Medical Nursing Research Articles

Based on Medicine, The Now and Future of Large Language Models.

This review explores the potential applications of large language models (LLMs) such as ChatGPT, GPT-3.5, and GPT-4 in the medical field, aiming to encourage their prudent use, provide professional support, and develop accessible medical AI tools that adhere to healthcare standards. This paper examines the impact of technologies such as OpenAI's Generative Pre-trained Transformers (GPT) series, including GPT-3.5 and GPT-4, and other large language models (LLMs) in medical education, scientific research, clinical practice, and nursing. Specifically, it includes supporting curriculum design, acting as personalized learning assistants, creating standardized simulated patient scenarios in education; assisting with writing papers, data analysis, and optimizing experimental designs in scientific research; aiding in medical imaging analysis, decision-making, patient education, and communication in clinical practice; and reducing repetitive tasks, promoting personalized care and self-care, providing psychological support, and enhancing management efficiency in nursing. LLMs, including ChatGPT, have demonstrated significant potential and effectiveness in the aforementioned areas, yet their deployment in healthcare settings is fraught with ethical complexities, potential lack of empathy, and risks of biased responses. Despite these challenges, significant medical advancements can be expected through the proper use of LLMs and appropriate policy guidance. Future research should focus on overcoming these barriers to ensure the effective and ethical application of LLMs in the medical field.

Prevalence of Unhealthy Lifestyles and Its Correlates Among College-Going Students in Rishikesh, India: A Cross-Sectional Study.

Introduction Non-communicable diseases (NCDs) have a significant impact on health concerns. The transition from school to college coincides with various stressors,affecting student health. The objective was to assess the prevalence of unhealthy lifestyles among college-going students and examine the association of composite lifestyle scores with selected demographic variables. Methods All undergraduate colleges of Rishikesh were included in the study. Cluster sampling with a population proportionate to size was used to select the participants. A structured questionnaire was administered using Google Forms or pen and paper. Index values for each lifestyle activity were added together to get a lifestyle composite score. An unhealthy lifestyle was considered with a score below 40. Association with risk factors was analyzed using a chi-square test and logistic regression. Results Among 742 participants, 166 (22.4%)lived an unhealthy lifestyle with a lifestyle score of <40. The majority of participants were either underweight or above normal weight. An unhealthy lifestyle was prevalent among fourth-year professional students (7; 58.5%), medical (33; 32%), dental (27; 34.6%), hosteller (79; 36%), and BSc Nursing (21; 56.8%)students. BSc Nursing course (AOR: 11.09; 95% CI: 1.17-104.74) and favorable attitude (AOR: 0.74; 95 % CI: 0.59- 0.93) were significant correlates of unhealthy lifestyles. Conclusion The current study indicates that nearly one-fourth of college students have unhealthy lifestyles. Four factors, i.e., health science stream, advancing professional year, hosteller, and unfavorable attitude towardhealth, were significantly associated with unhealthy lifestyles after adjusting for covariates.

The Effect Of Health Education Using E-Booklets On Medication Adherence In Type II DM Patients

This study aims to evaluate the effect of health education using E-Booklet on adherence to taking medication in type II diabetes mellitus (DM) patients at the Internal Medicine Polyclinic of Mitra Kasih Hospital. This study describes the level of compliance with taking medication before and after the E-Booklet education intervention. The results showed that before education, the majority of patients (83.6%) had low compliance, while after education, the level of low compliance decreased to 61.8%. Statistical analysis showed a significant effect of E-Booklet education on drug compliance with a p value = 0.003 at a significance level of 0.05. This study contributes theoretically to the science of surgical medical nursing and practically for Mitra Kasih Hospital in improving health education about adherence to taking medication in DM patients.

