped classrooms was developed to help students prepare for animal handling and clinical skills practical classes. Flipped classroom is a type of blended learning. In the context of clinical skills, it is designed to provide students with online learning resources prior to attendance at practical classes. The initiative was catalyzed by the pandemic, and the resources continue to be embedded throughout the curriculum. A team approach was used for the development of the bank, and the design embraced relevant pedagogical frameworks and active learning techniques. Feedback was gathered from a small group of students who completed an online form after each practical class throughout the academic year and wrote a reflective piece at the end of the project. Instructors who delivered practical classes participated in focus group discussions. Students particularly liked flipped classrooms that were well designed with a range of content and interactivity. The main benefits for students of the flipped approach were being more prepared and confident, less anxious, and making better use of in-class time to focus on learning skills. One of the main challenges encountered by instructors was managing a group when some students had not done the prework. A few other issues were mentioned, including when the standardized design template was not followed and the workload involved in continuing to enhance and expand the resources. Teamwork and training were crucial to the successful production of the large bank of flipped classrooms. Sharing our experience with the wider education community, within and beyond our institution, continues to be one of team's aims.

The Effect of Flipped Classroom Model and Kahoot for Intramuscular Injection Training on Nursing Students’ Knowledge, Skills and Self-Efficacy Levels

Article

Full-text available

Sep 2024

Objective: To investigate the effects of using a flipped classroom model and Kahoot for intramuscular injection skill training on the knowledge, skill, and self-efficacy levels of nursing students. Methods: The quasi-experimental study was conducted with a total of 180 nursing students (intervention group n=95, control group n=85). Data were collected using a “Knowledge Level Questionnaire,” “Psychomotor Skill Control Form,” and the “General Self-Efficacy Scale”. The flipped classroom model was used in the intervention group. In addition, the multiple-choice questions in Kahoot were asked to both groups. Results: The final test knowledge scores and general self-efficacy scores of the students in the intervention group were found to be statistically higher than the students in the control group (P<.001). The psychomotor skill scores of the students in the intervention group were statistically higher than the students in the control group (P=.010). Regarding the use of Kahoot, the percentage of correct answers for each question was significantly higher for the intervention group than the control group (P<.05). Conclusion: It can be said that the flipped classroom model and Kahoot are effective in intramuscular injection training. The flipped classroom model and Kahoot could also be used for the teaching of other basic nursing skills.

Assessing Content Assimilation in Health Research Methodology: A Comparative Study of Lecture and Flipped Classroom Instruction

Article

Full-text available

Jan 2024

Virtual education has evolved significantly, driven by the integration of Information and Communication Technology (ICT) resources, particularly during the COVID-19 pandemic. Health Sciences, with their practical components, present unique challenges in virtual education, including maintaining student engagement. This study aimed to compare the effectiveness of the flipped learning methodology with and without in-class content reinforcement in a virtual classroom for previously assimilated materials within Health Sciences. The study involved students in a Kinesiology program using the Blackboard Learn platform. Two groups were established: one completing a questionnaire at the beginning of the virtual class (FLI group) and the other at the end following a content reinforcement session (FLI+TRA group). While no statistically significant score differences were found between the two groups, the FLI+TRA group showed higher pass rates and improved average scores, indicating practical benefits. These results suggest that combining flipped learning with traditional in-class instruction can enhance content assimilation in virtual education, fostering increased student engagement and participation. However, further research is needed to explore the full implications and adaptability of this approach. In conclusion, this study highlights the potential of the FLI+TRA approach to improve learning outcomes in complex subjects like Epistemology and Research Methodology within Health Sciences. As virtual education continues to evolve, educators should consider this hybrid teaching model as a valuable tool to provide a more holistic and effective learning experience.

Cognitive engagement of nursing undergraduates in blended learning: A parallel mixed method study

Article

Aug 2023
NURS EDUC TODAY

Background: Blended learning is being integrated into undergraduate nursing education at all levels and from all directions. Cognitive engagement is not only an embodiment and guarantee of students' engagement into the curriculum from a cognitive level, deep engagement and high-level thinking, but also an important indicator of whether students are effectively engaged in the blended learning curricula. However, no studies have been seen to investigate the cognitive engagement of nursing undergraduates in the blended learning curricula and its influential factors. Objectives: To explore nursing undergraduates' cognitive engagement during the blended learning curricula and its influential factors. Design: A convergent parallel mixed-methods was used. Data were collected between November 2021 and May 2022, inclusive. Settings and participants: The study was carried out in the nursing school at a university in China. Participants including students undertaking entry to the blended learning curricula. Methods: In the quantitative component (n = 142), participants' cognitive engagement was investigated and factors associated with it were examined using univariate analysis, correlation analysis and multiple regression analysis. During this period, personal, semi-structured interviews were conducted with a subset of these participants (n = 15) to understand participants' cognitive engagement experiences. Results: The cognitive engagement of nursing undergraduates was at a moderate level and the cognitive engagement experiences were reflected in the four themes of Reconstitution, Connection, Elaboration and Retention. The influential factors of cognitive engagement were learning activities (β = 0.226, p = 0.004), autonomy (β = 0.158, p = 0.047), academic self-efficacy (β = 0.311, p < 0.001, β = 0.271, p < 0.001) and social interaction (β = 0.358, p < 0.001). Conclusions: The cognitive engagement of nursing undergraduates in the blended learning curricula needs to be improved. To maximize promote cognitive engagement of nursing undergraduates in the blended learning curricula, educators should design diverse learning activities, engage in high quality social interactions with students, and maximize students' autonomy and self-efficacy.

