The nursing workforce is slowly shifting to be dominated by the new generation of nurses, making it even more diverse. Previous generations, such as the Baby Boomers and General X, will slowly be taken over by the millennials and Generation Z.
Gen Zs are entering the workforce. These nurses have unique characteristics as they have been exposed to the digital age, where everything is instant in a matter of seconds, and waiting is no longer an option. They have become less sociable, which may lead to anxiety, insecurity, and depression. This is evident nowadays in a traditional training session, where nurses have a limited attention span to the subject matter experts and don't want long lecture hours and traditional-based discussions. In a systematic review done by Ozbay and Cinar (2021), they found that flipped classrooms increased the classroom participation and active learning of nursing students. Hence, a clinical problem arise that is specific to newly hired registered nurses.
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P - Newly Hired Registered Nurses
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I - Flipped Classroom
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C - Traditional Nursing Classroom
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O - Increase in knowledge retention and active participation
PICO Question: In newly hired Registered Nurse, how does a flipped classroom approach compared to a traditional nursing classroom impact knowledge retention and active participation in the onboarding program?
Article 1: Effectiveness of flipped classroom teaching models in nursing education: A systematic review
The systematic review focused on nursing graduates to post-graduate nursing students, assessing the effectiveness of flipped classrooms (FC) compared to traditional classrooms (TC). Inclusion and exclusion criteria were established to identify relevant studies for review. However, the scoring system—classified as "High," "Medium," and "Low"—appeared somewhat confusing. Titles and abstracts of studies were initially screened, followed by full-text evaluation. The Quality Assessment Tool for Quantitative Studies (QATQS) was employed to assess the quality of the included studies, evaluating aspects such as selection bias, study design, confounders, blinding, data collection methods, and participant withdrawals.
The findings revealed that the FC method significantly enhanced the skill competence of nursing students. Furthermore, compared to traditional classrooms, FCs were more effective in fostering student engagement and promoting higher-level thinking skills, including critical, logical, reflective, metacognitive, and creative thinking. The FC approach empowers learners to work at their own pace, offers flexibility in accessing resources, and uses in-class time for student discussions rather than direct instruction.
In the 15 studies reviewed, the FC method was associated with increased active participation, improved performance, and higher student satisfaction. However, confidence levels or margins of error were not provided. Given that the sample population consisted of nurses, these findings are relevant and applicable to local nursing populations as well.
Article 2: Investigation flipped classroom effectiveness in teaching anatomy: A systematic review
The outcome of the study was clearly identified, though the specific population for the applicability of the findings was not explicitly stated. The intervention, flipped classroom (FC), was clearly defined. Inclusion criteria were established to filter applicable studies for review. However, it is worth noting that the studies reviewed primarily came from first-world countries, which may limit the generalizability of the findings to other populations.
The review carefully considered references, criteria, study methodology, and explicit discussions. While some studies showed no effect, there were no studies that contradicted the overall results. The systematic review concluded that the flipped classroom method is generally perceived positively, with clear advantages such as increased self-confidence, academic achievement, engagement, participation in learning activities, interaction, satisfaction, and overall performance.
The majority of studies included in the review reported a 95% confidence level, lending credibility to the findings. Given that the population involved in the studies were health science students, the findings are applicable to the identified problem, particularly in the context of nursing and healthcare education. The expected outcomes were observed, and no harm was reported in the studies, further supporting the safety and effectiveness of the flipped classroom approach.
Overall, the two systematic reviews are applicable to the local setting especially to the onboarding programs of the hospital because it will enhance communication and creative thinking skills of the newly hired nurses. Furthermore, the majority of the newly hired nurses are fresh graduates leading to their limited skillset. Hence, active learning and participation could be be enhance in using the flipped learning style.
References:
Kazeminia, M., Salehi, L., Khosravipour, M., & Rajati, F. (2022). Investigation flipped classroom effectiveness in teaching anatomy: A systematic review. In Journal of Professional Nursing (Vol. 42, pp. 15–25). W.B. Saunders. https://doi.org/10.1016/j.profnurs.2022.05.007
Özbay, Ö., & Çınar, S. (2021). Effectiveness of flipped classroom teaching models in nursing education: A systematic review. Nurse Education Today, 102, 104922. https://doi.org/10.1016/j.nedt.2021.104