Flipped Classroom in Nursing Schools

Words: 1214
Topic: Education


This paper aims to review available scholarship on the flipped classroom model with the view to demonstrating how it can be effectively used in associate degree nursing schools.

The results demonstrate that the flipped classroom supports a sound pedagogical model that can be used to develop highly competent nurses due to its immense benefits, which include enabling students to gain confidence in independent learning and to develop skills in critical thinking, creativity, communication, engagement, collaboration, and team-based operations.


Today, many teachers are employing entirely new models to deliver educational content to students due to the ongoing pedagogical shifts and recent advances in technology (Hawks, 2014). The flipped or inverted classroom is one such model that is increasingly gaining currency and effectiveness not only in nursing but also in other domains of education (Enfield, 2013). This paper reviews literature on the flipped classroom model with the view to demonstrating how it can be effectively used in associate degree nursing schools.

Background and Significance of Flipped Classroom

Enfield (2013) acknowledges that flipping the classroom basically entails providing instructional resources (e.g., videos, podcasts, articles) that enable students to understand the concept outside of class, hence freeing up valuable class time for more engaging and collaborative tasks normally facilitated by the teacher.

In discussing the flipped class model, Hawks (2014) notes that, “instead of spending the classroom time lecturing about topics covered in pre-class reading assignments, faculty interact with students by discussing points of confusion, providing real-life examples relevant to course content, challenging students to think more deeply about complex processes, and monitoring pee-to-peer, team-based learning activities” (p. 265).

In the nursing context, out-of-class activities may include watching instructional videos and podcasts, reading assigned books and articles, as well as giving quizzes prior to the commencement of each class period over the assigned videos or podcasts to facilitate students to keep up with the instruction and be prepared for classroom encounters (Enfield, 2013; Hawks, 2014).

In-class activities under the model may include instructor led demonstration of new nursing concepts and applications, instructor led demonstration of nursing concepts and applications previously introduced in videos and podcasts, group-oriented activities and tasks aimed at practicing the nursing concepts and theories previously learnt, and open lab time to work on allocated projects (Enfield, 2013).

The flipped classroom model uses active learning methodology, which enables educators to “move from rote memorisation of knowledge and facts, known as surface learning, toward deep learning, where understanding is developed through active and constructive processes” (Roehl, Reddy, & Shannon, 2013, p. 45).

Educators in associate degree nursing schools must therefore shift their instructional methodology from a teaching-focussed paradigm toward a student-focussed paradigm; that is, they must focus on student activity as well as student engagement and collaboration in the learning process (Jamaludin & Osman, 2014; Roehl et al., 2013).

In using the flipped classroom model, associate degree nursing schools are likely to gain immeasurable benefits that are absent in traditional classroom contexts.

Available scholarship demonstrates that some of the benefits associated with the model include (1) enhancing class time for more engaging and collaborative instruction, (2) reinforcing students’ team-based skills and competencies, (3) personalising student guidance, (4) focusing classroom discussion, (5) facilitating the creative freedom of faculty while upholding a standardised curriculum, and (6) facilitating students to move at their own pace, derive instruction at any time, and access expertise from manifold sources (Enfield, 2013).

Some of the limitations associated with the flipped classroom model and active learning methodology include (1) concerns with accessibility to instructional resources offered through online protocols, (2) mounting predispositions toward no homework for students, (3) increasing concerns by instructors that their role will be reduced, (4) enhanced time requirements without improved pedagogy, and (5) lack of accountability for students in terms of completing out-of-class instructions (Enfield, 2013).

Other challenges associated with the methodology include inability to adapt the classroom environment to demonstrate the flipped classroom’s competence to sustain student-centred learning, inability to ensure that students’ experience with out-of-class instruction is interactive, inability to develop lectures that will provide classroom instruction based on individual student learning styles, as well as the restrictive cost and time required to develop instructional resources (Johnson, 2013; Roehl et al., 2013).

Brief Review of Literature

Available literature demonstrates that one of the most utilised methods in the flipped classroom involves small group discussions, whereby nursing students get into small groups to undertake formative and summative evaluations of classroom content and also engage in significant face-to-face learning activities aimed at encouraging them to organise their thinking by comparing notions and elucidations with each other (Enfield, 2013; Hawks, 2014).

Another method being used in flipped classroom contexts is the peer-to-peer learning, which not only facilitates active communication and conflict resolution among nursing students in the associate degree program, but also encourages team building and enhances student engagement and collaboration (Hawks, 2014).

In the flipped classroom, nursing students can also learn through role-playing, which basically provides them with the capacity to learn how to best handle a scenario by practicing simulated interactions and trying out different approaches that may be possible in real-life contexts (Jamaludin & Osman, 2014).

Other methods include case studies (directing student groups in investigating the same or different case studies and sharing results to develop practice in responding to corrective feedback and provide justifications for individual decisions), journal article reviews (evaluating and critiquing scholarly articles on current content with the view to developing students’ writing skills and their capability to translate evidence to practice), conceptual mapping, brainstorming, collaborative learning, and project-oriented learning (Enfield, 2013; Galway, Corbett, Takara, Tairyan, & Frank, 2014; Hawks, 2014).

It is important to review the results of several studies on the flipped classroom. In a study aimed at examining the effectiveness of the flipped classroom model among undergraduate students in a university setting, Enfield (2013) found that the model is effective in assisting students become more confident in their ability to learn independently and in using out of class instruction.

However, some of the limitations include inability of the videos and other instructional resources to effectively cover educational content, inability to plan in-class activities, and gaps in ensuring instructional materials comply with the various legislations protecting the rights of people with disabilities (Enfield, 2013).

In their presentation on the flipped classroom, Roehl et al (2013) found that the model is effective in developing important student qualities including critical thinking, creativity, communication and collaboration; however, a major limitation is that the model may not applicable to all subjects or classroom contexts.

Lastly, in a study aimed at investigating how a flipped classroom enhances engagement and promotes active learning, Jamaludin and Osman (2014) found that the model assists instructors to realise their teaching outcomes and to make teaching more engaging, collaborative, active, and student-centred through reinforcing behavioural, emotional, and cognitive engagements.


This paper shows that the flipped classroom supports a sound pedagogical model that can be effectively used in associate degree nursing schools to develop highly competent nursing professionals due to its immense benefits, which include enabling students to gain confidence in independent learning and to develop skills in critical thinking, creativity, communication, engagement, collaboration, and team-based operations.

However, more research studies need to be undertaken to deal with the observed limitations of the model and hence enhance optimal student instructional outcomes.


Enfield, J. (2013). Looking at the impact of the flipped classroom model of instruction on undergraduate multimedia students at CSUN. Tech Trends: Linking Research & Practice to Improving Learning, 57(6), 14-27.

Galway, L.P., Corbett, K.K., Takara, T.K., Tairyan, K., & Frank, E. (2014). A novel integration of online and flipped classroom instructional models in public health public education. BMC Medical Education, 14(2), 1-9.

Hawks, S.J. (2014). The flipped classroom: Now or never? AANA Journal, 82(4), 264-269.

Jamaludin, R., & Osman, S.Z.M. (2014). The use of flipped classroom to enhance engagement and promote active learning. Journal of Education and Practice, 5(2), 124-131.

Johnson, G.B. (2013). Student perceptions of the flipped classroom (Master’s thesis, the University of British Columbia, Vancouver, Canada).

Roehl, A., Reddy, S.L., & Shannon, C.J. (2013). The flipped classroom: An opportunity to engage millennial students through active learning strategies. Journal of Family & Consumer Sciences, 105(2), 44-49.