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Original Article
- Applying the Flipped Learning Model to an English-Medium Nursing Course
- Heeseung Choi1, Jeongeun Kim1, Kyung-Sook Bang1, Yeon-Hwan Park1, Nam-Ju Lee1, Chanhee Kim2
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Journal of Korean Academy of Nursing 2015;45(6):939-948.
DOI: https://doi.org/10.4040/jkan.2015.45.6.939
Published online: December 15, 2015
1College of Nursing and the Research Institute of Nursing Science, Seoul National University, Seoul
2College of Nursing, Seoul National University, Seoul, Korea
1College of Nursing and the Research Institute of Nursing Science, Seoul National University, Seoul
2College of Nursing, Seoul National University, Seoul, Korea
- Address reprint requests to : Choi, Heeseung College of Nursing and the Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: +82-2-740-8850 Fax: +82-2-765-4103 E-mail: hchoi20@snu.ac.kr
• Received: January 7, 2015 • Revised: January 16, 2015 • Accepted: August 11, 2015
Copyright © 2015 Korean Society of Nursing Science
This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.
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Abstract
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Purpose
- An emerging trend in Asian higher education is English-medium instruction (EMI), which uses English as the primary instructional language. EMI prepares domestic students for international leadership; however, students report difficulty in learning, and educators have raised questions concerning the effectiveness of EMI. The flipped learning model (FLM), in which lecture and homework activities for a course are reversed, was applied to an English-medium course offered by a college of nursing in Korea. The aims of this study were to: 1) revise an existing English-medium nursing course using the FLM; 2) explore students’ learning experiences and their acceptance of the FLM; and 3) identify key factors in the success of FLM.
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Methods
- We used a descriptive, cross-sectional, mixed-methods design and the participants were students at one nursing school in Korea. A series of course development meetings with faculties from the nursing school and the center for teaching and learning were used to develop the course format and content. We conducted course evaluations using the Flipped Course Evaluation Questionnaire with open-ended questions and focus group interviews.
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Results
- Students (N=75) in a 15-week nursing course responded to a survey after completing the course. Among them, seven students participated in one of two focus groups. Overall, students accepted and favored the flipped learning strategy, and indicated that the method enhanced lecture content and their understanding of it. Factors associated with effective instruction included structured monitoring systems and motivational environments.
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Conclusion
- The FLM requires sufficient preparation to facilitate student motivation and maximize learning outcomes.
Table 1.Content Outline of the Course
Table 2.Learning Activities using Pre-recorded Lectures (N=75)
| Learning activities | Categories | n (%) |
|---|---|---|
| 1. Have you watched the pre-recorded lectures | I watched every pre-recorded lecture | 40 (53.3) |
| prior to the class? | I missed the pre-recorded lectures 1~2 times | 33 (44.0) |
| I missed the pre-recorded lectures 3~4 times | 2 (2.7) | |
| I missed the pre-recorded lectures more than 5 times | 0 (0.0) | |
| 2. How did you watch the pre-recorded | I watched the pre-recorded lectures from beginning to end | 19 (25.3) |
| lectures? | I watched all of the pre-recorded lectures and the parts that I did not understand again | 49 (65.3) |
| I watched only the parts that I did not understand | 5 (6.7) | |
| No response | 2 (2.7) | |
| 3. Have you reviewed pre-recorded lectures | Yes | 51 (68.0) |
| when preparing for the final exam? | No | 24 (32.0) |
| 4. Do you think reviewing recorded lectures | Yes, it was helpful because I could repeatedly review parts that I did not understand | 38 (74.5) |
| helped you to prepare for the final exam?* | Yes, it was helpful because I could review only parts I did not understand | 10 (19.6) |
| No, it was not helpful for examinations | 1 (2.0) | |
| No response | 2 (3.9) |
Table 3.Evaluations of the Flipped Learning Method (N=75)
Table 4.Major Themes and Subthemes Extracted from the Focus Group Interviews
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XML DownloadApplying the Flipped Learning Model to an English-Medium Nursing Course
Figure 1. Flipped course format for the course titled,“Human Beings and Health”.
Figure 1.