Nursing students' skills in applying short-stretch compression bandages using the control of compression bandaging score

Article

Jun 2023

Aim To assess the feasibility using the Control of Compression Bandaging (CCB) score to measure skills development on short-stretch compression therapy during a second-year nursing students' workshop. Design A quasi-experimental pilot study with one group. Method All students followed a blended learning unit comprising an e-learning unit on leg ulcers and compression therapy including videos, followed by hands-on workshops where they could exercise how to apply short-stretch compression bandages. Clinical nurse specialists in wound care collected pre- and post-workshop measures. Data collection included feasibility, absolute pressure under compression bandages and the CCB score. Results Six clinical nurse specialists (CNSs) collected data and 16 students participated in this pilot study. The mean application time was 8.02 minutes (min=2, max=20) pre and 9.25 minutes (min=5, max=17) post workshop. Pressure under compression bandages increased at the forefoot (P=0.01) and the calf muscle base (P=0.03) post workshop. One extreme outlier was observed. In addition, the CCB score increased from 3.57 to 4.47 (P=0.16). Using pressure measuring devices was described as essential by all the CNSs and the CCB score was easy to use. Conclusion Using the CCB score and pressure measuring devices were feasible during an undergraduate education session. Recruitment procedure and modality of data collection were satisfactory. This score may be a valuable way to assess students' skills in short-stretch compression therapy. If used for formal assessment, a passing score should be defined.

Profiling students via clustering in a flipped clinical skills course using learning analytics

Article

Nov 2022
MED TEACH

Flipped classrooms have become popular as a student-centered approach in medical education because they allow students to improve higher-order thinking skills and problem-solving applications during in-class activities. However, students are expected to study videos and other class materials before class begins. Learning analytics and unsupervised machine learning algorithms (clustering) can be used to examine the pre-class activities of these students to identify inadequate student preparation before the in-class stage and make appropriate interventions. Furthermore, the students' profiles, which provide their interaction strategies towards online materials, can be used to design appropriate interventions. This study investigates student profiles in a flipped classroom. The learning management system interactions of 375 medical students are collected and preprocessed. The k-means clustering algorithms examined in this study show a two-cluster structure: 'high interaction' and 'low-interaction.' These results can be used to help identify low-engaged students and give appropriate feedback.

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

Article

Full-text available

Jan 2022
BMC Med Educ

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.

Flipped classroom improves Omani nursing students performance and satisfaction in anatomy and physiology

Article

Full-text available

Jan 2021
BMC Nurs

Abstract Background Nursing students struggle with anatomy and physiology course because of the complicated terminology and the difficulty in handling large amounts of information. New, innovative instructional strategies must be integrated into nursing education to improve nursing students’ performance in this challenging bioscience course. The aim of this study was to determine the impact of an innovative teaching strategy, the flipped classroom, on the performance and satisfaction of Omani nursing students in an anatomy and physiology course. Methods A quasi-experimental design was used with two classes of 112 first-year nursing students at the College of Nursing, Sultan Qaboos University, Oman. Online videos and active-learning activities about the respiratory system were developed and implemented in an anatomy and physiology course with 53 first-semester nursing students. The control group consisted of a previous cohort of 59 students enrolled in the same course but taught with a traditional lecture approach. The impact of the flipped classroom strategy was measured by students’ performance on the final examination and students’ self-reported satisfaction. Wilcoxon signed-rank and Mann-Whitney U tests were used to compare students’ academic performance. Results Our results showed that the performance of the flipped classroom group was better than that of the traditional lecture group. The mean scores of students instructed with the flipped classroom method on the respiratory system items in the final examination were significantly higher than those of the control group, U = 1089.00, z = − 2.789, p

Learning outcomes of a flipped classroom teaching approach in an adult-health nursing course: a quasi-experimental study

Article

Full-text available

Sep 2020
BMC Med Educ

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.

Facilitating Students' Critical Thinking and Decision Making Performances: A Flipped Classroom for Neonatal Health Care Training

Article

Full-text available

Jul 2020
EDUC TECHNOL SOC

In various case-based training courses, such as engineering, science and medical courses, students need to learn not only the skills to deal with problems, but also the knowledge to identify problems and make correct decisions. Such educational objectives have been recognized by educators as being important but challenging. In this study, an RSI (Recognize, Summarize, Inquire)-based flipped classroom is proposed to achieve this aim. Moreover, an explorative study was designed to probe the effectiveness of the proposed approach in a nursing case-based training course. The case-handling performances of the students trained with the RSI-based flipped classroom and those trained with the conventional flipped classroom were compared. The findings reveal that the RSI-based flipped classroom promoted the students' learning achievement, self-efficacy, critical thinking, and satisfaction more than the conventional case-based training did.

Flipped learning: Turning medical education upside down

Article

Full-text available

Sep 2019

Background: Flipped learning is an approach in which core teaching is delivered using online material viewed prior to face-to-face learning, applying knowledge gained from online material. Core teaching in a module for third-year undergraduate medical students was based around a 1-week course comprising 32 hours of lectures. Feedback suggested that students were poorly engaged and attendance was poor. Objectives: To develop and evaluate a programme of learning for medical students using flipped learning. Methods: Core lectures were videoed and students were advised to watch online at home in the morning prior to a case-based interactive discussion session in the afternoon. Feedback was undertaken prior to and following change in delivery; changes in Likert scale feedback were assessed. Thematic assessment of free-text feedback was undertaken. Results of in-course assessment examinations were compared prior to and following change in delivery. Results: Student feedback showed a significant improvement in satisfaction with flipped learning compared to standard lectures, both in scores and free-text feedback. Results of in-course assessments did not change between the two methods of delivery. Conclusions: Flipped learning can improve student satisfaction and engagement with teaching, but our study has not demonstrated an improvement in assessment scores.