Emergency rescue of a patient with hemorrhagic shock caused by superior mesenteric artery rupture: A case report

BACKGROUND Superior mesenteric artery (SMA) injuries rarely occur during blunt abdominal injuries, with an incidence of &lt; 1%. The clinical manifestations mainly include abdominal hemorrhage and peritoneal irritation, which progress rapidly and are easily misdiagnosed. Quick and accurate diagnosis and timely effective treatment are greatly significant in managing emergent cases. This report describes emergency rescue by a multidisciplinary team of a patient with hemorrhagic shock caused by SMA rupture. CASE SUMMARY A 55-year-old man with hemorrhagic shock presented with SMA rupture. On admission, he showed extremely unstable vital signs and was unconscious with a laceration on his head, heart rate of 143 beats/min, shallow and fast breathing (frequency &gt; 35 beats/min), and blood pressure as low as 20/10 mmHg (1 mmHg = 0.133 kPa). Computed tomography revealed abdominal and pelvic hematocele effusion, suggesting active bleeding. The patient was suspected of partial rupture of the distal SMA branch. The patient underwent emergency mesenteric artery ligation, scalp suture, and liver laceration closure. In view of conditions with acute onset, rapid progression, and high bleeding volume, key points of nursing were conducted, including activating emergency protocol, opening of the green channel, and arranging relevant examinations with various medical staff for quick diagnosis. The seamless collaboration of the multidisciplinary team helped shorten the preoperative preparation time. Emergency laparotomy exploration and mesenteric artery ligation were performed to mitigate hemorrhagic shock while establishing efficient venous accesses and closely monitoring the patient’s condition to ensure hemodynamic stability. Strict measures were taken to avoid intraoperative hypothermia and infection. CONCLUSION After 3.5 h of emergency rescue and medical care, bleeding was successfully controlled, and the patient’s condition was stabilized. Subsequently, the patient was transferred to the intensive care unit for continuous monitoring and treatment. On the sixth day, the patient was weaned off the ventilator, extubated, and relocated to a specialized ward. Through diligent medical intervention and attentive nursing, the patient made a full recovery and was discharged on day 22. The follow-up visit confirmed the patient’s successful recovery.

Vitamin B12 Deficiency in Clinical Practice-Proceedings of the International B12 Conference, June 2023, Rotterdam.

This supplement of the Food and Nutrition Bulletin is dedicated to the proceedings of "the International B12 Conference in Clinical Practice," held in Rotterdam in June 2023. The conference brought together physicians, scientists, patient groups, and health care professionals with substantial expertise in diagnosing and treating vitamin B12 deficiency from many universities around the world. With a collective commitment to advancing clinical practice and improving patient outcomes, this event was instrumental in addressing the many complex and challenging aspects of vitamin B12 deficiency. The subjects explored at the conference ranged from the latest research findings to real-world case studies, spanning diverse medical disciplines, including pediatrics, obstetrics, neurology, internal medicine, gastroenterology, psychiatry, clinical chemistry, nutrition, public health, biomedical science, and nursing. The broad spectrum of disciplines reflects the multifaceted nature of vitamin B12 deficiency and underscores the necessity of a comprehensive and multidisciplinary approach to its diagnosis and treatment. This supplement aims to distill into a concise and accessible format the knowledge shared by stimulating and provocative presentations at the B12 Conference and to make the information available for the broader scientific and health care community. The compendium bridges the insights generated at the conference and the wider audience of health care practitioners, researchers, and policymakers who recognize the urgency of addressing the critical public health concerns surrounding vitamin B12 deficiency.

From hospital to home: Analyzing the market dynamics of home health and hospital-at-home care

The home health care industry in the United States is expected to develop at a compound annual growth rate (CAGR) of 6.89% from 2023 to 2032, and is expected to reach approximately $300 billion by 2028. The aging population, rising rates of chronic illnesses, the need for post-hospitalization care, and patient preferences for at-home care are some of the factors contributing to this growth. In addition to non-medical help with everyday life activities, home health care offers medical treatments such skilled nursing and physical therapy. Large providers with the greatest patient volume, such as AccentCare, Amedisys, and Enhabit Home Health &amp; Hospice, dominate the industry. To guarantee patient safety and high-quality care, home health agencies are subject to regulatory scrutiny. Home health care can also be a valuable source of information and respite for family caregivers. The capabilities of home health care have been increased by technological developments in telehealth and remote monitoring, which allow medical professionals to keep an eye on patients' status and interact with them from a distance. All things considered, the home health care sector is changing to accommodate the expanding and varied requirements of patients who want to receive treatment in the convenience of their own homes, offering an affordable and individualized substitute for traditional hospital settings.

