Flipped Pedagogy versus Traditional Lecture: Examining Clinical Reasoning in Associate Degree Nursing Education

Abstract

The development of clinical reasoning in new graduate nurses is an essential component of nursing education. A lack of clinical reasoning in a new nurse can lead to poor patient outcomes and increased budget concerns for health care facilities. Limited studies were present regarding the use of the flipped classroom teaching method to promote development of clinical reasoning in the classroom setting. The question guiding the research was as follows: Is there a significant difference in the clinical reasoning skills of associate degree nursing students who have been instructed using the flipped classroom teaching method compared to those who have received instruction in a traditional lecture setting? A quasi experimental pretest/posttest design was utilized to answer the research question. Data produced from the Health Science Reasoning Test was analyzed using an analysis of covariance with the identified covariate of the pretest score to control for past developed clinical reasoning skills. The sample was consistent with national statistics related to gender and age of an associate degree nursing student. The intervention group had a large percentage of participants with previous experience as a health care worker. The career of a licensed practical nurse was the most represented health care career. Data analysis of the intervention group revealed a p 0.01; thereby indicating the flipped classroom teaching method had a positive effect on the development of clinical reasoning in associate degree nursing students. Results demonstrated the intervention was effective, however the resulted effect size was decreased due to the length of the intervention. Future recommendations for research included a longitudinal study of the flipped classroom to develop clinical reasoning, with the use of the intervention over multiple courses. Nurse educators and administrators should consider the length of the course instruction and the students’ previous experiences for maximum effectiveness of the method.