The use of flipped classroom as an active learning approach improves academic performance in social work: A randomized trial in a university

Article

Full-text available

Apr 2019
PLOS ONE

Background The flipped classroom (FC) is a pedagogical approach that means that the activities that have traditionally taken place within the classroom are carried out outside the classroom. Fundamentally it implies the way in which the student studies the subject. This change of perspective in teaching—learning has raised many questions regarding its effectiveness and student satisfaction in the university studies in the degree of Social Work. Objective The main objective of this study was to evaluate the effectiveness of a Flipped Classroom methodology in the academic performance of students of the Social Work Degree. Methods An educational study, with two parallel groups was developed. The randomization was carried out by class groups. Group 1 was assigned an active teaching methodology of Flip Teaching and it was implemented during theoretical teaching hours. The other group of students, Group 2, was assigned a traditional lecturer-based learning (LB) methodology. The participants were all the students of the morning shift who studied the subject Social Work with Groups of the Social Work Degree during the academic year 2017–2018. The sample was composed of 110 subjects, with 60 subjects who developed an active teaching methodology and 50 subjects who received a LB. Results In terms of the academic performance result variable, the FT group had a mean of 6.56 (SD: 1.58) and the LB group had a mean of 5.42 (SD: 1.97) (p-value: 0.002). The FT group also had a higher percentage of students receiving merit and outstanding scores (34.5% and 6.9% respectively) and a lower percentage of students who failed (19%) as compared to the LB group in which 20.9% and 2.3% of the students received merit or outstanding grades and 46.5% failed (p-value = 0.025). No significant differences were found with regards to satisfaction with the subject and the methodology used, long-term learning and time spent preparing for the exam. Conclusions The FC teaching methodology in comparison with the LB methodology has shown to be a more effective tool regarding academic performance evaluated in a quantitative and qualitative way with regards to Social Work education at university level.

A descriptive study of race and gender differences in how instructional style and perceived professor care influence decisions to major in STEM

Article

Full-text available

Feb 2019

Background Women and students of color are widely underrepresented in the majority of STEM fields. In order to investigate this underrepresentation, we interviewed over 200 male and female college seniors, primarily women and people of color, who either majored in STEM or started but dropped a STEM major. Here, we focus on one section of the longer interview that focused on students’ perceptions of professor care as well as perceived and preferred instruction style. Additionally, we look at correlations between professor care, course interactivity, and sense of belonging. In our analysis, we examine student responses through the lens of gender, race, and their intersections. Results We found that white women perceived their STEM professors cared about them and their learning the most while women of color reported the least perceived care. Notably, men, regardless of race, reported similar perceptions of professor care. We found that students commonly report their STEM courses were lecture-based but say they would prefer more active approaches. In particular, we found that women who left STEM majors reported more lecture-based instruction while stating the highest preference for active learning environments. We found that perceiving their professors cared was related to a greater sense of belonging in STEM. Additionally, we found that students who reported active classrooms also reported more professor care in their STEM field. Conclusions Our findings indicate that active teaching environments may positively impact students’ sense of belonging and desire to continue in STEM and that this impact may be higher for underrepresented students.

Effectiveness of flipped classrooms in nursing education: Systematic review and meta-analysis

Article

Full-text available

Dec 2017

Background The flipped classroom has generated considerable interest in nursing education in the last few years, especially in higher education in China. However, research to date has been insufficient to confirm the effectiveness of the flipped classroom approach. Since most of the Chinese studies are published in Chinese journals, they may not be easily accessible to international researchers. Therefore, this meta-analysis aimed to review the effectiveness of a flipped classroom in nursing education both in English and Chinese databases. Objective The aim of the present study was to identify the robust available evidence about the effectiveness of flipped classrooms in nursing education through a systematic review and meta-analysis. Methods A systematic search of English databases, including PubMed, EMBASE, Science Director, CINAHL and Google Scholar, and Chinese databases, including Chinese National Knowledge Infrastructure (CNKI), WanFang Data, VIP Information and Chinese Biomedical Literature (CMB), were conducted to identify peer-reviewed studies that met the inclusion criteria. Two reviewers independently performed study identification with Endnote X7 software and used Excel to extract data. The risk of bias in the included studies was assessed with Cochrane Collaboration's risk of bias tool, and a meta-analysis was conducted using RevMan 5.3 software following the guidelines proposed by PRISMA reporting standards with the protocol register No. CRD42016041826. Results A total of 29 studies were included in systematic review. There was a significant post-intervention improvement in academic performance both in knowledge with a pooled random-effects standardized mean difference of 1.13 and skills with a pooled random-effects standardized mean difference (SMD) of 1.68. Students' self-learning abilities were also improved with a pooled random-effects SMD of 1.51 compared with traditional lecture. In the subgroup analysis, we found that the effect sizes had high fidelity in terms of nursing degrees and research settings. There was a high rating of flipped classroom pedagogy from teaching evaluations, study satisfaction, study attitude and improvement in critical thinking and problem-solving skills. Conclusions These results indicated that a flipped classroom might help nursing students improve in knowledge, skills, attitudes, self-learning, study satisfaction, critical thinking and problem-solving skills. We recommend adopting this approach for nursing education reform. There is a call for robust empirical research and unification of appraisal standards for further support of the effectiveness of the flipped classroom. Furthermore, a meta-regression analysis is also recommended to explore the sources of heterogeneity in included studies.

Effectiveness of applying flipped learning to clinical nursing practicums for nursing students in Korea: A randomized controlled trial

Article

Full-text available

Jul 2017

Objectives: The purpose of this study was to develop flipped learning models for clinical practicums and compare their effectiveness regarding learner motivation toward learning, satisfaction, and confidence in performing core nursing skills among undergraduate nursing students in Korea. Methods: This study was a randomized clinical trial designed to compare the effectiveness of 2 flipped learning models. Data were collected for 3 days from October 21 to 23, 2015 before the clinical practicum was implemented and for 2 weeks from October 26 to December 18, 2015 during the practicum period. Results: The confidence of the students in performing core nursing skills was likely to increase after they engaged in the clinical practicum in both study groups. However, while learner confidence and motivation were not affected by the type of flipped learning, learner satisfaction did differ between the 2 groups. Conclusions: The findings indicate that applying flipped learning allows students to conduct individualized learning with a diversity of clinical cases at their own level of understanding and at their own pace before they participate in real-world practicums.

Telling Active Learning Pedagogies Apart: from theory to practice

Article

Full-text available

Jul 2017

Kelsey Hood Cattaneo Ed.D.