Facilitating Evidence-Based Practice among Nurses in a Tertiary General Hospital: A Six-Year Practice of an Implementation Strategy Informed by the i-PARIHS Framework

Aims. To develop an evidence-based practice (EBP) facilitating strategy informed by the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework and evaluates the strategy’s effectiveness on promoting EBP. Background. Nurses are increasingly expected to use research evidence in practice to improve patients’ outcomes, but the application of such evidence is still unsatisfactory. The facilitation of EBP in nursing needs the organization and the individual levels. Methods. Based on an analysis of EBP-promoting strategies and expert consultation, the core team of the nursing department developed an EBP group-based and project-oriented strategy under the guidance of the i-PARIHS framework. The strategy was implemented for six years and evaluated by a longitudinal design. The validated Chinese version of the self-reported Evidence Based Practice Questionnaire (EBPQ) was used to assess the attitudes, knowledge, and practice of the nurses. Results. The mean score of the total EBPQ was 4.46 (SD = 0.92) after one year of the EBP strategy, and the scores for knowledge, attitudes, and practice of EBP members were higher than those of general nurses p&lt;0.05. After four years, EBP members’ scores continued to increase. EBP groups conducted 51 EBP projects in the areas of emergency nursing, surgical and medical nursing, critical care, and so forth. Of these, 33 projects improved nursing practice by changing nursing procedures, upgrading nursing tools, and developing nursing standards, resulting in improved patient outcomes. Conclusion. The EBP group-based and project-oriented strategy can promote EBP. The composition of the EBP group, the annual audit of EBP projects, and the roles of internal and external facilitators were key components of this EBP-facilitating strategy. Implications for Nursing Management. The strategy is an organizational-level EBP-facilitation approach which can improve nurses’ academic preparation for EBP through ongoing training and sustained EBP behavior that involves annual projects.

Exploring clinical judgment ability in second-degree baccalaureate of science nursing students: A mixed methods study

BackgroundAs they have not yet embarked on clinical practice, most students who already have a bachelor's degree but require a bachelor's degree in nursing occasionally perceive the educator's instruction on clinical situations as abstract and challenging for making accurate clinical judgments. ObjectivesThis study aims to implement a clinical judgment model and case scenarios in classroom teaching to evaluate improvements in students' clinical judgment and critical thinking abilities. DesignA mixed-method design. SettingA second-degree Bachelor of Science in Nursing at a university in Taiwan. ParticipantsFirst-year undergraduate nursing students. MethodsThis mixed-methods study featured a survey at the beginning and end of a course, followed by one-on-one online interviews. A purposive sample of sophomore nursing students was recruited from a university in northern Taiwan between March 2020 and May 2021. Semi-structured interviews were conducted after a preliminary analysis of the collected quantitative data. ResultsIn total, 48 participants completed the study questionnaire, and 20 were interviewed. The results show that the students' ability to make clinical judgment and identify individual health problems from case scenarios significantly improved after completing the course. However, critical thinking did not differ significantly after the course. Qualitative data analysis revealed three key themes relevant to the participants' learning experiences: (1) establishing the context of clinical judgment, (2) building a bridge between basic medical science and clinical nursing, and (3) having a broader perspective. ConclusionsIncorporating clinical judgment measurement model and case scenarios in the curriculum may benefit second-degree Bachelor of Science in Nursing students who have not yet begun their clinical practice. Additionally, the result provides educators with valuable learning goals and evaluation strategies in the classroom and clinical practice.