Applying the Flipped Learning Model to an English-Medium Nursing Course
| Content | Activities and assignments |
|---|---|
| Main Topics | 2-minute self-video on the concepts of health, humans, and |
| 1. Meta-paradigms in nursing: Humans, health, environment, & nursing | nursing: Peer feedback and class discussions |
| 2. Theories of human development: Physical, psychosocial, cognitive, and | Group project: An analysis of a movie or drama using four |
| moral development | nursing meta-paradigms: Peer feedback |
| 3. Human developmental characteristics: Prenatal and infancy | Health promotion project: Peer feedback on both progress and |
| 4. Human developmental characteristics: Childhood | final outcomes of each other’s projects |
| 5. Human developmental characteristics: Adolescence | Critical thinking activities: Euthanasia, sexual behaviors among |
| 6. Human developmental characteristics: Early and middle adulthood | adolescents, depression and suicide among college students, |
| 7. Human developmental characteristics: Late adulthood and theories of aging | health disparities |
| Special Topics | |
| 1. How to utilize cTL and eTL services | |
| 2. How to create self-videos | |
| 3. How to use movie maker program | |
| 4. Mass media influences on health and sexuality | |
| 5. Hospice care and nursing | |
| 6. Facts about suicide among college student |
| Learning activities | Categories | n (%) |
|---|---|---|
| 1. Have you watched the pre-recorded lectures | I watched every pre-recorded lecture | 40 (53.3) |
| prior to the class? | I missed the pre-recorded lectures 1~2 times | 33 (44.0) |
| I missed the pre-recorded lectures 3~4 times | 2 (2.7) | |
| I missed the pre-recorded lectures more than 5 times | 0 (0.0) | |
| 2. How did you watch the pre-recorded | I watched the pre-recorded lectures from beginning to end | 19 (25.3) |
| lectures? | I watched all of the pre-recorded lectures and the parts that I did not understand again | 49 (65.3) |
| I watched only the parts that I did not understand | 5 (6.7) | |
| No response | 2 (2.7) | |
| 3. Have you reviewed pre-recorded lectures | Yes | 51 (68.0) |
| when preparing for the final exam? | No | 24 (32.0) |
| 4. Do you think reviewing recorded lectures | Yes, it was helpful because I could repeatedly review parts that I did not understand | 38 (74.5) |
| helped you to prepare for the final exam? |
Yes, it was helpful because I could review only parts I did not understand | 10 (19.6) |
| No, it was not helpful for examinations | 1 (2.0) | |
| No response | 2 (3.9) |
| Compared to traditional learning methods, the flipped learning method | Disagree |
Neutral |
Agree |
No response |
|---|---|---|---|---|
| n (%) | n (%) | n (%) | n (%) | |
| was strange and more uncomfortable | 27 (36.0) | 32 (42.7) | 15 (20.0) | 1 (1.3) |
| was more time-consuming | 8 (10.7) | 10 (13.3) | 56 (74.7) | 1 (1.3) |
| was more difficult to understand | 42 (56.0) | 19 (25.3) | 11 (14.7) | 3 (4.0) |
| was less interesting | 33 (44.0) | 22 (29.3) | 19 (25.4) | 1 (1.3) |
| was less efficient than a traditional class | 39 (52.0) | 18 (24.0) | 18 (24.0) | 0 (0.0) |
| made it harder to concentrate | 23 (30.7) | 14 (18.7) | 38 (50.6) | 0 (0.0) |
| was less effective in academic achievement | 40 (53.3) | 21 (28.0) | 12 (16.0) | 2 (2.7) |
| Main themes | Subthemes |
|---|---|
| Benefits of the flipped course | Improved comprehension |
| Able to preview and review material as needed | |
| Able to watch the lectures at one’s own pace | |
| Able to prepare questions for instructor | |
| Able to identify key concepts | |
| Flexibility & Efficiency | |
| Able to choose best time and place for learning | |
| Able to concentrate on materials | |
| Able to review material regularly and avoid cramming for final exam | |
| Enhanced learning experiences | |
| Able to pursue in-depth knowledge through critical questions and class discussions | |
| Experience sense of accomplishment as a result of self-directed learning | |
| Understand concepts of human beings and nursing from diverse perspectives | |
| Gain critical thinking skills | |
| Experience new ways of learning | |
| Gain ability to engage in diverse activities during class | |
| Being exposed to diverse lecture content | |
| Limitations or challenges | Demands, both time and effort |
| A lack of timely assessment and feedback on students’ questions | |
| Not familiar with class discussions | |
| Class size matters | |
| Key success factors | Structured monitoring systems |
| Strategies to assess students’ performance | |
| Mandatory participation on online discussions | |
| Maintaining an open communication channel | |
| Motivational environment: Well-thought-out plans | |
| For class activities: Effective utilization of class hours | |
| For class discussion: Topics appropriate to the learning level and class size | |
| Pre-recorded lecture: Proper length (25~30 minutes, no more than 40 minutes) |
Table 1. Content Outline of the Course
Table 2. Learning Activities using Pre-recorded Lectures (N=75)
Only students who answered “yes” to question #3 responded to question #4 (n=51).
Table 3. Evaluations of the Flipped Learning Method (N=75)
Table 4. Major Themes and Subthemes Extracted from the Focus Group Interviews
