An observational study in Evaluation of the Flipped Classroom Model in Infectious Disease Nursing Education, sponsored by Shantou University Medical College. Completed at 1 site in China. Per ClinicalTrials.gov, last updated 2026-09-08.
Sponsored by Shantou University Medical College · Observational
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The goal of this retrospective cohort study was to evaluate whether the flipped classroom (FC) teaching model improved academic performance and student engagement in an integrative Infectious Disease Nursing course, compared with traditional lecture-based instruction. The main questions it aimed to answer were:
Participants in the flipped classroom group (2024-2025 cohort):
This is a single-center, retrospective cohort study designed to evaluate the effectiveness of the flipped classroom (FC) teaching model compared with traditional lecture-based instruction in an integrative Infectious Disease Nursing course.
The study was conducted at Shantou University Medical College, China. Undergraduate nursing students enrolled in the Infectious Disease Nursing course during the 2024-2025 academic year (the FC cohort, n = 18) were compared with historical controls who received lecture-based instruction during the 2023 academic year (the control cohort, n = 36). All participants were from the same instructional track and completed the same course requirements.
For the FC cohort, the instructional design consisted of weekly modules that required students to complete pre-class preparation activities, including reviewing recorded educational videos and assigned readings. In-class sessions were structured around student-led presentations and case-based group discussions to reinforce the pre-class content. The historical control cohort received conventional teacher-centered lectures covering the same course content during the 2023 academic year.
Data were extracted retrospectively from existing academic records and course evaluation databases. The primary outcome measure was final examination score, which consisted of multiple-choice questions and open-questions covering integrative Infectious Disease Nursing content. Secondary outcome measures included gain scores (calculated as final examination score minus the average prerequisite course score) and course feedback ratings on student interest and overall learning experience.
Statistical analyses were performed using SPSS 30.0 and Python 3. Group differences in continuous variables were compared using independent-samples t-tests. Partial correlation analysis was conducted to examine the independent contributions of prerequisite course performances to Infectious Disease Nursing achievement. Analysis of covariance (ANCOVA), with gain score as a covariate, was used to evaluate the independent effect of the FC model after adjusting for prior academic achievement. All statistical tests were two-sided, with a significance level set at P \< 0.05.
Because this study was retrospective in nature and involved analysis of existing educational records, no study intervention was assigned as part of the protocol. The study was conducted in accordance with the Declaration of Helsinki and received ethical approval from the Ethics Committee of Shantou University Medical College (Approval No.: SUMC-2026-013).
Shantou University Medical College is the lead sponsor of 12 studies on the registry; 5 are open to participants now.
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All students in the 2021, 2022, and 2023 cohorts who completed the course of Infectious Diseases Nursing (IN) were eligible.
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Exclusion Criteria:
This group consisted of undergraduate nursing students enrolled in the Infectious Disease Nursing course during the 2023 academic year. Participants received traditional lecture-based instruction delivered in a teacher-centered format. Course content covered the same integrative Infectious Disease Nursing curriculum. Data were extracted retrospectively from existing academic records, including final examination scores, prerequisite course averages, and course feedback ratings.
This group consisted of undergraduate nursing students enrolled in the Infectious Disease Nursing course during the 2024-2025 academic year. Participants received instruction via the flipped classroom model. The instructional design comprised weekly modules requiring students to complete pre-class preparation activities, followed by in-class sessions emphasizing student-led presentations and case-based group discussions. Data were extracted retrospectively from existing academic records, including final examination scores, prerequisite course averages, and course feedback ratings.
Other: Flipped Classroom (FC) as the teaching mode
The FC comprised seven weekly modules. Pre-class: (a) guided readings (textbook chapters, articles, 15-20-min videos on epidemiology, pathophysiology, clinical manifestations); (b) independent PubMed search summarizing ≥5 relevant articles; (c) knowledge-synthesis worksheet identifying microbiological mechanisms (pathogen traits, transmission, virulence), immune responses, Nursing Care Plan (NCP) components from prerequisite Adults Nursing (AN), and transmission-based precautions. In-class (90 min/week, small groups): student presentations (30 min, groups of 2-3 linking mechanisms, NCP, precautions); case discussions (20 min); facilitator feedback and misconception correction (30 min); peer feedback (10 min on integration quality and evidence). Post-class: reflective prompts on challenging integration aspects and knowledge gaps.
Final examination score
All students completed the same final examination (100 points), consisting of three item types: knowledge recall items (30 points; A1-type multiple-choice questions on disease characteristics, transmission routes, and precaution protocols), clinical application items (40 points; A3-type multiple-choice questions presenting clinical case scenarios requiring cross-disciplinary synthesis and clinical judgment), and integrated case analysis items (30 points; case-based items requiring integration of microbiological knowledge, NCP (Nursing Care Plan) frameworks, and precaution decisions for complex patient scenarios). All responses were scored by the automated examination system, and a research assistant independently verified the scoring of all answer sheets against the system output; no discrepancies were detected.
Time frame: At the end of the semester, approximately 12 weeks after course commencement
Gain score
To index knowledge integration relative to each student's own starting point, a gain score was computed: examination score minus the mean of the two prerequisite course scores. Positive gain scores indicate performance above one's prerequisite baseline.
Time frame: At the end of the semester, approximately 12 weeks after course commencement
Course feedback
A post-course survey administered in the final week measured three dimensions on a 10-point Likert scale (1 = strongly disagree, 10 = strongly agree): interestingness, understanding, and overall effectiveness. One open-ended question invited suggestions for improving the course.
Time frame: At the end of the semester, approximately 11 weeks after course commencement
Plan to share: No — The data are not publicly available due to ethical restrictions (student academic records; the ethics approval did not include public deposition).
No publications or documents are linked to this record.
Ran from May 2026 to primary completion in Aug 2026, 3 months.
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Shantou University Medical College