The Flipped Classroom Model in Infectious Disease Nursing: Implementation and Assessment of Educational Effectiveness (FC)
The goal of this retrospective cohort study was to evaluate whether the flipped classroom (FC) teaching model improved academic performance and student engagement in an integrative Infectious Disease Nursing course, compared with traditional lecture-based instruction. The main questions it aimed to answer were:
- Did the flipped classroom model produce higher final examination scores than traditional lectures after adjusting for students' prior academic achievement?
- Did the flipped classroom model enhance students' self-reported course interest and engagement?
- How did prerequisite course performances contribute to final achievement in this integrative nursing course? Researchers compared undergraduate nursing students taught via the flipped classroom in the 2024-2025 academic year (n = 18) with historical controls who received lecture-based instruction in the 2023 academic year (n = 36) at a single university in China.
Participants in the flipped classroom group (2024-2025 cohort):
- Completed weekly pre-class preparation modules (e.g., reviewing recorded lectures, reading assignments) before each session
- Attended in-class sessions that emphasized student-led presentations and case-based group discussions
- Completed a final written examination covering integrative Infectious Disease Nursing content
- Provided anonymous feedback ratings on their course interest and overall learning experience The historical control group (2023 cohort) received traditional lecture-based instruction and completed the same final examination and feedback survey.
Visão geral do estudo
Status
Intervenção / Tratamento
Descrição detalhada
This is a single-center, retrospective cohort study designed to evaluate the effectiveness of the flipped classroom (FC) teaching model compared with traditional lecture-based instruction in an integrative Infectious Disease Nursing course.
The study was conducted at Shantou University Medical College, China. Undergraduate nursing students enrolled in the Infectious Disease Nursing course during the 2024-2025 academic year (the FC cohort, n = 18) were compared with historical controls who received lecture-based instruction during the 2023 academic year (the control cohort, n = 36). All participants were from the same instructional track and completed the same course requirements.
For the FC cohort, the instructional design consisted of weekly modules that required students to complete pre-class preparation activities, including reviewing recorded educational videos and assigned readings. In-class sessions were structured around student-led presentations and case-based group discussions to reinforce the pre-class content. The historical control cohort received conventional teacher-centered lectures covering the same course content during the 2023 academic year.
Data were extracted retrospectively from existing academic records and course evaluation databases. The primary outcome measure was final examination score, which consisted of multiple-choice questions and open-questions covering integrative Infectious Disease Nursing content. Secondary outcome measures included gain scores (calculated as final examination score minus the average prerequisite course score) and course feedback ratings on student interest and overall learning experience.
Statistical analyses were performed using SPSS 30.0 and Python 3. Group differences in continuous variables were compared using independent-samples t-tests. Partial correlation analysis was conducted to examine the independent contributions of prerequisite course performances to Infectious Disease Nursing achievement. Analysis of covariance (ANCOVA), with gain score as a covariate, was used to evaluate the independent effect of the FC model after adjusting for prior academic achievement. All statistical tests were two-sided, with a significance level set at P < 0.05.
Because this study was retrospective in nature and involved analysis of existing educational records, no study intervention was assigned as part of the protocol. The study was conducted in accordance with the Declaration of Helsinki and received ethical approval from the Ethics Committee of Shantou University Medical College (Approval No.: SUMC-2026-013).
Tipo de estudo
Inscrição (Real)
Contactos e Locais
Locais de estudo
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Guangdong
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Shantou, Guangdong, China, 515041
- Shantou University Medical College
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Filho
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Método de amostragem
População do estudo
Descrição
Inclusion Criteria:
- documented grades in both prerequisite courses (Microbiology & Immunology and Adults Nursing) AND
- completion of the final examination
Exclusion Criteria:
- incomplete prerequisite records OR
- withdrawal from the course
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
Coortes e Intervenções
Grupo / Coorte |
Intervenção / Tratamento |
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Historical Control Group (Traditional Lecture)
This group consisted of undergraduate nursing students enrolled in the Infectious Disease Nursing course during the 2023 academic year.
Participants received traditional lecture-based instruction delivered in a teacher-centered format.
Course content covered the same integrative Infectious Disease Nursing curriculum.
Data were extracted retrospectively from existing academic records, including final examination scores, prerequisite course averages, and course feedback ratings.
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Flipped Classroom Group
This group consisted of undergraduate nursing students enrolled in the Infectious Disease Nursing course during the 2024-2025 academic year.
Participants received instruction via the flipped classroom model.
The instructional design comprised weekly modules requiring students to complete pre-class preparation activities, followed by in-class sessions emphasizing student-led presentations and case-based group discussions.
Data were extracted retrospectively from existing academic records, including final examination scores, prerequisite course averages, and course feedback ratings.
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The FC comprised seven weekly modules.
Pre-class: (a) guided readings (textbook chapters, articles, 15-20-min videos on epidemiology, pathophysiology, clinical manifestations); (b) independent PubMed search summarizing ≥5 relevant articles; (c) knowledge-synthesis worksheet identifying microbiological mechanisms (pathogen traits, transmission, virulence), immune responses, Nursing Care Plan (NCP) components from prerequisite Adults Nursing (AN), and transmission-based precautions.
In-class (90 min/week, small groups): student presentations (30 min, groups of 2-3 linking mechanisms, NCP, precautions); case discussions (20 min); facilitator feedback and misconception correction (30 min); peer feedback (10 min on integration quality and evidence).
Post-class: reflective prompts on challenging integration aspects and knowledge gaps.
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
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Final examination score
Prazo: At the end of the semester, approximately 12 weeks after course commencement
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All students completed the same final examination (100 points), consisting of three item types: knowledge recall items (30 points; A1-type multiple-choice questions on disease characteristics, transmission routes, and precaution protocols), clinical application items (40 points; A3-type multiple-choice questions presenting clinical case scenarios requiring cross-disciplinary synthesis and clinical judgment), and integrated case analysis items (30 points; case-based items requiring integration of microbiological knowledge, NCP (Nursing Care Plan) frameworks, and precaution decisions for complex patient scenarios).
All responses were scored by the automated examination system, and a research assistant independently verified the scoring of all answer sheets against the system output; no discrepancies were detected.
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At the end of the semester, approximately 12 weeks after course commencement
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Gain score
Prazo: At the end of the semester, approximately 12 weeks after course commencement
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To index knowledge integration relative to each student's own starting point, a gain score was computed: examination score minus the mean of the two prerequisite course scores.
Positive gain scores indicate performance above one's prerequisite baseline.
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At the end of the semester, approximately 12 weeks after course commencement
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
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Course feedback
Prazo: At the end of the semester, approximately 11 weeks after course commencement
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A post-course survey administered in the final week measured three dimensions on a 10-point Likert scale (1 = strongly disagree, 10 = strongly agree): interestingness, understanding, and overall effectiveness.
One open-ended question invited suggestions for improving the course.
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At the end of the semester, approximately 11 weeks after course commencement
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Colaboradores e Investigadores
Patrocinador
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Real)
Conclusão do estudo (Real)
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Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
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Outros números de identificação do estudo
- SUMC-2026-013
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