Development And Application Of Flipped Classroom Model Of Fundamental Nursing Practicing Course

Objectives1.To develop a flipped classroom model of Fundamental Nursing Practicing Course(FCM-FNPC).2.To develop and psychometrically test the Nursing Course Experience Questionnaire(NCEQ).3.To evaluate the effect of FCM-FNPC among nursing undergraduates.Methods1.Based on literature review and expert panel meeting,the FCM-FNPC was constructed through three parts: the design of the teaching form,the improvement of the implementation conditions and the design of the evaluation measures for the teaching effect.2.A preliminary Nursing Course Experience Questionnaire(NCEQ)for nursing students evaluations of teaching was formed through literature review,focus group interviews and student group discussions.Then through two rounds of Delphi expert consultation and pre-test,the content of the questionnaire was checked.602 students were selected using cluster sampling to fill in the questionnaire,and 581 valid questionnaires were recovered.The reliability and validity of the questionnaire were tested in order to form the official version of NCEQ.3.The cluster sampling method was used to select 146 students from Class B enrolled in 2016 as a control group and 151 students of Class B enrolled in 2017 as an experimental group for the non-synchronized control experiment.The control group adopted the traditional teaching method,and the experimental group adopted the FCM-FNPC.The NCEQ,nursing student self-learning ability assessment tool,scores of course test,student focus group interviews and teacher’s personal interviews were used to evaluate the teaching effect of FCM-FNPC.Results1.The FCM-FNPC was developed,which includes: a teaching form consisting of pre-class section(online video learning,practice exercises),in-class section(quizzes and answers,students’ demonstration,students’ discussion and questioning,teachers’ instruction and commenting,in-class practice)and after-class section(video review and practice exercises);the learning resource based on an autonomous learning platform;the evaluation measures for the teaching effect,which regarded nursing students’ self-learning ability,students learning effectiveness,student evaluations of course teaching,and subjective experience of teachers and students as evaluation indicators.2.NCEQ was developed with good reliability and validity.The questionnaire contains31 items and 6 dimensions including teaching and curriculum,individual development,professional quality,academic support,practical activity and course assessment.The results of factor analysis showed that the factor load of all the retained items is above0.4.The percentage of the total variance explained by the common factors was 62.28%.The Cronbach’s α was 0.968 for the whole questionnaire and >0.751 for the sub-scales.3.The results of the application of FCM-FNPC were as follows.(1)Differences in the general information of the experimental group and the control group such as the gender of the students,average scores in last year and student residence had no statistically significance(P>0.05)and two groups were comparable.(2)The scores of the self-learning ability assessment: The total scores of self-learning ability assessment and the scores of the subscales,except learning motivation subscale,in the experimental group were significantly higher than those in the control group(P<0.05).The total scores and the scores of all the subscales in the experimental group after intervention were significantly higher than those before intervention(P<0.05).Two-way ANOVA results show that: The group effect was significant on total scores and information quality scores(P<0.05),but it was not significant on the scores of learning motivation,cooperation ability and self-management ability(P>0.05).The time effect on all dimensions were significant(P<0.05).The interaction effect between group and time was significant on total scores,information quality scores and cooperation ability scores(P<0.05),but it was not significant on the scores of learning motivation and self-management ability(P>0.05).(3)The scores of course test: The practicing scores of the experimental group were higher than those in the control group,and the difference was statistically significant(P<0.05).The differences between the average scores of the theoretical scores,ordinary scores,and total course scores of the experimental group and those of the control group,were not statistically significant(P>0.05).(4)The scores of NCEQ: The scores of the experimental group in all NCEQ dimensions were higher than those of the control group,and the differences were statistically significant(P<0.05).(5)Through the focus group interviews of the students,four themes including “FCM-FNPC is challenging”,“The learning resources of FCM-FNPC are rich and effective”,“FCM-FNPC can promote students learning” and“FCM-FNPC can improve the quality of teachers’ teaching”,emerged from the analysis.(6)Through analyzing the teacher’s personal interview data,three themes including “FCM-FNPC put forward higher requirements for teachers”,“FCM-FNPC enables students to participate in the classroom more actively” and “FCM-FNPC can reduce teachers’ in-class teaching burden” were extracted.Conclusions1.FCM-FNPC is scientific,applicable and feasible.2.NCEQ has good reliability and validity,which can be used as an instrument for nursing students to evaluate teaching.3.FCM-FNPC can effectively improve the self-learning ability of nursing undergraduates,the practicing scores and student evaluations of nursing course.Teachers and students can accept FCM-FNPC,and most of them had positive comments.