Description Competencies of Medical Surgical Nursing Preceptors at Naval Center Hospital Dr. Ramelan Surabaya, Indonesia

This study evaluated the competence of preceptors in surgical medical nursing. The research method uses quantitative descriptive with a cross-sectional research design. The sample number was 100 respondents doing clinical practice in medical-surgical nursing at the Navy Central Hospital. Dr. Ramelan Surabaya. The sampling technique uses Simple Random Sampling. The questionnaire used is the Preceptor Competency Questionnaire, which is a self-assessment. The results showed that all preceptors had good competence in all indicators. These indicators include knowledge competence, clinical skills, teaching ability, communication skills, personal characteristics, leadership, professional behavior, and ethics. However, a small percentage of receptors need to improve the ease of consultation. This research provides new insights into the practice of clinical guidance in surgical medical nursing. It can be applied to enhance the quality of clinical learning in hospitals and nursing education institutions.

Interprofessional evaluation of "soft skills" of students in the practical year

The present study deals with the implementation of a questionnaire with 360° evaluation to assess the performance of students in the practical year (PJ). A special focus is put on the "soft skills" (self-competence, methodological competence, social competence), whose evaluation in medical studies has not yet taken place comprehensively. The study was conducted prospectively with 21 PJ students of the Medical Faculty of the TU Dresden. The assessment was performed by means of a self-designed questionnaire, which was divided into 4 sub-competencies (self-competence, methodological competence, social competence, clinical skills and abilities), which could be assessed by means of a 6-point Likert scale. Four professions were involved in the assessment: Medical Service, Nursing Service, Functional Service, and Administration. On average, the strongest deficits in terms of self-confidence, willingness to perform, and ability to deal with conflict were revealed by students in the PJ. Students showed a very good performance in performing a medical history and basic skills of clinical examination. The implementation of 360° feedback is possible and useful for students in the internship year across disciplines and professions. Such personal and interprofessional feedback has not been widely available. The questionnaire represents the first comprehensive measurement tool of soft skills for medical students and provides a good basis for comprehensive feedback.

Study on the Combination of Medical Care and Nursing Care for the Disabled Elderly in Cities

Study on the Combination of Medical Care and Nursing Care for the Disabled Elderly in Cities

Kebumen Cares through Free Circumcision at Taman Winangun Kebumen Islamic Boarding School

Circumcision is an obligation for Muslims. declared an obligation because it has been exemplified in the sunnah of the Prophet. It is stated in Siroh Nabawiyah that Rasulullah SAW performed circumcision when he was 7 days old. However, socialisation of the sunnah of Rasulullah Muhammad SAW in Indonesian society is mostly carried out when children are 5 years old or older. Currently, circumcision, or what is more commonly referred to ascircumcision," can be done in various ways. The choice of a variety of ways and the effects that arise are also very influential on the costs incurred. The obstacle in general is that the cost of circumcision under the care of a doctor is not affordable for the poor, who are being squeezed by economic problems. Based on this, we intend to organise a mass circumcision social service for poor children. As a medical tertiary institution engaged in the world of medical surgical nursing, the Community Service Team for the Undergraduate Nursing Study Program, Muhammadiyah University of Gombong, is motivated to participate in creating a healthy young generation. This small step is very important for us, especially if the circumcision process brings social values towards a better social life. This mass circumcision programme was carried out at the Tathmainnul Qulub Islamic Boarding School, Taman Winangun, Kebumen, and was attended by 22 participants. With the mass circumcision program, we are sure that we can fully obtain these positive values. Therefore, we are ready and able to be part of this noble step and invite benefactors to participate in it.