Designing learning environments to incorporate active learning pedagogies is difficult as definitions are often contested and intertwined. This article seeks to determine whether classification of active learning pedagogies (i.e., project-based, problem-based, inquiry-based, case-based, and discovery-based), through theoretical and practical lenses, could function as a useful tool for researchers and practitioners in comparing pedagogies. This article classified five active learning pedagogies based on six constructivist elements. The comparison was completed through a comparative analysis and a content analysis informed by a systematic literature review. The findings were that learner-centeredness is a primary goal of all pedagogies; however, there is a strong dissonance between each pedagogy’s theoretical underpinnings and implementation realities. This dissonance complicates differentiating active learning pedagogies and classification as a comparative tool has proved to have limited usefulness.

Announcement of Retraction

Article

Full-text available

Jan 2025

Gavin Yu

The editorial board announced this article has been retracted on March 29, 2018.If you have any further question, please contact us at: elt@ccsenet.org

Project-based learning: A review of the literature

Article

Full-text available

Jul 2016

Project-based learning (PBL) is an active student-centred form of instruction which is characterised by students’ autonomy, constructive investigations, goal-setting, collaboration, communication and reflection within real-world practices. It has been explored in various contexts and in different phases of schooling, from primary to higher education. The majority of the reviewed studies were based on a quasi-experimental pretest–posttest design with some baseline equivalence established but no random allocation of participants to control and experimental groups, and as a result, a causal link between PBL instruction and positive student outcomes cannot be established with certainty. Modern digital technology, group processes of high quality, teachers’ ability to effectively scaffold students’ learning and provide guidance and support, the balance between didactic instruction with in-depth inquiry methods and well-aligned assessment have been identified in the literature as facilitating factors in the implementation of PBL. The article concludes with six key recommendations considered to be essential for the successful adoption of a PBL approach in the mainstream school setting.

The Implementation of A Flipped Classroom in Foreign Language Teaching

Article

Full-text available

Oct 2015

Ahmet Başal

Alongside the rise of educational technology, many teachers have been taking gradual but innovative steps to redesign their teaching methods. For example, in flipped learning or a flipped classroom, students watch instructional videos outside the classroom and do assignments or engage in activities inside the classroom. Language teachers are one group of educators exploring the flipped classroom. In foreign language classes, such an approach may offer great benefits for both the teachers and students since classroom time can be applied to more interactive tasks. By extending classroom hours in this way, language teachers can focus on successfully addressing all subjects in the curriculum. The aim of this study is (a) to gain insights into the perceptions of prospective English language teachers at a state university in Turkey on flipped classrooms and (b) to introduce the implementation of a flipped classroom into an English language class. A total of 47 prospective English teachers participated in the study. Qualitative research design was used and data were collected via an open-ended question. Findings of the study indicated that pre-service English teachers had positive perceptions towards the use of the flipped classroom as an integral part of face-to-face courses. It can be concluded that flipped classroom was beneficial in terms of 4 categories based on the content analysis of the responses: learning at one's own pace, advance student preparation, overcoming the limitations of class time, increasing the participation in the classroom. The study also provides recommendations towards LMS integration into courses in other English language teaching departments and for implementing flipped classrooms in language teaching.

No differences in grades or level of satisfaction in a flipped classroom for neuroanatomy

Article

Full-text available

Apr 2015

The intensive nature of a 5- or 6-week teaching block poses unique problems for adequate delivery of content. This study was designed to compare the delivery of a unit of undergraduate neuroanatomy in a short summer school period, as a traditionally taught unit, with a rendition given in the form of the "Flipped Classroom." The aim was to evaluate the effectiveness of the flipped classroom in the intensive mode classroom. The flipped classroom encompassed the same learning outcomes, but students were responsible for covering the content at home in preparation for tutorials that applied their acquired knowledge to higher levels of thinking. The main outcome measures were the final course grades and the level of satisfaction with the course. There were no significant differences between the 2 cohorts in final grades (p = .259), self-rated knowledge (p = .182), or overall satisfaction with the course (p = .892). This particular design of the flipped classroom did not add value to the intensive mode experience. It may be that this mode of delivery is ill suited to intensive classes for subjects that carry a lot of content. The use of the flipped classroom requires further research to fully evaluate its value.

Why Minimal Guidance During Instruction Does Not Work : An Analysis of the Failure of Constructivist , Discovery , Problem-Based , Experiential , and Inquiry-Based Teaching

Article

Full-text available

Jan 2006
EDUC PSYCHOL-US

Evidence for the superiority of guided instruction is explained in the context of our knowledge of human cognitive architecture, expert–novice differences, and cognitive load. Although unguided or minimally guided instructional approaches are very popular and intuitively appealing, the point is made that these approaches ignore both the structures that constitute human cognitive architecture and evidence from empirical studies over the past half-century that consistently indicate that minimally guided instruction is less effective and less efficient than instructional approaches that place a strong emphasis on guidance of the student learning process. The advantage of guidance begins to recede only when learners have sufficiently high prior knowledge to provide “internal” guidance. Recent developments in instructional research and instructional design models that support guidance during instruction are briefly described.

Developing a Framework to Create Effective Problem-Based Video Podcasts

Article

Full-text available

Mar 2014

Robin Holding Kay

The purpose of the following study was to develop a comprehensive, theory-based framework for creating instructional video podcasts designed to present worked examples. Sixteen design characteristics, organized according to four categories (establishing context, providing effective explanations, minimizing cognitive load, and engaging students), were used to develop 59 pre-calculus videos for 856 first-year university students. Overall, the vast majority of students noted that the video podcasts were useful and helped them understand mathematics better. With respect to establishing context, the evidence suggested that problem selection was appropriate and video podcasts were clear, straightforward, and detailed. Regarding the quality of explanations, a number of students commented on the effectiveness of the step-by-step presentation of solutions and the use of visuals to support learning. Students agreed that video podcasts were easy to read, but did not directly mention other issues involving cognitive load. Students also noted that video podcasts were engaging and better than using textbooks. They also enjoyed working on the interactive student-problems. Finally, significant gains were observed in all five pre-calculus knowledge categories evaluated. It is concluded that the framework proposed in this study is a reasonable starting point for creating effective worked-example video podcasts.

