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Comparison of Undergraduate Nursing Student Satisfaction in Flipped Class (FC), Active Lecture Class (ALC) and Traditional Lecture Class (TLC)

Hawazen Rawas
American Journal of Nursing Research. 2019, 7(6), 991-994. DOI: 10.12691/ajnr-7-6-12
Received August 16, 2019; Revised September 25, 2019; Accepted October 15, 2019

Abstract

Background: In recent years, different educational approaches have been broadly applied to nursing courses. However, a comparison between these approaches and assessing the students’ satisfaction has not been conducted. Aim: This study was designed to compare FC and ALC with the TLC model in teaching Medical-surgical courses to undergraduate nursing students and to assess the student response when they are asked to compare their experiences in FC, ALC, and TLC. Results: The mean age of the study participants was 22.19 ± 2.40. In terms of marital status, the differences between satisfied and unsatisfied students were significant in TLC (p=0.059). A larger number of married students preferred TLC over ALC/FC and the difference between married and unmarried was significant (p=0.036). Regarding residential status, the differences between satisfied and unsatisfied students were significant in TLC (p=0.034). A larger number of rural residents preferred FC over ALC/TLC and the difference between rural and urban residents was significant (p=0.036). In terms of previous GPA scores, the difference between the students preferring FC over ALC/TLC was significant (p=0.008), where a larger number of students preferred FC over other teaching methods. Conclusion: The student satisfaction in FLC, TLC, and ALC varies based on their social/residential statuses as well as their study habits and out of class self-study hours.

1. Background

Flipped class (FC) is a pedagogical practice that existed years before it was labeled 1. The flipped class is simply described as "events that have traditionally taken place inside the classroom now take place outside the classroom and vice versa” 2. The students embrace the responsibility to acquire knowledge in a flipped class, which is a highly engaging and interactive learning model 3. It is an inclusive learning environment. The instructional approach in FC is diverse and may include individual or interactive group activities for the students, meanwhile, the learning resources may comprise of video tutorials and textbook contents 4. The flipped class is effectively employed on course levels and have yielded better learning outcomes compared to traditional lecture class when tested in nursing students 5, 6. Average exam scores were higher in the FC model tested in nursing students. FC is shown to engage nursing students in a manner, which equips them substantially to address the complexities and challenges of contemporary healthcare 7.

Active learning class (ALC) involves in-class discussion of students with the instructor 8 and peers 9. Active learning can be effectively infused in classes with a large number of students 10. ALC strategies to teach nursing students are shown to be effective, resulting in improvements in grades 11. Mc Pherson and MacDonald 12 reported that ALC for nursing students has resulted in the contextualization of learning and has played a role in overcoming educational barriers. ALC model can positively cater to some of the commonly identified challenges in nursing students such as lack of motivation and concentration, class sizes, length of the allocated time and poor previous knowledge of students 13.

Traditional lecture class (TLC) involve didactic lecture without the active involvement of students in the learning process 14. TLC may involve audio-visual support with didactic lectures 15. The TLC model is the most commonly utilized teaching model for nursing courses 16. Thre are several studies conducted, which compare TLC with FC and ALC in teaching nursing courses 17, 18, 19.

Nursing is a self-governing profession and it demands the ability and skills to essentially apply theoretical concepts to clinical practice 20, 21. Nursing courses should be conducted in a way that the students have a strong foundation knowledge and application skills 22. FC and ALC models for teaching nursing students are shown to meet the aforementioned challenges. Medical-surgical courses are effectively and conveniently conducted employing FC and ALC models and it is a valid area of ongoing research in nurse education 23.

This study was designed to compare FC and ALC with the TLC model in teaching Medical-surgical courses to undergraduate nursing students and to assess the student response when they are asked to compare their experiences in FC, ALC, and TLC.

2. Methods

FC learning process was explained to students enrolled in Medical-Surgical courses. Learning resource was generated to be utilized before class comprising of video tutorials. In-class activities comprised of interactive group activities or individual practice exercises.

