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      A comparison of three interactive examination designs in active learning classrooms for nursing students

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          Abstract

          Background

          Despite the advantages of using active learning strategies in nursing education, researchers have rarely investigated how such pedagogic approaches can be used to assess students or how interactive examinations can be modified depending on circumstances of practice (e.g., in online education).

          Aims

          The aim was to compare three interactive examination designs, all based on active learning pedagogy, in terms of nursing students’ engagement and preparedness, their learning achievement, and instructional aspects.

          Methods

          A comparative research design was used including final-year undergraduate nursing students. All students were enrolled in a quality improvement course at a metropolitan university in Sweden. In this comparative study to evaluate three course layouts, participants (Cohort 1, n = 89; Cohort 2, n = 97; Cohort 3, n = 60) completed different examinations assessing the same course content and learning objectives, after which they evaluated the examinations on a questionnaire in numerical and free-text responses. Chi-squared tests were conducted to compare background variables between the cohorts and Kruskal–Wallis H tests to assess numerical differences in experiences between cohorts. Following the guidelines of the Good Reporting of a Mixed Methods Study (GRAMMS), a sequential mixed-methods analysis was performed on the quantitative findings, and the qualitative findings were used complementary to support the interpretation of the quantitative results.

          Results

          The 246 students who completed the questionnaire generally appreciated the interactive examination in active learning classrooms. Among significant differences in the results, Cohort 2 (e.g., conducted the examination on campus) scored highest for overall positive experience and engagement, whereas Cohort 3 (e.g., conducted the examination online) scored the lowest. Students in Cohort 3 generally commended the online examination’s chat function available for use during the examination.

          Conclusions

          Interactive examinations for nursing students succeed when they are campus-based, focus on student preparation, and provide the necessary time to be completed.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12912-021-00575-6.

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          Most cited references43

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          The quality of mixed methods studies in health services research.

          To assess the quality of mixed methods studies in health services research (HSR). We identified 118 mixed methods studies funded by the Department of Health in England between 1994 and 2004, and obtained proposals and/or final reports for 75. We applied a set of quality questions to both the proposal and report of each study, addressing the success of the study, the mixed methods design, the individual qualitative and quantitative components, the integration between methods and the inferences drawn from completed studies. Most studies were completed successfully. Researchers mainly ignored the mixed methods design and described only the separate components of a study. There was a lack of justification for, and transparency of, the mixed methods design in both proposals and reports, and this had implications for making judgements about the quality of individual components in the context of the design used. There was also a lack of transparency of the individual methods in terms of clear exposition of data collection and analysis, and this was more a problem for the qualitative than the quantitative component: 42% (19/45) versus 18% (8/45) of proposals (p = 0.011). Judgements about integration could rarely be made due to the absence of an attempt at integration of data and findings from different components within a study. The HSR community could improve mixed methods studies by giving more consideration to describing and justifying the design, being transparent about the qualitative component, and attempting to integrate data and findings from the individual components.
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            The flipped classroom: A review of its advantages and challenges

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              The evidence for 'flipping out': A systematic review of the flipped classroom in nursing education.

              The flipped classroom has generated interest in higher education providing a student-centred approach to learning. This has the potential to engage nursing students in ways that address the needs of today's students and the complexity of contemporary healthcare. Calls for educational reform, particularly in healthcare programs such as nursing, highlight the need for students to problem-solve, reason and apply theory into practice. The drivers towards student-based learning have manifested in team, problem and case-based learning models. Though there has been a shift towards the flipped classroom, comparatively little is known about how it is used in nursing curricula.
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                Author and article information

                Contributors
                christopher.holmberg@gu.se
                Journal
                BMC Nurs
                BMC Nurs
                BMC Nursing
                BioMed Central (London )
                1472-6955
                9 April 2021
                9 April 2021
                2021
                : 20
                : 59
                Affiliations
                [1 ]GRID grid.8761.8, ISNI 0000 0000 9919 9582, Institute of Health and Care Sciences, Section of Learning and Leadership for Health Care Professionals, , University of Gothenburg, ; Arvid Wallgrens Backe, Box 457, 405 30 Gothenburg, Sweden
                [2 ]GRID grid.1649.a, ISNI 000000009445082X, Department of Orthopedics, , Sahlgrenska University Hospital, ; Gothenburg, Sweden
                [3 ]GRID grid.1649.a, ISNI 000000009445082X, Department of Psychotic Disorders, , Sahlgrenska University Hospital, ; Gothenburg, Sweden
                Article
                575
                10.1186/s12912-021-00575-6
                8033549
                33836729
                ce5b2d7f-6252-4c01-92ca-a5d54329a27c
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 20 January 2021
                : 22 March 2021
                Funding
                Funded by: University of Gothenburg
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2021

                Nursing
                active learning,active learning classroom,digital education,formative assessment,interactive examination,nursing education,quality improvement

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