There is a call for instructional transformation in nursing education to include an innovative approach. This study aimed to investigate the effects of the flipped classroom method on student achievement and engagement in an associate degree nursing course. This study investigated associate degree nursing studies students' achievement and cognitive engagement under traditional learning (n=141) and flipped learning (n=130). This study was conducted in two first-year cohorts enrolled in their nursing fundamental course, before and during the COVID-19 pandemic respectively at a Hong Kong community college. A mixed methods approach was used with quantitative (examination scores) and qualitative (semi-structured focus group interview) measures applied. There was a significant increase in final exam scores for the flipped classroom, all p<0.01, with a medium-to-large (d = 0.60) effect size. Students commented flipped classroom method promoted their cognitive engagement and the benefits that contributed to such a positive student achievement included more peer interaction and more opportunity to apply their knowledge. This study contributed to our understanding of the effect of the flipped classroom method on student engagement in nursing education.
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