Activities to be conducted in the class were announced on the online blackboard system. Bit sized (chunk) learning was offered. Discussion with instructor and peers was encouraged. The active class comprised of pair group activity e.g. class divided into pair and mark which pair-arm collaboratively give better answers to questions posed throughout. During lectures, the learners were allowed in-class writing. The think-pair-share activity was conducted e.g. students divided into pairs and allowed to reflect and discuss answers with their partners and give a combined answer.

Learning resource was generated ahead of the class on the blackboard. Lectures were conducted with audiovisual support. Students were encouraged to ask questions at the end of the class. The students completed a survey by the end of the course. The first part of the survey comprised of participant characteristics such as marital status, residence, previous GPA, after class study habits and general study habits (individual or group study). The second part comprised of six yes and no response set related to satisfaction and preferences in terms of teaching methods. The survey was conducted within the premises of the college. A convenient sampling technique was used owing to a small number of students registered in the courses. The students (N=206) participated following informed consent and the nature of survey participation was voluntary. The survey was analyzed on SPSS software v.20.0.

3. Results

The mean age of the study participants was 22.19 ± 2.40. Table 1 shows student’s responses to the different types of teaching methods. In terms of marital status, the differences between satisfied and unsatisfied students were significant in TLC (p=0.059). A larger number of married students preferred TLC over ALC/FC and the difference between married and unmarried was significant (p=0.036). Regarding residential status, the differences between satisfied and unsatisfied students were significant in TLC (p=0.034). A larger number of rural residents preferred FC over ALC/TLC and the difference between rural and urban residents was significant (p=0.036). In terms of previous GPA scores, the difference between the students preferring FC over ALC/TLC was significant (p=0.008), where a larger number of students preferred FC over other teaching methods. Regarding the group of students divided based on the differences in self-study hours, the difference between the students preferring FC over ALC/TLC was significant (p=0.009), where a larger number of students preferred FC over other teaching methods. Based on general study habits, the difference between satisfied and unsatisfied students with ALC was significant (p=0.034).

4. Discussion

The purpose of this study was to compare FC and ALC with the TLC model in Medical-Surgical courses education in undergraduate nursing students and to analyze the student responses when they are asked to compare their experiences in FC, ALC, and TLC in terms of satisfaction and preferred teaching method.

The study shows that more students who were married preferred the traditional lecture format. It is also shown in previous studies that nursing students do not easily welcome a new teaching method and this study also supports the findings reported in similar studies 24, 25. The differences between satisfied and unsatisfied students were significant in TLC among those who were residing in rural and urban regions. Our study has shown that a larger number of rural residents preferred FC over ALC/TLC and the difference between rural and urban residents was significant. This finding is different than a previous study that has shown that rural student satisfaction is less in FC due to limited access to high-speed internet 26.

This study further shows the student's preferences of the teaching methods who were divided into groups based on their previous GPA scores. Within these groups, the differences between the students preferring FC over ALC/FC were significant, where a larger number of students preferred FC over other teaching methods. Interestingly, students with higher GPA scores preferred FC in larger numbers. This finding adds to the already reported results of FC preferences in different students with variations in academic backgrounds reported in earlier studies 27, 28.

Finally, in our study, it was revealed that with the group of students divided based on the differences in self-study hours, the difference between the students preferring FC over ALC/TLC was significant, where a larger number of students preferred FC over other teaching methods. However, regarding the general study habits, the difference between satisfied and unsatisfied students with ALC was significant. The students accustomed to individual study were more satisfied with ALC compared to students who were attuned in group study methods.

5. Conclusion

The student satisfaction in FLC, TLC, and ALC varies based on their social/residential statuses as well as their study habits and out of class self-study hours.