Intrinsic Motivation and Extrinsic Incentives Jointly Predict Performance: A 40-Year Meta-Analysis

Article

Full-text available

Feb 2014

More than 4 decades of research and 9 meta-analyses have focused on the undermining effect: namely, the debate over whether the provision of extrinsic incentives erodes intrinsic motivation. This review and meta-analysis builds on such previous reviews by focusing on the interrelationship among intrinsic motivation, extrinsic incentives, and performance, with reference to 2 moderators: performance type (quality vs. quantity) and incentive contingency (directly performance-salient vs. indirectly performance-salient), which have not been systematically reviewed to date. Based on random-effects meta-analytic methods, findings from school, work, and physical domains (k = 183, N = 212,468) indicate that intrinsic motivation is a medium to strong predictor of performance (ρ = .21-45). The importance of intrinsic motivation to performance remained in place whether incentives were presented. In addition, incentive salience influenced the predictive validity of intrinsic motivation for performance: In a "crowding out" fashion, intrinsic motivation was less important to performance when incentives were directly tied to performance and was more important when incentives were indirectly tied to performance. Considered simultaneously through meta-analytic regression, intrinsic motivation predicted more unique variance in quality of performance, whereas incentives were a better predictor of quantity of performance. With respect to performance, incentives and intrinsic motivation are not necessarily antagonistic and are best considered simultaneously. Future research should consider using nonperformance criteria (e.g., well-being, job satisfaction) as well as applying the percent-of-maximum-possible (POMP) method in meta-analyses. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Flipping the Classroom to Improve Student Performance and Satisfaction

Article

Full-text available

Sep 2013

This study aimed to determine the effects of a flipped classroom (i.e., reversal of time allotment for lecture and homework) and innovative learning activities on academic success and the satisfaction of nursing students. A quasi-experimental design was used to compare three approaches to learning: traditional lecture only (LO), lecture and lecture capture back-up (LLC), and the flipped classroom approach of lecture capture with innovative classroom activities (LCI). Examination scores were higher for the flipped classroom LCI group (M = 81.89, SD = 5.02) than for both the LLC group (M = 80.70, SD = 4.25), p = 0.003, and the LO group (M = 79.79, SD = 4.51), p < 0.001. Students were less satisfied with the flipped classroom method than with either of the other methods (p < 0.001). Blending new teaching technologies with interactive classroom activities can result in improved learning but not necessarily improved student satisfaction. [J Nurs Educ. 2013;52(x):xxx-xxx.].

Factors That Influence Student Completion of Course and Faculty Evaluations

Article

Full-text available

Mar 2013
AM J PHARM EDUC

Objective: To determine if there is a relationship between students' grades, gender, age, or ethnicity and their completion of course and/or faculty evaluations. Methods: Data were collected and analyzed for relationships among students' gender, age, ethnicity, and course grade on their completion rates of course and faculty evaluations. Results: The grade a student received in a course was not related to completion rates for course or faculty evaluations. Students born in 1987 or earlier were significantly more likely to complete course or faculty evaluations. Significant differences in completion rates were also found based on the course taken and the gender and ethnicity of the students. Conclusions: Several demographic characteristics were identified that correlated with the completion of course and/or faculty evaluations. However, no correlation was found with the grade a student receives in a course and completion of either course or faculty evaluations. In order to improve course and faculty evaluation rates, further analysis of the influence of demographics on completion rates is warranted.

The State of Cooperative Learning in Postsecondary And Professional Settings

Article

Full-text available

Mar 2007

Modern cooperative learning began in the mid- 1960s (D. W. Johnson & R. Johnson, 1999a). Its use, however, was resisted by advocates of social Darwinism (who believed that students must be taught to survive in a “dog-eat-dog” world) and individualism (who believed in the myth of the “rugged individualist”). Despite the resistance, cooperative learning is now an accepted, and often the preferred, instructional procedures at all levels of education. Cooperative learning is being used in postsecondary education in every part of the world. It is difficult to find a text on instructional methods, a journal on teaching, or instructional guidelines that do not discuss cooperative learning. Materials on cooperative learning have been translated into dozens of languages. Cooperative learning is one of the success stories of both psychology and education. One of the most distinctive characteristics of cooperative learning, and perhaps the reason for its success, is the close relationship between theory, research, and practice. In this article, social interdependence theory will be reviewed, the research validating the theory will be summarized, and the five basic elements needed to understand the dynamics of cooperation and operationalize the validated theory will be discussed. Finally the controversies in the research and the remaining questions that need to be answered by future research will be noted.

A Power Primer

Article

Full-text available

Jul 1992

Jacob Cohen

One possible reason for the continued neglect of statistical power analysis in research in the behavioral sciences is the inaccessibility of or difficulty with the standard material. A convenient, although not comprehensive, presentation of required sample sizes is provided. Effect-size indexes and conventional values for these are given for operationally defined small, medium, and large effects. The sample sizes necessary for .80 power to detect effects at these levels are tabled for 8 standard statistical tests: (1) the difference between independent means, (2) the significance of a product-moment correlation, (3) the difference between independent rs, (4) the sign test, (5) the difference between independent proportions, (6) chi-square tests for goodness of fit and contingency tables, (7) 1-way analysis of variance (ANOVA), and (8) the significance of a multiple or multiple partial correlation.

Why Minimal Guidance During Instruction Does Not Work: An Analysis of the Failure of Constructivist, Discovery, Problem-Based, Experiential, and Inquiry-Based Teaching

Article

Full-text available

Jun 2006

Evidence for the superiority of guided instruction is explained in the context of our knowledge of human cognitive architecture, expert–novice differences, and cognitive load. Although unguided or minimally guided instructional approaches are very popular and intuitively appealing, the point is made that these approaches ignore both the structures that constitute human cognitive architecture and evidence from empirical studies over the past half-century that consistently indicate that minimally guided instruction is less effective and less efficient than instructional approaches that place a strong emphasis on guidance of the student learning process. The advantage of guidance begins to recede only when learners have sufficiently high prior knowledge to provide “internal” guidance. Recent developments in instructional research and instructional designmodels that support guidance during instruction are briefly described.