A randomized comparative study of transversus abdominis plane block (tap) with 0.25% bupivacaine and 0.375% ropivacaine in the duration of post-operative analgesia in upper abdominal laparoscopic surgeries

Transversus abdominis plane (TAP) block is a successful postoperative analgesia technique in laparoscopic surgeries. This study compared the analgesic efficacy of 0.25% bupivacaine and 0.375% Ropivacaine in TAP block as post-operative analgesia for upper abdomen laparoscopic surgeries.: This randomized, double-blinded comparative study was conducted at the Dr Jeyasekharan Medical Trust and Nursing Home for 18 months. Seventy-one consenting adult patients undergoing upper abdominal laparoscopic surgeries qualifying the inclusion criteria to undergo Bilateral Subcostal TAP Block were included. The patient was labelled group A or B according to a computer-generated randomization list. TAP block was administered using 30 ml (15 ml on each side) of 0.25% bupivacaine (A) or 0.375% ropivacaine (B). Similar premedication and induction were given to all patients. : Among 71 patients in group A, males were 5 (14.7%), and females were 29 (85.3%). In group B, males were 7 (18.9%), and female was 30 (81.1%). There is no significant difference in gender, age, and BMI between groups. The mean duration of analgesia with 0.375% ropivacaine (10.21±3.36 hrs.) was significantly higher than 0.25% bupivacaine (6.38±2.03 hrs.). In the first 24 hours postoperatively, the mean total tramadol consumption was 147.06±11.94 mg in group A and 117.57±31.11 mg in group B, which is statistically significant.: This study concludes that 0.375% 30ml ropivacaine given as a TAP block under ultrasound guidance significantly prolonged the post-operative analgesia duration compared to 0.25% 30ml bupivacaine.

THE EDUCATION PATHWAY FOR NURSES IN MONTENEGRO

Nursing education in Montenegro has a relatively long tradition. Due to the great need for medical personnel in Montenegro, in 1946, a school for paramedics, caretakers, and nurses was opened in Cetinje, located in the facilities of the former Girls’ Institute. Since the establishment of the first school, there have been several reforms in nursing education. In Montenegro, nursing practice begins after the completion of nine years of general education. At both the secondary and higher education levels, there are two types of nursing education. After completing four years of secondary school, one can obtain the title of health technician. The educational program for the health technician was developed in accordance with occupational standards for pediatric and medical nursing. The development of a modular educational program for Health Technicians is currently underway. The Health Technician curriculum is based on occupational standards for various fields, including Health Technician for hospital work, Health Technician for primary healthcare institutions, Health Technician for preschool institutions, and Health Technician for geriatric and palliative care institutions. A person can acquire the title of nurse by completing a three-year higher education program, consisting of applied basic studies (bachelor’s degree). In addition to the basic studies, there are also one-year postgraduate applied specialist studies in healthcare and two-year Master’s studies in healthcare. In 2017, following the reaccreditation of the Faculty of Medicine in Podgorica, a study model was designed based on the 3+2 principle. This nursing education program, in alignment with European directives, enables the training of qualified personnel to provide healthcare services. Graduates of this program will have degrees recognized outside the borders of Montenegro.

Barriers to Conducting and Publishing Scientific Research Among Nursing Faculty Members in Saudi Arabia.

Publication in highly indexed journals is a complicated process that requires research skills, including writing, conceptualizing, and communication skills, to appropriately verbalize the findings. The current study assessed the barriers faced by nursing faculty at Saudi universities in conducting scientific research and publishing in highly indexed journals. This was a descriptive, cross-sectional study. Data were collected through convenience sampling by sending an online questionnaire to faculty members at Saudi universities. The questionnaire consisted of two parts: the first part for the demographic characteristics of staff and another part for the barriers associated with conducting scientific research and the publication process in highly indexed journals. The data was analyzed by SPSS using descriptive statistics as frequencies and percentages and inferential statistics using Chi Square test. The study included 152 participants, mainly female (70.4%) aged 30-40 years (73.7%). Most were non-Saudi (90.1%), attended government universities (82.9%), and specialized in Medical & Surgical Nursing (29.6%). Only 3.9% received publishing training, whereas 55.9% had been published in indexed journals. Barriers included difficulties following guidelines, lack of research-writing knowledge, language challenges, and financial constraints. Gender, age, university, qualifications, and training courses influenced these barriers. The identified barriers included lack of training, language-related challenges, and work pressures. This study emphasizes the importance of providing support, resources, and training opportunities to overcome these barriers and enhance research productivity in the nursing field.

