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Investigate the long-term effects of a flipped education —based on adult learning theory and incorporating multimedia teaching and physical workshops—on nurses’ self-efficacy in preventing and managing pressure injuries. Pressure injuries remain a global challenge, requiring caregivers to blend theory with practice. Flipped learning has shown promise in boosting nurses' confidence and competence in managing these injuries through higher-level processes such as interaction, reflection, application, analysis and integration. A single-blind, multicenter, quasi-experimental, two-group parallel repeated-measures design was conducted in seven medical institutions. A total of 404 participants adopted an adult self-directed learning model. The control group received PDF-based materials, while the intervention group additionally underwent a flipped education program that combined multimedia teaching with physical workshops. Self-efficacy in the four domains—assessment, planning, monitoring and decision-making—was measured at baseline, immediately post-intervention and at one- and three-months post-intervention. Data were analyzed using descriptive statistics, chi-square tests, t-tests and generalized estimating equations. Following the intervention, both groups showed a significant increase in self-efficacy (p < .05). The intervention group scored higher in all domains, with improvements lasting three months and reported greater learning satisfaction. Multimedia teaching enhances learners’ motivation and improves the effectiveness of adult self-directed learning. Physical workshops focused on higher-level analysis, integration and hands-on teaching further strengthened care confidence and self-efficacy. These findings confirm the effectiveness of flipped education in pressure injury education, especially regarding its long-term impact and offer valuable insights for designing future nursing training programs.

To assess the effectiveness of integrating Case-Based Learning (CBL) with Task-Driven Learning (TDL) in the clinical education of nursing interns specializing in cardiology. Traditional lecture-based learning (LBL) may not adequately prepare nursing interns for clinical problem-solving in cardiovascular specialties. Combining CBL with TDL methodologies could potentially enhance theoretical understanding and practical application skills. A randomized controlled trial was conducted at Beijing Friendship Hospital, focusing on nursing interns in the cardiology department. Nursing interns were randomly assigned to two groups: one group received a combination of Case-Based Learning (CBL) and Task-Driven Learning (TDL) (n = 220), while the other group underwent Lecture-Based Learning (LBL) (n = 218). The study was conducted from June 2021 to March 2024. Evaluation was based on examination scores, nursing round skills and an anonymous questionnaire survey. The CBL-TDL group engaged in more pre-class preparation and displayed significantly better post-internship theoretical knowledge (92.21 SD 5.73 vs 91.03 SD 4.43, P = 0.016) and ward round skills (means 90.99 SD 7.19 vs 86.62 SD 5.78, P < 0.001) than the LBL group. Higher satisfaction in the CBL-TDL group was noted across several educational aspects (P < 0.01), particularly in motivation to learn (OR 2.50, 95 %CI (1.80–3.45), P = 0.006) and practical skill (OR 2.40, 95 %CI (1.70–3.40), P = 0.002), although they reported less free time consumed. The synergistic application of CBL and TDL methodologies enhances the theoretical understanding and practical application skills of nursing interns in cardiovascular specialties, suggesting a valuable pedagogical strategy for improving clinical problem-solving abilities.

To compare the effects of traditional and platform-based case-based learning (CBL) on undergraduate nursing students’ academic performance, self-efficacy, clinical decision-making and critical thinking abilities. Traditional CBL can improve students’ academic performance but faces challenges in the era of “Internet + education.” It is unclear whether platform-based CBL is as effective as traditional CBL. Cluster randomized controlled trial. A total of 88 undergraduate nursing students from two classes were recruited using cluster sampling and separated into two groups by class. The control group (n = 45) received traditional CBL, and the experimental group (n = 43) received platform-based CBL. Academic performance, self-efficacy, clinical decision-making, critical thinking disposition and experimental group’s learning records from the online platform were evaluated. No difference was found between the two groups in overall academic performance, but formative evaluation and final examination scores in the course differed. Compared with the control group, the experimental group presented significant differences in self-efficacy and clinical decision-making. There was no difference between the total clinical thinking disposition scores; however, truth-seeking, systematicity and self-confidence exhibited significant differences. Concerning student progression, all experimental students advanced from “Grade I” to “Grade V” or “Grade IV”. The usability questionnaire’s average score regarding the platform was 77.03 (SD 7.43) and the top dimension was teaching utility. Compared with traditional CBL, platform-based CBL may better enhance self-efficacy and clinical decision-making abilities in nursing undergraduate students.

