Exploring flipped classrooms in undergraduate nursing and health science: A systematic review.

AIM: We conducted a systematic review to investigate the effect of implementing flipped classroom designs on academic performance, student satisfaction and self-efficacy in undergraduate health science disciplines. BACKGROUND: Blended learning approaches, including the flipped classroom, have been increasingly implemented in higher education. To date, studies examining the effectiveness of the flipped classroom in nursing and health sciences programs have reported mixed findings. DESIGN: Systematic review METHODS: We used the PRISMA framework and searched electronic databases (Education Source, ERIC via ProQuest, Scholars Portal, CINAHL, Pubmed) with the terms "flip* class", "health," and "undergraduate" or "higher education". Original research articles were limited to peer-reviewed, quantitative and/or mixed-methods studies published between 2010 and 2021. We extracted data through a full-text screening and of the articles. RESULTS: Three main themes emerged from the 16 articles reviewed, including positive gains in academic performance (n = 8/12 studies reporting; 67 % studies), student satisfaction (n = 7/13 studies reporting; 54 % studies) and increased self-efficacy (n = 1/1 reporting; 100 % studies). Effect sizes demonstrated significant heterogeneity in these outcome measures. Note that none of these studies reported a negative effect for flipped classroom interventions. Structured design of teaching strategies and curriculum appears to be an important determinant of performance, satisfaction and self-efficacy. CONCLUSION: Studies on flipped classrooms in undergraduate health sciences disciplines indicated positive changes in academic performance, student satisfaction and self-efficacy linked to well-designed curriculum. Methodological limitations in the studies reviewed include the absence of demographic analysis, minimal descriptions of the flipped classroom curriculum design, inadequate data reporting and the absence of randomized, comparison groups. Future research should focus on pre-class, in-class and post-class flipped classroom design, careful documentation of research methods and improving the quality of data collected. TWEETABLE ABSTRACT: A systematic review of flipped classroom use in undergraduate nursing and health science programs indicates positive academic performance, satisfaction and self-efficacy changes.