Digital subtraction angiography image segmentation based on multiscale Hessian matrix applied to medical diagnosis and clinical nursing of coronary stenting patients

ObjectiveTo introduce an improved method of digital subtraction angiography image segmentation based on a multi-scale Hessian matrix, to accurately segment vascular images before and after coronary stent implantation, which will have strong applications in medical diagnostics and clinical nursing of patients who underwent coronary stents implantation. MethodsFirstly, a vessel edge enhancement algorithm is proposed, which enhances the gradient of the vessel edge, which not only makes the obtained vessel edge smoother, but also enhances the visual effect of the intersection of vessels; secondly, introduces noise filtering based on morphology, which can detect and remove linear noise similar to blood vessels; finally, in view of the problem that each image in the DSA blood vessel sequence can only show part of the blood vessels, which is not conducive to observing the overall state of the blood vessels, a blood vessel sequence image fusion is designed to display the blood vessels in each image on the same image. The state of blood vessels can be understood as a whole in one image. ResultsCompared with the segmentation method in the literature, the blood vessel overlap rate increased by 0.0089, and the mis-segmentation rate decreased by 0.0334. In the quantitative analysis, the improved blood vessel segmentation algorithm in this paper improves the overlapping rate and reduces the mis-segmentation rate. ConclusionFor the comparison of visual effects, the blood vessels segmented by the algorithm in this paper have higher clarity, which is helpful for doctors and nurses to comprehensively synthesize blood vessel clinical information. There is a more objective image basis in the preoperative diagnosis and postoperative rehabilitation nursing of coronary angiographic stent implantation.

Analysing Home Pharmaceutical Care Under the Combination of Medical Care and Nursing.

Home pharmaceutical care delivers individualised, whole-process and continuous pharmaceutical services and health education. This study aims to explore the feasibility of home pharmaceutical services as a combination of medical and nursing care. Patient information was collected from 1 October 2020 to 30 September 2021 and was analysed and evaluated. We then developed a family medication plan and investigated its effectiveness and any issues encountered during the implementation process. A total of 102 patients received services, and 100% of the patients were satisfied with these. Moreover, using home pharmaceutical care saved approximately USD1,359.64 (RMB9,360.45) in outpatient costs and USD41,077.76 (RMB282,700) in inpatient costs, and the number of hospitalisations was reduced by 16%. It is beneficial to make home pharmaceutical services available as a combination of medical and nursing care. Pharmacists can help patients solve medication-related problems and reduce the number of hospitalisations and medical costs through standardised service models while ensuring safe, effective, economical and rational drug use for patients.

Facilitators and Barriers to Nurses Screening for Frailty in Acute Care in a Provincial Health-Care System: a Survey Study Guided by the Theoretical Domains Framework.

Older adults living with frailty represent the largest population of hospitalized patients in Canada, but they do not always receive the quality of care needed. Nurses are well-positioned to screen for frailty, but current frailty screening practices are poorly understood. A cross-sectional survey study was conducted over a six-week period with nurses from Alberta, Canada working in acute care with older adults. Demographics were descriptively reported. Frailty screening methods were quantified on 5-point frequency scales, reported descriptively and compared by practice area using linear regression. The top-five mean scores from a 43-item, 6-point Likert-type questionnaire based on the Theoretical Domains Framework were compared by practice area. Frailty screening by clinical impression was "usually" used (median = 4, IQR = 4-5), while tools were "rarely" used (median = 2, IQR = 1-3). Medical and/or surgical nursing had higher general frailty screening tool use (β = 0.81, r = .31, p < .001), but no significant (p > .05) differences for using clinical impression, or preference of screening method. The top facilitator was the disbelief that frailty screening negatively impacts relationships with older adults. The top barrier was belief that conducting frailty screening was routine. Nursing practice area influenced frailty screening beliefs. There is an opportunity to implement frailty screening tools into the nursing practice of Alberta' nurses working in acute care. Frailty screening tools that become routine have greater likelihood for utilization. Nursing practice areas may have unique situations that require tailored approached to tool implementation.