References

[1]  Bates JE, Almekdash H, Gilchrest-Dunnam MJ. The Flipped Classroom: A Brief, Brief History. InThe Flipped College Classroom 2017 (pp. 3-10). Springer International Publishing.
In article      View Article  PubMed  PubMed
 
[2]  Lage, M. J., Platt, G. J., & Treglia, M. (2000). Inverting the classroom: a gateway to creating an inclusive learning environment. The Journal of Economic Education, 31(1), 30-43.
In article      View Article
 
[3]  Green RD, Schlairet MC. Moving toward heutagogical learning: Illuminating undergraduate nursing students' experiences in a flipped classroom. Nurse Education Today. 2017 Feb 28; 49: 122-8.
In article      View Article  PubMed
 
[4]  Lo CK, Hew KF. A critical review of flipped classroom challenges in K-12 education: possible solutions and recommendations for future research. Research and Practice in Technology Enhanced Learning. 2017 Jan 7; 12(1): 4.
In article      View Article  PubMed  PubMed
 
[5]  Maxwell KL, Wright VH. Evaluating the Effectiveness of Two Teaching Strategies to Improve Nursing Students’ Knowledge, Skills, and Attitudes About Quality Improvement and Patient Safety. Nursing Education Perspectives. 2016 Sep 1; 37(5): 291-2.
In article      View Article  PubMed
 
[6]  Hanson J. Surveying the experiences and perceptions of undergraduate nursing students of a flipped-classroom approach to increase understanding of drug science and its application to clinical practice. Nurse education in practice. 2016 Jan 31; 16(1): 79-85.
In article      View Article  PubMed
 
[7]  Betihavas V, Bridgman H, Kornhaber R, Cross M. The evidence for ‘flipping out’: a systematic review of the flipped classroom in nursing education. Nurse education today. 2016 Mar 31; 38: 15-21.
In article      View Article  PubMed
 
[8]  Krieg A. What's in a name? Importance of student perceptions of an instructor knowing their name. In2017 AAAS Annual Meeting (February 16-20, 2017) 2017 Feb 18.
In article      
 
[9]  Smith MK, Wood WB, Adams WK, Wieman C, Knight JK, Guild N, Su TT. Why peer discussion improves student performance on in-class concept questions. Science. 2009 Jan 2; 323(5910): 122-4.
In article      View Article  PubMed
 
[10]  Liao SN, Griswold WG, Porter L. Impact of Class Size on Student Evaluations for Traditional and Peer Instruction Classrooms. InProceedings of the 2017 ACM SIGCSE Technical Symposium on Computer Science Education 2017 Mar 8 (pp. 375-380). ACM.
In article      View Article
 
[11]  Morales KA. Active Learning Strategies to Enhance Nursing Students' Knowledge of Pharmacology. Nursing Education Perspectives. 2017 Jan 10.
In article      View Article  PubMed
 
[12]  McPherson C, MacDonald C. Blending Simulation-Based Learning and Interpretative Pedagogy for Undergraduate Leadership Competency Development. Journal of Nursing Education. 2017 Jan 25; 56(1): 49-54.
In article      View Article  PubMed
 
[13]  Bakon S, Craft J, Christensen M, Wirihana L. Can active learning principles be applied to the bioscience assessments of nursing students? A review of the literature. Nurse education today. 2016 Feb 29; 37: 123-7.
In article      View Article  PubMed
 
[14]  Murray AR. Evidence-Based Teaching Strategies for Undergraduate Nursing Students to Deliver Human Trafficking Content. In leadership Connection 2016 (17-20 September) 2016 Sep 20. STTI.
In article      
 
[15]  Roca J, Reguant M, Canet O. Learning outcomes of “The Oncology Patient” study among nursing students: A comparison of teaching strategies. Nurse Education Today. 2016 Nov 30; 46: 29-35.
In article      View Article  PubMed
 
[16]  Price AM, Stephens M, Patterson C, Snelgrove-Clarke E, Work F, Chiang V. What are the patterns of personal learning environments (PLE) for undergraduate students undertaking degrees in nursing.2015
In article      
 