Make It Stick: The Science of Successful Learning

Book

Apr 2014

Statistical Power Analysis for the Behavioral Sciences

Book

May 2013

Jacob Cohen

Updating guidance for reporting systematic reviews: development of the PRISMA 2020 statement

Article

Feb 2021
J CLIN EPIDEMIOL

Objectives To describe the processes used to update the PRISMA 2009 statement for reporting systematic reviews, present results of a survey conducted to inform the update, summarise decisions made at the PRISMA update meeting, and describe and justify changes made to the guideline. Methods We reviewed 60 documents with reporting guidance for systematic reviews to generate suggested modifications to the PRISMA 2009 statement. We invited 220 systematic review methodologists and journal editors to complete a survey about the suggested modifications. The results of these projects were discussed at a 21-member in-person meeting. Following the meeting, we drafted the PRISMA 2020 statement and refined it based on feedback from co-authors and a convenience sample of 15 systematic reviewers. Results The review of 60 documents revealed that all topics addressed by the PRISMA 2009 statement could be modified. Of the 110 survey respondents, more than 66% recommended keeping six of the original checklist items as they were and modifying 15 of them using wording suggested by us. Attendees at the in-person meeting supported the revised wording for several items but suggested rewording for most to enhance clarity, and further refinements were made over six drafts of the guideline. Conclusions The PRISMA 2020 statement consists of updated reporting guidance for systematic reviews. We hope that providing this detailed description of the development process will enhance the acceptance and uptake of the guideline and assist those developing and updating future reporting guidelines.

Undergraduate Students Experience of Nutrition Education Using the Flipped Classroom Approach: A Descriptive Cohort Study

Article

Jul 2019

Objective: To explore undergraduate students self-reported learning experience in a foundation nutrition education course/unit delivered using a flipped classroom approach (FCA), which requires students to complete independent learning before and after interactive in-class learning experiences. Methods: A descriptive cohort study design used selected items from a self-report flipped classroom student engagement questionnaire to assess Australian undergraduate student (n = 105) engagement in the course/unit and compared with nonflipped courses, preference for FCA, academic achievement, learning behaviors for 3 FCA learning phases, and more or less engaging aspects of the course/unit. Results: Most (66.5%) students were engaged or very engaged, with half (55%) more engaged in this course/unit compared with other nonflipped courses/units with a preference for the FCA (53%). Almost half of the students agreed the FCA improved their academic performance (grade) (45%) and other academic skills (ie, teamwork) (48.5%). Most student comments related to the value of participate phase activities. Conclusions and implications: The FCA engaged most students in learning and is an emerging learning and teaching approach appropriate for undergraduate nutrition dietetic education.

Effects of a patient safety course using a flipped classroom approach among undergraduate nursing students: A quasi-experimental study

Article

May 2019
NURS EDUC TODAY

Background The nursing education system has changed with the increased emphasis on patient safety in healthcare settings. Early education in patient safety is crucial to preparing nurses to be competent in patient care. Therefore, providing undergraduate patient safety education courses using an innovative approach is essential to enhancing patient safety and quality in nursing care. Objectives This study aimed to examine the effects of a patient safety course using a flipped classroom approach on patient safety competency among undergraduate nursing students in South Korea. Design A pre- and post-test quasi-experimental design with a non-equivalent control group was adopted. Settings This study was conducted in the college of nursing at a university in Seoul, South Korea. Participants A total of 75 undergraduate nursing students participated. All students enrolled in the patient safety course comprised the experimental group (n = 32); those with similar characteristics to the experimental group (age, gender, and year) but did not take the course comprised the control group (n = 43). Methods A total of 14 sessions (28 h) addressing the topics from the World Health Organization patient safety curriculum guide were delivered using a flipped classroom approach. The teaching methods included online learning and quizzes, case studies, small and large discussions, incident report tasks, and group projects including the development of strategies for patient safety. A survey including a demographic questionnaire and the Patient Safety Competency Self-Evaluation tool was administered at the beginning and end of the fall semester. Results Pre- and post-test results demonstrated a significant increase in students' patient safety competency including attitude, skills, and knowledge. Mean scores of patient safety competency in the experimental group were significantly higher than in the control group. Conclusions The flipped-classroom patient safety course was shown to be effective in improving patient safety competency in terms of attitude, skills, and knowledge among undergraduate nursing students.

Effect of flipped teaching on student performance and perceptions in an Introductory Physiology course

Article

Mar 2019

Chaya Gopalan

Flipped teaching (FT) has caught educators' attention due to its success in engaging students through pre- and in-class activities. To learn if FT improved student performance, scores from the quizzes and exams of a fully flipped classroom with retrieval exercises were compared with those of five semesters of traditional lecture-based [unflipped (UF)] teaching in an undergraduate sophomore-level physiology course. Student attitude surveys were also evaluated. Student performance on both the quizzes and exams was significantly higher in the FT class in general compared with that of the UF teaching. Interestingly, however, when the individual exam scores were compared between the two styles, the scores for students in the FT were significantly higher for exams 2 and 3, yet lower for exam 1. The shift in performance from exam 1 to exams 2 and 3 is likely explained by the need for time to adjust to the new teaching style. Students reported an overall positive perception of FT in their course evaluations at the end of the semester. In conclusion, FT improved student performance compared with that of lecture-based traditional teaching practice, but required some time to adjust in the beginning of the semester.