Background Finnish permanent residents are covered by social security insurance administered by the Social Insurance Institution of Finland. The procedure of insurance is initiated with medical certificate written by the treating doctor. Thus, the doctor must have certificate writing skills accompanied with the knowledge of the content and goals for insurance. Quality certificates are important part of doctors’ professional skills worldwide and most effective teaching methods for learning these should be investigated. Methods Medical certificate data were collected from two independent courses of fourth-year student taught in autumn 2015 ( N  = 141) and 2016 ( N  = 142) in the medical faculty of the University of Eastern Finland. A random sample of 40 students per course was drawn for the analysis. All certificates were analyzed as one sample. This was done to obtain reliable results with internal control group on the differences between two teaching methods, the traditional approach and the flipped classroom (FC) approach, in 2015 and 2016, respectively. The medical certificates were evaluated and scored with a rubric (range: − 4.00–14.25) by two independent experienced specialists. Results Compared to students in the traditional classroom, students involved in the FC received significantly higher scores in all relevant sections of the assessed certificates. The mean of the total scores was 8.87 ( SD  = 1.70) for the traditional group and 10.97 ( SD  = 1.25) for the FC group. Based on the common language effect size, a randomly selected student from the FC group had an 85% probability of receiving a higher total score than a student from the traditional group. Conclusion In this study, the FC approach resulted in a statistical significant improvement in the content and technical quality of the certificates. The results suggest that the FC approach can be applied in the teaching of medical certificate writing.

Objective. To determine whether human patient simulation (HPS) is superior to case-based learning (CBL) in teaching diabetic ketoacidosis (DKA) and thyroid storm (TS) to pharmacy students. Design. In this cross-over, open-label, single center, randomized control trial, final-year undergraduate pharmacy students enrolled in an applied therapeutics course were randomized to HPS or CBL groups. Pretest, posttest, knowledge retention tests, and satisfaction survey were administered to students. Assessment. One hundred seventy-four students participated in this study. The effect sizes attributable to HPS were larger than CBL in both cases. HPS groups performed significantly better in posttest and knowledge retention test compared to CBL groups pertaining to TS case (p<0.05). Students expressed high levels of satisfaction with HPS sessions. Conclusion. HPS was superior to CBL in teaching DKA and TS to final-year undergraduate pharmacy students.

The aim of this study is to assess the impact of case based teaching (CBT) on learning rational prescribing and to compare CBT with the traditional method of teaching (TRD). Second year Bachelor of Medicine and Bachelor of Surgery (MBBS) students (n = 179) were administered a pre-test and randomly divided into groups to receive CBT (n = 96) and TRD (n = 83). CBT group was further sub-divided into CBT1 and CBT2. Both these groups were taught two topics each by CBT and TRD during tutorials; however, the topics were switched with respect to method of teaching. The post-test comprised of three therapeutic problems of which two were related, and one was not related to the tutorial topics. Marks obtained in the post-test were graded and analysed using Fischer's exact test. In the post-test, the therapeutic problems on diabetes mellitus and peptic ulcer were attempted by 85.41% students from CBT and 73.49% from TRD group. CBT group obtained more marks for these problems (4.23 ± 0.94; P < 0.001) than the TRD (3.32 ± 0.92) group. Also, more students in the CBT obtained grade 3 (P < 0.001) and fewer obtained grade 1 (P < 0.01), compared to the TRD group. When the grades of the two CBT groups were compared, it was found that fewer students in CBT 2 had obtained grade 1 and those scoring higher grades were comparable between the two groups. For the therapeutic problem on malaria, 7.29% students from CBT and 18.07% from TRD received 0 grade (P < 0.05). More students received ≥ 2 grade in CBT group (P < 0.05). Use of CBT during tutorials is better than TRD and facilitates learning of rational pharmacotherapy.