Research on the Influence of the Expansion of Traditional Film Aesthetics on Alleviating the Psychological Anxiety of the Audience in the Era of Digital Technology

In recent years, due to the spread of COVID-19, various problems caused by college students’ anxiety are common, which has attracted the attention of many researchers. Research shows that the anxiety level of social groups is getting higher and higher, and the mental health status is also decreasing year by year. It can be seen that anxiety has become one of the important obstacles to people’s mental health. At present, the intervention research on anxiety focuses on medical psychological nursing, and the intervention research specifically aimed at film audiences is relatively few. Tibetan Buddhist teacher Jongsa Chiang Yangkhin Chol Rinpoche said: film is the modern thangka. It is like a smart clown, opened the bathrobe of civilization, mouth hanging a strange smile, it is like an elegant wise man, insight into the secret of life, eyes full of compassion. Touching films are like realistic psychological cases, which are the analysis, disclosure and treatment of human nature, but also the guidance, inspiration and encouragement of the soul. Movies show us the rich and unique personality and complex and subtle emotions in three dimensions. Through movies, we examine the changes in our hearts and find the scale for self-revelation. Through movies, we travel in our own spiritual world and thus obtain the observation of our mind. This is the secret of movie healing.The development of high-tech film, especially the application of digital technology in film production, is the new trend of film technology development and the result of the concept change of the combination of science and art under the condition of post industrial revolution. In the digital technology era, the expansion of traditional film aesthetics can become a new means of psychological counseling and treatment, which has its unique advantages.

Implementation of the Flipped Classroom Combined with Problem-Based Learning in a Medical Nursing Course: A Quasi-Experimental Design.

Medical Nursing is one of the most important core courses in nursing education, and the emergence of the flipped classroom has made up for the shortcomings of traditional teaching and improved the effectiveness of teaching. However, it is worth exploring how to maximize the effect of students' self-study before class while making full use of classroom teaching to promote the cultivation of students' abilities, so that the flipped classroom can have a maximal teaching effect. Therefore, this study explored the effect of a flipped-classroom teaching mode based on a small private online course (SPOC) combined with problem-based learning (PBL) in a course of Medical Nursing. Nursing undergraduates from the years 2018 (control group) and 2019 (experimental group), respectively, used the traditional lecture method and the flipped-classroom teaching mode based on a SPOC combined with PBL. The teaching effect was evaluated by teaching-mode-recognition evaluation, critical thinking measurement, and academic achievement. The scores of teaching-mode recognition evaluated by the students in the experimental group were higher than those in the control group in the following five aspects: "helping to improve learning interest" (p = 0.003), "helping to improve autonomous learning ability" (p = 0.002), "helping to improve communication and cooperation ability" (p &lt; 0.001), "helping to cultivate clinical thinking" (p = 0.012), and "helping to promote self-perfection and sense of achievement" (p = 0.001). Compared with the control group, the score on the "analytical ability" dimension of the Critical Thinking Disposition Inventory in the experimental group was higher (p = 0.030). The excellent rates of the final theoretical examination (p = 0.046) and comprehensive case analysis (p = 0.046) in the experimental group were higher than those in the control group. The flipped-classroom teaching mode based on a SPOC combined with PBL can promote students' abilities of autonomous learning, communication and cooperation, and clinical and critical thinking; improves their academic performance; and is recognized and welcomed by them. However, to extend the flipped-classroom teaching model of a SPOC combined with PBL to other nursing education courses, more optimization and evaluation are required.