Development and evaluation of flipped learning using film clips within a nursing informatics course: Flipped learning with film clips

Article

Dec 2018
JPN J NURS SCI

Aim To develop flipped learning classes by using film clips for undergraduate nursing students in an online nursing informatics course, based on the Analysis, Design, Development, Implementation, and Evaluation model, and to evaluate the effectiveness and students’ responses to this method of teaching. Methods Sixty‐four second‐year nursing students participated in the course. The nursing students’ knowledge was assessed at the beginning and end of each of the five classes. Moreover, their intention to recommend the classes to other students and additional comments were elicited by using semistructured questionnaires. Results Knowledge about each core concept of nursing informatics reflected significant improvement. Regarding the intention to recommend the class to others, 62 (96.8%) students answered “strongly recommend” or “recommend.” Conclusion Integrating flipped learning classes by using film clips in an online nursing informatics course improved the nursing students’ knowledge and is a format that is desired by students.

Flipped Classroom Versus Traditional Lecture: Comparing Teaching Models in Undergraduate Nursing Courses

Article

Nov 2016

Exam scores, final grade averages, and course evaluations were compared for traditional lecture and flipped classroom models in two undergraduate nursing courses. Half of the exam score averages were higher for the flipped model. Although most course evaluations indicated an insignificant preference for the traditional lecture model, students perceived several advantages of the flipped model, including enhanced instructor-student interactions, improved preparation, and increased learning. Perceived disadvantages were minor and usually included technical problems and preparation time.

Application of Constructivist Theory in Flipped Classroom — Take College English Teaching as a Case Study

Article

Jul 2018

In the context of information globalization and the popularity of the Internet, the flipped classroom as a new teaching mode, a new pedagogical method has become a heated topic and a growing concern for educators across the world. In this paper, the flipped classroom is supported by constructivist learning theory. The teaching mode under the constructivist learning theory is typically students-centered which corresponds with the flipped classroom mode. This paper mainly focuses on the application of constructivist learning theory in flipped classroom, taking college English teaching for example to interpret the student- student, teacher- student interactions in the flipped classroom with the final goal to promote students’ learning efficiency and quality.

Statistical power analysis for the behavioral sciences

Book

Jan 1988

J. Cohen

Influence of study approaches and course design on academic success in the undergraduate anatomy laboratory

Article

Jan 2018

Many pre-health professional programs require completion of an undergraduate anatomy course with a laboratory component, yet grades in these courses are often low. Many students perceive anatomy as a more challenging subject than other coursework, and the resulting anxiety surrounding this perception may be a significant contributor to poor performance. Well-planned and deliberate guidance from instructors, as well as thoughtful course design, may be necessary to assist students in finding the best approach to studying for anatomy. This article assesses which study habits are associated with course success and whether course design influences study habits. Surveys (n = 1,274) were administered to students enrolled in three undergraduate human anatomy laboratory courses with varying levels of cooperative learning and structured guidance. The surveys collected information on potential predictors of performance, including student demographics, educational background, self-assessment ability, and study methods (e.g., flashcards, textbooks, diagrams). Compared to low performers, high performers perceive studying in laboratory, asking the instructor questions, quizzing alone, and quizzing others as more effective for learning. Additionally, students co-enrolled in a flipped, active lecture anatomy course achieve higher grades and find active learning activities (e.g., quizzing alone and in groups) more helpful for their learning in the laboratory. These results strengthen previous research suggesting that student performance is more greatly enhanced by an active classroom environment that practices successful study strategies rather than one that simply encourages students to employ such strategies inside and outside the classroom. Anat Sci Educ. © 2018 American Association of Anatomists.

A systematic review of the effectiveness of flipped classrooms in medical education

Article

Jun 2017
MED EDUC

Context: There are inconsistent claims made about the effectiveness of the flipped classroom (FC) in medical education; however, the quality of the empirical evidence used to back up these claims is not evident. The aims of this review are to examine the scope and quality of studies on the FC teaching approach in medical education and to assess the effects of FCs on medical learning. Methods: A literature search was conducted using the major electronic databases in 2016. Peer-reviewed papers were screened and reviewed according to explicit inclusion criteria. The scope and quality of all resultant studies were evaluated. Studies identified as using controlled designs were further synthesised to assess the effects of FCs on learning. Results: A total of 118 articles were obtained. Full texts of 82 articles were reviewed. Nine of the included 46 articles used a controlled design when examining the effects of the FC. There were generally positive perceptions of the FC approach. However, the effects of FCs on changes in knowledge and skills were less conclusive as the effect sizes ranged from d = -0.27 to 1.21, with a median of 0.08. The varying direction and magnitude of the effect sizes, together with their 95% confidence interval, which contained zero, suggested the lack of strong evidence for the effectiveness of FCs in promoting knowledge acquisition above and beyond the traditional learning methods. Conclusions: There has been a recent increase of research rigor and variety in measures of effectiveness in studies on the FC in medical education. The FC is a promising teaching approach to increase learners' motivation and engagement. More solid evidence on its effect on changes in knowledge and skills are warranted. Further studies should also examine the long-term effects of FCs with regard to knowledge retention and transfer of knowledge to professional practice and patient care.

The Future of Medical Education: Flipping the Classroom and Education Technology

Article

Apr 2016

Dustyn E Williams

The evidence for ‘flipping out’: A systematic review of the flipped classroom in nursing education

Article

Mar 2016

Make It Stick: The Science of Successful Learning

Book

Oct 2014
EDUC LEADERSHIP

Flipping out about The Flip: All Hype or Is There Hope?

Article

Oct 2015

The flipped classroom was founded on student-centered pedagogy, with the idea that students retain more information by using active learning techniques during class compared to sitting in a lecture-based course. We implement a randomized experiment to quantify the effect of flipping on the learning outcomes of economics students. We compare standardized exam scores of students who experienced a flipped classroom to those who experienced a traditional classroom in principles of microeconomics courses. OLS regression results show that, following a negative adjustment period, students who experienced the flipped classroom scored significantly higher on midterm and final exams than did the control group. The magnitude of these effects suggests improvements in the students' scores of a lower bound of two-thirds to an entire a letter grade.