[17]  Merriman CD, Stayt LC, Ricketts B. Comparing the effectiveness of clinical simulation versus didactic methods to teach undergraduate adult nursing students to recognize and assess the deteriorating patient. Clinical Simulation in Nursing. 2014 Mar 31; 10(3): e119-27.
In article      View Article
 
[18]  Simpson V, Richards E. Flipping the classroom to teach population health: Increasing the relevance. Nurse education in practice. 2015 May 31; 15(3): 162-7.
In article      View Article  PubMed
 
[19]  Mudd SS, Silbert-Flagg J. Implementing the Flipped Classroom to Enhance Nurse Practitioner Clinical Decision-Making in the Care of the Pediatric Asthma Patient. Nursing Education Perspectives. 2016 Nov 1; 37(6): 352-3.
In article      View Article
 
[20]  Holman R, Hanson AD. Flipped Classroom Versus Traditional Lecture: Comparing Teaching Models in Undergraduate Nursing Courses. Nursing Education Perspectives. 2016 Nov 1; 37(6): 320-2.
In article      View Article
 
[21]  N. Efstathiou, C. Bailey. Promoting active learning using Audience Response System in large bioscience classes Nurse Educ. Today, 32 (1) (2012), pp. 91-95
In article      View Article  PubMed
 
[22]  Taylor, S. Ashelford, P. Fell, P. Goacher Biosciences in nurse education: is the curriculum fir for practice? Lecturer's views and recommendations from across the UK J. Clin. Nurs. (2015), pp. 1-10.
In article      View Article
 
[23]  Carpenter S, Reddix R, Martin D. Pills, Thrills, and Pharmacology Drills! Strategies to Increase Student Retention in an Entry-Level Nursing Pharmacology Course. Teaching and Learning in Nursing. 2016 Oct 31; 11(4): 179-83.
In article      
 
[24]  Gale JL. Flipped Classroom: Student Perception and Learning Outcomes. In Leadership Connection 2016 (17-20 September) 2016 Sep 19. STTI.
In article      
 
[25]  Hannay, M., & Newvine, T. (2006). Perceptions of distance learning: A comparison of online and traditional learning. Journal of Online Learning and Teaching, 2(1), 1-11.
In article      
 
[26]  Yom, Y. H. (2004). Integration of Internet-based learning and traditional face-to-face learning in an RN-BSN course in Korea. CIN: Computers, Informatics, Nursing, 22(3), 145-152.
In article      View Article  PubMed
 
[27]  O'Flaherty, J., & Phillips, C. (2015). The use of flipped classrooms in higher education: A scoping review. The internet and higher education, 25, 85-95.
In article      View Article
 
[28]  Jenkins, S. (2015). Flipping the introductory American politics class: Student perceptions of the flipped classroom. PS: Political Science & Politics, 48(4), 607-611.
In article      View Article
 
[29]  Wong, T. H., Ip, E. J., Lopes, I., & Rajagopalan, V. (2014). Pharmacy students’ performance and perceptions in a flipped teaching pilot on cardiac arrhythmias. American journal of pharmaceutical education, 78(10), 185.
In article      View Article  PubMed  PubMed
 

Published with license by Science and Education Publishing, Copyright © 2019 Hawazen Rawas

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

Cite this article:

Normal Style
Hawazen Rawas. Comparison of Undergraduate Nursing Student Satisfaction in Flipped Class (FC), Active Lecture Class (ALC) and Traditional Lecture Class (TLC). American Journal of Nursing Research. Vol. 7, No. 6, 2019, pp 991-994. http://pubs.sciepub.com/ajnr/7/6/12
MLA Style
Rawas, Hawazen. "Comparison of Undergraduate Nursing Student Satisfaction in Flipped Class (FC), Active Lecture Class (ALC) and Traditional Lecture Class (TLC)." American Journal of Nursing Research 7.6 (2019): 991-994.
APA Style
Rawas, H. (2019). Comparison of Undergraduate Nursing Student Satisfaction in Flipped Class (FC), Active Lecture Class (ALC) and Traditional Lecture Class (TLC). American Journal of Nursing Research, 7(6), 991-994.
Chicago Style
Rawas, Hawazen. "Comparison of Undergraduate Nursing Student Satisfaction in Flipped Class (FC), Active Lecture Class (ALC) and Traditional Lecture Class (TLC)." American Journal of Nursing Research 7, no. 6 (2019): 991-994.
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[1]  Bates JE, Almekdash H, Gilchrest-Dunnam MJ. The Flipped Classroom: A Brief, Brief History. InThe Flipped College Classroom 2017 (pp. 3-10). Springer International Publishing.
In article      View Article  PubMed  PubMed
 
[2]  Lage, M. J., Platt, G. J., & Treglia, M. (2000). Inverting the classroom: a gateway to creating an inclusive learning environment. The Journal of Economic Education, 31(1), 30-43.
In article      View Article
 
[3]  Green RD, Schlairet MC. Moving toward heutagogical learning: Illuminating undergraduate nursing students' experiences in a flipped classroom. Nurse Education Today. 2017 Feb 28; 49: 122-8.
In article      View Article  PubMed
 
[4]  Lo CK, Hew KF. A critical review of flipped classroom challenges in K-12 education: possible solutions and recommendations for future research. Research and Practice in Technology Enhanced Learning. 2017 Jan 7; 12(1): 4.
In article      View Article  PubMed  PubMed
 
[5]  Maxwell KL, Wright VH. Evaluating the Effectiveness of Two Teaching Strategies to Improve Nursing Students’ Knowledge, Skills, and Attitudes About Quality Improvement and Patient Safety. Nursing Education Perspectives. 2016 Sep 1; 37(5): 291-2.
In article      View Article  PubMed
 
[6]  Hanson J. Surveying the experiences and perceptions of undergraduate nursing students of a flipped-classroom approach to increase understanding of drug science and its application to clinical practice. Nurse education in practice. 2016 Jan 31; 16(1): 79-85.
In article      View Article  PubMed
 
[7]  Betihavas V, Bridgman H, Kornhaber R, Cross M. The evidence for ‘flipping out’: a systematic review of the flipped classroom in nursing education. Nurse education today. 2016 Mar 31; 38: 15-21.
In article      View Article  PubMed
 
[8]  Krieg A. What's in a name? Importance of student perceptions of an instructor knowing their name. In2017 AAAS Annual Meeting (February 16-20, 2017) 2017 Feb 18.
In article      
 
[9]  Smith MK, Wood WB, Adams WK, Wieman C, Knight JK, Guild N, Su TT. Why peer discussion improves student performance on in-class concept questions. Science. 2009 Jan 2; 323(5910): 122-4.
In article      View Article  PubMed
 
[10]  Liao SN, Griswold WG, Porter L. Impact of Class Size on Student Evaluations for Traditional and Peer Instruction Classrooms. InProceedings of the 2017 ACM SIGCSE Technical Symposium on Computer Science Education 2017 Mar 8 (pp. 375-380). ACM.
In article      View Article
 
[11]  Morales KA. Active Learning Strategies to Enhance Nursing Students' Knowledge of Pharmacology. Nursing Education Perspectives. 2017 Jan 10.
In article      View Article  PubMed
 
[12]  McPherson C, MacDonald C. Blending Simulation-Based Learning and Interpretative Pedagogy for Undergraduate Leadership Competency Development. Journal of Nursing Education. 2017 Jan 25; 56(1): 49-54.
In article      View Article  PubMed
 
[13]  Bakon S, Craft J, Christensen M, Wirihana L. Can active learning principles be applied to the bioscience assessments of nursing students? A review of the literature. Nurse education today. 2016 Feb 29; 37: 123-7.
In article      View Article  PubMed
 
