Effects of flipped classroom on nursing psychomotor skill instruction for active and passive learners: A mixed methods study.

Abstract

Psychomotor skill instruction is a critical component of nursing education. For now, the optimal teaching method to help students acquire psychomotor skills remains elusive. A few studies have explored the effects of flipped classroom on skill instruction, but yield a mixed conclusion. Furthermore, little knowledge was eligible if flipped classroom was beneficial to all learners with different learning styles. This study aimed to investigate the effects of flipped classroom on nursing psychomotor skill instruction for students with different learning styles. The sequential explanatory mixed-methods design was used. In the quantitative study, students in the control group and the intervention group were instructed by traditional laboratory class and flipped classroom respectively. Self-report questionnaires evaluated students' satisfaction and perceived stress before and after the project. Students' skill performance was videotaped and graded by a nursing teacher. Independent sample t-test and paired sample t-test were used to study differences within and between two groups. In the qualitative component, a multiple case study was implemented to investigate the learning experience of flipped classroom among students with different learning styles. The quantitative study results showed that flipped classroom was more effective in improving student performance than traditional laboratory class, for both active and passive learner. However, after flipped classroom intervention, the learning satisfaction of passive learners decreased significantly (P<0.05), while the learning satisfaction of active learners showed an opposite increasing trend (P=0.07). Furthermore, compared with traditional laboratory class, the stress perception of passive learners in flipped classroom also increased significantly (p<0.001). The qualitative study analysis obtained similar results, although active students hold a more positive attitude toward flipped classroom, passive learners expressed more dissatisfaction and stress perception than their peers. In terms of skill performance, learning satisfaction and stress perception of students, flipped classroom maybe more suitable for active learners rather than passive learners. Therefore, evaluating the learning styles of students is necessary before the implementation of flipped classroom.