The Fundamentals of Surgery Curriculum (FSC) is an interactive system that engages interns in case-based scenarios that involve identifying symptoms, ordering tests, and formulating treatment plans. In this study, we examined the usefulness of the FSC as a knowledge preparatory tool for incoming interns. Twenty incoming interns participated in this study. Half were asked to complete 96 FSC cases before internship orientation (ie, the experimental group). The other half did not receive FSC accounts (ie, the control group). During orientation, all interns completed an examination that was representative of the FSC cases. Interns completed a survey to assess the usefulness of the FSC cases. American Board of Surgery In-Training Examination (ABSITE) scores were also examined. Interns in the experimental group completed an average of 71.1 cases before taking the examination and had higher median examination percent correct scores (P < .011). Interns rated the FSC cases as “extremely helpful.” There were no differences in terms of ABSITE percentile rank or the basic science and clinical management sections of the ABSITE. The FSC is a useful preparatory tool for interns when administered before starting internship; however, this benefit may not extend to the ABSITE.

Objective. To design an educational activity and evaluate its effectiveness on increasing third-year pharmacy students’ knowledge and confidence to recommend self-care products to patients. Design. Faculty members created a self-care activity, the Amazing Self-Care Race, for educational use in a pharmaceutical care laboratory course. Student teams worked competitively to complete 15 stations focused on self-care. A complex, real-world case was presented at each station. Student recommendations were presented to a facilitator. Prior to and following the activity, students were invited to complete an online anonymous survey instrument. Assessment. Eighty-six students completed presurvey and postsurvey instruments to assess their knowledge and perceived confidence to recommend a self-care product to a patient prior to and following participation in the Amazing Self-Care Race. Students demonstrated a significant increase in their ability and confidence to recommend self-care products following the activity (p<0.001). Conclusion. The Amazing Self-Care Race is an effective educational activity that increases student knowledge and confidence in self-care therapeutics. The activity helped students to develop self-care skills, enabled them to learn through doing, encouraged them to synthesize information while making self-care recommendations, and helped them to develop confidence by thinking on their feet.

Active-learning pedagogies have been repeatedly demonstrated to produce superior learning gains with large effect sizes compared with lecture-based pedagogies. Shifting large numbers of college science, technology, engineering, and mathematics (STEM) faculty to include any active learning in their teaching may retain and more effectively educate far more students than having a few faculty completely transform their teaching, but the extent to which STEM faculty are changing their teaching methods is unclear. Here, we describe the development and application of the machine-learning–derived algorithm Decibel Analysis for Research in Teaching (DART), which can analyze thousands of hours of STEM course audio recordings quickly, with minimal costs, and without need for human observers. DART analyzes the volume and variance of classroom recordings to predict the quantity of time spent on single voice (e.g., lecture), multiple voice (e.g., pair discussion), and no voice (e.g., clicker question thinking) activities. Applying DART to 1,486 recordings of class sessions from 67 courses, a total of 1,720 h of audio, revealed varied patterns of lecture (single voice) and nonlecture activity (multiple and no voice) use. We also found that there was significantly more use of multiple and no voice strategies in courses for STEM majors compared with courses for non-STEM majors, indicating that DART can be used to compare teaching strategies in different types of courses. Therefore, DART has the potential to systematically inventory the presence of active learning with ∼90% accuracy across thousands of courses in diverse settings with minimal effort.

Background There is evidence that newly qualified doctors do not feel prepared to start work. This study examined views of first year Foundation doctors (F1s) regarding how prepared they felt by their undergraduate medical education for skills required during the first Foundation training year in relation to their type of training. Method One-hundred and eighty two F1s completed a questionnaire during their first rotation of Foundation training. Analysis was conducted by type of medical school training: Problem-Based Learning (PBL), Traditional or Reformed. Results F1s from medical schools with a PBL curriculum felt better prepared for tasks associated with communication and team working, and paperwork than graduates from the other medical school types; but the majority of F1s from all three groups felt well prepared for most areas of practice. Less than half of graduates in all three groups felt well prepared to deal with a patient with neurological/visual problems; write referral letters; understand drug interactions; manage pain; and cope with uncertainty. F1s also indicated that lack of induction or support on starting work was affecting their ability to work in some areas. Conclusions Whilst F1s from medical schools with a PBL curriculum did feel better prepared in multiple areas compared to graduates from the other medical school types, specific areas of unpreparedness related to undergraduate and postgraduate medical training were identified across all F1s. These areas need attention to ensure F1s are optimally prepared for starting work.