Ping Xu1, Yingying Chen1, Wenbo Nie1, Yuan Wang1, Tianjiao Song1, Haoran Li1, Jin Li1, Jiang Yi2, Lijing Zhao3. 1. School of Nursing, Jilin University, Changchun, China. 2. School of Nursing, Jilin University, Changchun, China. Electronic address: sgyj@126.com. 3. School of Nursing, Jilin University, Changchun, China. Electronic address: zhao_lj@jlu.edu.cn.
Abstract
OBJECTIVES: Skill competence is essential for nursing students and flipped-classroom teaching has become increasingly popular in China's nursing education. However, no studies have yet specifically examined the effect of a flipped classroom versus a traditional classroom on their skill competence. DESIGN: A systematic review and meta-analysis of randomised controlled trials. DATA SOURCES: The China National Knowledge Infrastructure, Wanfang Data, VIP, Superstar, PubMed, and Web of Science databases were searched from their inception until 9 June 2018. REVIEW METHODS: We screened the studies according to inclusion and exclusion criteria, extracted the data, and assessed the quality. Then, a meta-analysis was conducted. RESULTS: Twenty-two studies were eligible after reviewing 484 citations. The flipped classroom increased the students' skills score compared with the traditional teaching method (standardised mean difference = 1.79, 95% confidence interval: 1.32-2.27, p = 0.000). Additionally, it improved the cooperative spirit and sense of teamwork (effect size = 1.60, 95% confidence interval: 1.15-2.06), practical ability (effect size = 1.47, 95% confidence interval: 0.93-2.01), enjoyment of the course (effect size = 1.39, 95% confidence interval: 0.81-1.97), expression and communication (effect size = 1.41, 95% confidence interval: 0.69-2.12), the curriculum's effects (effect size = 1.32, 95% confidence interval: 1.00-1.64), interest in participation (effect size = 1.58, 95% confidence interval: 1.28-1.87), ability to think and analyse problems (effect size = 1.62, 95% confidence interval: 1.24-2.00), and resolution and resilience (effect size = 1.62, 95% confidence interval: 1.29-1.94). CONCLUSIONS: The results suggest that the flipped classroom is more effective for the nursing students' skill competence than traditional teaching in China. However, due to heterogeneity and bias risk, a large sample and high-quality studies are needed in future to confirm its effectiveness.
OBJECTIVES: Skill competence is essential for nursing students and flipped-classroom teaching has become increasingly popular in China's nursing education. However, no studies have yet specifically examined the effect of a flipped classroom versus a traditional classroom on their skill competence. DESIGN: A systematic review and meta-analysis of randomised controlled trials. DATA SOURCES: The China National Knowledge Infrastructure, Wanfang Data, VIP, Superstar, PubMed, and Web of Science databases were searched from their inception until 9 June 2018. REVIEW METHODS: We screened the studies according to inclusion and exclusion criteria, extracted the data, and assessed the quality. Then, a meta-analysis was conducted. RESULTS: Twenty-two studies were eligible after reviewing 484 citations. The flipped classroom increased the students' skills score compared with the traditional teaching method (standardised mean difference = 1.79, 95% confidence interval: 1.32-2.27, p = 0.000). Additionally, it improved the cooperative spirit and sense of teamwork (effect size = 1.60, 95% confidence interval: 1.15-2.06), practical ability (effect size = 1.47, 95% confidence interval: 0.93-2.01), enjoyment of the course (effect size = 1.39, 95% confidence interval: 0.81-1.97), expression and communication (effect size = 1.41, 95% confidence interval: 0.69-2.12), the curriculum's effects (effect size = 1.32, 95% confidence interval: 1.00-1.64), interest in participation (effect size = 1.58, 95% confidence interval: 1.28-1.87), ability to think and analyse problems (effect size = 1.62, 95% confidence interval: 1.24-2.00), and resolution and resilience (effect size = 1.62, 95% confidence interval: 1.29-1.94). CONCLUSIONS: The results suggest that the flipped classroom is more effective for the nursing students' skill competence than traditional teaching in China. However, due to heterogeneity and bias risk, a large sample and high-quality studies are needed in future to confirm its effectiveness.