[14]  Murray AR. Evidence-Based Teaching Strategies for Undergraduate Nursing Students to Deliver Human Trafficking Content. In leadership Connection 2016 (17-20 September) 2016 Sep 20. STTI.
In article      
 
[15]  Roca J, Reguant M, Canet O. Learning outcomes of “The Oncology Patient” study among nursing students: A comparison of teaching strategies. Nurse Education Today. 2016 Nov 30; 46: 29-35.
In article      View Article  PubMed
 
[16]  Price AM, Stephens M, Patterson C, Snelgrove-Clarke E, Work F, Chiang V. What are the patterns of personal learning environments (PLE) for undergraduate students undertaking degrees in nursing.2015
In article      
 
[17]  Merriman CD, Stayt LC, Ricketts B. Comparing the effectiveness of clinical simulation versus didactic methods to teach undergraduate adult nursing students to recognize and assess the deteriorating patient. Clinical Simulation in Nursing. 2014 Mar 31; 10(3): e119-27.
In article      View Article
 
[18]  Simpson V, Richards E. Flipping the classroom to teach population health: Increasing the relevance. Nurse education in practice. 2015 May 31; 15(3): 162-7.
In article      View Article  PubMed
 
[19]  Mudd SS, Silbert-Flagg J. Implementing the Flipped Classroom to Enhance Nurse Practitioner Clinical Decision-Making in the Care of the Pediatric Asthma Patient. Nursing Education Perspectives. 2016 Nov 1; 37(6): 352-3.
In article      View Article
 
[20]  Holman R, Hanson AD. Flipped Classroom Versus Traditional Lecture: Comparing Teaching Models in Undergraduate Nursing Courses. Nursing Education Perspectives. 2016 Nov 1; 37(6): 320-2.
In article      View Article
 
[21]  N. Efstathiou, C. Bailey. Promoting active learning using Audience Response System in large bioscience classes Nurse Educ. Today, 32 (1) (2012), pp. 91-95
In article      View Article  PubMed
 
[22]  Taylor, S. Ashelford, P. Fell, P. Goacher Biosciences in nurse education: is the curriculum fir for practice? Lecturer's views and recommendations from across the UK J. Clin. Nurs. (2015), pp. 1-10.
In article      View Article
 
[23]  Carpenter S, Reddix R, Martin D. Pills, Thrills, and Pharmacology Drills! Strategies to Increase Student Retention in an Entry-Level Nursing Pharmacology Course. Teaching and Learning in Nursing. 2016 Oct 31; 11(4): 179-83.
In article      
 
[24]  Gale JL. Flipped Classroom: Student Perception and Learning Outcomes. In Leadership Connection 2016 (17-20 September) 2016 Sep 19. STTI.
In article      
 
[25]  Hannay, M., & Newvine, T. (2006). Perceptions of distance learning: A comparison of online and traditional learning. Journal of Online Learning and Teaching, 2(1), 1-11.
In article      
 
[26]  Yom, Y. H. (2004). Integration of Internet-based learning and traditional face-to-face learning in an RN-BSN course in Korea. CIN: Computers, Informatics, Nursing, 22(3), 145-152.
In article      View Article  PubMed
 
[27]  O'Flaherty, J., & Phillips, C. (2015). The use of flipped classrooms in higher education: A scoping review. The internet and higher education, 25, 85-95.
In article      View Article
 
[28]  Jenkins, S. (2015). Flipping the introductory American politics class: Student perceptions of the flipped classroom. PS: Political Science & Politics, 48(4), 607-611.
In article      View Article
 
[29]  Wong, T. H., Ip, E. J., Lopes, I., & Rajagopalan, V. (2014). Pharmacy students’ performance and perceptions in a flipped teaching pilot on cardiac arrhythmias. American journal of pharmaceutical education, 78(10), 185.
In article      View Article  PubMed  PubMed