Brown, P.C., Roediger III, H.L., & McDaniel, M.A. (2014). Make It Stick. The Science of Successful Learning

Article

Jul 2015

Jeffrey K Smith

A Review and Analysis of Constructivism for School-Based Practice

Article

Mar 2002

Constructivism, a multifaceted philosophical position on the nature of knowledge and educational practice, has recently emerged both in the literature on learning and in school reform efforts, despite no strong supporting research base. At present, four major perspectives on constructivism in classrooms may be identified. They are the perspectives of Piaget and Vygotsky as well as social and holistic constructivism. Because school psychologists may be asked to work in a constructivist framework, one purpose of this article is to describe the essential characteristics and difficult issues associated with implementing this approach for classroom practice. Included are goals, assumptions about learners, essential teacher skills, and research concerns. A second purpose is a discussion of the implications for school psychologists, highlighting currently recommended school psychology practices that may address important concerns within a constructivist approach. Recommendations for consultation and intervention, needs of students with learning difficulties, and assessment issues are addressed.

Quantitative Outcomes for Nursing Students in a Flipped Classroom

Article

May 2015

The study aim was to objectively compare learning outcomes of two pedagogies as measured quantitatively through exam questions, quiz scores, and course grades. Eighty-two baccalaureate nursing students were randomly assigned to either the flipped or the traditional classroom. No statistically significant differences were noted between groups in outcomes measured, and the flipped classroom was found to be an effective strategy for nursing education.

Flipping the classroom to teach population health: Increasing the relevance

Article

Dec 2014
Nurse Educ Pract

In recent years, there have been multiple calls to enhance the population health and health promotion aspects of nursing programs. Further impetus has been provided by passage of the Affordable Care Act in 2010 with its focus on prevention. The need to develop students who can critically think and apply knowledge learned is crucial to the development of nurses who can integrate and apply the concepts of population-focused practice in society and a healthcare system undergoing transformation. This coupled with the ever changing needs of learners requires a different approach to content delivery and presentation. Flipped classroom courses, with an online component, offer the flexibility and technology desired by current undergraduate students. The use of a flipped classroom approach to re-design a population health course in a Midwestern nursing program resulted in stronger course evaluations from students and reflected better student understanding of the relevance of such content in a nursing curriculum. Copyright © 2015 Elsevier Ltd. All rights reserved.

Enhancing Student Engagement Using the Flipped Classroom

Article

Sep 2014
J NUTR EDUC BEHAV

The flipped classroom is an innovative pedagogical approach that focuses on learner-centered instruction. The purposes of this report were to illustrate how to implement the flipped classroom and to describe students' perceptions of this approach within 2 undergraduate nutrition courses. The template provided enables faculty to design before, during, and after class activities and assessments based on objectives using all levels of Bloom's taxonomy. The majority of the 142 students completing the evaluation preferred the flipped method compared with traditional pedagogical strategies. The process described in the report was successful for both faculty and students.

Mobile computer-supported collaborative learning: A review of experimental research

Article

Sep 2013
BRIT J EDUC TECHNOL

A meta-analysis of the effects of face-to-face cooperative learning. Do recent studies falsify or verify earlier findings?

Article

Dec 2013
Educ Res Rev

Editorial: The Components of Authentic Learning

Article

Jan 2006

Audrey C. Rule

This editorial reports the results of a qualitative analysis of a selection of recent journal articles addressing authentic learning in different contexts, identifying overarching themes to guide teachers and potential authors of future articles for this journal. The four recognized themes are; real-world problems that engage learners in the work of professionals; inquiry activities that practice thinking skills and metacognition; discourse among a community of learners; and student empowerment through choice. Examples of authentic learning in articles from this issue are also discussed.

How learning in an inverted classroom influences cooperation, innovation and task orientation

Article

Jul 2012

Jeremy Strayer

Recent technological developments have given rise to blended learning classrooms. An inverted (or flipped) classroom is a specific type of blended learning design that uses technology to move lectures outside the classroom and uses learning activities to move practice with concepts inside the classroom. This article compares the learning environments of an inverted introductory statistics class with a traditional introductory statistics class at the same university. This mixed-methods research study used the College and University Classroom Environment Inventory (CUCEI), field notes, interviews and focus groups to investigate the learning environments of these two classrooms. Students in the inverted classroom were less satisfied with how the classroom structure oriented them to the learning tasks in the course, but they became more open to cooperative learning and innovative teaching methods. These findings are discussed in terms of how they contribute to the stability and connectedness of classroom learning communities.

Effects of Problem-Based Learning: A Meta-Analysis

Article

Oct 2003
LEARN INSTR

This meta-analysis has two aims: (a) to address the main effects of problem based learning on two categories of outcomes: knowledge and skills; and (b) to address potential moderators of the effect of problem based learning. We selected 43 articles that met the criteria for inclusion: empirical studies on problem based learning in tertiary education conducted in real-life classrooms. The review reveals that there is a robust positive effect from PBL on the skills of students. This is shown by the vote count, as well as by the combined effect size. Also no single study reported negative effects. A tendency to negative results is discerned when considering the effect of PBL on the knowledge of students. The combined effect size is significantly negative. However, this result is strongly influenced by two studies and the vote count does not reach a significant level. It is concluded that the combined effect size for the effect on knowledge is non-robust. As possible moderators of PBL effects, methodological factors, expertise-level of students, retention period and type of assessment method were investigated. This moderator analysis shows that both for knowledge- and skills-related outcomes the expertise-level of the student is associated with the variation in effect sizes. Nevertheless, the results for skills give a consistent positive picture. For knowledge-related outcomes the results suggest that the differences encountered in the first and the second year disappear later on. A last remarkable finding related to the retention period is that students in PBL gained slightly less knowledge, but remember more of the acquired knowledge.

Seven Goals for the Design of Constructivist Learning Environments

Chapter

Jan 1996

Peter C. Honebein

A Taxonomy for Learning, Teaching, and Assessing: a Revision of Bloom's Taxonomy of Educational Objectives

Article

Jan 2000

Incl. bibl., index.

Exploring Flipped Classrooms in Undergraduate Nursing and Health Science: A Systematic Review

Abstract

No full-text available

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